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Sample records for ptsd scale scores

  1. Examining various subthreshold definitions of PTSD using the Clinician Administered PTSD Scale for DSM-5.

    Science.gov (United States)

    Franklin, C Laurel; Raines, Amanda M; Chambliss, Jessica L; Walton, Jessica L; Maieritsch, Kelly P

    2018-07-01

    The Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5; American Psychiatric Association [APA], 2013) includes Other- and Unspecified- Trauma and Stressor-Related Disorders to capture subthreshold Posttraumatic Stress Disorder (PTSD) symptoms. However, the DSM-5 does not specify the number or type of symptoms needed to assign them. The purpose of the current study was to extend our understanding of subthreshold PTSD by comparing four commonly used definitions adapted to the DSM-5 PTSD criteria in an outpatient treatment-seeking sample. Veterans (N = 193) presenting to PTSD clinics were assessed using the Clinician Administered PTSD Scale for DSM-5 (CAPS-5). Participants reported a criterion A traumatic event, but did not meet criteria for threshold-PTSD. We hypothesized that the number of veterans captured would be highest when fewer specific criterion sets were required by the subthreshold definition. Our hypothesis was upheld in that the more criteria required by the subthreshold PTSD definition, the lower the number of veterans counted within the group. The study consisted primarily of trauma treatment-seeking male veterans, with chronic PTSD symptoms. In addition, the sample size was small and was collected as part of routine clinical care. These results support previous contentions around careful decision making when defining what constitutes subthreshold PTSD in research and clinical work. It also points to the need for continued research to better understand the diagnostic and treatment implications of subthreshold PTSD. Published by Elsevier B.V.

  2. The Child PTSD Symptom Scale: Psychometric Properties in Female Adolescent Sexual Assault Survivors

    Science.gov (United States)

    Gillihan, Seth J.; Aderka, Idan M.; Conklin, Phoebe H.; Capaldi, Sandra; Foa, Edna B.

    2013-01-01

    Traumatic experiences are common among youths and can lead to posttraumatic stress disorder (PTSD). In order to identify traumatized children who need PTSD treatment, instruments that can accurately and efficiently evaluate pediatric PTSD are needed. One such measure is the Child PTSD Symptom Scale (CPSS), which has been found to be a reliable and…

  3. Predicting PTSD using the New York Risk Score with genotype data: potential clinical and research opportunities

    Directory of Open Access Journals (Sweden)

    Boscarino JA

    2013-04-01

    Full Text Available Joseph A Boscarino,1,2 H Lester Kirchner,3,4 Stuart N Hoffman,5 Porat M Erlich1,4 1Center for Health Research, Geisinger Clinic, Danville, 2Department of Psychiatry, Temple University School of Medicine, Philadelphia, 3Division of Medicine, Geisinger Clinic, Danville, 4Department of Medicine, Temple University School of Medicine, Philadelphia, 5Department of Neurology, Geisinger Clinic, Danville, PA, USA Background: We previously developed a post-traumatic stress disorder (PTSD screening instrument, ie, the New York PTSD Risk Score (NYPRS, that was effective in predicting PTSD. In the present study, we assessed a version of this risk score that also included genetic information. Methods: Utilizing diagnostic testing methods, we hierarchically examined different prediction variables identified in previous NYPRS research, including genetic risk-allele information, to assess lifetime and current PTSD status among a population of trauma-exposed adults. Results: We found that, in predicting lifetime PTSD, the area under the receiver operating characteristic curve (AUC for the Primary Care PTSD Screen alone was 0.865. When we added psychosocial predictors from the original NYPRS to the model, including depression, sleep disturbance, and a measure of health care access, the AUC increased to 0.902, which was a significant improvement (P = 0.0021. When genetic information was added in the form of a count of PTSD risk alleles located within FKBP, COMT, CHRNA5, and CRHR1 genetic loci (coded 0–6, the AUC increased to 0.920, which was also a significant improvement (P = 0.0178. The results for current PTSD were similar. In the final model for current PTSD with the psychosocial risk factors included, genotype resulted in a prediction weight of 17 for each risk allele present, indicating that a person with six risk alleles or more would receive a PTSD risk score of 17 × 6 = 102, the highest risk score for any of the predictors studied. Conclusion: Genetic

  4. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD.

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    Armour, Cherie; Karstoft, Karen-Inge; Richardson, J Don

    2014-08-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD. The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity scores were used as indicators in a latent profile analysis (LPA) to investigate the existence of a dissociative-PTSD subtype. Subsequently, several covariates were added to the model to explore differences between severe PTSD alone and dissociative-PTSD. The LPA identified five classes: one of which constituted a severe PTSD group (30.5 %), and one of which constituted a dissociative-PTSD group (13.7 %). None of the included, demographic, trauma, or clinical covariates were significantly predictive of membership in the dissociative-PTSD group compared to the severe PTSD group. In conclusion, a significant proportion of individuals report high levels of dissociation alongside their PTSD, which constitutes a dissociative-PTSD subtype. Further investigation is needed to identify which factors may increase or decrease the likelihood of membership in a dissociative-PTSD subtype group compared to a severe PTSD only group.

  5. The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and initial psychometric evaluation in military veterans.

    Science.gov (United States)

    Weathers, Frank W; Bovin, Michelle J; Lee, Daniel J; Sloan, Denise M; Schnurr, Paula P; Kaloupek, Danny G; Keane, Terence M; Marx, Brian P

    2018-03-01

    The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  6. Assessing PTSD in the military

    DEFF Research Database (Denmark)

    Karstoft, Karen-Inge; Andersen, Søren B.; Nielsen, Anni Brit Sternhagen

    2017-01-01

    Since 1998, soldiers deployed to war zones with the Danish Defense (≈31,000) have been invited to fill out a questionnaire on post-mission reactions. This provides a unique data source for studying the psychological toll of war. Here, we validate a measure of PTSD-symptoms from the questionnaire...... including symptoms of PTSD (PRIM-PTSD). They also filled out a validated measure of PTSD-symptoms in DSM-IV, the PTSD-checklist (PCL). We tested reliability of PRIM-PTSD by estimating Cronbach's alpha, and tested validity by correlating items, clusters, and overall scale with corresponding items in the PCL....... Furthermore, we conducted two confirmatory factor analytic models to test the factor structure of PRIM-PTSD, and tested measurement invariance of the selected model. Finally, we established a screening and a clinical cutoff score by application of ROC analysis. We found high internal consistency of the PRIM-PTSD...

  7. Psychometric Properties and Factor Structure of the German Version of the Clinician-Administered PTSD Scale for DSM-5.

    Science.gov (United States)

    Müller-Engelmann, Meike; Schnyder, Ulrich; Dittmann, Clara; Priebe, Kathlen; Bohus, Martin; Thome, Janine; Fydrich, Thomas; Pfaltz, Monique C; Steil, Regina

    2018-05-01

    The Clinician-Administered PTSD Scale (CAPS) is a widely used diagnostic interview for posttraumatic stress disorder (PTSD). Following fundamental modifications in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ( DSM-5), the CAPS had to be revised. This study examined the psychometric properties (internal consistency, interrater reliability, convergent and discriminant validity, and structural validity) of the German version of the CAPS-5 in a trauma-exposed sample ( n = 223 with PTSD; n =51 without PTSD). The results demonstrated high internal consistency (αs = .65-.93) and high interrater reliability (ICCs = .81-.89). With regard to convergent and discriminant validity, we found high correlations between the CAPS severity score and both the Posttraumatic Diagnostic Scale sum score ( r = .87) and the Beck Depression Inventory total score ( r = .72). Regarding the underlying factor structure, the hybrid model demonstrated the best fit, followed by the anhedonia model. However, we encountered some nonpositive estimates for the correlations of the latent variables (factors) for both models. The model with the best fit without methodological problems was the externalizing behaviors model, but the results also supported the DSM-5 model. Overall, the results demonstrate that the German version of the CAPS-5 is a psychometrically sound measure.

  8. The co-occurrence of PTSD and dissociation: differentiating severe PTSD from dissociative-PTSD

    DEFF Research Database (Denmark)

    Armour, C.; Karstoft, K. I.; Richardson, J. D.

    2014-01-01

    A dissociative-posttraumatic stress disorder (PTSD) subtype has been included in the DSM-5. However, it is not yet clear whether certain socio-demographic characteristics or psychological/clinical constructs such as comorbid psychopathology differentiate between severe PTSD and dissociative-PTSD....... The current study investigated the existence of a dissociative-PTSD subtype and explored whether a number of trauma and clinical covariates could differentiate between severe PTSD alone and dissociative-PTSD. The current study utilized a sample of 432 treatment seeking Canadian military veterans. Participants...... were assessed with the Clinician Administered PTSD Scale (CAPS) and self-report measures of traumatic life events, depression, and anxiety. CAPS severity scores were created reflecting the sum of the frequency and intensity items from each of the 17 PTSD and 3 dissociation items. The CAPS severity...

  9. A cross-cultural validation of the Clinician Administered PTSD Scale for Children and Adolescents in a Dutch population

    NARCIS (Netherlands)

    Diehle, Julia; de Roos, Carlijn; Boer, Frits; Lindauer, Ramón J. L.

    2013-01-01

    Background: Trauma-focused interventions for children could be administered more efficiently and effectively if posttraumatic stress disorder (PTSD) and related symptoms were first investigated by a reliable and valid instrument. The Clinician Administered PTSD Scale for Children and Adolescents

  10. Trajectories of Scores on a Screening Instrument for PTSD Among World Trade Center Rescue, Recovery, and Clean-Up Workers.

    Science.gov (United States)

    Maslow, Carey B; Caramanica, Kimberly; Welch, Alice E; Stellman, Steven D; Brackbill, Robert M; Farfel, Mark R

    2015-06-01

    The longitudinal course of posttraumatic stress disorder (PTSD) over 8-9 years was examined among 16,488 rescue and recovery workers who responded to the events of September 11, 2001 (9/11) at the World Trade Center (WTC; New York, NY), and were enrolled in the World Trade Center Health Registry. Latent class growth analysis identified 5 groups of rescue and recovery workers with similar score trajectories at 3 administrations of the PTSD Checklist (PCL): low-stable (53.3%), moderate- stable (28.7%), moderate-increasing (6.4%), high-decreasing (7.7%), and high-stable (4.0%). Relative to the low-stable group, membership in higher risk groups was associated with 9/11-related exposures including duration of WTC work, with adjusted odds ratios ranging from 1.3 to 2.0, witnessing of horrific events (range = 1.3 to 2.1), being injured (range = 1.4 to 2.3), perceiving threat to life or safety (range = 2.2 to 5.2), bereavement (range = 1.6 to 4.8), and job loss due to 9/11 (range = 2.4 to 15.8). Within groups, higher PCL scores were associated with adverse social circumstances including lower social support, with B coefficients ranging from 0.2 to 0.6, divorce, separation, or widowhood (range = 0.4-0.7), and unemployment (range = 0.4-0.5). Given baseline, exposure-related, and contextual influences that affect divergent PTSD trajectories, screening for both PTSD and adverse circumstances should occur immediately, and at regular intervals postdisaster. © 2015 International Society for Traumatic Stress Studies.

  11. A brief screening tool for assessing psychological trauma in clinical practice: development and validation of the New York PTSD Risk Score.

    Science.gov (United States)

    Boscarino, Joseph A; Kirchner, H Lester; Hoffman, Stuart N; Sartorius, Jennifer; Adams, Richard E; Figley, Charles R

    2011-01-01

    The objective was to develop a brief posttraumatic stress disorder (PTSD) screening instrument that is useful in clinical practice, similar to the Framingham Risk Score used in cardiovascular medicine. We used data collected in New York City after the World Trade Center disaster (WTCD) and other trauma data to develop a new PTSD prediction tool--the New York PTSD Risk Score. We used diagnostic test methods to examine different clinical domains, including PTSD symptoms, trauma exposures, sleep disturbances, suicidal thoughts, depression symptoms, demographic factors and other measures to assess different PTSD prediction models. Using receiver operating curve (ROC) and bootstrap methods, five prediction domains, including core PTSD symptoms, sleep disturbance, access to care status, depression symptoms and trauma history, and five demographic variables, including gender, age, education, race and ethnicity, were identified. For the best prediction model, the area under the ROC curve (AUC) was 0.880 for the Primary Care PTSD Screen alone (specificity=82.2%, sensitivity=93.7%). Adding care status, sleep disturbance, depression and trauma exposure increased the AUC to 0.943 (specificity=85.7%, sensitivity=93.1%), a significant ROC improvement (Pdevelopment and validation samples. The New York PTSD Risk Score is a multifactor prediction tool that includes the Primary Care PTSD Screen, depression symptoms, access to care, sleep disturbance, trauma history and demographic variables and appears to be effective in predicting PTSD among patients seen in healthcare settings. This prediction tool is simple to administer and appears to outperform other screening measures. Copyright © 2011 Elsevier Inc. All rights reserved.

  12. Validity of CBCL-derived PTSD and dissociation scales: further evidence in a sample of neglected children and adolescents.

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    Milot, Tristan; Plamondon, André; Ethier, Louise S; Lemelin, Jean-Pascal; St-Laurent, Diane; Rousseau, Michel

    2013-05-01

    There is growing evidence that child neglect is an important risk factor for posttraumatic stress disorder (PTSD) and dissociation. Considering that the Child Behavior Checklist (CBCL) is a widely used measure, the possibility of using validated CBCL-derived trauma symptoms scales could be particularly useful to better understand how trauma symptoms develop among neglected children and adolescents. This study examined the factor structure of three CBCL-derived measures of PTSD and dissociation (namely, PTSD scale, Dissociation scale, and PTSD/Dissociation scale) in a sample of 239 neglected children and adolescents aged 6 to 18 years using the latest version of CBCL (CBCL 6-18). Evidence of convergent validity of these scales was also examined for participants aged 12 and under using two well-validated measures of PTSD and Dissociation: the Trauma Symptoms Checklist for Young Children and the Child Dissociation Checklist. Findings suggest that CBCL-derived measures of trauma symptoms, especially PTSD and Dissociations scales, may be of heuristic value in the study of trauma symptomatology in neglected samples. Factor structure and evidence of convergent validity were supported for these two scales. Results also provide further support to the well-established assumption that PTSD and dissociation are two related but different constructs.

  13. Development and Validation of a PTSD-Related Impairment Scale

    Science.gov (United States)

    2012-06-01

    Social Adjustment Scale (SAS-SR) (58] Dyadic Adjustment Scale (DAS) [59] Life Stressors and Social Resources Inventory ( LISRES ) [60] 3...measure that gauges on- 200 Social Resources lnven- 2. Spouse/partner going life stressors and social resources tory ( LISRES ; Moos & 3. Finances as well...measures (e.g., ICF checklist, LISRES ; Moos, Penn, & Billings, 1988) may nor be practical or desirable in many healthcare settings or in large-scale

  14. PTSD: National Center for PTSD

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    ... Care » PTSD: National Center for PTSD » Public » Videos PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" ( ...

  15. PTSD: National Center for PTSD

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    Full Text Available ... Care » PTSD: National Center for PTSD » Public » Videos PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Prescribing for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" ( ...

  16. Conditional Standard Errors of Measurement for Scale Scores.

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    Kolen, Michael J.; And Others

    1992-01-01

    A procedure is described for estimating the reliability and conditional standard errors of measurement of scale scores incorporating the discrete transformation of raw scores to scale scores. The method is illustrated using a strong true score model, and practical applications are described. (SLD)

  17. The Impact of PTSD on Functioning in Patients Seeking Treatment for Chronic Pain and Validation of the Posttraumatic Diagnostic Scale.

    Science.gov (United States)

    Åkerblom, Sophia; Perrin, Sean; Rivano Fischer, Marcelo; McCracken, Lance M

    2017-04-01

    The purpose of this study was to assess the psychometric properties of a Swedish version of the Posttraumatic Diagnostic Scale (PDS); to investigate the prevalence of traumatic experiences, trauma types, and posttraumatic stress disorder (PTSD) in a sample of patients seeking treatment for chronic pain; and to examine how indices of pain-related functioning vary with a history of traumatic exposure and PTSD diagnostic status. Participants were 463 consecutive patients with chronic pain referred for assessment at the Pain Rehabilitation Unit at Skåne University Hospital. The translated version of the PDS demonstrated high levels of internal consistency and a factor structure similar to that reported in previous validation studies using samples identified because of trauma exposure (not chronic pain), both of which provide preliminary support for the validity of this translated version. Based on their responses to the PDS, most patients (71.8%) reported one or more traumatic events with 28.9% fulfilling criteria for a current PTSD diagnosis. The patients with PTSD also reported significantly higher levels of pain interference, kinesiophobia, anxiety, and depression and significantly lower levels of life control, compared to patients exposed to trauma and not fulfilling criteria for PTSD and patients with no history of traumatic exposure. Consistent with previous research, a significant proportion of patients seeking treatment for chronic pain reported a history of traumatic exposure and nearly one third of these met current criteria for PTSD according to a standardized self-report measure. The presence of PTSD was associated with multiple indictors of poorer functioning and greater treatment need and provides further evidence that routine screening of chronic pain patients for PTSD is warranted. Self-report measures like the PDS appear to be valid for use in chronic pain samples and offer a relative low-cost method for screening for PTSD.

  18. PTSD: National Center for PTSD

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    Full Text Available ... for PTSD, Know Your Options . × What is PTSD? Right Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right Click here to download "PTSD Treatment: Know Your ...

  19. Symptom structure and severity: a comparison of responses to the positive and negative syndrome scale (PANSS) between patients with PTSD or schizophrenia.

    Science.gov (United States)

    Stefanovics, Elina A; Krystal, John H; Rosenheck, Robert A

    2014-05-01

    To describe and compare the structure and relative severity of symptoms in clinical trial patients diagnosed with Post Traumatic Stress Disorder (PTSD) or schizophrenia using the Positive and Negative Syndrome Scale (PANSS), developed originally to evaluate symptoms of schizophrenia. This secondary data analysis used baseline PANSS symptom ratings (n=267) from a six-month multicenter randomized placebo-controlled trial of adjunctive risperidone in patients with chronic military-related PTSD. First, using a split-half design, Exploratory Factor Analysis (EFA) was employed to identify independent factors which were then compared to published factor structures for schizophrenia. Next, Confirmatory Factor Analysis (CFA) was applied to the second half of the sample to compare the results of the EFA and published factor structures. Finally, T-tests were used to compare the severity of factor scores between the PTSD sample and the baseline PANSS ratings from the Clinical Antipsychotic Trial for Intervention Effectiveness (CATIE) schizophrenia sample (n=1460). EFA suggested five factors similar to those identified in a summary of 29 schizophrenia studies by Wallwork (Schizophrenia Research, 137:246-250). CFA showed that the five factor Wallwork model fit the data better than the EFA, although both had relatively high goodness of fit. T-tests showed that the PTSD sample had more severe symptoms on the Depressive factor, and the schizophrenia sample on the Positive, Negative, and Disorganized factors, with no significant difference on the Excited factor. Veterans with PTSD had similar symptom structure to patients with schizophrenia on the PANSS, but were less symptomatic on psychosis-related factors and more symptomatic on depression. Dimensional symptom factors can be virtually the same across diagnoses. Published by Elsevier Inc.

  20. Clinical scoring scales in thyroidology: A compendium

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2011-01-01

    Full Text Available This compendium brings together traditional as well as contemporary scoring and grading systems used for the screening and diagnosis of various thyroid diseases, dysfunctions, and complications. The article discusses scores used to help diagnose hypo-and hyperthyroidism, to grade and manage goiter and ophthalmopathy, and to assess the risk of thyroid malignancy.

  1. Facilitating the Interpretation of English Language Proficiency Scores: Combining Scale Anchoring and Test Score Mapping Methodologies

    Science.gov (United States)

    Powers, Donald; Schedl, Mary; Papageorgiou, Spiros

    2017-01-01

    The aim of this study was to develop, for the benefit of both test takers and test score users, enhanced "TOEFL ITP"® test score reports that go beyond the simple numerical scores that are currently reported. To do so, we applied traditional scale anchoring (proficiency scaling) to item difficulty data in order to develop performance…

  2. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions

    Directory of Open Access Journals (Sweden)

    Ruth A. Lanius

    2015-03-01

    Full Text Available Background: Three intrinsic connectivity networks in the brain, namely the central executive, salience, and default mode networks, have been identified as crucial to the understanding of higher cognitive functioning, and the functioning of these networks has been suggested to be impaired in psychopathology, including posttraumatic stress disorder (PTSD. Objective: 1 To describe three main large-scale networks of the human brain; 2 to discuss the functioning of these neural networks in PTSD and related symptoms; and 3 to offer hypotheses for neuroscientifically-informed interventions based on treating the abnormalities observed in these neural networks in PTSD and related disorders. Method: Literature relevant to this commentary was reviewed. Results: Increasing evidence for altered functioning of the central executive, salience, and default mode networks in PTSD has been demonstrated. We suggest that each network is associated with specific clinical symptoms observed in PTSD, including cognitive dysfunction (central executive network, increased and decreased arousal/interoception (salience network, and an altered sense of self (default mode network. Specific testable neuroscientifically-informed treatments aimed to restore each of these neural networks and related clinical dysfunction are proposed. Conclusions: Neuroscientifically-informed treatment interventions will be essential to future research agendas aimed at targeting specific PTSD and related symptoms.

  3. Factor Structure of Child Behavior Scale Scores in Peruvian Preschoolers

    Science.gov (United States)

    Meyer, Erin L.; Schaefer, Barbara A.; Soto, Cesar Merino; Simmons, Crystal S.; Anguiano, Rebecca; Brett, Jeremy; Holman, Alea; Martin, Justin F.; Hata, Heidi K.; Roberts, Kimberly J.; Mello, Zena R.; Worrell, Frank C.

    2011-01-01

    Behavior rating scales aid in the identification of problem behaviors, as well as the development of interventions to reduce such behavior. Although scores on many behavior rating scales have been validated in the United States, there have been few such studies in other cultural contexts. In this study, the structural validity of scores on a…

  4. Validation of a Brief PTSD Scale for Clients with Severe Mental Illnesses

    Science.gov (United States)

    O'Hare, Thomas; Shen, Ce; Sherrer, Margaret

    2012-01-01

    Trauma and Posttraumatic Stress Disorder (PTSD) are more common in severe mental illnesses (SMI) clients than in the general population, yet brief screens for detecting probable PTSD in SMI clients are nonexistent. In a two-part study, the authors used correlation analysis and receiver operating characteristics (ROC) analysis to develop and…

  5. Validation of two screening instruments for PTSD in Dutch substance use disorder inpatients.

    Science.gov (United States)

    Kok, Tim; de Haan, Hein A; van der Velden, Helena J W; van der Meer, Margreet; Najavits, Lisa M; de Jong, Cor A J

    2013-03-01

    Posttraumatic stress disorder (PTSD) is highly prevalent in substance use disorder (SUD) populations. Because resources for extensive and thorough diagnostic assessment are often limited, reliable screening instruments for PTSD are needed. The aim of the current study was to test two short PTSD measures for diagnostic efficiency in predicting PTSD compared to the Clinician-Administered PTSD Scale (CAPS). The sample consisted of 197 SUD patients receiving residential substance use treatment who completed questionnaires regarding substance use and trauma-related symptoms, all abstinent from substance for 4weeks. The PTSD section of the Mini International Neuropsychiatric Interview plus (MINIplus) and the Self-Report Inventory for PTSD (SRIP) are compared to the CAPS. Results showed low sensitivity (.58) and high specificity (.91) for the PTSD section of the MINIplus. The SRIP showed high sensitivity (.80) and moderately high specificity (.73) at a cut-off score of 48. The prevalence of PTSD as measured with the CAPS was 25.4% current and 46.2% lifetime. Results indicate that the MINIplus, a short clinical interview, has insufficient quality as a screener for PTSD. The SRIP, however, is a reliable instrument in detecting PTSD in a SUD inpatient population in The Netherlands. Screening for PTSD is time efficient and increases detection of PTSD in SUD treatment settings. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. PTSD: National Center for PTSD

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    Full Text Available ... Specific to Women Types of Trauma War Terrorism Violence and Abuse Disasters Is it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ...

  7. Screening for HIV-related PTSD: sensitivity and specificity of the 17-item Posttraumatic Stress Diagnostic Scale (PDS) in identifying HIV-related PTSD among a South African sample.

    Science.gov (United States)

    Martin, L; Fincham, D; Kagee, A

    2009-11-01

    The identification of HIV-positive patients who exhibit criteria for Posttraumatic Stress Disorder (PTSD) and related trauma symptomatology is of clinical importance in the maintenance of their overall wellbeing. This study assessed the sensitivity and specificity of the 17-item Posttraumatic Stress Diagnostic Scale (PDS), a self-report instrument, in the detection of HIV-related PTSD. An adapted version of the PTSD module of the Composite International Diagnostic Interview (CIDI) served as the gold standard. 85 HIV-positive patients diagnosed with HIV within the year preceding data collection were recruited by means of convenience sampling from three HIV clinics within primary health care facilities in the Boland region of South Africa. A significant association was found between the 17-item PDS and the adapted PTSD module of the CIDI. A ROC curve analysis indicated that the 17-item PDS correctly discriminated between PTSD caseness and non-caseness 74.9% of the time. Moreover, a PDS cut-off point of > or = 15 yielded adequate sensitivity (68%) and 1-specificity (65%). The 17-item PDS demonstrated a PPV of 76.0% and a NPV of 56.7%. The 17-item PDS can be used as a brief screening measure for the detection of HIV-related PTSD among HIV-positive patients in South Africa.

  8. PTSD: National Center for PTSD

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    Full Text Available ... Apps Videos Web Links PTSD Site Search For Professionals Professional Section Home PTSD Overview Types of Trauma Trauma ... Watch our whiteboard video for clinicians in the Professional Section: Prescribing for PTSD, Know Your Options . × What ...

  9. PTSD: National Center for PTSD

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  10. PTSD: National Center for PTSD

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    Full Text Available ... and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ... Articles by Center Staff Clinician’s Trauma Update PTSD Research Quarterly Publications Search Using the PILOTS Database What ...

  11. PTSD: National Center for PTSD

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    Full Text Available ... Adult Self Report Child Measures Deployment Measures DSM-5 Measures PTSD Screens Trauma Exposure Measures Assessment Request ... Click here to download "What is PTSD?" (30.5 MB) Close × PTSD Treatment: Know Your Options Right ...

  12. PTSD: National Center for PTSD

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    Full Text Available ... the Public Public Section Home PTSD Overview PTSD Basics Return from War Specific to Women Types of ... Section Home PTSD Overview Types of Trauma Trauma Basics Disaster and Terrorism Military Trauma Violence & other Trauma ...

  13. PTSD: National Center for PTSD

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    Full Text Available ... Locations Contact Us FAQs Ask a Question Toll Free Numbers ... it PTSD? Treatment and Coping Treatment Self-Help and Coping PTSD Research Where to Get Help for PTSD Help with ...

  14. PTSD: National Center for PTSD

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    Full Text Available ... VA PTSD Care or Benefits Other Common Problems Family and Friends PTSD and Communities Paginas en Espanol ... Cultural Considerations Women Children Older Adults Working with Families PTSD Consultation For Specific Providers VA Providers and ...

  15. PTSD: National Center for PTSD

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    Full Text Available ... PTSD or Get Help with VA PTSD Care, Benefits, or Claims For Web site help: Web Policies PTSD Information Voice Mail: (802) 296-6300 ... Complete Directory EMAIL UPDATES Email Address Required Button ...

  16. PTSD: National Center for PTSD

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  17. Automatic scoring of the severity of psoriasis scaling

    DEFF Research Database (Denmark)

    Gomez, David Delgado; Ersbøll, Bjarne Kjær; Carstensen, Jens Michael

    2004-01-01

    In this work, a combined statistical and image analysis method to automatically evaluate the severity of scaling in psoriasis lesions is proposed. The method separates the different regions of the disease in the image and scores the degree of scaling based on the properties of these areas. The pr...... with scores made by doctors. This and the fact that the obtained measures are continuous indicate the proposed method is a suitable tool to evaluate the lesion and to track the evolution of dermatological diseases....

  18. How Common Is PTSD?

    Science.gov (United States)

    ... Center for PTSD » Public » How Common Is PTSD? PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... here Enter ZIP code here How Common Is PTSD? Public This section is for Veterans, General Public, ...

  19. How Is PTSD Measured?

    Science.gov (United States)

    ... Public » Is it PTSD? » How is PTSD Measured? PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here How is PTSD Measured? Public This section is for Veterans, General ...

  20. PTSD: National Center for PTSD

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  1. The Impact of Emotional Priming on MMPI-2 Scale Scores

    Science.gov (United States)

    Lee, Tayla T. C.; Forbey, Johnathan D.; Ritchey, Kristin A.

    2011-01-01

    The current study investigated potential emotional priming effects on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale scores. Participants included 98 college students who completed a personal narrative intended to induce temporary mood states, the MMPI-2, and a mood rating inventory. Results of the mood manipulation indicated that…

  2. Characterizing Sources of Uncertainty in Item Response Theory Scale Scores

    Science.gov (United States)

    Yang, Ji Seung; Hansen, Mark; Cai, Li

    2012-01-01

    Traditional estimators of item response theory scale scores ignore uncertainty carried over from the item calibration process, which can lead to incorrect estimates of the standard errors of measurement (SEMs). Here, the authors review a variety of approaches that have been applied to this problem and compare them on the basis of their statistical…

  3. Improving PTSD Symptoms and Preventing Progression of Subclinical PTSD to an Overt Disorder by Treating Comorbid OSA With CPAP.

    Science.gov (United States)

    Ullah, M I; Campbell, Douglas G; Bhagat, Rajesh; Lyons, Judith A; Tamanna, Sadeka

    2017-10-15

    Obstructive sleep apnea (OSA) and posttraumatic stress disorder (PTSD) are common in United States veterans. These conditions often coexist and symptoms overlap. Previous studies reported improvement in PTSD symptoms with continuous positive airway pressure (CPAP) therapy for comorbid OSA but its effect has not been assessed in a non-PTSD cohort. We have prospectively assessed the effect of CPAP therapy on clinical symptom improvement as a function of CPAP compliance levels among PTSD and non-PTSD veterans. Veterans in whom OSA was newly diagnosed were enrolled in our study (n = 192). Assignment to PTSD and non-PTSD cohorts was determined by chart review. Each patient completed the military version of the PTSD Checklist (PCL), Epworth Sleepiness Scale (ESS), and reported nightmare frequency (NMF) at baseline and 6 months after CPAP therapy. CPAP adherence was objectively documented from machine compliance data. We had complete data for 177 veterans (PTSD n = 59, non-PTSD n = 118) for analysis. The mean ages were 51.24 years in the PTSD cohort and 52.36 years in the non-PTSD cohort ( P = .30). In the PTSD cohort, the mean total PCL score (baseline = 66.06, post-CPAP = 61.27, P = .004, d = -0.34) and NMF (baseline = 4.61, post-CPAP = 1.49, P = .0001, d = -0.51) decreased after 6 months of CPAP treatment. Linear regression analysis showed that the CPAP compliance was the only significant predictor for these changes among veterans with PTSD (PCL score: P = .033, R 2 = .65; NMF; P = .03, R 2 = .61). Further analysis by CPAP compliance quartiles in this cohort (Q1 = 0% to 25%, Q2 = 26% to 50%, Q3 = 51% to 75%, Q4 > 75%) revealed that mean total PCL score declined in Q2 (change = -3.91, P = .045, d = 0.43), Q3 (change = -6.6, P = .002, d = 0.59), and Q4 (change = -7.94, P = .037, d = 0.49). In the non-PTSD cohort, the PCL score increased despite CPAP therapy in lower CPAP compliance quartiles Q1 (change = 8.71, P = .0001, d = 0.46) and Q2 (change = 4.51, P = .046, d = 0

  4. Establishing Concurrent Validity for a Brief PTSD Screen Among Women in a Domestic Violence Shelter.

    Science.gov (United States)

    Symes, Lene; McFarlane, Judith; Maddoux, John; Levine, Lisa Beth; Landrum, Kimberly S; McFarlane, Cari Delgado

    2018-06-01

    There is a particular need for valid scales to screen for posttraumatic stress disorder (PTSD) among women who seek safe shelter from intimate partner violence. Screening to identify women who are at risk for PTSD can lead to early intervention that reduces the risk for PTSD-related outcomes such as poor decision making, inconsistent parenting, and behavior dysfunction among their children. The gold standard for diagnosing PTSD is the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) (CAPS-5). A seven-item PTSD screen has been used for in this population and has a well-established cutoff score but has not been validated against the DSM-5 diagnostic criteria for PTSD. The study purpose was to establish concurrent validity for a seven-item screen for PTSD with the CAPS-5. Participants were 75 women, 18 years or older, who were residents of a 120-bed shelter in the southern United States. They spoke English or Spanish. They reported intimate partner physical or sexual violence within 4 months of their entry into the study. Following informed consent, data were collected in individual interviews, conducted in either English or Spanish. In addition to demographic data, the seven-item PTSD screen and the CAPS-5 were administered. A receiver operating characteristic (ROC) curve analysis was conducted to assess the concurrent validity of the seven-item PTSD screen with the CAPS-5. The seven-item PTSD screen results were significantly correlated with the CAPS-5 results in this sample (area under the curve [AUC] = .640, z = 2.670, p = .008). Sensitivity was 96.2, and observed specificity was 31.8. The seven-item PTSD screen demonstrates excellent sensitivity (e.g., 96% of true PTSD cases) and acceptable specificity (32% of non-PTSD cases) and can be used to quickly and accurately identify individuals for diagnostic assessment and intervention.

  5. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Science.gov (United States)

    2011-01-01

    Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i) purpose of instrument, (ii) construct measured, (iii) contents of construct, (iv) local idioms employed, (v) structure of response sets, and (vi) comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS) and Child PTSD Symptom Scale (CPSS) in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64) aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old). The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS) and Global Assessment of Psychosocial Disability (GAPD) were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC) = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14); CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20). The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7), "feeling that life is not worth living" (DSRS.10), and "feeling

  6. Validation of cross-cultural child mental health and psychosocial research instruments: adapting the Depression Self-Rating Scale and Child PTSD Symptom Scale in Nepal

    Directory of Open Access Journals (Sweden)

    Tol Wietse A

    2011-08-01

    Full Text Available Abstract Background The lack of culturally adapted and validated instruments for child mental health and psychosocial support in low and middle-income countries is a barrier to assessing prevalence of mental health problems, evaluating interventions, and determining program cost-effectiveness. Alternative procedures are needed to validate instruments in these settings. Methods Six criteria are proposed to evaluate cross-cultural validity of child mental health instruments: (i purpose of instrument, (ii construct measured, (iii contents of construct, (iv local idioms employed, (v structure of response sets, and (vi comparison with other measurable phenomena. These criteria are applied to transcultural translation and alternative validation for the Depression Self-Rating Scale (DSRS and Child PTSD Symptom Scale (CPSS in Nepal, which recently suffered a decade of war including conscription of child soldiers and widespread displacement of youth. Transcultural translation was conducted with Nepali mental health professionals and six focus groups with children (n = 64 aged 11-15 years old. Because of the lack of child mental health professionals in Nepal, a psychosocial counselor performed an alternative validation procedure using psychosocial functioning as a criterion for intervention. The validation sample was 162 children (11-14 years old. The Kiddie-Schedule for Affective Disorders and Schizophrenia (K-SADS and Global Assessment of Psychosocial Disability (GAPD were used to derive indication for treatment as the external criterion. Results The instruments displayed moderate to good psychometric properties: DSRS (area under the curve (AUC = 0.82, sensitivity = 0.71, specificity = 0.81, cutoff score ≥ 14; CPSS (AUC = 0.77, sensitivity = 0.68, specificity = 0.73, cutoff score ≥ 20. The DSRS items with significant discriminant validity were "having energy to complete daily activities" (DSRS.7, "feeling that life is not worth living" (DSRS.10, and

  7. Stroke scale score and early prediction of outcome after stroke

    International Nuclear Information System (INIS)

    Ahmed, R.; Zuberi, F.Z.; Afsar, S.

    2004-01-01

    Objective: To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. Subjects and Methods: The study included 50 patients who presented to Civil Hospital, Karachi, during the study period with acute stroke and were evaluated with CT scan of brain. Only those patients were enrolled in the study that had acute ischemic stroke. The enrolled subjects were then evaluated for the neurological impairment using National Institute of Health Stroke Scale (NIHSS). The subjects were followed-up and their functional outcome was assessed using Barthel index (BI) on the 7th day of their admission. Results: Of the fifty patients enrolled in the study, 31 (62%) were males and 19 (38%) were females, with age ranging from 45 years to 95 years and a mean age of 59.9 years. Neurological impairment at presentation was assessed by NIHSS. The score ranged between 2 and 28. The functional outcome was evaluated on the 7th day using Barthel index (BI), which ranged from 0 to 80. NIHSS score was found to be a good predictor of functional outcome in patients with ischemic stroke (p<0.001). Other factors like gender, hypertension and heart disease did not affect the functional recovery in such patients. Various factors were found to be significant for early prediction of stroke recovery. The NIHSS score was the strongest predictor of outcome after ischemic stroke. Age at the time of the event was also found to be an important predictor for stroke recovery. Conclusion: The NIHSS score is a good predictor of patient's recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan. (author)

  8. PTSD: National Center for PTSD

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  9. PTSD: National Center for PTSD

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  1. PTSD: National Center for PTSD

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  5. PTSD: National Center for PTSD

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  6. PTSD: National Center for PTSD

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  7. PTSD: National Center for PTSD

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  8. PTSD: National Center for PTSD

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  10. [Circadian rhythm : Influence on Epworth Sleepiness Scale score].

    Science.gov (United States)

    Herzog, M; Bedorf, A; Rohrmeier, C; Kühnel, T; Herzog, B; Bremert, T; Plontke, S; Plößl, S

    2017-02-01

    The Epworth Sleepiness Scale (ESS) is frequently used to determine daytime sleepiness in patients with sleep-disordered breathing. It is still unclear whether different levels of alertness induced by the circadian rhythm influence ESS score. The aim of this study is to investigate the influence of circadian rhythm-dependent alertness on ESS performance. In a monocentric prospective noninterventional observation study, 97 patients with suspected sleep-disordered breathing were investigated with respect to daytime sleepiness in temporal relationship to polysomnographic examination and treatment. The Karolinska Sleepiness Scale (KSS) and the Stanford Sleepiness Scale (SSS) served as references for the detection of present sleepiness at three different measurement times (morning, noon, evening), prior to and following a diagnostic polysomnography night as well as after a continuous positive airway pressure (CPAP) titration night (9 measurements in total). The KSS, SSS, and ESS were performed at these times in a randomized order. The KSS and SSS scores revealed a circadian rhythm-dependent curve with increased sleepiness at noon and in the evening. Following a diagnostic polysomnography night, the scores were increased compared to the measurements prior to the night. After the CPAP titration night, sleepiness in the morning was reduced. KSS and SSS reflect the changes in alertness induced by the circadian rhythm. The ESS score war neither altered by the intra-daily nor by the inter-daily changes in the level of alertness. According to the present data, the ESS serves as a reliable instrument to detect the level of daytime sleepiness independently of the circadian rhythm-dependent level of alertness.

  11. PTSD: National Center for PTSD

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  19. PTSD: National Center for PTSD

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  1. PTSD symptom reports of patients evaluated for the New Mexico Medical Cannabis Program.

    Science.gov (United States)

    Greer, George R; Grob, Charles S; Halberstadt, Adam L

    2014-01-01

    New Mexico was the first state to list post-traumatic stress disorder (PTSD) as a condition for the use of medical cannabis. There are no published studies, other than case reports, of the effects of cannabis on PTSD symptoms. The purpose of the study was to report and statistically analyze psychometric data on PTSD symptoms collected during 80 psychiatric evaluations of patients applying to the New Mexico Medical Cannabis Program from 2009 to 2011. The Clinician Administered Posttraumatic Scale for DSM-IV (CAPS) was administered retrospectively and symptom scores were then collected and compared in a retrospective chart review of the first 80 patients evaluated. Greater than 75% reduction in CAPS symptom scores were reported when patients were using cannabis compared to when they were not. Cannabis is associated with reductions in PTSD symptoms in some patients, and prospective, placebo-controlled study is needed to determine efficacy of cannabis and its constituents in treating PTSD.

  2. River Discharge and Local Scale Habitat Influence LIFE Score Macroinvertebrate LIFE Scores

    DEFF Research Database (Denmark)

    Dunbar, Michael J.; Pedersen, Morten Lauge; Cadman, Dan

    2010-01-01

    Midlands of the U.K., we describe how local-scale habitat features (indexed through River Habitat Survey or Danish Habitat Quality Survey) and changing river flow (discharge) influence the response of a macroinvertebrate community index. The approach has broad applicability in developing regional flow...... Invertebrate index for Flow Evaluation (LIFE), an average of abundance-weighted flow groups which indicate the microhabitat preferences of each taxon for higher velocities and clean gravel/cobble substrata or slow/still velocities and finer substrata. 3. For the Danish fauna, the LIFE score responded to three...... of the channel (negative). In both cases, LIFE responded negatively to features associated with historical channel modification. We suggest that there are several mechanisms for these relationships, including the narrower tolerances of taxa preferring high velocity habitat; these taxa are also continually...

  3. Dorsal Anterior Cingulate Thickness Is Related to Alexithymia in Childhood Trauma-Related PTSD.

    Directory of Open Access Journals (Sweden)

    Lauren A Demers

    Full Text Available Alexithymia, or "no words for feelings", is highly prevalent in samples with childhood maltreatment and posttraumatic stress disorder (PTSD. The dorsal anterior cingulate cortex (dACC has been identified as a key region involved in alexithymia, early life trauma, and PTSD. Functional alterations in the dACC also have been associated with alexithymia in PTSD. This study examined whether dACC morphology is a neural correlate of alexithymia in child maltreatment-related PTSD. Sixteen adults with PTSD and a history of childhood sexual abuse, physical abuse, or exposure to domestic violence, and 24 healthy controls (HC completed the Toronto Alexithymia Scale 20 (TAS-20 and underwent magnetic resonance imaging. Cortical thickness of the dACC was measured using FreeSurfer, and values were correlated with TAS-20 scores, controlling for sex and age, in both groups. Average TAS-20 score was significantly higher in the PTSD than the HC group. TAS-20 scores were significantly positively associated with dACC thickness only in the PTSD group. This association was strongest in the left hemisphere and for TAS-20 subscales that assess difficulty identifying and describing feelings. We found that increasing dACC gray matter thickness is a neural correlate of greater alexithymia in the context of PTSD with childhood maltreatment. While findings are correlational, they motivate further inquiry into the relationships between childhood adversity, emotional awareness and expression, and dACC morphologic development in trauma-related psychopathology.

  4. Dorsal Anterior Cingulate Thickness Is Related to Alexithymia in Childhood Trauma-Related PTSD.

    Science.gov (United States)

    Demers, Lauren A; Olson, Elizabeth A; Crowley, David J; Rauch, Scott L; Rosso, Isabelle M

    2015-01-01

    Alexithymia, or "no words for feelings", is highly prevalent in samples with childhood maltreatment and posttraumatic stress disorder (PTSD). The dorsal anterior cingulate cortex (dACC) has been identified as a key region involved in alexithymia, early life trauma, and PTSD. Functional alterations in the dACC also have been associated with alexithymia in PTSD. This study examined whether dACC morphology is a neural correlate of alexithymia in child maltreatment-related PTSD. Sixteen adults with PTSD and a history of childhood sexual abuse, physical abuse, or exposure to domestic violence, and 24 healthy controls (HC) completed the Toronto Alexithymia Scale 20 (TAS-20) and underwent magnetic resonance imaging. Cortical thickness of the dACC was measured using FreeSurfer, and values were correlated with TAS-20 scores, controlling for sex and age, in both groups. Average TAS-20 score was significantly higher in the PTSD than the HC group. TAS-20 scores were significantly positively associated with dACC thickness only in the PTSD group. This association was strongest in the left hemisphere and for TAS-20 subscales that assess difficulty identifying and describing feelings. We found that increasing dACC gray matter thickness is a neural correlate of greater alexithymia in the context of PTSD with childhood maltreatment. While findings are correlational, they motivate further inquiry into the relationships between childhood adversity, emotional awareness and expression, and dACC morphologic development in trauma-related psychopathology.

  5. Psychometric analysis of the PTSD Checklist-5 (PCL-5) among treatment-seeking military service members.

    Science.gov (United States)

    Wortmann, Jennifer H; Jordan, Alexander H; Weathers, Frank W; Resick, Patricia A; Dondanville, Katherine A; Hall-Clark, Brittany; Foa, Edna B; Young-McCaughan, Stacey; Yarvis, Jeffrey S; Hembree, Elizabeth A; Mintz, Jim; Peterson, Alan L; Litz, Brett T

    2016-11-01

    The Posttraumatic Stress Disorder Checklist (PCL-5; Weathers et al., 2013) was recently revised to reflect the changed diagnostic criteria for posttraumatic stress disorder (PTSD) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). We investigated the psychometric properties of PCL-5 scores in a large cohort (N = 912) of military service members seeking PTSD treatment while stationed in garrison. We examined the internal consistency, convergent and discriminant validity, and DSM-5 factor structure of PCL-5 scores, their sensitivity to clinical change relative to PTSD Symptom Scale-Interview (PSS-I; Foa, Riggs, Dancu, & Rothbaum, 1993) scores, and their diagnostic utility for predicting a PTSD diagnosis based on various measures and scoring rules. PCL-5 scores exhibited high internal consistency. There was strong agreement between the order of hypothesized and observed correlations among PCL-5 and criterion measure scores. The best-fitting structural model was a 7-factor hybrid model (Armour et al., 2015), which demonstrated closer fit than all other models evaluated, including the DSM-5 model. The PCL-5's sensitivity to clinical change, pre- to posttreatment, was comparable with that of the PSS-I. Optimally efficient cut scores for predicting PTSD diagnosis were consistent with prior research with service members (Hoge, Riviere, Wilk, Herrell, & Weathers, 2014). The results indicate that the PCL-5 is a psychometrically sound measure of DSM-5 PTSD symptoms that is useful for identifying provisional PTSD diagnostic status, quantifying PTSD symptom severity, and detecting clinical change over time in PTSD symptoms among service members seeking treatment. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  6. PTSD: National Center for PTSD

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  16. PTSD in Children and Teens

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  17. Effects of PTSD on Family

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    ... for PTSD » Public » Effects of PTSD on Family PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here Effects of PTSD on Family Public This section is for Veterans, ...

  18. Differences in relationship conflict, attachment, and depression in treatment-seeking veterans with hazardous substance use, PTSD, or PTSD and hazardous substance use.

    Science.gov (United States)

    Owens, Gina P; Held, Philip; Blackburn, Laura; Auerbach, John S; Clark, Allison A; Herrera, Catherine J; Cook, Jerome; Stuart, Gregory L

    2014-05-01

    Veterans (N = 133) who were seeking treatment in either the Posttraumatic Stress Program or Substance Use Disorders Program at a Veterans Affairs Medical Center (VAMC) and, based on self-report of symptoms, met clinical norms for posttraumatic stress disorder (PTSD) or hazardous substance use (HSU) completed a survey related to relationship conflict behaviors, attachment styles, and depression severity. Participants were grouped into one of three categories on the basis of clinical norm criteria: PTSD only, HSU only, and PTSD + HSU. Participants completed the PTSD Checklist-Military, Experiences in Close Relationships Scale-Short Form, Center for Epidemiologic Studies-Depression scale, Alcohol Use Disorders Identification Test, Drug Use Disorders Identification Test, and Psychological Aggression and Physical Violence subscales of the Conflict Tactics Scale. Most participants were male and Caucasian. Significant differences were found between groups on depression, avoidant attachment, psychological aggression perpetration and victimization, and physical violence perpetration and victimization. Post hoc analyses revealed that the PTSD + HSU group had significantly higher levels of depression, avoidant attachment, and psychological aggression than the HSU only group. The PTSD + HSU group had significantly higher levels of physical violence than did the PTSD only group, but both groups had similar mean scores on all other variables. Potential treatment implications are discussed.

  19. PTSD: National Center for PTSD

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  9. Identifying PTSD personality subtypes in a workplace trauma sample.

    Science.gov (United States)

    Sellbom, Martin; Bagby, R Michael

    2009-10-01

    The authors sought to identify personality clusters derived from the Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Personality Psychopathology Five Scales in a sample of workplace claimants with posttraumatic stress disorder (PTSD). Three clusters--low pathology, internalizing, and externalizing were recovered similar to those obtained by M. W. Miller and colleagues (2003, 2004, 2007) in samples of combat veterans and sexual assault victims. Internalizers and externalizers scored comparably on measures of PTSD symptom severity, general distress, and negative affect. Internalizers were uniquely characterized by anhedonia and depressed mood; externalizers by antisocial behavior, substance abuse, and anger/aggression.

  10. Psychometric properties of the child PTSD checklist in a community sample of South African children and adolescents.

    Directory of Open Access Journals (Sweden)

    Mark E Boyes

    Full Text Available OBJECTIVE: The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD in a large sample of South African youth. METHODOLOGY: The checklist was completed by 1025 (540 male; 485 female South African youth (aged between 10 and 19 years. The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach's alpha and McDonald's omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD. RESULTS: Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues' Dysphoria Model of PTSD symptoms which provided a better fit to the observed data. CONCLUSION: Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made.

  11. Psychometric Properties of the Child PTSD Checklist in a Community Sample of South African Children and Adolescents

    Science.gov (United States)

    Boyes, Mark E.; Cluver, Lucie D.; Gardner, Frances

    2012-01-01

    Objective The current study assessed the basic psychometric properties of the Child PTSD Checklist and examined the structure of symptoms of posttraumatic stress disorder (PTSD) in a large sample of South African youth. Methodology The checklist was completed by 1025 (540 male; 485 female) South African youth (aged between 10 and 19 years). The factor structure of the scale was assessed with a combination of confirmatory and exploratory techniques. Internal consistencies for the full scale and all subscales were evaluated with Cronbach’s alpha and McDonald’s omega. Validity was assessed by comparing PTSD scores obtained by children who had and had not experienced a traumatic event, and by examining associations between total PTSD scores and known correlates of PTSD. Results Scores on the Child PTSD Checklist clearly discriminated between youth who had experienced a traumatic event and those who had not. Internal consistencies for the full scale (and all subscales) were acceptable to good and hypothesized correlations between PTSD, depression, anxiety, somatic symptoms, and age were observed. Two of the reported fit statistics for the tripartite DSM-IV-TR model of PTSD did not meet traditional criteria and further exploratory analyses revealed a four-factor structure (broadly consistent with Simms and colleagues’ Dysphoria Model of PTSD symptoms) which provided a better fit to the observed data. Conclusion Given the continued use of the Child PTSD Checklist in South Africa, findings offer an important first step in establishing the reliability and validity of the checklist for use with South African youth. However, further evaluation of the checklist in South African samples is clearly required before conclusions regarding its use as diagnostic tool in this context can be made. PMID:23056523

  12. Psychometric properties of the Brazilian version of the Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A

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    Jair B. Barbosa Neto

    2014-12-01

    Full Text Available Objective: Sleep disturbances play a fundamental role in the pathophysiology posttraumatic stress disorder (PTSD, and are not only a secondary feature. The aim of this study was to validate and assess the psychometric properties of the Brazilian version of the Pittsburgh Sleep Quality Index Addendum for PTSD (PSQI-A-BR, a self-report instrument designed to assess the frequency of seven disruptive nocturnal behaviors, in a sample of participants with and without PTSD. Methods: PSQI-A was translated into Brazilian Portuguese and applied to a convenience sample of 190 volunteers, with and without PTSD, who had sought treatment for the consequences of a traumatic event. Results: The PSQI-A-BR displayed satisfactory internal consistency (Cronbach's coefficient of 0.83 between all items and convergent validity with the Clinician Administered PTSD Scale (CAPS, even when excluding sleep-related items (r = 0.52. Test-retest yielded high agreement in the global PSQI-A-BR, with good stability over time (r = 0.88. A global PSQI-A-BR cutoff score of 7 yielded a sensitivity of 79%, specificity of 64%, and a global score of 7 yielded a positive predictive value of 93% for discriminating participants with PTSD from those without PTSD. Conclusion: The PSQI-A-BR is a valid instrument for PTSD assessment, applicable to both clinical and research settings.

  13. PTSD: National Center for PTSD

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  16. Reliability Generalization: Exploring Variation of Reliability Coefficients of MMPI Clinical Scales Scores.

    Science.gov (United States)

    Vacha-Haase, Tammi; Kogan, Lori R.; Tani, Crystal R.; Woodall, Renee A.

    2001-01-01

    Used reliability generalization to explore the variance of scores on 10 Minnesota Multiphasic Personality Inventory (MMPI) clinical scales drawing on 1,972 articles in the literature on the MMPI. Results highlight the premise that scores, not tests, are reliable or unreliable, and they show that study characteristics do influence scores on the…

  17. Multiple scaling behaviour and nonlinear traits in music scores

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    González-Espinoza, Alfredo; Larralde, Hernán; Martínez-Mekler, Gustavo; Müller, Markus

    2017-12-01

    We present a statistical analysis of music scores from different composers using detrended fluctuation analysis (DFA). We find different fluctuation profiles that correspond to distinct autocorrelation structures of the musical pieces. Further, we reveal evidence for the presence of nonlinear autocorrelations by estimating the DFA of the magnitude series, a result validated by a corresponding study of appropriate surrogate data. The amount and the character of nonlinear correlations vary from one composer to another. Finally, we performed a simple experiment in order to evaluate the pleasantness of the musical surrogate pieces in comparison with the original music and find that nonlinear correlations could play an important role in the aesthetic perception of a musical piece.

  18. Evidence for proposed ICD-11 PTSD and complex PTSD: a latent profile analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2013-05-01

    Full Text Available Background: The WHO International Classification of Diseases, 11th version (ICD-11, has proposed two related diagnoses, posttraumatic stress disorder (PTSD and complex PTSD within the spectrum of trauma and stress-related disorders. Objective: To use latent profile analysis (LPA to determine whether there are classes of individuals that are distinguishable according to the PTSD and complex PTSD symptom profiles and to identify potential differences in the type of stressor and severity of impairment associated with each profile. Method: An LPA and related analyses were conducted on 302 individuals who had sought treatment for interpersonal traumas ranging from chronic trauma (e.g., childhood abuse to single-incident events (e.g., exposure to 9/11 attacks. Results: The LPA revealed three classes of individuals: (1 a complex PTSD class defined by elevated PTSD symptoms as well as disturbances in three domains of self-organization: affective dysregulation, negative self-concept, and interpersonal problems; (2 a PTSD class defined by elevated PTSD symptoms but low scores on the three self-organization symptom domains; and (3 a low symptom class defined by low scores on all symptoms and problems. Chronic trauma was more strongly predictive of complex PTSD than PTSD and, conversely, single-event trauma was more strongly predictive of PTSD. In addition, complex PTSD was associated with greater impairment than PTSD. The LPA analysis was completed both with and without individuals with borderline personality disorder (BPD yielding identical results, suggesting the stability of these classes regardless of BPD comorbidity. Conclusion: Preliminary data support the proposed ICD-11 distinction between PTSD and complex PTSD and support the value of testing the clinical utility of this distinction in field trials. Replication of results is necessary.For the abstract or full text in other languages, please see Supplementary files under Article Tools online

  19. Treatment preferences of psychotherapy patients with chronic PTSD.

    Science.gov (United States)

    Markowitz, John C; Meehan, Kevin B; Petkova, Eva; Zhao, Yihong; Van Meter, Page E; Neria, Yuval; Pessin, Hayley; Nazia, Yasmin

    2016-03-01

    Patient treatment preference may moderate treatment effect in major depressive disorder (MDD) studies. Little research has addressed preference in posttraumatic stress disorder (PTSD); almost none has assessed actual patients' PTSD psychotherapy preferences. From a 14-week trial of chronic PTSD comparing prolonged exposure, relaxation therapy, and interpersonal psychotherapy, we report treatment preferences of the 110 randomized patients, explore preference correlates, and assess effects on treatment outcome. Patients recruited between 2008 and 2013 with chronic DSM-IV PTSD (Clinician-Administered PTSD Scale [CAPS] score ≥ 50) received balanced, scripted psychotherapy descriptions prerandomization and indicated their preferences. Analyses assessed relationships of treatment attitudes to demographic and clinical factors. We hypothesized that patients randomized to preferred treatments would have better outcomes, and to unwanted treatment worse outcomes. Eighty-seven patients (79%) voiced treatment preferences or disinclinations: 29 (26%) preferred prolonged exposure, 29 (26%) preferred relaxation therapy, and 56 (50%) preferred interpersonal psychotherapy (Cochran Q = 18.46, P psychotherapy (Cochran Q = 22.71, P psychotherapy preferences to outcome. Despite explanations emphasizing prolonged exposure's greater empirical support, patients significantly preferred interpersonal psychotherapy. Preference subtly affected psychotherapy outcome; depression appeared an important moderator of the effect of unwanted treatment on outcome. Potential biases to avoid in future research are discussed. ClinicalTrials.gov identifier: NCT00739765. © Copyright 2015 Physicians Postgraduate Press, Inc.

  20. Normal variability of children's scaled scores on subtests of the Dutch Wechsler Preschool and Primary scale of Intelligence - third edition.

    Science.gov (United States)

    Hurks, P P M; Hendriksen, J G M; Dek, J E; Kooij, A P

    2013-01-01

    Intelligence tests are included in millions of assessments of children and adults each year (Watkins, Glutting, & Lei, 2007a , Applied Neuropsychology, 14, 13). Clinicians often interpret large amounts of subtest scatter, or large differences between the highest and lowest scaled subtest scores, on an intelligence test battery as an index for abnormality or cognitive impairment. The purpose of the present study is to characterize "normal" patterns of variability among subtests of the Dutch Wechsler Preschool and Primary Scale of Intelligence - Third Edition (WPPSI-III-NL; Wechsler, 2010 ). Therefore, the frequencies of WPPSI-III-NL scaled subtest scatter were reported for 1039 healthy children aged 4:0-7:11 years. Results indicated that large differences between highest and lowest scaled subtest scores (or subtest scatter) were common in this sample. Furthermore, degree of subtest scatter was related to: (a) the magnitude of the highest scaled subtest score, i.e., more scatter was seen in children with the highest WPPSI-III-NL scaled subtest scores, (b) Full Scale IQ (FSIQ) scores, i.e., higher FSIQ scores were associated with an increase in subtest scatter, and (c) sex differences, with boys showing a tendency to display more scatter than girls. In conclusion, viewing subtest scatter as an index for abnormality in WPPSI-III-NL scores is an oversimplification as this fails to recognize disparate subtest heterogeneity that occurs within a population of healthy children aged 4:0-7:11 years.

  1. A Reliability Generalization Study of Scores on Rotter's and Nowicki-Strickland's Locus of Control Scales

    Science.gov (United States)

    Beretvas, S. Natasha; Suizzo, Marie-Anne; Durham, Jennifer A.; Yarnell, Lisa M.

    2008-01-01

    The most commonly used measures of locus of control are Rotter's Internality-Externality Scale (I-E) and Nowicki and Strickland's Internality-Externality Scale (NSIE). A reliability generalization study is conducted to explore variability in I-E and NSIE score reliability. Studies are coded for aspects of the scales used (number of response…

  2. Alterations in white matter microstructure as vulnerability factors and acquired signs of traffic accident-induced PTSD.

    Directory of Open Access Journals (Sweden)

    Yawen Sun

    Full Text Available It remains unclear whether white matter (WM changes found in post-traumatic stress disorder (PTSD patients are stress-induced or precursors for vulnerability. The current study aimed to identify susceptibility factors relating to the development of PTSD and to examine the ability of these factors to predict the course of longitudinal PTSD. Sixty two victims who had experienced traffic accidents underwent diffusion tensor imaging using a 3.0T MRI system within 2 days after their accidents. Of these, 21 were diagnosed with PTSD at 1 or 6 months using the Clinician-Administered Ptsd Scale (CAPS. Then, 11 trauma-exposed victims with PTSD underwent the second MRI scan. Compared with the victims without PTSD, the victims with PTSD showed decreased fractional anisotropy (FA in WM of the anterior cingulate cortex, ventromedial prefrontal cortex (vmPFC, temporal lobes and midbrain, and increased mean diffusivity (MD in the vmPFC within 2 days after the traumatic event. Importantly, decreased FA of the vmPFC in the acute phase predicted greater future CAPS scores. In addition, we found decreased FA in the insula in the follow-up scan in the victims with PTSD, which correlated with the decreased FA of the vmPFC in their baseline scan. These results suggested that the WM might have changed within 2 days after the traumatic event in the individuals who would later develop PTSD. Furthermore, decreased FA of the vmPFC could be a possible vulnerability marker predicting future development of PTSD and may provide an outcome prediction of the acquired signs.

  3. Developing the PTSD Checklist-I/F for the DSM-IV (PCL-I/F: Assessing PTSD Symptom Frequency and Intensity in a Pilot Study of Male Veterans with Combat-Related PTSD

    Directory of Open Access Journals (Sweden)

    Ryan Holliday

    2015-02-01

    Full Text Available The widely used posttraumatic stress disorder (PTSD Checklist (PCL has established reliability and validity, but it does not differentiate posttraumatic symptom frequency from intensity as elements of posttraumatic symptom severity. Thus, the PCL in its existing form may not provide a comprehensive appraisal of posttraumatic symptomatology. Because of this, we modified the PCL to create the PCL-I/F that measures both frequency and intensity of PTSD symptoms via brief self-report. To establish validity and internal consistency of the PCL-I/F, we conducted a pilot study comparing PCL-I/F scores to structured diagnostic interview for PTSD (the Clinician Administered PTSD Scale [CAPS] in a male combat veteran sample of 92 participants. Statistically significant correlations between the PCL-I/F and the CAPS were found, suggesting initial validation of the PCL-I/F to screen and assess frequency and intensity of combat-related PTSD symptoms. Implications are discussed for screening and assessment of PTSD related to combat and non-combat trauma.

  4. Psychometric Properties of Raw and Scale Scores on Mixed-Format Tests

    Science.gov (United States)

    Kolen, Michael J.; Lee, Won-Chan

    2011-01-01

    This paper illustrates that the psychometric properties of scores and scales that are used with mixed-format educational tests can impact the use and interpretation of the scores that are reported to examinees. Psychometric properties that include reliability and conditional standard errors of measurement are considered in this paper. The focus is…

  5. Comparing the MMPI-2 Scale Scores of Parents Involved in Parental Competency and Child Custody Assessments

    Science.gov (United States)

    Resendes, John; Lecci, Len

    2012-01-01

    MMPI-2 scores from a parent competency sample (N = 136 parents) are compared with a previously published data set of MMPI-2 scores for child custody litigants (N = 508 parents; Bathurst et al., 1997). Independent samples t tests yielded significant and in some cases substantial differences on the standard MMPI-2 clinical scales (especially Scales…

  6. A comparative study on assessment procedures and metric properties of two scoring systems of the Coma Recovery Scale-Revised items: standard and modified scores.

    Science.gov (United States)

    Sattin, Davide; Lovaglio, Piergiorgio; Brenna, Greta; Covelli, Venusia; Rossi Sebastiano, Davide; Duran, Dunja; Minati, Ludovico; Giovannetti, Ambra Mara; Rosazza, Cristina; Bersano, Anna; Nigri, Anna; Ferraro, Stefania; Leonardi, Matilde

    2017-09-01

    The study compared the metric characteristics (discriminant capacity and factorial structure) of two different methods for scoring the items of the Coma Recovery Scale-Revised and it analysed scale scores collected using the standard assessment procedure and a new proposed method. Cross sectional design/methodological study. Inpatient, neurological unit. A total of 153 patients with disorders of consciousness were consecutively enrolled between 2011 and 2013. All patients were assessed with the Coma Recovery Scale-Revised using standard (rater 1) and inverted (rater 2) procedures. Coma Recovery Scale-Revised score, number of cognitive and reflex behaviours and diagnosis. Regarding patient assessment, rater 1 using standard and rater 2 using inverted procedures obtained the same best scores for each subscale of the Coma Recovery Scale-Revised for all patients, so no clinical (and statistical) difference was found between the two procedures. In 11 patients (7.7%), rater 2 noted that some Coma Recovery Scale-Revised codified behavioural responses were not found during assessment, although higher response categories were present. A total of 51 (36%) patients presented the same Coma Recovery Scale-Revised scores of 7 or 8 using a standard score, whereas no overlap was found using the modified score. Unidimensionality was confirmed for both score systems. The Coma Recovery Scale Modified Score showed a higher discriminant capacity than the standard score and a monofactorial structure was also supported. The inverted assessment procedure could be a useful evaluation method for the assessment of patients with disorder of consciousness diagnosis.

  7. Reliability and Validity of the Korean Version of the Symptom Checklist-Post-Traumatic Stress Disorder Scale

    Science.gov (United States)

    2016-01-01

    The Symptom Checklist - Post-Traumatic Stress Disorder Scale (SCL-PTSD), also known as Crime-Related PTSD Scale has been validated in survivors of interpersonal trauma in the general population. However, the psychometric properties have not been investigated in a clinical setting for patients with PTSD from diverse traumatic events. This study investigates the reliability and validity of the Korean version of the SCL-PTSD among 104 psychiatric outpatients with PTSD, caused by interpersonal (n = 50) or non-interpersonal trauma (n = 54). Self-report data of the SCL-PTSD, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), and Impact of Events Scale-Revised (IES-R) were gathered. The Korean version of the SCL-PTSD showed excellent internal consistency and moderate-to-good four-week temporal stability in both the interpersonal and non-interpersonal trauma groups. In comparison with other diagnostic groups, the scores of the SCL-PTSD were significantly higher compared to those of adjustment disorder, depression, other anxiety disorders, and schizophrenia, demonstrating its criteria-related validity. Convergent validity was confirmed because the scores of the SCL-PTSD were significantly correlated with BDI, SAI and TAI scores. Concurrent validity was demonstrated by significant correlation with the IES-R score. This study demonstrated the favorable psychometric prosperities of the Korean version of the SCL-PTSD, supporting its use in clinical research and practice. PMID:27134501

  8. Which clinical variable influences health-related quality of life the most after spontaneous subarachnoid hemorrhage? Hunt and Hess scale, Fisher score, World Federation of Neurosurgeons score, Brussels coma score, and Glasgow coma score compared.

    Science.gov (United States)

    Kapapa, Thomas; Tjahjadi, Martin; König, Ralph; Wirtz, Christian Rainer; Woischneck, Dieter

    2013-12-01

    To determine the strength of the correlation between the Hunt and Hess scale, Fisher score, Brussels coma score, World Federation of Neurosurgeons score, and Glasgow coma score and health-related quality of life. Evaluable questionnaires from 236 patients (5.6 years [± standard deviation, 2.854 years] on average after hemorrhage) were included in the analysis. Quality of life was documented using the MOS-36 item short form health survey. Because of the ordinal nature of the variables, Kendall tau was used for calculation. Significance was established as P ≤ 0.05. Weak and very weak correlations were found in general (r ≤ 0.28). The strongest correlations were found between the Glasgow coma score and quality of life (r = 0.236, P = 0.0001). In particular, the "best verbal response" achieved the strongest correlations in the comparison, at r = 0.28/P = 0.0001. The Fisher score showed very weak correlations (r = -0.148/P = 0.012). The Brussels coma score (r = -0.216/P = 0.0001), Hunt and Hess scale (r = -0.197/P = 0.0001), and the World Federation of Neurosurgeons score (r = -0.185/P = 0.0001) revealed stronger correlations, especially in terms of the physical aspects of quality of life. The Glasgow coma scale revealed the strongest, and the Fisher score showed the weakest correlations. Thus the Fisher score, as an indicator of the severity of a hemorrhage, has little significance in terms of health-related quality of life. Copyright © 2013 Elsevier Inc. All rights reserved.

  9. The Effects of a Short-term Cognitive Behavioral Group Intervention on Bam Earthquake Related PTSD Symptoms in Adolescents

    Directory of Open Access Journals (Sweden)

    Fatemeh Naderi

    2009-04-01

    Full Text Available "n "n "nObjective :Post traumatic stress disorder (PTSD may be the first reaction after disasters. Many studies have shown the efficacy of cognitive- behavioral therapy in treatment of post traumatic stress disorder. The main objective of this study is to evaluate the effect of group CBT in adolescent survivors of a large scale disaster (Bam earthquake. "n "nMethods: In a controlled trial, we evaluated the efficacy of a short term method of group cognitive-behavioral therapy in adolescent survivors of Bam earthquake who had PTSD symptoms and compared it with a control group. The adolescents who had severe PTSD or other psychiatric disorders that needed pharmacological interventions were excluded. We evaluated PTSD symptoms using Post traumatic Stress Scale (PSS pre and post intervention and compared them with a control group. "n "nResults: 100 adolescents were included in the study and 15 were excluded during the intervention. The mean age of the participants was 14.6±2.1 years. The mean score of total PTSD symptoms and the symptoms of avoidance was reduced after interventions, and was statistically significant. The mean change of re-experience and hyper arousal symptoms of PTSD were not significant. "n "nConclusion: Psychological debriefing and group cognitive behavioral therapy may be effective in reducing some of the PTSD symptoms.

  10. Validation of patient determined disease steps (PDDS) scale scores in persons with multiple sclerosis.

    Science.gov (United States)

    Learmonth, Yvonne C; Motl, Robert W; Sandroff, Brian M; Pula, John H; Cadavid, Diego

    2013-04-25

    The Patient Determined Disease Steps (PDDS) is a promising patient-reported outcome (PRO) of disability in multiple sclerosis (MS). To date, there is limited evidence regarding the validity of PDDS scores, despite its sound conceptual development and broad inclusion in MS research. This study examined the validity of the PDDS based on (1) the association with Expanded Disability Status Scale (EDSS) scores and (2) the pattern of associations between PDDS and EDSS scores with Functional System (FS) scores as well as ambulatory and other outcomes. 96 persons with MS provided demographic/clinical information, completed the PDDS and other PROs including the Multiple Sclerosis Walking Scale-12 (MSWS-12), and underwent a neurological examination for generating FS and EDSS scores. Participants completed assessments of cognition, ambulation including the 6-minute walk (6 MW), and wore an accelerometer during waking hours over seven days. There was a strong correlation between EDSS and PDDS scores (ρ = .783). PDDS and EDSS scores were strongly correlated with Pyramidal (ρ = .578 &ρ = .647, respectively) and Cerebellar (ρ = .501 &ρ = .528, respectively) FS scores as well as 6 MW distance (ρ = .704 &ρ = .805, respectively), MSWS-12 scores (ρ = .801 &ρ = .729, respectively), and accelerometer steps/day (ρ = -.740 &ρ = -.717, respectively). This study provides novel evidence supporting the PDDS as valid PRO of disability in MS.

  11. Construct Validity and Reliability Measures of Scores from the Science Teachers' Pedagogical Discontentment (STPD) Scale

    Science.gov (United States)

    Kahveci, Murat; Kahveci, Ajda; Mansour, Nasser; Mohammed, Maher

    2016-01-01

    The Science Teachers' Pedagogical Discontentment (STPD) scale has formerly been developed in the United States and used since 2006. Based on the perceptions of selected teachers, the scale is deeply rooted in the cultural and national standards. Given these limitations, the measurement integrity of its scores has not yet been conclusively…

  12. Exploring Shared Measurement Properties and Score Comparability between Two Versions of the "Supports Intensity Scale"

    Science.gov (United States)

    Seo, Hyojeong; Shogren, Karrie A.; Wehmeyer, Michael L.; Hughes, Carolyn; Thompson, James R.; Little, Todd D.; Palmer, Susan B.

    2016-01-01

    This study examined similarities and differences in measurement properties and score comparability of the "Supports Intensity Scale-Adult Version" (16-64 years) and the "Supports Intensity Scale-Children's Version" (5-16 years). Data were collected from 142 adolescents with intellectual disability with both versions of the…

  13. Sleep and Posttraumatic Stress Disorder (PTSD)

    Science.gov (United States)

    ... National Center for PTSD » Public » Sleep and PTSD PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... code here Enter ZIP code here Sleep and PTSD Public This section is for Veterans, General Public, ...

  14. PTSD and Problems with Alcohol Use

    Science.gov (United States)

    ... PTSD » Public » PTSD and Problems with Alcohol Use PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... Enter ZIP code here Enter ZIP code here PTSD and Problems with Alcohol Use Public This section ...

  15. Auditory hallucinations and PTSD in ex-POWS

    DEFF Research Database (Denmark)

    Crompton, Laura; Lahav, Yael; Solomon, Zahava

    2017-01-01

    (PTSD) symptoms, over time. Former prisoners of war (ex-POWs) from the 1973 Yom Kippur War (n = 99) with and without PTSD and comparable veterans (n = 103) were assessed twice, in 1991 (T1) and 2003 (T2) in regard to auditory hallucinations and PTSD symptoms. Findings indicated that ex-POWs who suffered...... from PTSD reported higher levels of auditory hallucinations at T2 as well as increased hallucinations over time, compared to ex-POWs without PTSD and combatants who did not endure captivity. The relation between PTSD and auditory hallucinations was unidirectional, so that the PTSD overall score at T1...... predicted an increase in auditory hallucinations between T1 and T2, but not vice versa. Assessing the role of PTSD clusters in predicting hallucinations revealed that intrusion symptoms had a unique contribution, compared to avoidance and hyperarousal symptoms. The findings suggest that auditory...

  16. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD.

    Science.gov (United States)

    Wagenmans, Anouk; Van Minnen, Agnes; Sleijpen, Marieke; De Jongh, Ad

    2018-01-01

    Background : It is assumed that PTSD patients with a history of childhood sexual abuse benefit less from trauma-focused treatment than those without such a history. Objective : To test whether the presence of a history of childhood sexual abuse has a negative effect on the outcome of intensive trauma-focused PTSD treatment. Method : PTSD patients, 83% of whom suffered from severe PTSD, took part in a therapy programme consisting of 2 × 4 consecutive days of Prolonged Exposure (PE) and EMDR therapy (eight of each). In between sessions, patients participated in sport activities and psycho-education sessions. No prior stabilization phase was implemented. PTSD symptom scores of clinician-administered and self-administered measures were analysed using the data of 165 consecutive patients. Pre-post differences were compared between four trauma groups; patients with a history of childhood sexual abuse before age 12 (CSA), adolescent sexual abuse (ASA; i.e. sexual abuse between 12 and 18 years of age), sexual abuse (SA) at age 18 and over, or no history of sexual abuse (NSA). Results : Large effect sizes were achieved for PTSD symptom reduction for all trauma groups (Cohen's d  = 1.52-2.09). For the Clinical Administered PTSD Scale (CAPS) and the Impact of Event Scale (IES), no differences in treatment outcome were found between the trauma (age) groups. For the PTSD Symptom Scale Self Report (PSS-SR), there were no differences except for one small effect between CSA and NSA. Conclusions : The results do not support the hypothesis that the presence of a history of childhood sexual abuse has a detrimental impact on the outcome of first-line (intensive) trauma-focused treatments for PTSD.

  17. Decreasing scoring errors on Wechsler Scale Vocabulary, Comprehension, and Similarities subtests: a preliminary study.

    Science.gov (United States)

    Linger, Michele L; Ray, Glen E; Zachar, Peter; Underhill, Andrea T; LoBello, Steven G

    2007-10-01

    Studies of graduate students learning to administer the Wechsler scales have generally shown that training is not associated with the development of scoring proficiency. Many studies report on the reduction of aggregated administration and scoring errors, a strategy that does not highlight the reduction of errors on subtests identified as most prone to error. This study evaluated the development of scoring proficiency specifically on the Wechsler (WISC-IV and WAIS-III) Vocabulary, Comprehension, and Similarities subtests during training by comparing a set of 'early test administrations' to 'later test administrations.' Twelve graduate students enrolled in an intelligence-testing course participated in the study. Scoring errors (e.g., incorrect point assignment) were evaluated on the students' actual practice administration test protocols. Errors on all three subtests declined significantly when scoring errors on 'early' sets of Wechsler scales were compared to those made on 'later' sets. However, correcting these subtest scoring errors did not cause significant changes in subtest scaled scores. Implications for clinical instruction and future research are discussed.

  18. An Analysis of Cross Racial Identity Scale Scores Using Classical Test Theory and Rasch Item Response Models

    Science.gov (United States)

    Sussman, Joshua; Beaujean, A. Alexander; Worrell, Frank C.; Watson, Stevie

    2013-01-01

    Item response models (IRMs) were used to analyze Cross Racial Identity Scale (CRIS) scores. Rasch analysis scores were compared with classical test theory (CTT) scores. The partial credit model demonstrated a high goodness of fit and correlations between Rasch and CTT scores ranged from 0.91 to 0.99. CRIS scores are supported by both methods.…

  19. Reassessing the "traditional background hypothesis" for elevated MMPI and MMPI-2 Lie-scale scores.

    Science.gov (United States)

    Rosen, Gerald M; Baldwin, Scott A; Smith, Ronald E

    2016-10-01

    The Lie (L) scale of the Minnesota Multiphasic Personality Inventory (MMPI) is widely regarded as a measure of conscious attempts to deny common human foibles and to present oneself in an unrealistically positive light. At the same time, the current MMPI-2 manual states that "traditional" and religious backgrounds can account for elevated L scale scores as high as 65T-79T, thereby tempering impression management interpretations for faith-based individuals. To assess the validity of the traditional background hypothesis, we reviewed 11 published studies that employed the original MMPI with religious samples and found that only 1 obtained an elevated mean L score. We then conducted a meta-analysis of 12 published MMPI-2 studies in which we compared L scores of religious samples to the test normative group. The meta-analysis revealed large between-study heterogeneity (I2 = 87.1), L scale scores for religious samples that were somewhat higher but did not approach the upper limits specified in the MMPI-2 manual, and an overall moderate effect size (d¯ = 0.54, p < .001; 95% confidence interval [0.37, 0.70]). Our analyses indicated that religious-group membership accounts, on average, for elevations on L of about 5 t-score points. Whether these scores reflect conscious "fake good" impression management or religious-based virtuousness remains unanswered. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. The impact of endorsing Spitzer's proposed criteria for PTSD in the forthcoming DSM-V on male and female Veterans.

    Science.gov (United States)

    Miller, Lyndsey N; Chard, Kathleen M; Schumm, Jeremiah A; O'Brien, Carol

    2011-06-01

    This study explored differences between Spitzer's proposed model of posttraumatic stress disorder (PTSD) and the current DSM-IV diagnostic classification scheme in 353 Veterans. The majority of Veterans (89%) diagnosed with PTSD as specified in the DSM-IV also met Spitzer's proposed criteria. Veterans who met both DSM-IV and Spitzer's proposed criteria had significantly higher Clinician Administered PTSD Scale severity scores than Veterans only meeting DSM-IV criteria. Logistic regression indicated that being African American and having no comorbid diagnosis of major depressive disorder or history of a substance use disorder were found to predict those Veterans who met current, but not proposed criteria. These findings have important implications regarding proposed changes to the diagnostic classification criteria for PTSD in the forthcoming DSM-V. Copyright © 2011 Elsevier Ltd. All rights reserved.

  1. Is Exposure Necessary? A Randomized Clinical Trial of Interpersonal Psychotherapy for PTSD

    Science.gov (United States)

    Markowitz, John C.; Petkova, Eva; Neria, Yuval; Van Meter, Page E.; Zhao, Yihong; Hembree, Elizabeth; Lovell, Karina; Biyanova, Tatyana; Marshall, Randall D.

    2015-01-01

    Background Exposure to trauma reminders has been considered imperative in psychotherapy for posttraumatic stress disorder (PTSD). No treatment benefits all patients, however. We tested Interpersonal Psychotherapy, which has demonstrated antidepressant efficacy and showed promise in pilot PTSD research, as a non-exposure-based, non-cognitive behavioral PTSD treatment. Methods A randomized, fourteen-week trial compared Interpersonal Psychotherapy; Prolonged Exposure, an exposure-based exemplar; and Relaxation Therapy, an active control psychotherapy. Subjects were 110 unmedicated patients having DSM-IV chronic PTSD and Clinician-Administered PTSD Scale (CAPS) score >50. Randomization stratified for comorbid major depression. We hypothesized Interpersonal Psychotherapy would be no more than minimally inferior (CAPS difference 30% CAPS improvement) were: Interpersonal Psychotherapy 63%, Prolonged Exposure 47%, Relaxation Therapy 38% (n.s.). Interpersonal psychotherapy and Prolonged Exposure CAPS outcome differed by 5.5 points (n.s.); the null hypothesis of more than minimal Interpersonal Psychotherapy inferiority was rejected (p=0.035). Patients with comorbid major depression dropped out from Prolonged Exposure nine times more than non-depressed Prolonged Exposure patients. Interpersonal Psychotherapy and Prolonged Exposure improved quality of life and social functioning more than Relaxation Therapy. Conclusions This first controlled study of individual Interpersonal Psychotherapy for PTSD demonstrated non-inferiority to the “gold standard” PTSD treatment. Interpersonal Psychotherapy had (non-significantly) lower attrition and higher response rates than Prolonged Exposure. Contradicting a widespread clinical belief, PTSD treatment may not require cognitive behavioral exposure to trauma reminders. Moreover, as differential therapeutics, patients with comorbid major depression may fare better in Interpersonal Psychotherapy than Prolonged Exposure. PMID:25677355

  2. Impact of terrorism on the development of posttraumatic stress disorder (PTSD) among the residents of Khyber Bazaar and its immediate surrounding areas in Peshawar, Khyber Pakhtunkhwa, Pakistan.

    Science.gov (United States)

    Abbas, Syed Asad; Hassan, Asad; Ali, Shahid

    2017-01-01

    This study evaluated the prevalence of posttraumatic stress disorder (PTSD) and the severity of PTSD symptoms in survivors, rescuers and witnesses of terrorist attacks on Khyber bazaar, Qissa Khawani bazaar, and All Saints Church in Peshawar city area. Cross-sectional survey is carried out on a sample of one hundred survivors, rescuers and witness of terrorist attacks using structured interviews to assess the severity of posttraumatic stress, five months after the attacks. The study period extended from January 24, 2014 to March 24, 2014 which constitutes a total of period of 8 weeks. PTSD symptoms are measured using Posttraumatic Symptom Scale Interview (PSSI) and conferred to a diagnosis of PTSD at 5 months. Additionally, the severity of PTSD symptoms were determined using PSSI scores, severity ranged from 0-51. Of the one hundred survey respondents, 88% were males and 12% were females. Forty percent (40%) had attained 10 years of education, matriculation, but irrespective of the gender or educational status, all had some degree of PTSD. Sixty-six (66%) percent respondents are diagnosed as having moderate PTSD while 11% of the sample suffered from severe PTSD level. Age, gender, occupation and education level did not have any correlation with PTSD development. The contemporary findings indicate that any person who has witnessed or survived catastrophes of terrorist activities like bomb blast or being exposed to suicide attacks is at risk for developing PTSD, and there is necessity to deliver specialized post-disaster mental health facilities to the people having substantial levels of PTSD after calamities of such great intensity.

  3. Suicide and PTSD

    Science.gov (United States)

    ... higher for those with PTSD who have certain styles of coping with stress, such as not expressing ... manage stress. Search Pilots Search PILOTS *, the largest citation database on PTSD. What is PILOTS? Subscribe Sign ...

  4. The Impact of Overreporting on MMPI-2-RF Substantive Scale Score Validity

    Science.gov (United States)

    Burchett, Danielle L.; Ben-Porath, Yossef S.

    2010-01-01

    This study examined the impact of overreporting on the validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scale scores by comparing correlations with relevant external criteria (i.e., validity coefficients) of individuals who completed the instrument under instructions to (a) feign psychopathology…

  5. Technical Analysis of Scores on the "Self-Efficacy Self-Report Scale"

    Science.gov (United States)

    Erford, Bradley T.; Schein, Hallie; Duncan, Kelly

    2011-01-01

    The purpose of this study was to provide preliminary analysis of reliability and validity of scores on the "Self-Efficacy Self-Report Scale", which was designed to assess general self-efficacy in students aged 10 to 17 years. Confirmatory factor analysis on cross-validated samples was conducted revealing a marginal fit of the data to the…

  6. A Note on the Score Reliability for the Satisfaction with Life Scale: An RG Study

    Science.gov (United States)

    Vassar, Matt

    2008-01-01

    The purpose of the present study was to meta-analytically investigate the score reliability for the Satisfaction With Life Scale. Four-hundred and sixteen articles using the measure were located through electronic database searches and then separated to identify studies which had calculated reliability estimates from their own data. Sixty-two…

  7. Comparison of WAIS-III Short Forms for Measuring Index and Full-Scale Scores

    Science.gov (United States)

    Girard, Todd A.; Axelrod, Bradley N.; Wilkins, Leanne K.

    2010-01-01

    This investigation assessed the ability of the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) short forms to estimate both index and IQ scores in a large, mixed clinical sample (N = 809). More specifically, a commonly used modification of Ward's seven-subtest short form (SF7-A), a recently proposed index-based SF7-C and eight-subtest…

  8. [The Collage Impression Scoring Scale (CIISS) may help predict sobriety for alcoholics].

    Science.gov (United States)

    Itoh, Mitsuru; Ishii, Takayoshi

    2009-08-01

    The Collage Impression Scoring Scale (CISS; Imamura, 2004) was used by 54 raters to score collages made by 24 alcoholics on admission to the hospital and at discharge. The CISS contains three factors: stability, expression and creativity. Comparisons using paired t-tests showed that the collages made at discharge had lower scores on the three CISS factors than the collages made on admission. The results for 11 alcoholics, who were followed for six months after discharge, showed that the scores for CISS factors for the abstinent group were lower than those for the relapsed drinking group. The abstinent group showed more anxiety than the relapsed drinking group. This result suggests that the abstinent alcoholics'anxieties were projected onto the collages because they were facing their internal problems more seriously. Thus the CISS was effective as a predictive index for alcoholics who maintain sobriety.

  9. Fall risk assessment: retrospective analysis of Morse Fall Scale scores in Portuguese hospitalized adult patients.

    Science.gov (United States)

    Sardo, Pedro Miguel Garcez; Simões, Cláudia Sofia Oliveira; Alvarelhão, José Joaquim Marques; Simões, João Filipe Fernandes Lindo; Melo, Elsa Maria de Oliveira Pinheiro de

    2016-08-01

    The Morse Fall Scale is used in several care settings for fall risk assessment and supports the implementation of preventive nursing interventions. Our work aims to analyze the Morse Fall Scale scores of Portuguese hospitalized adult patients in association with their characteristics, diagnoses and length of stay. Retrospective cohort analysis of Morse Fall Scale scores of 8356 patients hospitalized during 2012. Data were associated to age, gender, type of admission, specialty units, length of stay, patient discharge, and ICD-9 diagnosis. Elderly patients, female, with emergency service admission, at medical units and/or with longer length of stays were more frequently included in the risk group for falls. ICD-9 diagnosis may also be an important risk factor. More than a half of hospitalized patients had "medium" to "high" risk of falling during the length of stay, which determines the implementation and maintenance of protocoled preventive nursing interventions throughout hospitalization. There are several fall risk factors not assessed by Morse Fall Scale. There were no statistical differences in Morse Fall Scale score between the first and the last assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Assessment of Plasma C-Reactive Protein as a Biomarker of PTSD Risk

    Science.gov (United States)

    Eraly, Satish A.; Nievergelt, Caroline M.; Maihofer, Adam X.; Barkauskas, Donald A.; Biswas, Nilima; Agorastos, Agorastos; O’Connor, Daniel T.; Baker, Dewleen G.; Team, MRS

    2014-01-01

    Importance Post-traumatic stress disorder (PTSD) has been associated in cross-sectional studies with peripheral inflammation. It is not known whether this observed association is due to PTSD predisposing to inflammation (as sometimes postulated) or to inflammation predisposing to PTSD. Objective To determine whether plasma concentration of the inflammatory marker, C-reactive protein (CRP), helps predict future PTSD symptoms. Design and Setting The Marine Resiliency Study (MRS), a prospective study of ~2,600 war zone-deployed Marines, during which PTSD symptomatology and various physiological and psychological parameters were determined pre-deployment and at approximately three and six months following a seven month deployment. Participants Subjects were recruited from four all-male infantry battalions imminently deploying to a war zone. Participation was requested of 2,978 subjects, of whom 2,610 (87.6%) consented and 2,555 (85.8%) were included in the current analysis. Post-deployment data on combat exposure were included from 2,215 subjects (86.7% of the 2,555 included subjects), and on PTSD symptomatology from 1,861 (72.8%) and 1,609 subjects (63.0%) at three and six months following deployment, respectively. Main Outcome Measure(s) PTSD symptoms three months after deployment, assessed by the Clinician Administered PTSD Scale (CAPS). Results We determined the effects of baseline plasma CRP concentration on post-deployment CAPS using Zero-inflated negative binomial regression (ZINBR), a procedure designed for distributions, such as CAPS in this study, which have an excess of zeros in addition to being positively skewed. Adjusting for baseline CAPS, trauma exposure, and other relevant covariates, we found baseline plasma CRP concentration to be a highly significant overall predictor of post-deployment CAPS scores (p=0.002): each 10-fold increment in CRP concentration was associated with an odds ratio of non-zero outcome (presence vs. absence of any PTSD symptoms

  11. Genetic parameter estimates among scale activity score and farrowing disposition with reproductive traits in swine.

    Science.gov (United States)

    Schneider, J F; Rempel, L A; Rohrer, G A; Brown-Brandl, T M

    2011-11-01

    The primary objective of this study was to determine if certain behavior traits were genetically correlated with reproduction. If 1 or both of the behavior traits were found to be correlated, a secondary objective was to determine if the behavior traits could be useful in selecting for more productive females. A scale activity score taken at 5 mo of age and a farrowing disposition score taken at farrowing were selected as the behavioral traits. Scale activity score ranged from 1 to 5 and farrowing disposition ranged from 1 to 3. Reproductive traits included age at puberty, number born alive, number born dead, litter birth weight, average piglet birth weight, number weaned, litter weaning weight, average weaning weight, wean-to-estrus interval, ovulation rate including gilts, and postweaning ovulation rate. Genetic correlations between scale activity score and reproduction ranged from -0.79 to 0.61. Three of the correlations, number born alive (P < 0.01), average piglet birth weight (P < 0.001), and wean-to-estrus interval (P = 0.014), were statistically significant but included both favorable and antagonistic correlations. In contrast, all but 1 of the farrowing disposition correlations was favorable and ranged from -0.66 to 0.67. Although only the correlation with litter birth weight was significant (P = 0.018), the consistent favorable direction of all farrowing disposition correlations, except average weaning weight, shows a potential for inclusion of farrowing disposition into a selection program.

  12. Examining anxiety sensitivity as a mediator of the association between PTSD symptoms and suicide risk among women firefighters.

    Science.gov (United States)

    Stanley, Ian H; Hom, Melanie A; Spencer-Thomas, Sally; Joiner, Thomas E

    2017-08-01

    Posttraumatic stress disorder (PTSD) symptoms are associated with increased suicide risk. Anxiety sensitivity (AS)-the fear of anxiety-related sensations-is both a vulnerability factor for and consequence of PTSD symptoms. AS also predicts suicide risk. To our knowledge, no study has examined whether AS concerns account for the association between PTSD symptoms and suicide risk. A total of 254 women firefighters completed a web-based mental health survey. The Life Events Checklist for DSM-5 (LEC-5) was administered as a prelude to the PTSD Checklist for DSM-5 (PCL-5) to assess for exposure to a Criterion A event. The PCL-5, Anxiety Sensitivity Index-3 (ASI-3), and Suicidal Behaviors Questionnaire-Revised (SBQ-R) were utilized to assess PTSD symptoms, AS concerns, and suicide risk, respectively. Bootstrap mediation analyses were conducted, controlling for depression symptoms as measured by the Center for Epidemiologic Studies Depression Scale-Revised (CESD-R). Global and cognitive AS concerns, but neither physical nor social AS concerns, were statistically significant mediators of the relationship between PTSD symptoms (total score, re-experiencing and numbing clusters) and suicide risk. Alternate mediation models testing PTSD symptoms as a mediator of the relationship between AS concerns and suicide risk were not statistically significant, supporting the specificity of our proposed model. Anxiety sensitivity concerns-specifically, cognitive AS concerns-account for the link between PTSD symptoms and suicide risk among women firefighters. Among firefighters with elevated PTSD symptoms, interventions that address cognitive AS concerns may thwart the trajectory to suicidal thoughts and behaviors. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Graduate Student WAIS-III Scoring Accuracy Is a Function of Full Scale IQ and Complexity of Examiner Tasks

    Science.gov (United States)

    Hopwood, Christopher J.; Richard, David C. S.

    2005-01-01

    Research on the Wechsler Adult Intelligence Scale-Revised and Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) suggests that practicing clinical psychologists and graduate students make item-level scoring errors that affect IQ, index, and subtest scores. Studies have been limited in that Full-Scale IQ (FSIQ) and examiner administration,…

  14. Severity score system for progressive myelopathy: development and validation of a new clinical scale

    Directory of Open Access Journals (Sweden)

    R.M. Castilhos

    2012-07-01

    Full Text Available Progressive myelopathies can be secondary to inborn errors of metabolism (IEM such as mucopolysaccharidosis, mucolipidosis, and adrenomyeloneuropathy. The available scale, Japanese Orthopaedic Association (JOA score, was validated only for degenerative vertebral diseases. Our objective is to propose and validate a new scale addressing progressive myelopathies and to present validating data for JOA in these diseases. A new scale, Severity Score System for Progressive Myelopathy (SSPROM, covering motor disability, sphincter dysfunction, spasticity, and sensory losses. Inter- and intra-rater reliabilities were measured. External validation was tested by applying JOA, the Expanded Disability Status Scale (EDSS, the Barthel index, and the Osame Motor Disability Score. Thirty-eight patients, 17 with adrenomyeloneuropathy, 3 with mucopolysaccharidosis I, 3 with mucopolysaccharidosis IV, 2 with mucopolysaccharidosis VI, 2 with mucolipidosis, and 11 with human T-cell lymphotropic virus type-1 (HTLV-1-associated myelopathy participated in the study. The mean ± SD SSPROM and JOA scores were 74.6 ± 11.4 and 12.4 ± 2.3, respectively. Construct validity for SSPROM (JOA: r = 0.84, P < 0.0001; EDSS: r = -0.83, P < 0.0001; Barthel: r = 0.56, P < 0.002; Osame: r = -0.94, P < 0.0001 and reliability (intra-rater: r = 0.83, P < 0.0001; inter-rater: r = 0.94, P < 0.0001 were demonstrated. The metric properties of JOA were similar to those found in SSPROM. Several clinimetric requirements were met for both SSPROM and JOA scales. Since SSPROM has a wider range, it should be useful for follow-up studies on IEM myelopathies.

  15. Psychometric Properties of the Quantitative Myasthenia Gravis Score and the Myasthenia Gravis Composite Scale.

    Science.gov (United States)

    Barnett, Carolina; Merkies, Ingemar S J; Katzberg, Hans; Bril, Vera

    2015-09-02

    The Quantitative Myasthenia Gravis Score and the Myasthenia Gravis Composite are two commonly used outcome measures in Myasthenia Gravis. So far, their measurement properties have not been compared, so we aimed to study their psychometric properties using the Rasch model. 251 patients with stable myasthenia gravis were assessed with both scales, and 211 patients returned for a second assessment. We studied fit to the Rasch model at the first visit, and compared item fit, thresholds, differential item functioning, local dependence, person separation index, and tests for unidimensionality. We also assessed test-retest reliability and estimated the Minimal Detectable Change. Neither scale fit the Rasch model (X2p Myasthenia Gravis Composite had lower discrimination properties than the Quantitative Myasthenia Gravis Scale (Person Separation Index: 0.14 and 0.7). There was local dependence in both scales, as well as differential item functioning for ocular and generalized disease. Disordered thresholds were found in 6(60%) items of the Myasthenia Gravis Composite and in 4(31%) of the Quantitative Myasthenia Gravis Score. Both tools had adequate test-retest reliability (ICCs >0.8). The minimally detectable change was 4.9 points for the Myasthenia Gravis Composite and 4.3 points for the Quantitative Myasthenia Gravis Score. Neither scale fulfilled Rasch model expectations. The Quantitative Myasthenia Gravis Score has higher discrimination than the Myasthenia Gravis Composite. Both tools have items with disordered thresholds, differential item functioning and local dependency. There was evidence of multidimensionality in the QMGS. The minimal detectable change values are higher than previous studies on the minimal significant change. These findings might inform future modifications of these tools.

  16. Method of administration of PROMIS scales did not significantly impact score level, reliability, or validity

    DEFF Research Database (Denmark)

    Bjorner, Jakob B; Rose, Matthias; Gandek, Barbara

    2014-01-01

    OBJECTIVES: To test the impact of the method of administration (MOA) on score level, reliability, and validity of scales developed in the Patient Reported Outcomes Measurement Information System (PROMIS). STUDY DESIGN AND SETTING: Two nonoverlapping parallel forms each containing eight items from......, no significant mode differences were found and all confidence intervals were within the prespecified minimal important difference of 0.2 standard deviation. Parallel-forms reliabilities were very high (ICC = 0.85-0.93). Only one across-mode ICC was significantly lower than the same-mode ICC. Tests of validity...... questionnaire (PQ), personal digital assistant (PDA), or personal computer (PC) and a second form by PC, in the same administration. Method equivalence was evaluated through analyses of difference scores, intraclass correlations (ICCs), and convergent/discriminant validity. RESULTS: In difference score analyses...

  17. Recovery from PTSD following Hurricane Katrina.

    Science.gov (United States)

    McLaughlin, Katie A; Berglund, Patricia; Gruber, Michael J; Kessler, Ronald C; Sampson, Nancy A; Zaslavsky, Alan M

    2011-06-01

    We examined patterns and correlates of speed of recovery of estimated posttraumatic stress disorder (PTSD) among people who developed PTSD in the wake of Hurricane Katrina. A probability sample of prehurricane residents of areas affected by Hurricane Katrina was administered a telephone survey 7-19 months following the hurricane and again 24-27 months posthurricane. The baseline survey assessed PTSD using a validated screening scale and assessed a number of hypothesized predictors of PTSD recovery that included sociodemographics, prehurricane history of psychopathology, hurricane-related stressors, social support, and social competence. Exposure to posthurricane stressors and course of estimated PTSD were assessed in a follow-up interview. An estimated 17.1% of respondents had a history of estimated hurricane-related PTSD at baseline and 29.2% by the follow-up survey. Of the respondents who developed estimated hurricane-related PTSD, 39.0% recovered by the time of the follow-up survey with a mean duration of 16.5 months. Predictors of slow recovery included exposure to a life-threatening situation, hurricane-related housing adversity, and high income. Other sociodemographics, history of psychopathology, social support, social competence, and posthurricane stressors were unrelated to recovery from estimated PTSD. The majority of adults who developed estimated PTSD after Hurricane Katrina did not recover within 18-27 months. Delayed onset was common. Findings document the importance of initial trauma exposure severity in predicting course of illness and suggest that pre- and posttrauma factors typically associated with course of estimated PTSD did not influence recovery following Hurricane Katrina. © 2011 Wiley-Liss, Inc.

  18. A pediatric FOUR score coma scale: interrater reliability and predictive validity.

    Science.gov (United States)

    Czaikowski, Brianna L; Liang, Hong; Stewart, C Todd

    2014-04-01

    The Full Outline of UnResponsiveness (FOUR) Score is a coma scale that consists of four components (eye and motor response, brainstem reflexes, and respiration). It was originally validated among the adult population and recently in a pediatric population. To enhance clinical assessment of pediatric intensive care unit patients, including those intubated and/or sedated, at our children's hospital, we modified the FOUR Score Scale for this population. This modified scale would provide many of the same advantages as the original, such as interrater reliability, simplicity, and elimination of the verbal component that is not compatible with the Glasgow Coma Scale (GCS), creating a more valuable neurological assessment tool for the nursing community. Our goal was to potentially provide greater information than the formally used GCS when assessing critically ill, neurologically impaired patients, including those sedated and/or intubated. Experienced pediatric intensive care unit nurses were trained as "expert raters." Two different nurses assessed each subject using the Pediatric FOUR Score Scale (PFSS), GCS, and Richmond Agitation Sedation Scale at three different time points. Data were compared with the Pediatric Cerebral Performance Category (PCPC) assessed by another nurse. Our hypothesis was that the PFSS and PCPC should highly correlate and the GCS and PCPC should correlate lower. Study results show that the PFSS is excellent for interrater reliability for trained nurse-rater pairs and prediction of poor outcome and in-hospital mortality, under various situations, but there were no statistically significant differences between the PFSS and the GCS. However, the PFSS does have the potential to provide greater neurological assessment in the intubated and/or sedated patient based on the outcomes of our study.

  19. Relationship between family history of alcohol addiction, parents' education level, and smartphone problem use scale scores.

    Science.gov (United States)

    Beison, Ashley; Rademacher, David J

    2017-03-01

    Background and aims Smartphones are ubiquitous. As smartphones increased in popularity, researchers realized that people were becoming dependent on their smartphones. The purpose here was to provide a better understanding of the factors related to problematic smartphone use (PSPU). Methods The participants were 100 undergraduates (25 males, 75 females) whose ages ranged from 18 to 23 (mean age = 20 years). The participants completed questionnaires to assess gender, ethnicity, year in college, father's education level, mother's education level, family income, age, family history of alcoholism, and PSPU. The Family Tree Questionnaire assessed family history of alcoholism. The Mobile Phone Problem Use Scale (MPPUS) and the Adapted Cell Phone Addiction Test (ACPAT) were used to determine the degree of PSPU. Whereas the MPPUS measures tolerance, escape from other problems, withdrawal, craving, and negative life consequences, the ACPAT measures preoccupation (salience), excessive use, neglecting work, anticipation, lack of control, and neglecting social life. Results Family history of alcoholism and father's education level together explained 26% of the variance in the MPPUS scores and 25% of the variance in the ACPAT scores. The inclusion of mother's education level, ethnicity, family income, age, year in college, and gender did not significantly increase the proportion of variance explained for either MPPUS or ACPAT scores. Discussion and conclusions Family history of alcoholism and father's education level are good predictors of PSPU. As 74%-75% of the variance in PSPU scale scores was not explained, future studies should aim to explain this variance.

  20. Apparently abnormal Wechsler Memory Scale index score patterns in the normal population.

    Science.gov (United States)

    Carrasco, Roman Marcus; Grups, Josefine; Evans, Brittney; Simco, Edward; Mittenberg, Wiley

    2015-01-01

    Interpretation of the Wechsler Memory Scale-Fourth Edition may involve examination of multiple memory index score contrasts and similar comparisons with Wechsler Adult Intelligence Scale-Fourth Edition ability indexes. Standardization sample data suggest that 15-point differences between any specific pair of index scores are relatively uncommon in normal individuals, but these base rates refer to a comparison between a single pair of indexes rather than multiple simultaneous comparisons among indexes. This study provides normative data for the occurrence of multiple index score differences calculated by using Monte Carlo simulations and validated against standardization data. Differences of 15 points between any two memory indexes or between memory and ability indexes occurred in 60% and 48% of the normative sample, respectively. Wechsler index score discrepancies are normally common and therefore not clinically meaningful when numerous such comparisons are made. Explicit prior interpretive hypotheses are necessary to reduce the number of index comparisons and associated false-positive conclusions. Monte Carlo simulation accurately predicts these false-positive rates.

  1. Spacecraft COst REduction Team (SCORE): TQM/CI on a massive scale

    Science.gov (United States)

    Bullard, Jerry D.

    1992-01-01

    The business of building satellites and space systems has matured. Few missions require, or can afford, excellent performance at any price. The new paradigm is doing more with less, providing quality systems at lower cost--in other words, doing our job 'Faster-Better-Cheaper.' The TRW Spacecraft COst REduction (SCORE) initiative was launched in 1990 by Daniel S. Goldin, then general manager of TRW's Space & Technology Group. The SCORE mission is to apply continuous improvement (CI) techniques to effect major reductions in the cost (our primary goal) and span time (as a corollary) required for the production of spacecraft. SCORE is a multi-year initiative that is having a profound effect on both the procedural and the cultural aspects of how we do business. The objectives of this initiative are being realized. The focus of this paper is not on the results of SCORE per se, but rather on the things we have leaned about how to do continuous improvement on a massive scale, with multilevel (hierarchical) CI teams. The following sections summarize the chronology of the SCORE initiative, from team formation to development of the year-end report for 1991. Lessons learned, the core of this presentation, are discussed--with particular focus on the unique aspects of SCORE. The SCORE initiative is continuing and, as a part of our evolving culture, will never end. It has resulted in profound insights into the way we do work and (the topic at hand) how to do CI for large and complex multidisciplinary development activities.

  2. Assessing coral reefs on a Pacific-wide scale using the microbialization score.

    Directory of Open Access Journals (Sweden)

    Tracey McDole

    Full Text Available The majority of the world's coral reefs are in various stages of decline. While a suite of disturbances (overfishing, eutrophication, and global climate change have been identified, the mechanism(s of reef system decline remain elusive. Increased microbial and viral loading with higher percentages of opportunistic and specific microbial pathogens have been identified as potentially unifying features of coral reefs in decline. Due to their relative size and high per cell activity, a small change in microbial biomass may signal a large reallocation of available energy in an ecosystem; that is the microbialization of the coral reef. Our hypothesis was that human activities alter the energy budget of the reef system, specifically by altering the allocation of metabolic energy between microbes and macrobes. To determine if this is occurring on a regional scale, we calculated the basal metabolic rates for the fish and microbial communities at 99 sites on twenty-nine coral islands throughout the Pacific Ocean using previously established scaling relationships. From these metabolic rate predictions, we derived a new metric for assessing and comparing reef health called the microbialization score. The microbialization score represents the percentage of the combined fish and microbial predicted metabolic rate that is microbial. Our results demonstrate a strong positive correlation between reef microbialization scores and human impact. In contrast, microbialization scores did not significantly correlate with ocean net primary production, local chla concentrations, or the combined metabolic rate of the fish and microbial communities. These findings support the hypothesis that human activities are shifting energy to the microbes, at the expense of the macrobes. Regardless of oceanographic context, the microbialization score is a powerful metric for assessing the level of human impact a reef system is experiencing.

  3. Assessing coral reefs on a Pacific-wide scale using the microbialization score.

    Science.gov (United States)

    McDole, Tracey; Nulton, James; Barott, Katie L; Felts, Ben; Hand, Carol; Hatay, Mark; Lee, Hochul; Nadon, Marc O; Nosrat, Bahador; Salamon, Peter; Bailey, Barbara; Sandin, Stuart A; Vargas-Angel, Bernardo; Youle, Merry; Zgliczynski, Brian J; Brainard, Russell E; Rohwer, Forest

    2012-01-01

    The majority of the world's coral reefs are in various stages of decline. While a suite of disturbances (overfishing, eutrophication, and global climate change) have been identified, the mechanism(s) of reef system decline remain elusive. Increased microbial and viral loading with higher percentages of opportunistic and specific microbial pathogens have been identified as potentially unifying features of coral reefs in decline. Due to their relative size and high per cell activity, a small change in microbial biomass may signal a large reallocation of available energy in an ecosystem; that is the microbialization of the coral reef. Our hypothesis was that human activities alter the energy budget of the reef system, specifically by altering the allocation of metabolic energy between microbes and macrobes. To determine if this is occurring on a regional scale, we calculated the basal metabolic rates for the fish and microbial communities at 99 sites on twenty-nine coral islands throughout the Pacific Ocean using previously established scaling relationships. From these metabolic rate predictions, we derived a new metric for assessing and comparing reef health called the microbialization score. The microbialization score represents the percentage of the combined fish and microbial predicted metabolic rate that is microbial. Our results demonstrate a strong positive correlation between reef microbialization scores and human impact. In contrast, microbialization scores did not significantly correlate with ocean net primary production, local chla concentrations, or the combined metabolic rate of the fish and microbial communities. These findings support the hypothesis that human activities are shifting energy to the microbes, at the expense of the macrobes. Regardless of oceanographic context, the microbialization score is a powerful metric for assessing the level of human impact a reef system is experiencing.

  4. Defining the minimal detectable change in scores on the eight-item Morisky Medication Adherence Scale.

    Science.gov (United States)

    Muntner, Paul; Joyce, Cara; Holt, Elizabeth; He, Jiang; Morisky, Donald; Webber, Larry S; Krousel-Wood, Marie

    2011-05-01

    Self-report scales are used to assess medication adherence. Data on how to discriminate change in self-reported adherence over time from random variability are limited. To determine the minimal detectable change for scores on the 8-item Morisky Medication Adherence Scale (MMAS-8). The MMAS-8 was administered twice, using a standard telephone script, with administration separated by 14-22 days, to 210 participants taking antihypertensive medication in the CoSMO (Cohort Study of Medication Adherence among Older Adults). MMAS-8 scores were calculated and participants were grouped into previously defined categories (<6, 6 to <8, and 8 for low, medium, and high adherence). The mean (SD) age of participants was 78.1 (5.8) years, 43.8% were black, and 68.1% were women. Overall, 8.1% (17/210), 16.2% (34/210), and 51.0% (107/210) of participants had low, medium, and high MMAS-8 scores, respectively, at both survey administrations (overall agreement 75.2%; 158/210). The weighted κ statistic was 0.63 (95% CI 0.53 to 0.72). The intraclass correlation coefficient was 0.78. The within-person standard error of the mean for change in MMAS-8 scores was 0.81, which equated to a minimal detectable change of 1.98 points. Only 4.3% (9/210) of the participants had a change in MMAS-8 of 2 or more points between survey administrations. Within-person changes in MMAS-8 scores of 2 or more points over time may represent a real change in antihypertensive medication adherence.

  5. Evaluation of the effectiveness of a novel brain and vestibular rehabilitation treatment modality in PTSD patients who have suffered combat related traumatic brain injuries

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-02-01

    Full Text Available Introduction: Blast-related head injuries are among the most prevalent injuries suffered by military personnel deployed in combat and mild traumatic brain injury (mTBI or concussion on the battlefield in Iraq/Afghanistan has resulted in its designation as a signature injury. Vestibular complaints are the most frequent sequelae of mTBI and vestibular rehabilitation (VR has been established as the most important treatment modality for this group of patients. Material and Methods:We studied the effectiveness of a novel brain and VR treatment PTSD in subjects who had suffered combat related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. (http://clinicaltrials.gov/ct2/show/NCT02003352?term=carrick&rank=6. We analyzed the difference in the Clinician Administered DSM-IV PTSD Scale (CAPS scores pre and post treatment using our subjects as their own matched controls. The study population consisted of 98 combat veterans maintaining an alpha of <0.05 and power of 80%. Results:Prior to treatment, 75 subjects representing 76.53 % of the sample were classified in the 2 most severe categories of PTSD. 41 subjects, representing 41.80 % of the total sample, were classified in the extreme category of PTSD and 34 subjects, representing 34.70 % of the total sample, were classified in the severe category of PTSD. After treatment we observed a large reduction in CAPS severity scores with both statistical and substantive significance. Discussion:Treatment of PTSD as a physical injury rather than a psychiatric disorder is associated with strong statistical and substantive significant outcomes associated with a decrease of PTSD classification. The stigma associated with neuropsychiatric disorders may be lessened when PTSD is treated with brain and VR with a potential decrease in suffering of patients, family and society.

  6. Self-stigma in PTSD: Prevalence and correlates.

    Science.gov (United States)

    Bonfils, Kelsey A; Lysaker, Paul H; Yanos, Philip T; Siegel, Alysia; Leonhardt, Bethany L; James, Alison V; Brustuen, Beth; Luedtke, Brandi; Davis, Louanne W

    2018-04-03

    Self-stigma is the internalization of negative societal stereotypes about those with mental illnesses. While self-stigma has been carefully characterized in severe mental disorders, like schizophrenia, the field has yet to examine the prevalence and correlates of self-stigma in post-traumatic stress disorder (PTSD). Thus, we assessed self-stigma in veterans diagnosed with PTSD and compared with veterans with schizophrenia. We further examined associations between PTSD, depressive symptoms and self-stigma in the PTSD sample. Data came from two larger studies of people with PTSD (n = 46) and schizophrenia-spectrum disorders (n = 82). All participants completed the Internalized Stigma of Mental Illness Scale (ISMIS). Results revealed that people with schizophrenia report more experiences of discrimination as a result of stigma than do those with PTSD, but these diagnostic groups did not differ for other subscales. In the PTSD group, feelings of alienation positively correlated with PTSD and depressive symptoms; other subscales positively correlated with depressive symptoms only. Taken together, results suggest a significant level of self-stigma exists among veterans with PTSD, and that self-stigma has an effect on PTSD and commonly comorbid symptoms, like depression. Future work should investigate whether current self-stigma interventions for other groups could be applicable for those with PTSD. Published by Elsevier B.V.

  7. Association of metabolic syndrome and change in Unified Parkinson's Disease Rating Scale scores.

    Science.gov (United States)

    Leehey, Maureen; Luo, Sheng; Sharma, Saloni; Wills, Anne-Marie A; Bainbridge, Jacquelyn L; Wong, Pei Shieen; Simon, David K; Schneider, Jay; Zhang, Yunxi; Pérez, Adriana; Dhall, Rohit; Christine, Chadwick W; Singer, Carlos; Cambi, Franca; Boyd, James T

    2017-10-24

    To explore the association between metabolic syndrome and the Unified Parkinson's Disease Rating Scale (UPDRS) scores and, secondarily, the Symbol Digit Modalities Test (SDMT). This is a secondary analysis of data from 1,022 of 1,741 participants of the National Institute of Neurological Disorders and Stroke Exploratory Clinical Trials in Parkinson Disease Long-Term Study 1, a randomized, placebo-controlled trial of creatine. Participants were categorized as having or not having metabolic syndrome on the basis of modified criteria from the National Cholesterol Education Program Adult Treatment Panel III. Those who had the same metabolic syndrome status at consecutive annual visits were included. The change in UPDRS and SDMT scores from randomization to 3 years was compared in participants with and without metabolic syndrome. Participants with metabolic syndrome (n = 396) compared to those without (n = 626) were older (mean [SD] 63.9 [8.1] vs 59.9 [9.4] years; p metabolic syndrome experienced an additional 0.6- (0.2) unit annual increase in total UPDRS ( p = 0.02) and 0.5- (0.2) unit increase in motor UPDRS ( p = 0.01) scores compared with participants without metabolic syndrome. There was no difference in the change in SDMT scores. Persons with Parkinson disease meeting modified criteria for metabolic syndrome experienced a greater increase in total UPDRS scores over time, mainly as a result of increases in motor scores, compared to those who did not. Further studies are needed to confirm this finding. NCT00449865. © 2017 American Academy of Neurology.

  8. Modified Ashworth scale and spasm frequency score in spinal cord injury

    DEFF Research Database (Denmark)

    Baunsgaard, C. B.; Nissen, U. V.; Christensen, K. B.

    2016-01-01

    .94 and inter-rater κweighted=0.93. Correlation between MAS and SFS showed non-significant correlation coefficients from-0.11 to 0.90. CONCLUSION: Reliability of MAS is highly affected by the weighting scheme. With a weighted-κ it was overall reliable and simple-κ overall unreliability. Repeated tests should......STUDY DESIGN: Intra- and inter-rater reliability study. OBJECTIVES: To assess intra- and inter-rater reliability of the Modified Ashworth Scale (MAS) and Spasm Frequency Score (SFS) in lower extremities in a population of spinal cord-injured persons, as well as correlations between the two scales....... SETTING: Clinic for Spinal Cord Injuries, Rigshospitalet, Hornbaek, Denmark. METHODS: Thirty-one persons participated in the study and were tested four times in total with MAS and SFS by three experienced raters. Cohen's kappa (κ), simple and quadratic weighted (nominal and ordinal scale level...

  9. Reliability and validity of the new Tanaka B Intelligence Scale scores: a group intelligence test.

    Directory of Open Access Journals (Sweden)

    Yota Uno

    Full Text Available OBJECTIVE: The present study evaluated the reliability and concurrent validity of the new Tanaka B Intelligence Scale, which is an intelligence test that can be administered on groups within a short period of time. METHODS: The new Tanaka B Intelligence Scale and Wechsler Intelligence Scale for Children-Third Edition were administered to 81 subjects (mean age ± SD 15.2 ± 0.7 years residing in a juvenile detention home; reliability was assessed using Cronbach's alpha coefficient, and concurrent validity was assessed using the one-way analysis of variance intraclass correlation coefficient. Moreover, receiver operating characteristic analysis for screening for individuals who have a deficit in intellectual function (an FIQ<70 was performed. In addition, stratum-specific likelihood ratios for detection of intellectual disability were calculated. RESULTS: The Cronbach's alpha for the new Tanaka B Intelligence Scale IQ (BIQ was 0.86, and the intraclass correlation coefficient with FIQ was 0.83. Receiver operating characteristic analysis demonstrated an area under the curve of 0.89 (95% CI: 0.85-0.96. In addition, the stratum-specific likelihood ratio for the BIQ≤65 stratum was 13.8 (95% CI: 3.9-48.9, and the stratum-specific likelihood ratio for the BIQ≥76 stratum was 0.1 (95% CI: 0.03-0.4. Thus, intellectual disability could be ruled out or determined. CONCLUSION: The present results demonstrated that the new Tanaka B Intelligence Scale score had high reliability and concurrent validity with the Wechsler Intelligence Scale for Children-Third Edition score. Moreover, the post-test probability for the BIQ could be calculated when screening for individuals who have a deficit in intellectual function. The new Tanaka B Intelligence Test is convenient and can be administered within a variety of settings. This enables evaluation of intellectual development even in settings where performing intelligence tests have previously been difficult.

  10. Reliability and validity of the new Tanaka B Intelligence Scale scores: a group intelligence test.

    Science.gov (United States)

    Uno, Yota; Mizukami, Hitomi; Ando, Masahiko; Yukihiro, Ryoji; Iwasaki, Yoko; Ozaki, Norio

    2014-01-01

    The present study evaluated the reliability and concurrent validity of the new Tanaka B Intelligence Scale, which is an intelligence test that can be administered on groups within a short period of time. The new Tanaka B Intelligence Scale and Wechsler Intelligence Scale for Children-Third Edition were administered to 81 subjects (mean age ± SD 15.2 ± 0.7 years) residing in a juvenile detention home; reliability was assessed using Cronbach's alpha coefficient, and concurrent validity was assessed using the one-way analysis of variance intraclass correlation coefficient. Moreover, receiver operating characteristic analysis for screening for individuals who have a deficit in intellectual function (an FIQIntelligence Scale IQ (BIQ) was 0.86, and the intraclass correlation coefficient with FIQ was 0.83. Receiver operating characteristic analysis demonstrated an area under the curve of 0.89 (95% CI: 0.85-0.96). In addition, the stratum-specific likelihood ratio for the BIQ≤65 stratum was 13.8 (95% CI: 3.9-48.9), and the stratum-specific likelihood ratio for the BIQ≥76 stratum was 0.1 (95% CI: 0.03-0.4). Thus, intellectual disability could be ruled out or determined. The present results demonstrated that the new Tanaka B Intelligence Scale score had high reliability and concurrent validity with the Wechsler Intelligence Scale for Children-Third Edition score. Moreover, the post-test probability for the BIQ could be calculated when screening for individuals who have a deficit in intellectual function. The new Tanaka B Intelligence Test is convenient and can be administered within a variety of settings. This enables evaluation of intellectual development even in settings where performing intelligence tests have previously been difficult.

  11. Gait and Glasgow Coma Scale scores can predict functional recovery in patients with traumatic brain injury☆

    Science.gov (United States)

    Bilgin, Sevil; Guclu-Gunduz, Arzu; Oruckaptan, Hakan; Kose, Nezire; Celik, Bülent

    2012-01-01

    Fifty-one patients with mild (n = 14), moderate (n = 10) and severe traumatic brain injury (n = 27) received early rehabilitation. Level of consciousness was evaluated using the Glasgow Coma Score. Functional level was determined using the Glasgow Outcome Score, whilst mobility was evaluated using the Mobility Scale for Acute Stroke. Activities of daily living were assessed using the Barthel Index. Following Bobath neurodevelopmental therapy, the level of consciousness was significantly improved in patients with moderate and severe traumatic brain injury, but was not greatly influenced in patients with mild traumatic brain injury. Mobility and functional level were significantly improved in patients with mild, moderate and severe traumatic brain injury. Gait recovery was more obvious in patients with mild traumatic brain injury than in patients with moderate and severe traumatic brain injury. Activities of daily living showed an improvement but this was insignificant except for patients with severe traumatic brain injury. Nevertheless, complete recovery was not acquired at discharge. Multiple regression analysis showed that gait and Glasgow Coma Scale scores can be considered predictors of functional outcomes following traumatic brain injury. PMID:25624828

  12. Substantial improvements in large-scale redocking and screening using the novel HYDE scoring function

    Science.gov (United States)

    Schneider, Nadine; Hindle, Sally; Lange, Gudrun; Klein, Robert; Albrecht, Jürgen; Briem, Hans; Beyer, Kristin; Claußen, Holger; Gastreich, Marcus; Lemmen, Christian; Rarey, Matthias

    2012-06-01

    The HYDE scoring function consistently describes hydrogen bonding, the hydrophobic effect and desolvation. It relies on HYdration and DEsolvation terms which are calibrated using octanol/water partition coefficients of small molecules. We do not use affinity data for calibration, therefore HYDE is generally applicable to all protein targets. HYDE reflects the Gibbs free energy of binding while only considering the essential interactions of protein-ligand complexes. The greatest benefit of HYDE is that it yields a very intuitive atom-based score, which can be mapped onto the ligand and protein atoms. This allows the direct visualization of the score and consequently facilitates analysis of protein-ligand complexes during the lead optimization process. In this study, we validated our new scoring function by applying it in large-scale docking experiments. We could successfully predict the correct binding mode in 93% of complexes in redocking calculations on the Astex diverse set, while our performance in virtual screening experiments using the DUD dataset showed significant enrichment values with a mean AUC of 0.77 across all protein targets with little or no structural defects. As part of these studies, we also carried out a very detailed analysis of the data that revealed interesting pitfalls, which we highlight here and which should be addressed in future benchmark datasets.

  13. Empirical Correlates of Low Scores on MMPI-2/MMPI-2-RF Restructured Clinical Scales in a Sample of University Students

    Science.gov (United States)

    Avdeyeva, Tatyana V.; Tellegen, Auke; Ben-Porath, Yossef S.

    2012-01-01

    In the present study, the authors explored the meaning of low scores on the MMPI-2/MMPI-2-RF Restructured Clinical (RC) scales. Using responses of a sample of university students (N = 811), the authors examined whether low (T less than 39), within-normal-limits (T = 39-64), and high (T greater than 65) score levels on the RC scales are…

  14. PTSD and Substance Abuse

    Science.gov (United States)

    2014-10-01

    24 (depression functioning, emotional lability, psychosis , relationships , total score) – Coping Self-Efficacy (mean of all items) – Trauma Symptom...Scale (total score) •BASIS-24 (depression functioning, emotional lability, psychosis , relationships , total score) •Coping Self-Efficacy (mean of all...K.J., Tapert, S.F., Lang, A.J., Najavits, L.M. (2010). A pilot study of Seeking Safety therapy with OEF/OIF Veterans. Journal of Psychoactive Drugs

  15. Does Wechsler Intelligence Scale administration and scoring proficiency improve during assessment training?

    Science.gov (United States)

    Platt, Tyson L; Zachar, Peter; Ray, Glen E; Lobello, Steven G; Underhill, Andrea T

    2007-04-01

    Studies have found that Wechsler scale administration and scoring proficiency is not easily attained during graduate training. These findings may be related to methodological issues. Using a single-group repeated measures design, this study documents statistically significant, though modest, error reduction on the WAIS-III and WISC-III during a graduate course in assessment. The study design does not permit the isolation of training factors related to error reduction, or assessment of whether error reduction is a function of mere practice. However, the results do indicate that previous study findings of no or inconsistent improvement in scoring proficiency may have been the result of methodological factors. Implications for teaching individual intelligence testing and further research are discussed.

  16. Posttraumatic stress disorder (PTSD) Treatment

    Science.gov (United States)

    ... does the current evidence say about treatment for PTSD? Read Psych Health Evidence Briefs , which summarize available ... first-line and emerging PTSD treatments. Psychotherapy for PTSD According to the VA/DoD Clinical Practice Guideline ...

  17. Relationship between family history of alcohol addiction, parents’ education level, and smartphone problem use scale scores

    Science.gov (United States)

    Beison, Ashley; Rademacher, David J.

    2017-01-01

    Background and aims Smartphones are ubiquitous. As smartphones increased in popularity, researchers realized that people were becoming dependent on their smartphones. The purpose here was to provide a better understanding of the factors related to problematic smartphone use (PSPU). Methods The participants were 100 undergraduates (25 males, 75 females) whose ages ranged from 18 to 23 (mean age = 20 years). The participants completed questionnaires to assess gender, ethnicity, year in college, father’s education level, mother’s education level, family income, age, family history of alcoholism, and PSPU. The Family Tree Questionnaire assessed family history of alcoholism. The Mobile Phone Problem Use Scale (MPPUS) and the Adapted Cell Phone Addiction Test (ACPAT) were used to determine the degree of PSPU. Whereas the MPPUS measures tolerance, escape from other problems, withdrawal, craving, and negative life consequences, the ACPAT measures preoccupation (salience), excessive use, neglecting work, anticipation, lack of control, and neglecting social life. Results Family history of alcoholism and father’s education level together explained 26% of the variance in the MPPUS scores and 25% of the variance in the ACPAT scores. The inclusion of mother’s education level, ethnicity, family income, age, year in college, and gender did not significantly increase the proportion of variance explained for either MPPUS or ACPAT scores. Discussion and conclusions Family history of alcoholism and father’s education level are good predictors of PSPU. As 74%–75% of the variance in PSPU scale scores was not explained, future studies should aim to explain this variance. PMID:28316252

  18. Outcome After Radiosurgery for Brain Metastases in Patients With Low Karnofsky Performance Scale (KPS) Scores

    International Nuclear Information System (INIS)

    Chernov, Mikhail F.; Nakaya, Kotaro; Izawa, Masahiro; Hayashi, Motohiro; Usuba, Yuki; Kato, Koichi; Muragaki, Yoshihiro; Iseki, Hiroshi; Hori, Tomokatsu; Takakura, Kintomo

    2007-01-01

    Purpose: The objective of this retrospective study was evaluation of the outcome after stereotactic radiosurgery (SRS) in patients with intracranial metastases and poor performance status. Methods and Materials: Forty consecutive patients with metastatic brain tumors and Karnofsky performance scale (KPS) scores ≤50 (mean, 43 ± 8; median, 40) treated with SRS were analyzed. Poor performance status was caused by presence of intracranial metastases in 28 cases (70%) and resulted from uncontrolled extracerebral disease in 12 (30%). Results: Survival after SRS varied from 3 days to 11.5 months (mean, 3.8 ± 2.9 months; median, 3.3 months). Survival probability constituted 0.50 ± 0.07 at 3 months and 0.20 ± 0.05 at 6 months posttreatment. Cause of low KPS score (p = 0.0173) and presence of distant metastases beside the brain (p = 0.0308) showed statistically significant associations with overall survival in multivariate Cox proportional hazards regression analysis. Median survival was 6.0 months if low KPS score was caused by cerebral disease and distant metastases in regions beyond the brain were absent, 3.3 months if low KPS score was caused by cerebral disease and distant metastases in regions beyond the brain were present, and 1.0 month if poor performance status resulted from extracerebral disease. Conclusions: Identification of the cause of low KPS score (cerebral vs. extracerebral) in patients with metastatic brain tumor(s) may be important for prediction of the outcome after radiosurgical treatment. If poor patient performance status without surgical indications is caused by intracranial tumor(s), SRS may be a reasonable treatment option

  19. PTSD-8: A Short PTSD Inventory.

    Science.gov (United States)

    Hansen, Maj; Andersen, Tonny Elmose; Armour, Cherie; Elklit, Ask; Palic, Sabina; Mackrill, Thomas

    2010-09-28

    Traumatic events pose great challenges on mental health services in scarcity of specialist trauma clinicians and services. Simple short screening instruments for detecting adverse psychological responses are needed. Several brief screening instruments have been developed. However, some are limited, especially in relation to reflecting the posttraumatic stress disorder (PTSD) diagnosis. Recently, several studies have challenged pre-existing ideas about PTSD's latent structure. Factor analytic research currently supports two four factor models. One particular model contains a dysphoria factor which has been associated with depression and anxiety. The symptoms in this factor have been hailed as less specific to PTSD. The scope of this article is therefore to present a short screening instrument, based on this research; Posttraumatic Stress Disorder (PTSD) - 8 items. The PTSD-8 is shown to have good psychometric properties in three independent samples of whiplash patients (n=1710), rape victims (n=305), and disaster victims (n=516). Good test-rest reliability is also shown in a pilot study of young adults from families with alcohol problems (n=56).

  20. Glasgow Coma Scale Scores, Early Opioids, and 4-year Psychological Outcomes among Combat Amputees

    Science.gov (United States)

    2014-01-01

    psychological outcomes, loss of consciousness, military and VA health data, morphine , posttraumatic stress disorder, traumatic brain injury. INTRODUCTION...appropriate for postinjury analgesia [15–17]. Unfortu- nately, little research has compared the psychological benefits of morphine or fentanyl...that morphine reduced PTSD compared with fentanyl because mor- phine produced more long-lasting pain relief and/or was more effective at blocking

  1. High Agreement was Obtained Across Scores from Multiple Equated Scales for Social Anxiety Disorder using Item Response Theory.

    Science.gov (United States)

    Sunderland, Matthew; Batterham, Philip; Calear, Alison; Carragher, Natacha; Baillie, Andrew; Slade, Tim

    2018-04-10

    There is no standardized approach to the measurement of social anxiety. Researchers and clinicians are faced with numerous self-report scales with varying strengths, weaknesses, and psychometric properties. The lack of standardization makes it difficult to compare scores across populations that utilise different scales. Item response theory offers one solution to this problem via equating different scales using an anchor scale to set a standardized metric. This study is the first to equate several scales for social anxiety disorder. Data from two samples (n=3,175 and n=1,052), recruited from the Australian community using online advertisements, were utilised to equate a network of 11 self-report social anxiety scales via a fixed parameter item calibration method. Comparisons between actual and equated scores for most of the scales indicted a high level of agreement with mean differences <0.10 (equivalent to a mean difference of less than one point on the standardized metric). This study demonstrates that scores from multiple scales that measure social anxiety can be converted to a common scale. Re-scoring observed scores to a common scale provides opportunities to combine research from multiple studies and ultimately better assess social anxiety in treatment and research settings. Copyright © 2018. Published by Elsevier Inc.

  2. ICD-11 trauma questionnaires for PTSD and complex PTSD

    DEFF Research Database (Denmark)

    Dokkedahl, Sarah Bøgelund; Oboke, Henry; Ovuga, Emilio

    2015-01-01

    Objectives: ICD-11 is expected to introduce a new diagnosis of C-PTSD, along with a revision of the current PTSD diagnosis. Are the suggested diagnostic tools for PTSD and C-PTSD valid in a developing country? Method: The tools have been tested on former abducted and regular civilians in northern...

  3. Hematoma shape, hematoma size, Glasgow coma scale score and ICH score: which predicts the 30-day mortality better for intracerebral hematoma?

    Directory of Open Access Journals (Sweden)

    Chih-Wei Wang

    Full Text Available To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS score, and intracerebral hematoma (ICH score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality.This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant.The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P = 0.0018, 0.715 (P = 0.0008 (by ABC/2 to 0.738 (P = 0.0002 (by CAVA, 0.877 (P<0.0001 (by ABC/2 to 0.882 (P<0.0001 (by CAVA, and 0.912 (P<0.0001, respectively.Our study shows that hematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score.

  4. Hematoma Shape, Hematoma Size, Glasgow Coma Scale Score and ICH Score: Which Predicts the 30-Day Mortality Better for Intracerebral Hematoma?

    Science.gov (United States)

    Wang, Chih-Wei; Liu, Yi-Jui; Lee, Yi-Hsiung; Hueng, Dueng-Yuan; Fan, Hueng-Chuen; Yang, Fu-Chi; Hsueh, Chun-Jen; Kao, Hung-Wen; Juan, Chun-Jung; Hsu, Hsian-He

    2014-01-01

    Purpose To investigate the performance of hematoma shape, hematoma size, Glasgow coma scale (GCS) score, and intracerebral hematoma (ICH) score in predicting the 30-day mortality for ICH patients. To examine the influence of the estimation error of hematoma size on the prediction of 30-day mortality. Materials and Methods This retrospective study, approved by a local institutional review board with written informed consent waived, recruited 106 patients diagnosed as ICH by non-enhanced computed tomography study. The hemorrhagic shape, hematoma size measured by computer-assisted volumetric analysis (CAVA) and estimated by ABC/2 formula, ICH score and GCS score was examined. The predicting performance of 30-day mortality of the aforementioned variables was evaluated. Statistical analysis was performed using Kolmogorov-Smirnov tests, paired t test, nonparametric test, linear regression analysis, and binary logistic regression. The receiver operating characteristics curves were plotted and areas under curve (AUC) were calculated for 30-day mortality. A P value less than 0.05 was considered as statistically significant. Results The overall 30-day mortality rate was 15.1% of ICH patients. The hematoma shape, hematoma size, ICH score, and GCS score all significantly predict the 30-day mortality for ICH patients, with an AUC of 0.692 (P = 0.0018), 0.715 (P = 0.0008) (by ABC/2) to 0.738 (P = 0.0002) (by CAVA), 0.877 (Phematoma shape, hematoma size, ICH scores and GCS score all significantly predict the 30-day mortality in an increasing order of AUC. The effect of overestimation of hematoma size by ABC/2 formula in predicting the 30-day mortality could be remedied by using ICH score. PMID:25029592

  5. Validación Preliminar de la Escala Infantil de Síntomas del Trastorno de Estrés Postraumático (Child PTSD Symptom Scale, CPSS en Niños/as y Adolescentes Víctimas de Violencia Sexual Preliminary Validation of the Child PTSD Symptom Scale (CPSS in Children and Adolescent Victims of Sexual Violence

    Directory of Open Access Journals (Sweden)

    Patricia Bustos

    2009-11-01

    Full Text Available Se presenta la validación preliminar en Chile de la Escala Infantil de Síntomas del Trastorno de Estrés Postraumático, desarrollada por Foa, Johnson, Feeny y Treadwell (2001 para evaluar el trastorno en niños/as y adolescentes expuestos a situaciones traumáticas, con arreglo a criterios DSM-IV. La muestra fue de 75 niños y adolescentes chilenos de la región del Bío Bío que sufrieron abuso sexual o violación. Los resultados indican una alta consistencia interna, medida con alfa de Cronbach, de 0,916. Asimismo, la consistencia interna de cada subescala es alta. La validez convergente con el criterio de juicio experto es adecuada, con puntuaciones significativas en la escala y todas las subescalas.The preliminary validation in Chile of the Infantile Scale of Symptoms of Post Traumatic Stress Disorder (CPSS is presented. This instrument was developed by Johnson, Feeny, and Treadwell (2001 to evaluate PTSD in children and adolescents exposed to traumatic events, in accordance with DSM-IV criteria. The sample consisted of 75 Chilean children and adolescents of the Bio Bio region of Chile who suffered sexual abuse or rape. The results indicate high internal consistency, measured with Cronbach's alpha, of 0.916. The convergent validity with the criterion of expert judgment is also adequate, with significant punctuations in the scale and all the subscales.

  6. Image subsampling and point scoring approaches for large-scale marine benthic monitoring programs

    Science.gov (United States)

    Perkins, Nicholas R.; Foster, Scott D.; Hill, Nicole A.; Barrett, Neville S.

    2016-07-01

    Benthic imagery is an effective tool for quantitative description of ecologically and economically important benthic habitats and biota. The recent development of autonomous underwater vehicles (AUVs) allows surveying of spatial scales that were previously unfeasible. However, an AUV collects a large number of images, the scoring of which is time and labour intensive. There is a need to optimise the way that subsamples of imagery are chosen and scored to gain meaningful inferences for ecological monitoring studies. We examine the trade-off between the number of images selected within transects and the number of random points scored within images on the percent cover of target biota, the typical output of such monitoring programs. We also investigate the efficacy of various image selection approaches, such as systematic or random, on the bias and precision of cover estimates. We use simulated biotas that have varying size, abundance and distributional patterns. We find that a relatively small sampling effort is required to minimise bias. An increased precision for groups that are likely to be the focus of monitoring programs is best gained through increasing the number of images sampled rather than the number of points scored within images. For rare species, sampling using point count approaches is unlikely to provide sufficient precision, and alternative sampling approaches may need to be employed. The approach by which images are selected (simple random sampling, regularly spaced etc.) had no discernible effect on mean and variance estimates, regardless of the distributional pattern of biota. Field validation of our findings is provided through Monte Carlo resampling analysis of a previously scored benthic survey from temperate waters. We show that point count sampling approaches are capable of providing relatively precise cover estimates for candidate groups that are not overly rare. The amount of sampling required, in terms of both the number of images and

  7. The use of test scores from large-scale assessment surveys: psychometric and statistical considerations

    Directory of Open Access Journals (Sweden)

    Henry Braun

    2017-11-01

    Full Text Available Abstract Background Economists are making increasing use of measures of student achievement obtained through large-scale survey assessments such as NAEP, TIMSS, and PISA. The construction of these measures, employing plausible value (PV methodology, is quite different from that of the more familiar test scores associated with assessments such as the SAT or ACT. These differences have important implications both for utilization and interpretation. Although much has been written about PVs, it appears that there are still misconceptions about whether and how to employ them in secondary analyses. Methods We address a range of technical issues, including those raised in a recent article that was written to inform economists using these databases. First, an extensive review of the relevant literature was conducted, with particular attention to key publications that describe the derivation and psychometric characteristics of such achievement measures. Second, a simulation study was carried out to compare the statistical properties of estimates based on the use of PVs with those based on other, commonly used methods. Results It is shown, through both theoretical analysis and simulation, that under fairly general conditions appropriate use of PV yields approximately unbiased estimates of model parameters in regression analyses of large scale survey data. The superiority of the PV methodology is particularly evident when measures of student achievement are employed as explanatory variables. Conclusions The PV methodology used to report student test performance in large scale surveys remains the state-of-the-art for secondary analyses of these databases.

  8. Stress disorder and PTSD after burn injuries: a prospective study of predictors of PTSD at Sina Burn Center, Iran

    Directory of Open Access Journals (Sweden)

    Sadeghi-Bazargani H

    2011-07-01

    Full Text Available Homayoun Sadeghi-Bazargani1, Hemmat Maghsoudi2, Mohsen Soudmand-Niri3, Fatemeh Ranjbar4, Hossein Mashadi-Abdollahi51Neuroscience Research Center, Statistics and Epidemiology Department, School of Health and Nutrition, 2Department of Surgery, 3School of Psychology, 4Department of Psychiatry, 5National Public Health Management Centre, Tabriz University of Medical Sciences, Tabriz, IranBackground: A burn injury can be a traumatic experience with tremendous social, physical, and psychological consequences. The aim of this study was to investigate the existence of post-traumatic stress disorder (PTSD and predictors of PTSD Checklist score initially and 3 months after injury in burns victims admitted to the Sina Burn Center in north-west Iran.Methods: This prospective study examined adult patients aged 16–65 years with unintentional burns. The PTSD Checklist was used to screen for PTSD.Results: Flame burns constituted 49.4% of all burns. Mean PTSD score was 23.8 ± 14.7 early in the hospitalization period and increased to 24.2 ± 14.3, 3 months after the burn injury. Twenty percent of victims 2 weeks into treatment had a positive PTSD screening test, and this figure increased to 31.5% after 3 months. The likelihood of developing a positive PTSD screening test increased significantly after 3 months (P < 0.01. Using multivariate regression analysis, factors independently predicting PTSD score were found to be age, gender, and percentage of total body surface area burned.Conclusion: PTSD was a problem in the population studied and should be managed appropriately after hospital admission due to burn injury. Male gender, younger age, and higher total body surface area burned may predict a higher PTSD score after burn injury. Keywords: post-traumatic stress disorder, burn injury, predictors, Iran

  9. Comparability of scores on the MMPI-2-RF scales generated with the MMPI-2 and MMPI-2-RF booklets.

    Science.gov (United States)

    Van der Heijden, P T; Egger, J I M; Derksen, J J L

    2010-05-01

    In most validity studies on the recently released 338-item MMPI-2 (Butcher, Dahlstrom, Graham, Tellegen, & Kaemmer, 1989) Restructured Form (MMPI-2-RF; Ben-Porath & Tellegen, 2008; Tellegen & Ben-Porath, 2008), scale scores were derived from the 567-item MMPI-2 booklet. In this study, we evaluated the comparability of the MMPI-2-RF scale scores derived from the original 567-item MMPI-2 booklet with MMPI-2-RF scale scores derived from the 338-item MMPI-2-RF booklet in a Dutch student sample (N = 107). We used a counterbalanced (ABBA) design. We compared results with those previously reported by Tellegen and Ben-Porath (2008). Our findings support the comparability of the scores of the 338-item version and the 567-item version of the 50 MMPI-2-RF scales. We discuss clinical implications and directions for further research.

  10. Toward an empirical definition of pediatric PTSD: the phenomenology of PTSD symptoms in youth.

    Science.gov (United States)

    Carrion, Victor G; Weems, Carl F; Ray, Rebecca; Reiss, Allan L

    2002-02-01

    To examine the frequency and intensity of posttraumatic stress disorder (PTSD) symptoms and their relation to clinical impairment, to examine the requirement of meeting all DSM-IV symptom cluster criteria (i.e., criteria B, C, D), and to examine the aggregation of PTSD symptom clusters across developmental stages. Fifty-nine children between the ages of 7 and 14 years with a history of trauma and PTSD symptoms were assessed with the Clinician-Administered PTSD Scale for Children and Adolescents. Data support the utility of distinguishing between the frequency and the intensity of symptoms in the investigation of the phenomenology of pediatric PTSD. Children fulfilling requirements for two symptom clusters did not differ significantly from children meeting all three cluster criteria with regard to impairment and distress. Reexperience (cluster B) showed increased aggregation with avoidance and numbing (cluster C) and hyperarousal (cluster D) in the later stages of puberty. Frequency and intensity of symptoms may both contribute to the phenomenology of pediatric PTSD. Children with subthreshold criteria for PTSD demonstrate substantial functional impairment and distress.

  11. Recall of false memories in individuals scoring high in schizotypy: memory distortions are scale specific.

    Science.gov (United States)

    Saunders, Jo; Randell, Jordan; Reed, Phil

    2012-06-01

    Previous research has indicated abnormal semantic activation in individuals scoring higher in schizotypy. In the current experiment, semantic activation was examined by using the Deese-Roediger-McDermott paradigm of false memories. Participants were assessed for schizotypy using the Oxford-Liverpool Inventory of Feelings (OLIFE). Participants studied lists of semantically related words in which a critical and highly associated word was absent. Participants then recalled the list. Participants high in Unusual Experiences and Cognitive Disorganization recalled more critical non-presented words, weakly related studied words, and fewer studied words than participants who scored low on these measures. Previous research using the cognitive-perceptual factor of the Schizotypy Personality Questionnaire found reduced false memories, while the Unusual Experiences subscale of the OLIFE was associated with more false memories. Both scales cover similar unusual perceptual experiences and it is unclear why they led to divergent results. The findings suggest that subtypes of schizotypy are associated with abnormal semantic activation. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Late effects of normal tissues (lent) scoring system: the soma scale

    International Nuclear Information System (INIS)

    Mornex, F.; Pavy, J.J.; Denekamp, J.

    1997-01-01

    Radiation tolerance of normal tissues remains the limiting factor for delivering tumoricidal dose. The late toxicity of normal tissues is the most critical element of an irradiation: somatic, functional and structural alterations occur during the actual treatment itself, but late effects manifest months to years after acute effects heal, and may progress with time. The optimal therapeutic ratio ultimately requires not only complete tumor clearance, but also minimal residual injury to surrounding vital normal tissues. The disparity between the intensity of acute and late effects and the inability to predict the eventual manifestation of late normal tissue injury has made radiation oncologists recognize the importance of careful patient follow-up. There is so far no uniform toxicity scoring system to compare several clinical studies in the absence of a 'common toxicity language'. This justifies the need to establish a precise evaluation system for the analysis of late effects of radiation on normal tissues. The SOMA/LENT scoring system results from an international collaboration. European Organization Treatment of Cancer (EORTC) and Radiation Therapy Oncology Group (RTOG) have created subcommittees with the aim of addressing the question of standardized toxic effects criteria. This effort appeared as a necessity to standardize and improve the data recording, to then describe and evaluate uniform toxicity at regular time intervals. The current proposed scale is not yet validated, and should be used cautiously. (authors)

  13. Comparing Canadian and American normative scores on the Wechsler Adult Intelligence Scale-Fourth Edition.

    Science.gov (United States)

    Harrison, Allyson G; Armstrong, Irene T; Harrison, Laura E; Lange, Rael T; Iverson, Grant L

    2014-12-01

    Psychologists practicing in Canada must decide which set of normative data to use for the Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV). The purpose of this study was to compare the interpretive effects of applying American versus Canadian normative systems in a sample of 432 Canadian postsecondary-level students who were administered the WAIS-IV as part of an evaluation for a learning disability, attention-deficit hyperactivity disorder, or other mental health problems. Employing the Canadian normative system yielded IQ, Index, and subtest scores that were systematically lower than those obtained using the American norms. Furthermore, the percentage agreement in normative classifications, defined as American and Canadian index scores within five points or within the same classification range, was between 49% and 76%. Substantial differences are present between the American and Canadian WAIS-IV norms. Clinicians should consider carefully the implications regarding which normative system is most appropriate for specific types of evaluations. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  14. CORRELATION OF MOBILE PHONE ADDICTION SCALE (MPAS SCORE WITH CRANIOVERTEBRAL ANGLE, SCAPULAR INDEX AND BECKS DEPRESSION INVENTORY SCORE IN YOUNG ADULTS

    Directory of Open Access Journals (Sweden)

    Rupali Salvi

    2018-02-01

    Full Text Available Background: Mobile phone usage has become increasingly common in today’s youth. Its heavy use often leads to an addiction. Dependency on these devices could lead to postural dysfunctions as well as produce an adverse effect on psychology. Hence, this study is done to correlate mobile addiction with the craniovertebral angle, scapular index and Beck’s depression inventory score in young adults. Methods: An observational study was performed on 100 subjects out of which 51 were males and 49 were females in the age group of 18- 25 years who were pursuing their graduation and post-graduation courses. Mobile Phone Addiction Scale was used to determine the level of addiction. Craniovertebral angle, Scapular Index, and Beck’s Depression Inventory score were measured. Correlation of Mobile Phone Addiction Scale score with the above-mentioned parameters was done using GraphPad Instat Version 3.10 (Pearson correlation coefficient and Spearman correlation coefficient. Results: Mobile phone addiction was found low in 27%, moderate in 30% and high in 43% participants. There is significant correlation of mobile phone addiction scale score with Craniovertebral angle (r = -0.6470, p = <0.0001, Scapular Index (r = -0.4370, p = < 0.001 and Beck’s depression Inventory score (r = 0.3172, p = 0.0013. Conclusion: This study shows that mobile phone addiction is common amongst the youth and it contributes to considerable stresses on neck and shoulder. It could even cause unfavorable repercussion on an individual’s psychological status, such as depression. Hence, it is important to create awareness amongst the youth and take preventive measures for the same.

  15. Different regional gray matter loss in recent onset PTSD and non PTSD after a single prolonged trauma exposure.

    Directory of Open Access Journals (Sweden)

    Yunchun Chen

    Full Text Available OBJECTIVE: Gray matter loss in the limbic structures was found in recent onset post traumatic stress disorder (PTSD patients. In the present study, we measured regional gray matter volume in trauma survivors to verify the hypothesis that stress may cause different regional gray matter loss in trauma survivors with and without recent onset PTSD. METHOD: High resolution T1-weighted magnetic resonance imaging (MRI were obtained from coal mine flood disaster survivors with (n = 10 and without (n = 10 recent onset PTSD and 20 no trauma exposed normal controls. The voxel-based morphometry (VBM method was used to measure the regional gray matter volume in three groups, the correlations of PTSD symptom severities with the gray matter volume in trauma survivors were also analyzed by multiple regression. RESULTS: Compared with normal controls, recent onset PTSD patients had smaller gray matter volume in left dorsal anterior cingulate cortex (ACC, and non PTSD subjects had smaller gray matter volume in the right pulvinar and left pallidum. The gray matter volume of the trauma survivors correlated negatively with CAPS scores in the right frontal lobe, left anterior and middle cingulate cortex, bilateral cuneus cortex, right middle occipital lobe, while in the recent onset PTSD, the gray matter volume correlated negatively with CAPS scores in bilateral superior medial frontal lobe and right ACC. CONCLUSION: The present study identified gray matter loss in different regions in recent onset PTSD and non PTSD after a single prolonged trauma exposure. The gray matter volume of left dorsal ACC associated with the development of PTSD, while the gray matter volume of right pulvinar and left pallidum associated with the response to the severe stress. The atrophy of the frontal and limbic cortices predicts the symptom severities of the PTSD.

  16. Using Score Equating and Measurement Invariance to Examine the Flynn Effect in the Wechsler Adult Intelligence Scale.

    Science.gov (United States)

    Benson, Nicholas; Beaujean, A Alexander; Taub, Gordon E

    2015-01-01

    The Flynn effect (FE; i.e., increase in mean IQ scores over time) is commonly viewed as reflecting population shifts in intelligence, despite the fact that most FE studies have not investigated the assumption of score comparability. Consequently, the extent to which these mean differences in IQ scores reflect population shifts in cognitive abilities versus changes in the instruments used to measure these abilities is unclear. In this study, we used modern psychometric tools to examine the FE. First, we equated raw scores for each common subtest to be on the same scale across instruments. This enabled the combination of scores from all three instruments into one of 13 age groups before converting raw scores into Z scores. Second, using age-based standardized scores for standardization samples, we examined measurement invariance across the second (revised), third, and fourth editions of the Wechsler Adult Intelligence Scale. Results indicate that while scores were equivalent across the third and fourth editions, they were not equivalent across the second and third editions. Results suggest that there is some evidence for an increase in intelligence, but also call into question many published FE findings as presuming the instruments' scores are invariant when this assumption is not warranted.

  17. Influence of Mild Traumatic Brain Injury (TBI) and Posttraumatic Stress Disorder (PTSD) on Pain Intensity Levels in OEF/OIF/OND Veterans.

    Science.gov (United States)

    Stojanovic, Milan P; Fonda, Jennifer; Fortier, Catherine Brawn; Higgins, Diana M; Rudolph, James L; Milberg, William P; McGlinchey, Regina E

    2016-11-01

    Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are common among US veterans of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND). We postulated that these injuries may modulate pain processing in these individuals and affect their subjective pain levels. Cross-sectional. 310 deployed service members of OEF/OIF/OND without a lifetime history of moderate or severe TBI were included in this study. All participants completed a comprehensive evaluation for Blast Exposure, mTBI, PTSD, and Pain Levels. The Boston Assessment of TBI-Lifetime Version (BAT-L) was used to assess blast exposure and potential brain injury during military service. The Clinician-Administered PTSD Scale (CAPS) characterized presence and severity of PTSD. The Visual Analog Scale (VAS) was used to assess pain intensity over the previous month before the interview, with higher scores indicative of worse pain. Statistical analysis was performed by ANOVA and results were adjusted for co-morbidities, clinical characteristics and demographic data. In comparison to control participants (veterans without mTBI or current PTSD), veterans with both current PTSD and mTBI reported the highest pain intensity levels, followed by veterans with PTSD only (P Pain levels in veterans with mTBI only were comparable to control participants. Comorbid PTSD and mTBI is associated with increased self-reported pain intensity. mTBI alone was not associated with increased pain. Published by Oxford University Press on behalf of the American Academy of Pain Medicine 2016. This work is written by US Government employees and is in the public domain in the US.

  18. An image based system to automatically and objectivelly score the degreeof redness and scaling in psoriasi lesions

    DEFF Research Database (Denmark)

    Gomez, David Delgado; Ersbøll, Bjarne Kjær; Carstensen, Jens Michael

    2004-01-01

    In this work, a combined statistical and image analysis method to automatically evaluate the severity of scaling in psoriasis lesions is proposed. The method separates the different regions of the disease in the image and scores the degree of scaling based on the properties of these areas. The pr...... that the obtained scores are highly correlated with scores made by doctors. This and the fact that the obtained measures are continuous indicate the proposed method is a suitable tool to evaluate the lesion and to track the evolution of dermatological diseases....

  19. Biomarkers for PTSD

    Science.gov (United States)

    2011-07-01

    Intern Med 167, 476-82 (2007). 5 P. B. Watson and B. Daniels, Follow up of post - traumatic stress disorder symptoms in Australian servicemen...for DOD and VA as objective indicators of PTSD for use in post - deployment medical screening, treatment selection, treatment outcome monitoring...mitigating the associations between war zone-related PTSD and physical health problems, including cardiovascular and metabolic disorders 6-10. In

  20. Correlation between Manchester Grading Scale and American Orthopaedic Foot and Ankle Society Score in Patients with Hallux Valgus

    Science.gov (United States)

    Iliou, Kalliopi; Paraskevas, George; Kanavaros, Panagiotis; Barbouti, Alexandra; Vrettakos, Aristidis; Gekas, Christos; Kitsoulis, Panagiotis

    2015-01-01

    Objective To evaluate the correlation between the Manchester Grading Scale and the American Orthopaedic Foot and Ankle Society (AOFAS) score in patients with a hallux valgus deformity. Subjects and Methods The study sample included 181 feet of 122 patients with hallux valgus and 424 feet of 212 individuals without hallux valgus deformity as the control group. The severity of hallux valgus, utilizing a relative nonmetric scale, the Manchester Grading Scale, and the metric AOFAS score, was determined for all individuals in the hallux valgus and control groups. SPSS version 18 (Chicago, Ill., USA) was used for data analysis. Results According to the Manchester Grading Scale, the 424 feet of the normal group were classified as ‘no deformity−. In the hallux valgus group, 85 feet were classified as ‘mild deformity−, 67 as ‘moderate deformity' and 29 as ‘severe deformity−. The AOFAS total score in the control group was 99.14. In the hallux valgus group, patients with mild or moderate deformity had total scores of 86.20 and 68.19, respectively. For those with severe hallux valgus, the total score was 44.69 and the differences were statistically significant (p = 0.000). Using the Pearson correlation, strong negative correlations were found between the AOFAS score and the hallux valgus angle (HVA; r = −0.899, p = 0.000). Strong negative correlations were demonstrated between the AOFAS score and the first intermetatarsal angle (IMA) as well (r = −0.748, p = 0.000). Conclusions The AOFAS score was negatively associated with the Manchester Grading Scale, HVA and first IMA. As the severity of hallux valgus increased, the AOFAS score seemed to decrease. PMID:26335050

  1. Neurobiological basis of PTSD

    International Nuclear Information System (INIS)

    Yamasue, Hidenori; Kasai, Kiyoto

    2006-01-01

    This review describes posttraumatic stress disorder (PTSD) from the aspect that it is one of precious neurobiological models where the stress caused by an outer environmental factor affects the livings afterwards. Also described are the actual imaging investigations of PTSD in people encountered the sarin subway terrorism in Tokyo (1995). High resolution MRI has revealed the decreased volume of hippocampus in PTSD patients in recent years. In victims of the terrorism above, authors have found that the volume of anterior cingulate cortical (ACC) gray matter is reduced in voxel-based MRI morphometry and the reduction is well correlated with PTSD severity and lower P300 amplitude. PET and fMRI have shown the hyperactivity of amygdala and hypoactivity of medial prefrontal region around ACC in PTSD. Findings in conditioned animal studies have indicated the importance of ACC neuronal cell activation for fear extinction, where, in humans, fMRI has revealed the cooperation between amygdala and ACC. At present, genetic factors like serotonin transporter polymorphism, environmental ones at infantile stage and their interactive activity are subject to investigation and discussion. Imaging studies will contribute to the clinical diagnosis, treatment and intervention of PTSD. (T.I)

  2. Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women.

    Science.gov (United States)

    Gelaye, Bizu; Zheng, Yinnan; Medina-Mora, Maria Elena; Rondon, Marta B; Sánchez, Sixto E; Williams, Michelle A

    2017-05-12

    The PTSD Checklist-civilian (PCL-C) is one of the most commonly used self-report measures of PTSD symptoms, however, little is known about its validity when used in pregnancy. This study aims to evaluate the reliability and validity of the PCL-C as a screen for detecting PTSD symptoms among pregnant women. A total of 3372 pregnant women who attended their first prenatal care visit in Lima, Peru participated in the study. We assessed the reliability of the PCL-C items using Cronbach's alpha. Criterion validity and performance characteristics of PCL-C were assessed against an independent, blinded Clinician-Administered PTSD Scale (CAPS) interview using measures of sensitivity, specificity and receiver operating characteristics (ROC) curves. We tested construct validity using exploratory and confirmatory factor analytic approaches. The reliability of the PCL-C was excellent (Cronbach's alpha =0.90). ROC analysis showed that a cut-off score of 26 offered optimal discriminatory power, with a sensitivity of 0.86 (95% CI: 0.78-0.92) and a specificity of 0.63 (95% CI: 0.62-0.65). The area under the ROC curve was 0.75 (95% CI: 0.71-0.78). A three-factor solution was extracted using exploratory factor analysis and was further complemented with three other models using confirmatory factor analysis (CFA). In a CFA, a three-factor model based on DSM-IV symptom structure had reasonable fit statistics with comparative fit index of 0.86 and root mean square error of approximation of 0.09. The Spanish-language version of the PCL-C may be used as a screening tool for pregnant women. The PCL-C has good reliability, criterion validity and factorial validity. The optimal cut-off score obtained by maximizing the sensitivity and specificity should be considered cautiously; women who screened positive may require further investigation to confirm PTSD diagnosis.

  3. Validation of Scores on the Marlowe-Crowne Social Desirability Scale and the Balanced Inventory of Desirable Responding

    Science.gov (United States)

    Leite, Walter L.; Beretvas, S. Natasha

    2005-01-01

    The Marlowe-Crowne Social Desirability Scale (MCSDS), the most commonly used social desirability bias (SDB) assessment, conceptualizes SDB as an individual's need for approval. The Balanced Inventory of Desirable Responding (BIDR) measures SDB as two separate constructs: impression management and self-deception. Scores on SDB scales are commonly…

  4. Symptoms of PTSD in Frontline Journalists: A Retrospective Examination of 18 Years of War and Conflict.

    Science.gov (United States)

    Feinstein, Anthony; Osmann, Jonas; Patel, Viral

    2018-01-01

    The objective of the current study was to determine the frequency and severity of symptoms of posttraumatic stress disorder (PTSD) in journalists covering conflict. PTSD data (Impact of Event Scale-Revised) collected over an 18-year period from 684 conflict journalists were analyzed retrospectively for frequency and severity of reexperiencing, avoidance, and arousal symptoms. Conflicts covered were civil wars in the Balkans ( n = 140 journalists), 9/11 attack in New York City ( n = 46), Iraq war ( n = 84), Mexico drug wars ( n = 104), civil war in Syria ( n = 59), Kenya election violence/Al-Shabab terror ( n = 57), state-sanctioned media intimidation in Iran ( n = 114), and the current migration crisis in Europe ( n = 80). The mean age of the sample was 38.59 (SD = 8.35) years, 461 (67%) journalists were men, and the mean duration of conflict work was 13.42 (SD = 7.74) years. The 5 most frequently endorsed symptoms were in the reexperiencing/intrusion category. Mean intrusion (1.31, SD = 0.97), avoidance (1.08, SD = 0.89), and arousal (1.07, SD = 0.96) scores for the entire sample were in the mild range. Being female and less educated independently predicted PTSD symptoms. PTSD phenomenology in a group of conflict journalists with well over a decade of frontline experience is dominated by reexperiencing symptoms. While symptom severity is for the most part mild, group means can obscure those individuals with significantly more severe difficulties.

  5. The DSM-5 dissociative-PTSD subtype: can levels of depression, anxiety, hostility, and sleeping difficulties differentiate between dissociative-PTSD and PTSD in rape and sexual assault victims?

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Lauterbach, Dean; Elhai, Jon D

    2014-05-01

    The DSM-5 currently includes a dissociative-PTSD subtype within its nomenclature. Several studies have confirmed the dissociative-PTSD subtype in both American Veteran and American civilian samples. Studies have begun to assess specific factors which differentiate between dissociative vs. non-dissociative PTSD. The current study takes a novel approach to investigating the presence of a dissociative-PTSD subtype in its use of European victims of sexual assault and rape (N=351). Utilizing Latent Profile Analyses, we hypothesized that a discrete group of individuals would represent a dissociative-PTSD subtype. We additionally hypothesized that levels of depression, anger, hostility, and sleeping difficulties would differentiate dissociative-PTSD from a similarly severe form of PTSD in the absence of dissociation. Results concluded that there were four discrete groups termed baseline, moderate PTSD, high PTSD, and dissociative-PTSD. The dissociative-PTSD group encompassed 13.1% of the sample and evidenced significantly higher mean scores on measures of depression, anxiety, hostility, and sleeping difficulties. Implications are discussed in relation to both treatment planning and the newly published DSM-5. Copyright © 2014 Elsevier Ltd. All rights reserved.

  6. Dementia knowledge assessment scale (DKAS): confirmatory factor analysis and comparative subscale scores among an international cohort.

    Science.gov (United States)

    Annear, Michael J; Toye, Chris; Elliott, Kate-Ellen J; McInerney, Frances; Eccleston, Claire; Robinson, Andrew

    2017-07-31

    Dementia is a life-limiting condition that is increasing in global prevalence in line with population ageing. In this context, it is necessary to accurately measure dementia knowledge across a spectrum of health professional and lay populations with the aim of informing targeted educational interventions and improving literacy, care, and support. Building on prior exploratory analysis, which informed the development of the preliminarily valid and reliable version of the Dementia Knowledge Assessment Scale (DKAS), a Confirmatory Factor Analysis (CFA) was performed to affirm construct validity and proposed subscales to further increase the measure's utility for academics and educators. A large, de novo sample of 3649 volunteer respondents to a dementia-related online course was recruited to evaluate the performance of the DKAS and its proposed subscales. Respondents represented diverse cohorts, including health professionals, students, and members of the general public. Analyses included CFA (using structural equation modelling), measures of internal consistency (α), and non-parametric tests of subscale correlation (Spearman Correlation) and score differences between cohorts (Kruskal-Wallis one-way analysis of variance). Findings of the CFA supported a 25-item, four-factor model for the DKAS with two items removed due to poor performance and one item moved between factors. The resultant model exhibited good reliability (α = .85; ω h  = .87; overall scale), with acceptable subscale internal consistency (α ≥ .65; subscales). Subscales showed acceptable correlation without any indication of redundancy. Finally, total and DKAS subscale scores showed good discrimination between cohorts of respondents who would be anticipated to hold different levels of knowledge on the basis of education or experience related to dementia. The DKAS has been confirmed as a reliable and valid measure of dementia knowledge for diverse populations that is capable of elucidating

  7. Correlation of Social Network Attributes with Individuals’ Score on Bipolar Spectrum Diagnostic Scale

    Directory of Open Access Journals (Sweden)

    Amir Momeni Boroujeni

    2012-09-01

    Full Text Available Introduction: Bipolar Spectrum Disorders include a variety of mood disorders from bipolar II disorder to conditions characterized by hyperthymic mood states. It has been suggested that psychosocial factors also play an important role in bipolar disorders, in this study we have used social network analysis in order to better understand the social positions of those affected by bipolar spectrum disorders. Methods: In this cross sectional study 90 individuals within a bounded network were included and studied by using a standard questionnaire for bipolar spectrum disorder scale (BSDS and a sociometric questionnaire for analyzing the social network of those individuals.Results: This study showed that BSDS score is signi.cantly correlated with the Bonacich power of the participants (P= 0.009 as well as with their Outdegree Strength (P= 0.013.Discussion: The results of this study show that there is interplay between social attributes and Bipolar Spectrum Disorders. This emphasizes the need for understanding the role of social networks and performing further research into quantifying social aspects of psychiatric disorders.

  8. Correlation of Social Network Attributes with Individuals’ Score on Bipolar Spectrum Diagnostic Scale

    Directory of Open Access Journals (Sweden)

    Amir Momeni Boroujeni

    2012-12-01

    Full Text Available Bipolar Spectrum Disorders include a variety of mood disorders from bipolar II disorder to conditions characterized by hyperthymic mood states. It has been suggested that psychosocial factors also play an important role in bipolar disorders, in this study we have used social network analysis in order to better understand the social positions of those affected by bipolar spectrum disorders.Methods and Materials: In this cross sectional study 90 individuals within a bounded network were included and studied by using a standard questionnaire for bipolar spectrum disorder scale (BSDS and a sociometric questionnaire for analyzing the social network of those individuals.Results: This study showed that BSDS score is significantly correlated with the Bonacich power of the participants (P= 0.009 as well as with their Outdegree Strength (P= 0.013.Discussion:The results of this study show that there is interplay between social attributes and Bipolar Spectrum Disorders. This emphasizes the need for understanding the role of social networks and performing further research into quantifying social aspects of psychiatric disorders.

  9. PTSD, mental illness, and care among survivors of sexual violence in Northern Uganda: Findings from the WAYS study.

    Science.gov (United States)

    Amone-P'Olak, Kennedy; Elklit, Ask; Dokkedahl, Sarah Bøgelund

    2018-05-01

    Previous studies have mainly considered war-affected youth as a homogenous group yet several subpopulations of war-affected youth, such as survivors of sexual violence, exist with unique mental health problems and treatment needs. This study aimed to assess posttraumatic stress disorder (PTSD), perceptions and meaning of mental illness, and access and barriers to mental health care among survivors of sexual violence. Data were collected from survivors of sexual violence during war (N = 181) who are participants in the longitudinal War-Affected Youth Survey (WAYS) study in Northern Uganda. Chi-square tests of independence and binary logistic regression were used to compute participants' characteristics and assess relations between exposure to sexual violence and PTSD. Sixty-six (n = 119, 66%) reported sexual abuse: 35% (n = 63) of whom returned from captivity with at least 1 child, and 43% (n = 78) met the criteria for PTSD (Impact of Events Scale-Revised score [IES-R] ≥33). Those who reported sexual abuse scored significantly higher on PTSD (OR = 3.23; 95% CI [2.09, 6.93]), perceived more stigma, reported more barriers to seeking care, and viewed mental illness as futile and fatal compared with their peers without a history of sexual abuse. Survivors of sexual violence are at risk of PTSD and report major obstacles to treatment and care. More resources should be allocated for interventions to improve access to care for survivors of sexual violence. Psychoeducation to create awareness, demystify myths and public stigma about mental illness, and trauma-focused cognitive-behavioral therapies to reduce PTSD among survivors are recommended. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

  10. Conditional standard errors of measurement for composite scores on the Wechsler Preschool and Primary Scale of Intelligence-Third Edition.

    Science.gov (United States)

    Price, Larry R; Raju, Nambury; Lurie, Anna; Wilkins, Charles; Zhu, Jianjun

    2006-02-01

    A specific recommendation of the 1999 Standards for Educational and Psychological Testing by the American Educational Research Association, the American Psychological Association, and the National Council on Measurement in Education is that test publishers report estimates of the conditional standard error of measurement (SEM). Procedures for calculating the conditional (score-level) SEM based on raw scores are well documented; however, few procedures have been developed for estimating the conditional SEM of subtest or composite scale scores resulting from a nonlinear transformation. Item response theory provided the psychometric foundation to derive the conditional standard errors of measurement and confidence intervals for composite scores on the Wechsler Preschool and Primary Scale of Intelligence-Third Edition.

  11. Conservative treatment of soft tissue sarcomas of the extremities. Functional evaluation with LENT-SOMA scales and the Enneking score

    International Nuclear Information System (INIS)

    Tawfiq, N.; Lagarde, P.; Thomas, L.; Kantor, G.; Stockle, E.; Bui, B.N.

    2000-01-01

    Objective. - The aim of this prospective study is the feasibility of late effects assessment by LENT-SOMA scales after conservative treatment of soft tissue sarcomas of the extremities and a comparison with the functional evaluation by the Enneking score. Patients and methods. - During the systematic follow-up consultations, a series of 32 consecutive patients was evaluated in terms of late effects by LENT SOMA scales and functional results by the Enneking score. The median time after treatment was 65 months. The treatment consisted of conservative surgery (all cases) followed by radiation therapy (29 cases), often combined with adjuvant therapy (12 concomitant radio-chemotherapy association cases out of 14). The assessment of the toxicity was retrospective for acute effects and prospective for the following late tissue damage: skin/subcutaneous tissues, muscles/soft tissues and peripheral nerves. Results. -According to the Enneking score, the global score for the overall series was high (24/30) despite four the scores zero for the psychological acceptance. According to LENT SOMA scales, a low rate of severe sequelae (grade 3-4) was observed. The occurrence of high-grade sequelae and their functional consequences were not correlated with quality of exeresis, dose of radiotherapy or use of concomitant chemotherapy. A complementarity was observed between certain factors of the Enneking score and some criteria of the LENTSOMA scales, especially of muscles/soft tissues. Conclusion. -The good quality of functional results was confirmed by the two mean scoring systems for late normal tissue damage. The routine use of LENT-SOMA seems to be more time consuming than the Enneking score (mean time of scoring: 1 3 versus five minutes). The LENT-SOMA scales are aimed at a detailed description of late toxicity and sequelae while the Enneking score provides a more global evaluation, including the psychological acceptance of treatment. The late effects assessment by the LENT

  12. Appetitive aggression as a resilience factor against trauma disorders: appetitive aggression and PTSD in German World War II veterans.

    Directory of Open Access Journals (Sweden)

    Roland Weierstall

    Full Text Available Repeated exposure to traumatic stressors such as combat results in chronic symptoms of PTSD. However, previous findings suggest that former soldiers who report combat-related aggression to be appetitive are more resilient to develop PTSD. Appetitive Aggression should therefore prevent widespread mental suffering in perpetrators of severe atrocities even after decades.To test the long-term relationship between trauma-related illness and attraction to aggression, we surveyed a sample of 51 German male World-War II veterans (age: M = 86.7, SD = 2.8. War-related appetitive aggression was assessed with the Appetitive Aggression Scale (AAS. Current- and lifetime PTSD symptoms were assessed with the PSS-I. In a linear regression analysis accounting for 31% of the variance we found that veterans that score higher on the AAS show lower PSS-I symptom severity scores across their whole post-war lifetime (β = - .31, p = .014. The effect size and power were sufficient (f(2 = 0.51, (1-β = .99. The same was true for current PTSD (β = - .27, p = .030.Appetitive Aggression appears to be a resilience factor for negative long-term effects of combat experiences in perpetrators of violence. This result has practical relevance for preventing trauma-related mental suffering in Peace Corps and for designing adequate homecoming reception for veterans.

  13. Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: a pilot study.

    Science.gov (United States)

    Fujiwara, Takeo; Mizuki, Rie; Miki, Takahiro; Chemtob, Claude

    2015-01-01

    "Emotional numbing" is a symptom of post-traumatic stress disorder (PTSD) characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent's Report of the Child's Reaction to Stress scale. Children were filmed while watching a 2-min video compilation of natural scenes ('baseline video') followed by a 2-min video clip from a television comedy ('comedy video'). Children's facial expressions were processed the using Noldus FaceReader software, which implements the Facial Action Coding System (FACS). We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age, and baseline facial expression (p software, has the potential to index emotional numbing in young children. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children's reactions to disasters.

  14. Relationship of early-life trauma, war-related trauma, personality traits, and PTSD symptom severity: a retrospective study on female civilian victims of war

    Directory of Open Access Journals (Sweden)

    Aleksandra Stevanović

    2016-04-01

    Full Text Available Background: Consequences of war-related traumatisation have mostly been investigated in military and predominant male populations, while research on female civilian victims of war has been neglected. Furthermore, research of post-war posttraumatic stress disorder (PTSD in women has rarely included early-life trauma in their prediction models, so the contribution of trauma in childhood and early youth is still unexplored. Objective: To examine the relationship of early-life trauma, war-related trauma, personality traits, and symptoms of posttraumatic stress among female civilian victims of the recent war in Croatia. Method: The cross-sectional study included 394 participants, 293 war-traumatised adult women civilians, and 101 women without war-related trauma. Participants were recruited using the snowball sampling method. The applied instruments included the Clinician-Administrated PTSD Scale (CAPS, the NEO Personality Inventory-Revised (NEO-PI-R, the War Stressors Assessment Questionnaire (WSAQ, and the Early Trauma Inventory Self Report-Short Form (ETISR-SF. A hierarchical multiple regression analysis was performed to assess the prediction model of PTSD symptom severity measured by CAPS score for current PTSD. Results: The prevalence of current PTSD (CAPS cut-off score=65 in this cohort was 20.7%. The regression model that included age, early-life trauma, war-related trauma, neuroticism, and extraversion as statistically significant predictors explained 45.8% of variance in PTSD symptoms. Conclusions: Older age, exposure to early-life trauma, exposure to war-related traumatic events, high neuroticism, and low extraversion are independent factors associated with higher level of PTSD symptoms among women civilian victims of war.

  15. A comparison of low IQ scores from the Reynolds Intellectual Assessment Scales and the Wechsler Adult Intelligence Scale-Third Edition.

    Science.gov (United States)

    Umphress, Thomas B

    2008-06-01

    Twenty people with suspected intellectual disability took the Reynolds Intellectual Assessment Scales (RIAS; C. R. Reynolds & R. W. Kamphaus, 1998) and the Wechsler Adult Intelligence Scale-3rd Edition (WAIS-III; D. Wechsler, 1997) to see if the 2 IQ tests produced comparable results. A t test showed that the RIAS Composite Intelligence Index scores were significantly higher than WAIS-III Full Scale IQ scores at the alpha level of .01. There was a significant difference between the RIAS Nonverbal Intelligence and WAIS-III Performance Scale, but there was no significant difference between the RIAS Verbal Intelligence Index and the WAIS-III Verbal Scale IQ. The results raise questions concerning test selection for diagnosing intellectual disability and the use of the correlation statistic for comparing intelligence tests.

  16. Circadian variability of the initial Glasgow Coma Scale score in traumatic brain injury patients

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    John K. Yue

    2017-01-01

    Conclusions: Nighttime TBI patients present with decreased GCS scores and are admitted to ICU at higher rates, yet have fewer prior comorbidities and similar systemic injuries. The interaction between nighttime hours and decreased GCS score on ICU admissions has important implications for clinical assessment/triage.

  17. Robust Scale Transformation Methods in IRT True Score Equating under Common-Item Nonequivalent Groups Design

    Science.gov (United States)

    He, Yong

    2013-01-01

    Common test items play an important role in equating multiple test forms under the common-item nonequivalent groups design. Inconsistent item parameter estimates among common items can lead to large bias in equated scores for IRT true score equating. Current methods extensively focus on detection and elimination of outlying common items, which…

  18. Using Raters from India to Score a Large-Scale Speaking Test

    Science.gov (United States)

    Xi, Xiaoming; Mollaun, Pam

    2011-01-01

    We investigated the scoring of the Speaking section of the Test of English as a Foreign Language[TM] Internet-based (TOEFL iBT[R]) test by speakers of English and one or more Indian languages. We explored the extent to which raters from India, after being trained and certified, were able to score the TOEFL examinees with mixed first languages…

  19. Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans.

    Science.gov (United States)

    Bovin, Michelle J; Marx, Brian P; Weathers, Frank W; Gallagher, Matthew W; Rodriguez, Paola; Schnurr, Paula P; Keane, Terence M

    2016-11-01

    This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  20. Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans

    Science.gov (United States)

    Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

    2017-01-01

    ABSTRACT Background: Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective: This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods: Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results: The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions: Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment. PMID:29435200

  1. Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans.

    Science.gov (United States)

    Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

    2017-01-01

    Background : Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective : This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods : Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results : The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions : Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment.

  2. Chronic Pain and PTSD: A Guide for Patients

    Science.gov (United States)

    ... Chronic Pain and PTSD: A Guide for Patients PTSD: National Center for PTSD Menu Menu PTSD PTSD Home For the Public ... here Enter ZIP code here Chronic Pain and PTSD: A Guide for Patients Public This section is ...

  3. DSM-5 PTSD and posttraumatic stress spectrum in Italian emergency personnel: correlations with work and social adjustment

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    Carmassi C

    2016-02-01

    Full Text Available Claudia Carmassi,1 Camilla Gesi,1 Marly Simoncini,1 Luca Favilla,1 Gabriele Massimetti,1 Maria Cristina Olivieri,1 Ciro Conversano,2 Massimo Santini,2 Liliana Dell’Osso1 1Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy; 2Emergency Medicine and Emergency Room Unit, Azienda Ospedaliero-Universitaria Pisana (AOUP, Pisa, Italy Abstract: The Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5 has recently recognized a particular risk for posttraumatic stress disorder (PTSD among first responders (criterion A4, acknowledging emergency units as stressful places of employment. Little data is yet available on DSM-5 among emergency health operators. The aim of this study was to assess DSM-5 symptomatological PTSD and posttraumatic stress spectrum, as well as their impact on work and social functioning, in the emergency staff of a major university hospital in Italy. One hundred and ten subjects (doctors, nurses, and health-care assistants were recruited at the Emergency Unit of the Azienda Ospedaliero-Universitaria Pisana (Italy and assessed by the Trauma and Loss Spectrum-Self Report (TALS-SR and Work and Social Adjustment Scale (WSAS. A 15.7% DSM-5 symptomatological PTSD prevalence rate was found. Nongraduated persons reported significantly higher TALS-SR Domain IV (reaction to loss or traumatic events scores and a significantly higher proportion of individuals presenting at least one maladaptive behavior (TALS-SR Domain VII, with respect to graduate ones. Women reported significantly higher WSAS scores. Significant correlations emerged between PTSD symptoms and WSAS total scores among health-care assistants, nongraduates and women. Our results showed emergency workers to be at risk for posttraumatic stress spectrum and related work and social impairment, particularly among women and nongraduated subjects. Keywords: posttraumatic stress disorder (PTSD, emergency, emergency

  4. Guilt, Shame and Compassionate Imagery in War: Traumatized German Soldiers with PTSD, a Pilot Study

    Directory of Open Access Journals (Sweden)

    Christina Alliger-Horn

    2016-10-01

    Full Text Available Background: The consideration of specific trauma-associated emotions poses a challenge for the differential treatment planning in trauma therapy. Soldiers experiencing deployment-related posttraumatic stress disorder often struggle with emotions of guilt and shame as a central component of their PTSD. Objective: The purpose of this study was to examine the extent to which soldiers’ PTSD symptoms and their trauma-related guilt and shame may be affected as a function of their ability to develop compassionate imagery between their CURRENT SELF (today and their TRAUMATIZED SELF (back then. Method: The sample comprised 24 male German soldiers diagnosed with PTSD who were examined on the Posttraumatic Diagnostic Scale (PDS and two additional measures: the Emotional Distress Inventory (EIBE and the Quality of Interaction between the CURRENT SELF and the TRAUMATIZED SELF (QUI-HD: Qualität der Interaktion zwischen HEUTIGEN ICH und DAMALIGEN ICH at pre- and post-treatment and again at follow-up. The treatment used was imagery rescripting and reprocessing therapy (IRRT. Results: Eighteen of the 24 soldiers showed significant improvement in their PTSD symptoms at post-treatment and at follow-up (on their reliable change index. A significant change in trauma-associated guilt and shame emerged when compassionate imagery was developed towards one’s TRAUMATIZED SELF. The degree and intensity of the guilt and shame felt at the beginning of treatment and the degree of compassionate imagery developed toward the TRAUMATIZED SELF were predictors for change on the PDS scores. Conclusions: For soldiers suffering from specific war-related trauma involving PTSD, the use of self-nurturing, compassionate imagery that fosters reconciling with the traumatized part of the self can effectively diminish trauma-related symptoms, especially when guilt and shame are central emotions.

  5. Reconsolidation of Traumatic Memories for PTSD: A randomized controlled trial of 74 male veterans.

    Science.gov (United States)

    Gray, Richard; Budden-Potts, Denise; Bourke, Frank

    2017-12-14

    A randomized waitlist-controlled design (n = 74) examined the efficacy of Reconsolidation of Traumatic Memories (RTM) among male veterans with current-month flashbacks and nightmares. Volunteers were randomly assigned to immediate treatment (three 120-minute sessions of RTM), or to a 3-week waiting condition before receiving the RTM treatment. Blinded psychometricians evaluated the symptoms at intake, 2 weeks, and 6 weeks post. Wait-listed participants were re-evaluated and then treated. Sixty-five volunteers completed the treatment. Of those treated, 46 (71%) lost DSM diagnosis for post-traumatic stress disorder (PTSD) by one of the following definitions: 42 persons (65%) were in complete remission (PTSD Symptom Scale Interview (PSS-I) ≤ 20 and DSM criteria not met). Four others (6%) lost the DSM diagnosis or were otherwise sub-clinical by dichotomous criteria (PSS-I < 20 and absence of flashbacks and nightmares) but non-ambiguous on the PTSD Checklist Military Version measures. Within-group RTM effect sizes (Hedges' g) for PSS-I score changes ranged from 1.5 to 2.2. The between-group comparison between the treatment group and the untreated controls was significant (p < .001) with an effect size equivalent to two standard deviations (g = -2.121; 95% CI [-4.693-0.453]). Patient satisfaction with the intervention was high. RTM shows promise as a brief, cost-effective intervention for PTSD characterized primarily by intrusive symptoms. Clinical or methodological significance of this article: The article provides evidence to support a fast (5 hours or fewer) robust intervention for PTSD characterized by intrusive symptoms including current-month flashbacks, nightmares, and accompanied by sympathetic arousal in response to trauma narratives. The intervention is well tolerated and has demonstrated efficacy up to one year.

  6. Somatoform dissociation and posttraumatic stress syndrome - two sides of the same medal? A comparison of symptom profiles, trauma history and altered affect regulation between patients with functional neurological symptoms and patients with PTSD.

    Science.gov (United States)

    Kienle, Johanna; Rockstroh, Brigitte; Bohus, Martin; Fiess, Johanna; Huffziger, Silke; Steffen-Klatt, Astrid

    2017-07-11

    History of traumatic experience is common in dissociative disorder (DD), and similarity of symptoms and characteristics between DD and posttraumatic stress disorder (PTSD) encouraged to consider DD as trauma-related disorder. However, conceptualization of DD as a trauma-related syndrome would critically affect diagnosis and treatment strategies. The present study addressed overlap and disparity of DD and PTSD by directly comparing correspondence of symptoms, adverse/traumatic experience, and altered affect regulation between patients diagnosed with dissociative disorder (characterized by negative functional neurological symptoms) and patients diagnosed with PTSD. Somatoform and psychoform dissociation, symptoms of posttraumatic stress, general childhood adversities and lifetime traumata, and alexithymia as index of altered affect regulation were screened with standardized questionnaires and semi-structured interviews in 60 patients with DD (ICD-codes F44.4, F44.6, F44.7), 39 patients with PTSD (ICD-code F43.1), and 40 healthy comparison participants (HC). DD and PTSD patients scored higher than HC on somatoform and psychoform dissociative symptom scales and alexithymia, and reported more childhood adversities and higher trauma load. PTSD patients reported higher symptom severity and more traumata than DD patients. Those 20 DD patients who met criteria of co-occuring PTSD did not differ from PTSD patients in the amount of reported symptoms of somatoform dissociation, physical and emotional childhood adversities and lifetime traumata, while emotional neglect/abuse in childhood distinguished DD patients with and without co-occuring PTSD (DD patients with co-occuring PTSD reporting more emotional maltreatment). The pattern of distinctive somatoform and psychoform dissociative symptom severity, type of childhood and lifetime traumata, and amount of alexithymia suggests that DD and PTSD are distinctive syndromes and, therefore, challenges the conceptualization of DD as

  7. Epigenetic Effects of PTSD Remediation in Veterans Using Clinical Emotional Freedom Techniques: A Randomized Controlled Pilot Study.

    Science.gov (United States)

    Church, Dawson; Yount, Garret; Rachlin, Kenneth; Fox, Louis; Nelms, Jerrod

    2018-01-01

    To assess the feasibility of measuring changes in gene expression associated with post-traumatic stress disorder (PTSD) treatment using emotional freedom techniques (EFT). Participants were randomized into an EFT group receiving EFT and treatment as usual (TAU) throughout a 10-week intervention period and a group receiving only TAU during the intervention period and then receiving EFT. A community clinic and a research institute in California. Sixteen veterans with clinical levels of PTSD symptoms. Ten hour-long sessions of EFT. Messenger RNA levels for a focused panel of 93 genes related to PTSD. The Symptom Assessment 45 questionnaire, Hospital Anxiety and Depression Scale, Insomnia Severity Scale, SF-12v2 for physical impairments, and Rivermead Postconcussion Symptoms Questionnaire. Pre-, posttreatment, and follow-up mean scores on questionnaires were assessed using repeated measures 1-way analysis of variance. A Student t test and post hoc analyses were performed on gene expression data. Post-traumatic stress disorder symptoms declined significantly in the EFT group (-53%, P expression of 6 genes was found ( P expression levels before and after the intervention period in participants receiving EFT. Study results identify candidate gene expression correlates of successful PTSD treatment, providing guidelines for the design of further studies aimed at exploring the epigenetic effects of EFT.

  8. Malingering in Toxic Exposure. Classification Accuracy of Reliable Digit Span and WAIS-III Digit Span Scaled Scores

    Science.gov (United States)

    Greve, Kevin W.; Springer, Steven; Bianchini, Kevin J.; Black, F. William; Heinly, Matthew T.; Love, Jeffrey M.; Swift, Douglas A.; Ciota, Megan A.

    2007-01-01

    This study examined the sensitivity and false-positive error rate of reliable digit span (RDS) and the WAIS-III Digit Span (DS) scaled score in persons alleging toxic exposure and determined whether error rates differed from published rates in traumatic brain injury (TBI) and chronic pain (CP). Data were obtained from the files of 123 persons…

  9. Optimizing cutoff scores for the Barthel Index and the modified Rankin Scale for defining outcome in acute stroke trials

    NARCIS (Netherlands)

    Uyttenboogaart, Maarten; Stewart, Roy E; Vroomen, Patrick C A J; De Keyser, Jacques; Luijckx, Gert-Jan

    Background and Purpose - There is little agreement on how to assess outcome in acute stroke trials. Cutoff scores for the Barthel Index (BI) and modified Rankin Scale (mRS) are frequently arbitrarily chosen to dichotomize favorable and unfavorable outcome. We investigated sensitivity and specificity

  10. Differences in Cortisol Response to Trauma Activation in Individuals with and without Comorbid PTSD and Depression

    Directory of Open Access Journals (Sweden)

    Sharon Dekel

    2017-05-01

    Full Text Available Background: Although depression symptoms are often experienced by individuals who develop posttraumatic stress disorder (PTSD following trauma exposure, little is know about the biological correlates associated with PTSD and depression co-morbidity vs. those associated with PTSD symptoms alone.Methods: Here we examined salivary cortisol responses to trauma activation in a sample of 60 survivors of the World Trade Center attacks on September 11, 2001. Participants recalled the escape from the attacks 7 months post 9/11. Salivary cortisol levels were measured before and after their recollection of the trauma. PTSD, depression, and somatic symptoms were also assessed. From the behavioral assessment scales, the participants were grouped into three conditions: those with comorbid PTSD and depressive symptoms, PTSD alone symptoms, or no-pathology.Results: Baseline and cortisol response levels differed between the comorbid, PTSD alone, and no-pathology groups. Individuals endorsing co-morbid symptoms had higher PTSD and somatic symptom severity and their cortisol response decreased following their trauma reminder while a trend of an elevated response to the trauma was found in the PTSD alone group. Our findings show distinct psychological and biological correlates related to the endorsement of PTSD with and without depression comorbidity.Conclusions: The findings suggest that comorbidity symptoms manifestation entails a separate trauma induced condition from PTSD. Future research on biological correlates of comorbid PTSD and depression is warranted.

  11. Cross Racial Identity Scale (CRIS) scores and profiles in African American adolescents involved with the juvenile justice system.

    Science.gov (United States)

    Worrell, Frank C; Andretta, James R; Woodland, Malcolm H

    2014-10-01

    In this study, we examined the internal consistency and structural validity of Cross Racial Identity Scale (CRIS) scores in a sample of 477 African American adolescents who had been arrested in a city in the mid-Atlantic. Using cluster analysis, we also identified profiles of CRIS scores and compared adolescents with different profiles on Major Depressive Episode, Manic Episode, Generalized Anxiety Disorder, and Obsessive-Compulsive Disorder scores. Results indicated that CRIS subscale scores were reliable, and the 6-factor structure of the CRIS was supported. Five nigrescence profiles were identified: Miseducation-Pro-Black, Conflicted-Self-Hatred, Multiculturalist, Low Race Salience, and Conflicted-Anti-White. Individuals with Conflicted-Self-Hatred profiles reported significantly and meaningfully higher scores on the 4 syndromes than did their peers, and individuals with the Multiculturalist and Low Race Salience profiles reported the lowest scores. A greater percentage of individuals with Conflicted racial identity profiles had syndrome scores in the clinically significant range. The results of this study demonstrate that some of the nigrescence profiles found in college-age students generalize to adolescents. The implications of the findings for theory, research, and practice are discussed. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  12. Bullying and PTSD Symptoms

    Science.gov (United States)

    Idsoe, Thormod; Dyregrov, Atle; Idsoe, Ella Cosmovici

    2012-01-01

    PTSD symptoms related to school bullying have rarely been investigated, and never in national samples. We used data from a national survey to investigate this among students from grades 8 and 9 (n = 963). The prevalence estimates of exposure to bullying were within the range of earlier research findings. Multinomial logistic regression showed that…

  13. Evaluation of novel scoring system named 5-5-5 exacerbation grading scale for allergic conjunctivitis disease.

    Science.gov (United States)

    Shoji, Jun; Inada, Noriko; Sawa, Mitsuru

    2009-12-01

    The objective of this study is to evaluate the practical usefulness of a scoring system using the 5-5-5 exacerbation grading scale for allergic conjunctivitis disease (ACD). Subjects were 103 patients with ACD including 40 patients with vernal keratoconjunctivitis (VKC), 20 patients with atopic keratoconjunctivitis (AKC), and 43 patients with allergic conjunctivitis (AC). The 5-5-5 exacerbation grading scale consists of the following 3 graded groups of clinical observations: the 100-point-grade group (100 points for each observation) includes active giant papillae, gelatinous infiltrates of the limbus, exfoliative epithelial keratopathy, shield ulcer and papillary proliferation at lower palpebral conjunctiva; the 10-point-grade group (10 points for each observation) includes blepharitis, papillary proliferation with velvety appearance, Horner-Trantas spots, edema of bulbal conjunctiva, and superficial punctate keratopathy; and the 1-point-grade group (1 point for each observation) includes papillae at upper palpebral conjunctiva, follicular lesion at lower palpebral conjunctiva, hyperemia of palpebral conjunctiva, hyperemia of bulbal conjunctiva, and lacrimal effusion. The total points in each grade group were determined as the severity score of the 5-5-5 exacerbation grading scale. The median severity scores of the 5-5-5 exacerbation grading scale in VKC, AKC and AC were 243 (range: 12-444), 32.5 (11-344), and 13 (2-33), respectively. The severity score of each ACD disease type was significantly different (P Kruskal-Wallis test). The severity of each type of ACD was classified as severe, moderate, or mild according to the severity score. The 5-5-5 exacerbation grading scale is a useful clinical tool for grading the severity of each type of ACD.

  14. Event centrality in trauma and PTSD: relations between event relevance and posttraumatic symptoms

    Directory of Open Access Journals (Sweden)

    Thiago Loreto Garcia da Silva

    2016-01-01

    Full Text Available Abstract Recent investigations propose that cognitive characteristics of autobiographical memory significantly interact with Posttraumatic Stress Disorder (PTSD. A traumatic event becoming more or less central in a person’s identity and life story might influence development of the disorder. Studies show high correlations between event centrality (EC and PTSD. Participated in this study 68 treatment-seeking individuals referred to a specialized service for suspected trauma-related disorder: 39 matched criteria for PTSD and 29 were exposed to trauma without PTSD. Our aims were to explore how the groups differ regarding EC, depression, anxiety, posttraumatic cognitions, PTSD symptom severity, and peritraumatic dissociative experience; and how distinctively EC interacts with the measures in each group. The PTSD group had higher scores in all variables but dissociation. EC correlated with overall PTSD symptoms only in the PTSD group and with dissociation only in the no-PTSD group. Findings support a model emphasizing the role of memory processes in PTSD. People exposed to trauma who developed PTSD had the memory of the traumatic experience more intensively governing their sense of self and thus eliciting more negative cognitive reactions. As EC facilitates recollection of the traumatic event, it could also mediate a semantization process that reinforces and increases posttraumatic symptoms.

  15. Establishing the cut-off score for remission and severity-ranges on the Psychotic Depression Assessment Scale (PDAS)

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Rothschild, Anthony J; Flint, Alastair J

    2016-01-01

    BACKGROUND: The Psychotic Depression Assessment Scale (PDAS) is a rating scale dedicated to the measurement of severity in psychotic depression (PD). The aim of this study was to establish the PDAS cut-off for remission of PD as well as PDAS score-ranges for mild, moderate, and severe PD...... on the PDAS and the severity-ranges for mild, moderate, and severe PD were defined using the Clinical Global Impression - Severity scale (CGI-S) as reference by means of pair-wise receiver operating characteristic (ROC) analyses. Subsequently, it was tested whether remission on the PDAS could separate...... the effects of Olanzapine+Sertraline vs. Olanzapine+Placebo through an intention-to-treat, mixed-effects logistic regression of the data from STOP-PD. RESULTS: According to the ROC analyses, the ideal cut-off for remission of PD was a PDAS total score moderate...

  16. Veterans’ PTSD Symptoms and their Partners’ Desired Changes in Key Relationship Domains

    OpenAIRE

    LaMotte, Adam D.; Taft, Casey T.; Reardon, Annemarie F.; Miller, Mark W.

    2015-01-01

    There is a growing literature investigating the connection between veterans’ posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans’ PTSD symptoms and their partners’ perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners’ desired changes in the areas of intimacy, shared activities, and respon...

  17. Reliability and Validity of the New Tanaka B Intelligence Scale Scores: A Group Intelligence Test

    OpenAIRE

    Uno, Yota; Mizukami, Hitomi; Ando, Masahiko; Yukihiro, Ryoji; Iwasaki, Yoko; Ozaki, Norio

    2014-01-01

    OBJECTIVE: The present study evaluated the reliability and concurrent validity of the new Tanaka B Intelligence Scale, which is an intelligence test that can be administered on groups within a short period of time. METHODS: The new Tanaka B Intelligence Scale and Wechsler Intelligence Scale for Children-Third Edition were administered to 81 subjects (mean age ± SD 15.2 ± 0.7 years) residing in a juvenile detention home; reliability was assessed using Cronbach's alpha coefficient, and concurre...

  18. Frontal and subcortical grey matter reductions in PTSD.

    Science.gov (United States)

    O'Doherty, Daniel C M; Tickell, Ashleigh; Ryder, Will; Chan, Charles; Hermens, Daniel F; Bennett, Maxwell R; Lagopoulos, Jim

    2017-08-30

    Post-traumatic stress disorder (PTSD) is characterised by a range of debilitating psychological, physical and cognitive symptoms. PTSD has been associated with grey matter atrophy in limbic and frontal cortical brain regions. However, previous studies have reported heterogeneous findings, with grey matter changes observed beyond limbic/frontal areas. Seventy-five adults were recruited from the community, 25 diagnosed with PTSD along with 25 healthy and 25 trauma exposed age and gender matched controls. Participants underwent clinical assessment and magnetic resonance imaging. The data-analyses method Voxel Based Morphometry (VBM) was used to estimate cortical grey matter volumes. When compared to both healthy and trauma exposed controls, PTSD subjects demonstrated decreased grey matter volumes within subcortical brain regions-including the hippocampus and amygdala-along with reductions in the anterior cingulate cortex, frontal medial cortex, middle frontal gyrus, superior frontal gyrus, paracingulate gyrus, and precuneus cortex. Significant negative correlations were found between total CAPS lifetime clinical scores/sub-scores and GM volume of both the PTSD and TC groups. GM volumes of the left rACC and right amygdala showed a significant negative correlation within PTSD diagnosed subjects. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  19. Sensitivity and Specificity of the Coma Recovery Scale--Revised Total Score in Detection of Conscious Awareness.

    Science.gov (United States)

    Bodien, Yelena G; Carlowicz, Cecilia A; Chatelle, Camille; Giacino, Joseph T

    2016-03-01

    To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. Data were retrospectively extracted from the medical records of patients enrolled in a specialized disorders of consciousness (DOC) program. Sensitivity and specificity analyses were completed using CRS-R-derived diagnoses of minimally conscious state (MCS) or emerged from minimally conscious state (EMCS) as the reference standard for conscious awareness and the total CRS-R score as the test criterion. A receiver operating characteristic curve was constructed to demonstrate the optimal CRS-R total cutoff score for maximizing sensitivity and specificity. Specialized DOC program. Patients enrolled in the DOC program (N=252, 157 men; mean age, 49y; mean time from injury, 48d; traumatic etiology, n=127; nontraumatic etiology, n=125; diagnosis of coma or vegetative state, n=70; diagnosis of MCS or EMCS, n=182). Not applicable. Sensitivity and specificity of CRS-R total scores in detecting conscious awareness. A CRS-R total score of 10 or higher yielded a sensitivity of .78 for correct identification of patients in MCS or EMCS, and a specificity of 1.00 for correct identification of patients who did not meet criteria for either of these diagnoses (ie, were diagnosed with vegetative state or coma). The area under the curve in the receiver operating characteristic curve analysis is .98. A total CRS-R score of 10 or higher provides strong evidence of conscious awareness but resulted in a false-negative diagnostic error in 22% of patients who demonstrated conscious awareness based on CRS-R diagnostic criteria. A cutoff score of 8 provides the best balance between sensitivity and specificity, accurately classifying 93% of cases. The optimal total score cutoff will vary depending on the user's objective. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  20. Higher stress scores for female medical students measured by the Kessler Psychological Distress Scale (K10 in Pakistan

    Directory of Open Access Journals (Sweden)

    Khadija Qamar

    2014-10-01

    Full Text Available The aim of this study was to determine the stress level of medical students and the relationship between stress and academic year. A cross-sectional, descriptive study was conducted at an undergraduate medical school with a five-year curriculum, in Pakistan, from January 2014 to April 2014. Medical students in the first four years were included in the study. The Kessler Psychological Distress Scale (K10, a self-administered questionnaire, was distributed to the students. A total of 445 medical students completed the questionnaire. The average stress score was 19.61 (SD = 6.76 with a range from 10 to 43. Stress was experienced by 169 students (41.7%. The scores of female students were higher than scores of males, indicating a higher stress level (P = 0.011. The relationship between stress and academic year was insignificant (P = 0.392.

  1. Predicting symptom clusters of posttraumatic stress disorder (PTSD) in Croatian war veterans: the role of socio-demographics, war experiences and subjective quality of life.

    Science.gov (United States)

    Lončar, Mladen; Plašć, Ivana Dijanić; Bunjevac, Tomislav; Hrabač, Pero; Jakšić, Nenad; Kozina, Slavica; Henigsberg, Neven; Sagud, Marina; Marčinko, Darko

    2014-09-01

    Previous research has documented multiple chains of risk in the development of PTSD among war veterans. However, existing studies were mostly carried out in the West, while they also did not analyze specific symptom clusters of PTSD. The aim of this study was to examine the role of socio-demographic characteristics, war experiences and subjective quality of life in the prediction of three clusters of PTSD symptoms (i.e., avoidance, intrusion, hyperarousal). This study comprised 184 male participants who have survived war imprisonment during the Croatian Homeland War in the period from 1991 to 1995. The data was collected through several self-report measuring instruments: questionnaire on socio-demographic data, war experiences (Questionnaire on Traumatic Combat and War Experiences), subjective quality of life (WHO-Five Well-being Index), and PTSD symptoms (Impact of Events Scale - Revised). The level of three symptom clusters of PTSD was found to be moderate to high, as indicated by the scores on the IES-R. Results of the three hierarchical regression analyses showed the following: traumatic war experiences were significant predictors of avoidance symptoms; traumatic war experiences and subjective quality of life were significant predictors of hyperarousal symptoms; and traumatic war experiences, material status and subjective quality of life were significant predictors of intrusion symptoms. These findings support the widespread belief that the development of war-related PTSD is accounted for by multiple chains of risk, while traumatic war experiences seem to be the only predictor of all three symptom clusters. Future research should put more emphasis on specific PTSD symptom clusters when investigating the etiopathogenesis of this disorder among war-affected populations.

  2. The relationship of PTSD to key somatic complaints and cultural syndromes among Cambodian refugees attending a psychiatric clinic: the Cambodian Somatic Symptom and Syndrome Inventory (CSSI).

    Science.gov (United States)

    Hinton, Devon E; Kredlow, M Alexandra; Pich, Vuth; Bui, Eric; Hofmann, Stefan G

    2013-06-01

    This article describes a culturally sensitive questionnaire for the assessment of the effects of trauma in the Cambodian refugee population, the Cambodian Somatic Symptom and Syndrome Inventory (CSSI), and gives the results of a survey with the instrument. The survey examined the relationship of the CSSI, the two CSSI subscales, and the CSSI items to posttraumatic stress disorder (PTSD) severity and self-perceived functioning. A total of 226 traumatized Cambodian refugees were assessed at a psychiatric clinic in Lowell, MA, USA. There was a high correlation of the CSSI, the CSSI somatic and syndrome scales, and all the CSSI items to the PTSD Checklist (PCL), a measure of PTSD severity. All the CSSI items varied greatly across three levels of PTSD severity, and patients with higher levels of PTSD had very high scores on certain CSSI-assessed somatic items such as dizziness, orthostatic dizziness (upon standing), and headache, and on certain CSSI-assessed cultural syndromes such as khyâl attacks, "fear of fainting and dying upon standing up," and "thinking a lot." The CSSI was more highly correlated than the PCL to self-perceived disability assessed by the Short Form-12 Health Survey (SF-12). The study demonstrates that the somatic symptoms and cultural syndromes described by the CSSI form a central part of the Cambodian refugee trauma ontology. The survey indicates that locally salient somatic symptoms and cultural syndromes need be profiled to adequately assess the effects of trauma.

  3. [Golf handicap score is a suitable scale for monitoring rehabilitation after apoplexia cerebri].

    Science.gov (United States)

    Jensen, Per; Meden, Per; Knudsen, Lars V; Knudsen, G M; Thomsen, Carsten; Feng, Ling; Pinborg, Lars H

    2015-12-21

    A 67-year-old male was examined nine, 35 and 135 days after stroke using conventional stroke scales, 18 holes of golf, functional MRI (fist closures) and translocator protein imaging of microglial function in the brain using single photon emission computed tomography. The data showed that the over 100-year-old golf handicap scale is better suited for quantifying recovery after stroke than conventional stroke assessment scales, which are prone to ceiling effect. We suggest that rating with golf handicap should be used more widely in stroke research, and we find it tremendously important that these new findings are published before Christmas.

  4. Wechsler Adult Intelligence Scale-Third Edition short form for index and IQ scores in a psychiatric population.

    Science.gov (United States)

    Christensen, Bruce K; Girard, Todd A; Bagby, R Michael

    2007-06-01

    An eight-subtest short form (SF8) of the Wechsler Adult Intelligence Scale, Third Edition (WAIS-III), maintaining equal representation of each index factor, was developed for use with psychiatric populations. Data were collected from a mixed inpatient/outpatient sample (99 men and 101 women) referred for neuropsychological assessment. Psychometric analyses revealed an optimal SF8 comprising Vocabulary, Similarities, Arithmetic, Digit Span, Picture Completion, Matrix Reasoning, Digit Symbol Coding, and Symbol Search, scored by linear scaling. Expanding on previous short forms, the current SF8 maximizes the breadth of information and reduces administration time while maintaining the original WAIS-III factor structure. (c) 2007 APA, all rights reserved

  5. Dysregulation in cortical reactivity to emotional faces in PTSD patients with high dissociation symptoms

    Directory of Open Access Journals (Sweden)

    Aleksandra Klimova

    2013-09-01

    Full Text Available Background: Predominant dissociation in posttraumatic stress disorder (PTSD is characterized by restricted affective responses to positive stimuli. To date, no studies have examined neural responses to a range of emotional expressions in PTSD with high dissociative symptoms. Objective: This study tested the hypothesis that PTSD patients with high dissociative symptoms will display increased event-related potential (ERP amplitudes in early components (N1, P1 to threatening faces (angry, fearful, and reduced later ERP amplitudes (Vertex Positive Potential (VPP, P3 to happy faces compared to PTSD patients with low dissociative symptoms. Methods: Thirty-nine civilians with PTSD were classified as high dissociative (n=16 or low dissociative (n=23 according to their responses on the Clinician Administered Dissociative States Scale. ERPs were recorded, whilst participants viewed emotional (happy, angry, fear and neutral facial expressions in a passive viewing task. Results: High dissociative PTSD patients displayed significantly increased N120 amplitude to the majority of facial expressions (neutral, happy, and angry compared to low dissociative PTSD patients under conscious and preconscious conditions. The high dissociative PTSD group had significantly reduced VPP amplitude to happy faces in the conscious condition. Conclusion: High dissociative PTSD patients displayed increased early (preconscious cortical responses to emotional stimuli, and specific reductions to happy facial expressions in later (conscious, face-specific components compared to low dissociative PTSD patients. Dissociation in PTSD may act to increase initial pre-attentive processing of affective stimuli, and specifically reduce cortical reactivity to happy faces when consciously processing these stimuli.

  6. The London handicap scale: a re-evaluation of its validity using standard scoring and simple summation

    OpenAIRE

    Jenkinson, C.; Mant, J.; Carter, J.; Wade, D.; Winner, S.

    2000-01-01

    OBJECTIVE—To assess the validity of the London handicap scale (LHS) using a simple unweighted scoring system compared with traditional weighted scoring
METHODS—323 patients admitted to hospital with acute stroke were followed up by interview 6 months after their stroke as part of a trial looking at the impact of a family support organiser. Outcome measures included the six item LHS, the Dartmouth COOP charts, the Frenchay activities index, the Barthel index, and the hospital...

  7. Conversion between mini-mental state examination, montreal cognitive assessment, and dementia rating scale-2 scores in Parkinson's disease.

    Science.gov (United States)

    van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E; Rick, Jacqueline; Chahine, Lama M; Dahodwala, Nabila; Trojanowski, John Q; Roalf, David R; Moberg, Paul J; Weintraub, Daniel

    2014-12-01

    Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson's disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. © 2014 International Parkinson and Movement Disorder Society.

  8. Evaluation of stratification factors and score-scales in clinical trials of treatment of clinical mastitis in dairy cows.

    Science.gov (United States)

    Hektoen, L; Ødegaard, S A; Løken, T; Larsen, S

    2004-05-01

    There is often a need to reduce sample size in clinical trials due to practical limitations and ethical considerations. Better comparability between treatment groups by use of stratification in the design, and use of continuous outcome variables in the evaluation of treatment results, are two methods that can be used in order to achieve this. In this paper the choice of stratification factors in trials of clinical mastitis in dairy cows is investigated, and two score-scales for evaluation of clinical mastitis are introduced. The outcome in 57 dairy cows suffering from clinical mastitis and included in a clinical trial comparing homeopathic treatment, placebo and a standard antibiotic treatment is investigated. The strata of various stratification factors are compared across treatments to determine which other factors influence outcome. The two score scales, measuring acute and chronic mastitis symptoms, respectively, are evaluated on their ability to differentiate between patients classified from clinical criteria as responders or non-responders to treatment. Differences were found between the strata of the factors severity of mastitis, lactation number, previous mastitis this lactation and bacteriological findings. These factors influence outcome of treatment and appear relevant as stratification factors in mastitis trials. Both score scales differentiated between responders and non-responders to treatment and were found useful for evaluation of mastitis and mastitis treatment.

  9. Inclusion of Highest Glasgow Coma Scale Motor Component Score in Mortality Risk Adjustment for Benchmarking of Trauma Center Performance.

    Science.gov (United States)

    Gomez, David; Byrne, James P; Alali, Aziz S; Xiong, Wei; Hoeft, Chris; Neal, Melanie; Subacius, Harris; Nathens, Avery B

    2017-12-01

    The Glasgow Coma Scale (GCS) is the most widely used measure of traumatic brain injury (TBI) severity. Currently, the arrival GCS motor component (mGCS) score is used in risk-adjustment models for external benchmarking of mortality. However, there is evidence that the highest mGCS score in the first 24 hours after injury might be a better predictor of death. Our objective was to evaluate the impact of including the highest mGCS score on the performance of risk-adjustment models and subsequent external benchmarking results. Data were derived from the Trauma Quality Improvement Program analytic dataset (January 2014 through March 2015) and were limited to the severe TBI cohort (16 years or older, isolated head injury, GCS ≤8). Risk-adjustment models were created that varied in the mGCS covariates only (initial score, highest score, or both initial and highest mGCS scores). Model performance and fit, as well as external benchmarking results, were compared. There were 6,553 patients with severe TBI across 231 trauma centers included. Initial and highest mGCS scores were different in 47% of patients (n = 3,097). Model performance and fit improved when both initial and highest mGCS scores were included, as evidenced by improved C-statistic, Akaike Information Criterion, and adjusted R-squared values. Three-quarters of centers changed their adjusted odds ratio decile, 2.6% of centers changed outlier status, and 45% of centers exhibited a ≥0.5-SD change in the odds ratio of death after including highest mGCS score in the model. This study supports the concept that additional clinical information has the potential to not only improve the performance of current risk-adjustment models, but can also have a meaningful impact on external benchmarking strategies. Highest mGCS score is a good potential candidate for inclusion in additional models. Copyright © 2017 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  10. Predicting SF-6D utility scores from the Oswestry disability index and numeric rating scales for back and leg pain.

    Science.gov (United States)

    Carreon, Leah Y; Glassman, Steven D; McDonough, Christine M; Rampersaud, Raja; Berven, Sigurd; Shainline, Michael

    2009-09-01

    Cross-sectional cohort. The purpose of this study is to provide a model to allow estimation of utility from the Short Form (SF)-6D using data from the Oswestry Disability Index (ODI), Back Pain Numeric Rating Scale (BPNRS), and the Leg Pain Numeric Rating Scale (LPNRS). Cost-utility analysis provides important information about the relative value of interventions and requires a measure of utility not often available from clinical trial data. The ODI and numeric rating scales for back (BPNRS) and leg pain (LPNRS), are widely used disease-specific measures for health-related quality of life in patients with lumbar degenerative disorders. The purpose of this study is to provide a model to allow estimation of utility from the SF-6D using data from the ODI, BPNRS, and the LPNRS. SF-36, ODI, BPNRS, and LPNRS were prospectively collected before surgery, at 12 and 24 months after surgery in 2640 patients undergoing lumbar fusion for degenerative disorders. Spearman correlation coefficients for paired observations from multiple time points between ODI, BPNRS, and LPNRS, and SF-6D utility scores were determined. Regression modeling was done to compute the SF-6D score from the ODI, BPNRS, and LPNRS. Using a separate, independent dataset of 2174 patients in which actual SF-6D and ODI scores were available, the SF-6D was estimated for each subject and compared to their actual SF-6D. In the development sample, the mean age was 52.5 +/- 15 years and 34% were male. In the validation sample, the mean age was 52.9 +/- 14.2 years and 44% were male. Correlations between the SF-6D and the ODI, BPNRS, and LPNRS were statistically significant (P < 0.0001) with correlation coefficients of 0.82, 0.78, and 0.72, respectively. The regression equation using ODI, BPNRS,and LPNRS to predict SF-6D had an R of 0.69 and a root mean square error of 0.076. The model using ODI alone had an R of 0.67 and a root mean square error of 0.078. The correlation coefficient between the observed and estimated

  11. When combat prevents PTSD symptoms—results from a survey with former child soldiers in Northern Uganda

    Directory of Open Access Journals (Sweden)

    Weierstall Roland

    2012-05-01

    Full Text Available Abstract Background Human beings from time immemorial have eradicated neighbouring tribes, languages, religions, and cultures. In war and crisis, the cumulative exposure to traumatic stress constitutes a predictor of the development of post traumatic stress disorder (PTSD. However, homicide has evolved as a profitable strategy in man, leading to greater reproductive success. Thus, an evolutionary advantage of perpetrating violence would be eliminated if the exposure to aggressive acts would traumatize the perpetrator. We argue that perpetrating violence could actually ‘immunize’ a person against adverse effects of traumatic stressors, significantly reducing the risk of developing PTSD. Methods We surveyed 42 former child soldiers in Northern Uganda that have all been abducted by the Lord Resistance Army (LRA as well as 41 non-abducted controls. Results Linear regression analyses revealed a dose–response effect between the exposure to traumatic events and the Posttraumatic Diagnostic Scale (PDS sum score. However, the vulnerability to develop trauma related symptoms was reduced in those with higher scores on the Appetitive Aggression Scale (AAS. This effect was more pronounced in the formerly abducted group. Conclusions We conclude that attraction to aggression when being exposed to the victim’s struggling can lead to a substantial risk-reduction for developing PTSD.

  12. Performance on large-scale science tests: Item attributes that may impact achievement scores

    Science.gov (United States)

    Gordon, Janet Victoria

    Significant differences in achievement among ethnic groups persist on the eighth-grade science Washington Assessment of Student Learning (WASL). The WASL measures academic performance in science using both scenario and stand-alone question types. Previous research suggests that presenting target items connected to an authentic context, like scenario question types, can increase science achievement scores especially in underrepresented groups and thus help to close the achievement gap. The purpose of this study was to identify significant differences in performance between gender and ethnic subgroups by question type on the 2005 eighth-grade science WASL. MANOVA and ANOVA were used to examine relationships between gender and ethnic subgroups as independent variables with achievement scores on scenario and stand-alone question types as dependent variables. MANOVA revealed no significant effects for gender, suggesting that the 2005 eighth-grade science WASL was gender neutral. However, there were significant effects for ethnicity. ANOVA revealed significant effects for ethnicity and ethnicity by gender interaction in both question types. Effect sizes were negligible for the ethnicity by gender interaction. Large effect sizes between ethnicities on scenario question types became moderate to small effect sizes on stand-alone question types. This indicates the score advantage the higher performing subgroups had over the lower performing subgroups was not as large on stand-alone question types compared to scenario question types. A further comparison examined performance on multiple-choice items only within both question types. Similar achievement patterns between ethnicities emerged; however, achievement patterns between genders changed in boys' favor. Scenario question types appeared to register differences between ethnic groups to a greater degree than stand-alone question types. These differences may be attributable to individual differences in cognition

  13. Oxytocin is associated with PTSD's anxious arousal symptoms in Chinese male earthquake survivors

    Directory of Open Access Journals (Sweden)

    Chengqi Cao

    2014-12-01

    Full Text Available Background: Posttraumatic stress disorder (PTSD is a complex and severe mental disorder triggered by exposure to an extraordinarily traumatic event. Human and animal studies have implied the functional role of the oxytocin system in the development of PTSD (Cochran, Fallon, Hill, & Frazier, 2013; Koch et al., 2014; Olff, 2012. Specification of the role of the oxytocin system in the emergence and progression of PTSD symptomatology would provide evidence to inform both theory and clinical practice. Methods: This study examined the association between oxytocin serum levels and PTSD symptoms. A total of 106 Chinese male adults who suffered from the deadly 2008 Wenchuan earthquake participated in this study. PTSD symptoms were measured with PTSD Checklist for DSM-5 (PCL-5, and serum oxytocin level was determined with ELISA oxytocin kits. Results: The mean score on the PCL-5 was 19.30 (SD=14.50, range: 1–65 in this sample. The mean oxytocin level was 101.59 pg/ml (SD=55.89, range: 31.50–286.71. The results indicated that although the oxytocin was not associated with total PTSD symptoms, it was associated with PTSD's anxious arousal symptoms. Conclusion: These findings support that the oxytocin may play an important functional role in the development of PTSD and contribute to the extant knowledge on the genetic basis of the PTSD symptoms.

  14. A simple model for prediction postpartum PTSD in high-risk pregnancies.

    Science.gov (United States)

    Shlomi Polachek, Inbal; Dulitzky, Mordechai; Margolis-Dorfman, Lilia; Simchen, Michal J

    2016-06-01

    This study aimed to examine the prevalence and possible antepartum risk factors of complete and partial post-traumatic stress disorder (PTSD) among women with complicated pregnancies and to define a predictive model for postpartum PTSD in this population. Women attending the high-risk pregnancy outpatient clinics at Sheba Medical Center completed the Edinburgh Postnatal Depression Scale (EPDS) and a questionnaire regarding demographic variables, history of psychological and psychiatric treatment, previous trauma, previous childbirth, current pregnancy medical and emotional complications, fears from childbirth, and expected pain. One month after delivery, women were requested to repeat the EPDS and complete the Post-traumatic Stress Diagnostic Scale (PDS) via telephone interview. The prevalence rates of postpartum PTSD (9.9 %) and partial PTSD (11.9 %) were relatively high. PTSD and partial PTSD were associated with sadness or anxiety during past pregnancy or childbirth, previous very difficult birth experiences, preference for cesarean section in future childbirth, emotional crises during pregnancy, increased fear of childbirth, higher expected intensity of pain, and depression during pregnancy. We created a prediction model for postpartum PTSD which shows a linear growth in the probability for developing postpartum PTSD when summing these seven antenatal risk factors. Postpartum PTSD is extremely prevalent after complicated pregnancies. A simple questionnaire may aid in identifying at-risk women before childbirth. This presents a potential for preventing or minimizing postpartum PTSD in this population.

  15. An automated four-point scale scoring of segmental wall motion in echocardiography using quantified parametric images

    International Nuclear Information System (INIS)

    Kachenoura, N; Delouche, A; Ruiz Dominguez, C; Frouin, F; Diebold, B; Nardi, O

    2010-01-01

    The aim of this paper is to develop an automated method which operates on echocardiographic dynamic loops for classifying the left ventricular regional wall motion (RWM) in a four-point scale. A non-selected group of 37 patients (2 and 4 chamber views) was studied. Each view was segmented according to the standardized segmentation using three manually positioned anatomical landmarks (the apex and the angles of the mitral annulus). The segmented data were analyzed by two independent experienced echocardiographists and the consensual RWM scores were used as a reference for comparisons. A fast and automatic parametric imaging method was used to compute and display as static color-coded parametric images both temporal and motion information contained in left ventricular dynamic echocardiograms. The amplitude and time parametric images were provided to a cardiologist for visual analysis of RWM and used for RWM quantification. A cross-validation method was applied to the segmental quantitative indices for classifying RWM in a four-point scale. A total of 518 segments were analyzed. Comparison between visual interpretation of parametric images and the reference reading resulted in an absolute agreement (Aa) of 66% and a relative agreement (Ra) of 96% and kappa (κ) coefficient of 0.61. Comparison of the automated RWM scoring against the same reference provided Aa = 64%, Ra = 96% and κ = 0.64 on the validation subset. Finally, linear regression analysis between the global quantitative index and global reference scores as well as ejection fraction resulted in correlations of 0.85 and 0.79. A new automated four-point scale scoring of RWM was developed and tested in a non-selected database. Its comparison against a consensual visual reading of dynamic echocardiograms showed its ability to classify RWM abnormalities.

  16. RSE-40: An Alternate Scoring System for the Rosenberg Self-Esteem Scale (RSE).

    Science.gov (United States)

    Wallace, Gaylen R.

    The Rosenberg Self-Esteem Inventory (RSE) is a 10-item scale purporting to measure self-esteem using self-acceptance and self-worth statements. This analysis covers concerns about the degree to which the RSE items represent a particular content universe, the RSE's applicability, factor analytic methods used, and the RSE's reliability and validity.…

  17. The Factor Structure of Preschool Learning Behaviors Scale Scores in Peruvian Children

    Science.gov (United States)

    Hahn, Kathryn R.; Schaefer, Barbara A.; Merino, Cesar; Worrell, Frank C.

    2009-01-01

    The factor structure of the Escala de Conductas de Aprendizaje Preescolar (ECAP), a Spanish translation of the Preschool Learning Behaviors Scale (PLBS), was examined in this study. Children aged 2 to 6 years (N = 328) enrolled in public and private preschools in the Republic of Peru were rated by classroom teachers on the frequency of observable,…

  18. The Development and Validation of Scores on the Mathematics Information Processing Scale (MIPS).

    Science.gov (United States)

    Bessant, Kenneth C.

    1997-01-01

    This study reports on the development and psychometric properties of a new 87-item Mathematics Information Processing Scale that explores learning strategies, metacognitive problem-solving skills, and attentional deployment. Results with 340 college students support the use of the instrument, for which factor analysis identified five theoretically…

  19. Determining minimally important score differences in scales of the Copenhagen Psychosocial Questionnaire

    DEFF Research Database (Denmark)

    Pejtersen, Jan Hyld; Bjorner, Jakob Bue; Hasle, Peter

    2010-01-01

    AIM: To determine minimally important differences (MIDs) for scales in the first version of the Copenhagen Psychosocial Questionnaire (COPSOQ). METHODS: Data were taken from two separate studies: a national population survey (N = 1062), and an intervention study at 14 workplaces (N = 1505). On th...

  20. Validity Evidence for the Interpretation and Use of Essential Elements of Communication Global Rating Scale Scores

    Science.gov (United States)

    Schneider, Nancy Rhoda

    2015-01-01

    Purpose. Clinical communication influences health outcomes, so medical schools are charged to prepare future physicians with the skills they need to interact effectively with patients. Communication leaders at The University of New Mexico School of Medicine (UNMSOM) developed The Essential Elements of Communication-Global Rating Scale (EEC-GRS) to…

  1. Associations between MMPI-2-RF validity scale scores and extra-test measures of personality and psychopathology.

    Science.gov (United States)

    Forbey, Johnathan D; Lee, Tayla T C; Ben-Porath, Yossef S; Arbisi, Paul A; Gartland, Diane

    2013-08-01

    The current study explored associations between two potentially invalidating self-report styles detected by the Validity scales of the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF), over-reporting and under-reporting, and scores on the MMPI-2-RF substantive, as well as eight collateral self-report measures administered either at the same time or within 1 to 10 days of MMPI-2-RF administration. Analyses were conducted with data provided by college students, male prisoners, and male psychiatric outpatients from a Veterans Administration facility. Results indicated that if either an over- or under-reporting response style was suggested by the MMPI-2-RF Validity scales, scores on the majority of the MMPI-2-RF substantive scales, as well as a number of collateral measures, were significantly affected in all three groups in the expected directions. Test takers who were identified as potentially engaging in an over- or under-reporting response style by the MMPI-2-RF Validity scales appeared to approach extra-test measures similarly regardless of when these measures were administered in relation to the MMPI-2-RF. Limitations and suggestions for future study are discussed.

  2. [Correlation between dental pulp demyelination degree and pain visual analogue scale scores data under acute and chronic pulpitis].

    Science.gov (United States)

    Korsantiia, N B; Davarashvili, X T; Gogiashvili, L E; Mamaladze, M T; Tsagareli, Z G; Melikadze, E B

    2013-05-01

    The aim of study is the analysis of pulp nerve fibers demyelination degree and its relationship with Visual Analogue Scale (VAS) score that may be measured as objective criteria. Material and methods of study. Step I: electron micrografs of dental pulp simples with special interest of myelin structural changes detected in 3 scores system, obtained from 80 patients, displays in 4 groups: 1) acute and 2) chronic pulpitis without and with accompined systemic deseases, 20 patients in each group. Dental care was realized in Kutaisi N1 Dental clinic. Step II - self-reported VAS used for describing dental pain. All data were performed by SPSS 10,0 version statistics including Spearmen-rank and Mann-Whitny coefficients for examine the validity between pulp demyelination degree and pain intensity in verbal, numbered and box scales. Researched Data were shown that damaged myelin as focal decomposition of membranes and Schwann cells hyperthrophia correspond with acute dental pain intensity as Spearman index reported in VAS numbered Scales, myelin and axoplasm degeneration as part of chronic gangrenous pulpitis disorders are in direct correlation with VAS in verbal, numbered and behavioral Rating Scales. In fact, all morphological and subjective data, including psychomotoric assessment of dental painin pulpitis may be used in dental practice for evaluation of pain syndrome considered personal story.

  3. Normative scores on the Berg Balance Scale decline after age 70 years in healthy community-dwelling people: a systematic review.

    Science.gov (United States)

    Downs, Stephen; Marquez, Jodie; Chiarelli, Pauline

    2014-06-01

    What is the mean Berg Balance Scale score of healthy elderly people living in the community and how does it vary with age? How much variability in Berg Balance Scale scores is present in groups of healthy elderly people and how does this vary with age? Systematic review with meta-analysis. Any group of healthy community-dwelling people with a mean age of 70 years or greater that has undergone assessment using the Berg Balance Scale. Mean and standard deviations of Berg Balance Scale scores within cohorts of elderly people of known mean age. The search yielded 17 relevant studies contributing data from a total of 1363 participants. The mean Berg Balance Scale scores ranged from 37 to 55 out of a possible maximum score of 56. The standard deviation of Berg Balance Scale scores varied from 1.0 to 9.2. Although participants aged around 70 years had very close to normal Berg Balance Scale scores, there was a significant decline in balance with age at a rate of 0.7 points on the 56-point Berg Balance Scale per year. There was also a strong association between increasing age and increasing variability in balance (R(2) = 0.56, p balance deficits, as measured by the Berg Balance Scale, although balance scores deteriorate and become more variable with age. Copyright © 2014. Published by Elsevier B.V.

  4. Peritraumatic tonic immobility is associated with PTSD symptom severity in Brazilian police officers: a prospective study

    Directory of Open Access Journals (Sweden)

    Deborah B. Maia

    2015-03-01

    Full Text Available Objective: Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD. Peritraumatic tonic immobility (PTI, a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132. Methods: Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C, Physical Reactions Subscale (PRS, Peritraumatic Dissociative Experiences Questionnaire (PDEQ, Tonic Immobility Scale (TIS, and Critical Incident History Questionnaire. Results: Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09, whereas for PRS, the increment was 7% (RM = 1.07. As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22. Conclusions: Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

  5. Peritraumatic tonic immobility is associated with PTSD symptom severity in Brazilian police officers: a prospective study.

    Science.gov (United States)

    Maia, Deborah B; Nóbrega, Augusta; Marques-Portella, Carla; Mendlowicz, Mauro V; Volchan, Eliane; Coutinho, Evandro S; Figueira, Ivan

    2015-01-01

    Peritraumatic reactions feature prominently among the main predictors for development of posttraumatic stress disorder (PTSD). Peritraumatic tonic immobility (PTI), a less investigated but equally important type of peritraumatic response, has been recently attracting the attention of researchers and clinicians for its close association with traumatic reactions and PTSD. Our objective was to investigate the role of PTI, peritraumatic panic, and dissociation as predictors of PTSD symptoms in a cohort of police recruits (n=132). Participants were asked to complete the following questionnaires during academy training and after the first year of work: Posttraumatic Stress Disorder Checklist - Civilian Version (PCL-C), Physical Reactions Subscale (PRS), Peritraumatic Dissociative Experiences Questionnaire (PDEQ), Tonic Immobility Scale (TIS), and Critical Incident History Questionnaire. Employing a zero-inflated negative binomial regression model, we found that each additional point in the TIS was associated with a 9% increment in PCL-C mean scores (RM = 1.09), whereas for PRS, the increment was 7% (RM = 1.07). As the severity of peritraumatic dissociation increased one point in the PDEQ, the chance of having at least one symptom in the PCL-C increased 22% (OR = 1.22). Our findings highlight the need to expand investigation on the incidence and impact of PTI on the mental health of police officers.

  6. An evaluation of ICD-11 PTSD and complex PTSD criteria in a sample of adult survivors of childhood institutional abuse

    Directory of Open Access Journals (Sweden)

    Matthias Knefel

    2013-12-01

    Full Text Available Background : The WHO recently launched the proposal for the 11th version of the International Classification of Diseases (ICD-11 that also includes two diagnoses related to traumatic stress. In contrast to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5, ICD-11 will probably, in addition to posttraumatic stress disorder (PTSD, also define a new diagnosis termed “complex posttraumatic stress disorder” (CPTSD. Objective : We aimed to apply the proposed ICD-11 criteria for PTSD and CPTSD and to compare their prevalence to the ICD-10 (International Classification of Diseases [10th revision] PTSD prevalence. In addition, we compiled a list of symptoms for CPTSD based on subthreshold PTSD so as to include a wider group of individuals. Methods : To evaluate the appropriateness of the WHO ICD-11 proposal compared to the criteria of ICD-10, we applied the newly introduced criteria for PTSD and CPTSD deriving from the Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C and the Brief Symptom Inventory (BSI scales, to a sample of adult survivors (N=229 of childhood institutional abuse. We evaluated the construct validity of CPTSD using confirmatory factor analysis (CFA. Results : More individuals fulfilled the criteria for PTSD according to ICD-10 (52.8% than the ICD-11 proposal (17% for PTSD only; 38.4% if combined with complex PTSD. The new version of PTSD neutralized the gender effects. The prevalence of CPTSD was 21.4%, and women had a significantly higher rate of CPTSD than men (40.4 and 15.8%, respectively. Those survivors who were diagnosed with CPTSD experienced institutional abuse for a longer time. CFA showed a strong model fit. Conclusion : CPTSD is a highly relevant classification for individuals with complex trauma history, but surprisingly, effects of gender were apparent. Further research should thus address gender effects.

  7. Predicting the future development of depression or PTSD after injury.

    Science.gov (United States)

    Richmond, Therese S; Ruzek, Josef; Ackerson, Theimann; Wiebe, Douglas J; Winston, Flaura; Kassam-Adams, Nancy

    2011-01-01

    The objective was to develop a predictive screener that when given soon after injury will accurately differentiate those who will later develop depression or posttraumatic stress disorder (PTSD) from those who will not. This study used a prospective, longitudinal cohort design. Subjects were randomly selected from all injured patients in the emergency department; the majority was assessed within 1 week postinjury with a short predictive screener, followed with in-person interviews after 3 and 6 months to determine the emergence of depression or PTSD within 6 months after injury. A total of 192 completed a risk factor survey at baseline; 165 were assessed over 6 months. Twenty-six subjects [15.8%, 95% confidence interval (CI) 10.2-21.3] were diagnosed with depression, four (2.4%, 95% CI 0.7-5.9) with PTSD and one with both. The final eight-item predictive screener was derived; optimal cutoff scores were ≥2 (of 4) depression risk items and ≥3 (of 5) PTSD risk items. The final screener demonstrated excellent sensitivity and moderate specificity both for clinically significant symptoms and for the diagnoses of depression and PTSD. A simple screener that can help identify those patients at highest risk for future development of PTSD and depression postinjury allows the judicious allocation of costly mental health resources. Copyright © 2011 Elsevier Inc. All rights reserved.

  8. PTSD and depressive symptoms are linked to DHEAS via personality.

    Science.gov (United States)

    Savic, Danka; Knezevic, Goran; Matic, Gordana; Damjanovic, Svetozar

    2018-06-01

    Research results on dehydroepiandrosterone sulfate ester (DHEAS) in post-traumatic stress disorder (PTSD) are inconsistent. We hypothesized that personality traits could be the confounders of DHEAS levels and disease symptoms, which could in part explain the discrepancy in findings. This study was a part of a broader project in which simultaneous psychological and biological investigations were carried out in hospital conditions. 380 male subjects were categorized in four groups: A) current PTSD (n = 132), B) lifetime PTSD (n = 66), C) trauma controls (n = 101), and D) healthy controls (n = 81), matched by age. The level of DHEAS is significantly lower in the current PTSD group than in trauma controls. All groups significantly differ in personality traits Disintegration and Neuroticism (current PTSD group having the highest scores). DHEAS is related to both PTSD and depressive symptoms; however, Structural Equation Model (SEM) shows that the relations are indirect, realized via their confounder - personality trait Disintegration. According to our project results, DHEAS is the second putative biomarker for trauma-related disorders that fails to fulfil this expectation. It appears to be more directly related to personality than to the disease symptoms (the first one being basal cortisol). Our data promote personality as a biologically based construct with seemingly important role in understanding the mental health status. Copyright © 2018 Elsevier Ltd. All rights reserved.

  9. Injured civilian survivors of suicide bomb attacks: from partial PTSD to recovery or to traumatisation. Where is the turning point?

    Science.gov (United States)

    Dolberg, Ornah T; Barkai, Gabriel; Leor, Agnes; Rapoport, Helena; Bloch, Miki; Schreiber, Shaul

    2010-03-01

    To assess the short- (3-9 months) and medium-term (30 months) occurrence and severity of post-traumatic stress disorder (PTSD) in civilian survivors of suicide bombing terrorist attacks. We evaluated 129 injured survivors of nine attacks in Israel who were treated in our emergency room between June 2000 and September 2002. Data on demographics, physical injuries and psychiatric symptoms were collected by both a structured clinical interview and standard assessment scales for depression, anxiety, and sleep quality. Diagnosis of PTSD was based on a Hebrew-validated DSM-IV SCID-PTSD rating scale. At the first assessment (short-term), 20 survivors (15.5%) met the criteria for full-blown PTSD and 54 (42%) for sub-clinical PTSD, while 55 (42.5%) evidenced no symptoms of PTSD. Two years later, only 54 patients could be located: 19 (35%) of them had either persistent or de novo PTSD and none had residual sub-clinical PTSD. Relatively few survivors of suicide bomb attacks had full-blown PTSD, while a substantial number of survivors had short-term sub-clinical PTSD. Two-year follow-up evaluations revealed that a significant a number of the patients available for testing (35%) had full-blown PTSD. These findings imply that medium-term follow-up of survivors is needed in order to establish the actual prevalence of PTSD.

  10. Short and long term effectiveness of a subject's specific novel brain and vestibular rehabilitation treatment modality in combat veterans suffering from PTSD

    Directory of Open Access Journals (Sweden)

    Frederick Robert Carrick

    2015-06-01

    Full Text Available AbstractIntroduction: Treatment for post-traumatic stress disorder (PTSD in combat veterans that have a long-term positive clinical effect has the potential to modify the treatment of PTSD. This outcome may result in changed and saved lives of our service personnel and their families. In a previous before-after-intervention study we demonstrated high statistical and substantively significant short-term changes in the Clinician Administered DSM-IV PTSD Scale (CAPS scores after a two week trial of a subject's particular novel brain and vestibular rehabilitation (VR program. The long-term maintenance of PTSD severity reduction was the subject of this study.Material and Methods:We studied the short and long term effectiveness of a subject's particular novel brain and VR treatment of PTSD in subjects who had suffered combat-related traumatic brain injuries in terms of PTSD symptom reduction. The trial was registered as ClinicalTrials.gov Identifier: NCT02003352. We analyzed the difference in the CAPS scores pre and post treatment (one week and three months using our subjects as their matched controls. Results:The generalized least squares (GLS technique demonstrated that with our 26 subjects in the 3 timed groups the R2 within groups was 0.000, R2 between groups was 0.000 and overall the R2 was 0.000. The GLS regression was strongly statistically significant z = 21.29, p < 0.001, 95% CI [58.7, 70.63]. The linear predictive margins over time demonstrated strong statistical and substantive significance of decreasing PTSD severity scores for all timed CAPS tests.Discussion:Our investigation has the promise of the development of superior outcomes of treatments in this area that will benefit a global society. The length of the treatment intervention involved (two weeks is less that other currently available treatments and has profound implications for cost, duration of disability and outcomes in the treatment of PTSD in combat veterans.

  11. Frequency of posttraumatic stress disorder (ptsd) among flood affected individuals

    International Nuclear Information System (INIS)

    Aslam, N.; Kamal, A.

    2014-01-01

    Objectives: To investigate the relationship of exposure to a traumatic event and the subsequent onset of Posttraumatic Stress Disorder (PTSD) in the population exposed to floods in Pakistan. Study Design: Cross sectional study. Place and duration of study: Individuals exposed to the 2010 flood in district Shadadkot, Sindh from April 2012 to September 2012. Methodology: Sample of the study comprised of 101 individuals from the flood affected areas in Pakistan. Age range of the participants was 15 to 50 years (M=27.73, SD = 7.19), with participation of both males and females. PTSD was assessed by using the self report measure, impact of Event Scale (IES) and the subjective and objective experience to flood was assessed through Flood Related Exposure Scale (FRES) devised by the authors. Results: The prevalence rate of PTSD among the flood affected population was 35.5%. Trauma had significant positive relation with objective flood exposure and subjective flood exposure (r=.27 and r =.38) respectively. Inverse relation appeared between age and PTSD (r=-.20). PTSD was higher among females as compared to males. Conclusion: Understanding the prevalence of PTSD helps the mental health professionals in devising intervention strategies. A longitudinal study design is recommended that may be developed for better understanding of trajectories of trauma response across time span. Our findings may help identify populations at risk for treatment research. (author)

  12. A comparison of intraoperative morphine sulfate and methadone hydrochloride on postoperative visual analogue scale pain scores and narcotic requirements.

    Science.gov (United States)

    Laur, D F; Sinkovich, J; Betley, K

    1995-02-01

    Morphine sulfate and methadone hydrochloride exhibit very different half-lives but are described as having an analgesic potency of one. The use of a drug like methadone may provide prolonged and constant analgesia in the perioperative setting. This double-blinded investigation used methadone and morphine intraoperatively and measured pain scores and narcotic requirements in the first 24 hours postoperatively. Thirty American Society of Anesthesiology (ASA) patients, physical status I through III, between the ages of 18 to 65 years were scheduled for orthopedic surgery and randomly assigned to receive morphine or methadone at 0.30 mg/kg. Fifteen patients received morphine and fifteen patients received methadone. There was no significant difference between the two groups in terms of age, height, weight, and ASA status. No statistically significant difference was observed among the two groups between the amount of analgesic requirements postoperatively or in the visual analogue scale pain score.

  13. Social support, oxytocin, and PTSD

    NARCIS (Netherlands)

    Olff, Miranda; Koch, Saskia B. J.; Nawijn, Laura; Frijling, Jessie L.; van Zuiden, Mirjam; Veltman, Dick J.

    2014-01-01

    A lack of social support and recognition by the environment is one of the most consistent risk factors for posttraumatic stress disorder (PTSD), and PTSD patients will recover faster with proper social support. The oxytocin system has been proposed to underlie beneficial effects of social support as

  14. Mitigating PTSD: Emotionally Intelligent Leaders

    Science.gov (United States)

    2010-05-28

    stress . Post Traumatic Stress Disorder ( PTSD ) is a signature injury of this war with far...to combat related stress . Post Traumatic Stress Disorder ( PTSD ) is a signature injury of this war with far reaching implications that include reduced...Washington DC: American Psychiatric Association,1994). 3 Babette Rothschild, “ Post - Traumatic Stress Disorder : Identification and Diagnosis,”

  15. The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample.

    Science.gov (United States)

    Prins, Annabel; Bovin, Michelle J; Smolenski, Derek J; Marx, Brian P; Kimerling, Rachel; Jenkins-Guarnieri, Michael A; Kaloupek, Danny G; Schnurr, Paula P; Kaiser, Anica Pless; Leyva, Yani E; Tiet, Quyen Q

    2016-10-01

    Posttraumatic Stress Disorder (PTSD) is associated with increased health care utilization, medical morbidity, and tobacco and alcohol use. Consequently, screening for PTSD has become increasingly common in primary care clinics, especially in Veteran healthcare settings where trauma exposure among patients is common. The objective of this study was to revise the Primary Care PTSD screen (PC-PTSD) to reflect the new Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for PTSD (PC-PTSD-5) and to examine both the diagnostic accuracy and the patient acceptability of the revised measure. We compared the PC-PTSD-5 results with those from a brief psychiatric interview for PTSD. Participants also rated screening preferences and acceptability of the PC-PTSD-5. A convenience sample of 398 Veterans participated in the study (response rate = 41 %). Most of the participants were male, in their 60s, and the majority identified as non-Hispanic White. The PC-PTSD-5 was used as the screening measure, a modified version of the PTSD module of the MINI-International Neuropsychiatric Interview was used to diagnose DSM-5 PTSD, and five brief survey items were used to assess acceptability and preferences. The PC-PTSD-5 demonstrated excellent diagnostic accuracy (AUC = 0.941; 95 % C.I.: 0.912- 0.969). Whereas a cut score of 3 maximized sensitivity (κ[1]) = 0.93; SE = .041; 95 % C.I.: 0.849-1.00), a cut score of 4 maximized efficiency (κ[0.5] = 0.63; SE = 0.052; 95 % C.I.: 0.527-0.731), and a cut score of 5 maximized specificity (κ[0] = 0.70; SE = 0.077; 95 % C.I.: 0.550-0.853). Patients found the screen acceptable and indicated a preference for administration by their primary care providers as opposed to by other providers or via self-report. The PC-PTSD-5 demonstrated strong preliminary results for diagnostic accuracy, and was broadly acceptable to patients.

  16. Sequence analysis of annually normalized citation counts: an empirical analysis based on the characteristic scores and scales (CSS) method.

    Science.gov (United States)

    Bornmann, Lutz; Ye, Adam Y; Ye, Fred Y

    2017-01-01

    In bibliometrics, only a few publications have focused on the citation histories of publications, where the citations for each citing year are assessed. In this study, therefore, annual categories of field- and time-normalized citation scores (based on the characteristic scores and scales method: 0 = poorly cited, 1 = fairly cited, 2 = remarkably cited, and 3 = outstandingly cited) are used to study the citation histories of papers. As our dataset, we used all articles published in 2000 and their annual citation scores until 2015. We generated annual sequences of citation scores (e.g., [Formula: see text]) and compared the sequences of annual citation scores of six broader fields (natural sciences, engineering and technology, medical and health sciences, agricultural sciences, social sciences, and humanities). In agreement with previous studies, our results demonstrate that sequences with poorly cited (0) and fairly cited (1) elements dominate the publication set; sequences with remarkably cited (3) and outstandingly cited (4) periods are rare. The highest percentages of constantly poorly cited papers can be found in the social sciences; the lowest percentages are in the agricultural sciences and humanities. The largest group of papers with remarkably cited (3) and/or outstandingly cited (4) periods shows an increasing impact over the citing years with the following orders of sequences: [Formula: see text] (6.01%), which is followed by [Formula: see text] (1.62%). Only 0.11% of the papers ( n  = 909) are constantly on the outstandingly cited level.

  17. Predicting PTSD following bank robbery

    DEFF Research Database (Denmark)

    Hansen, Maj; Elklit, Ask

    Each year, numerous bank robberies take place worldwide. Even so, only few studies have investigated the psychological sequelae of bank robbery and little is known about the risk factors associated with the development of posttraumatic stress disorder (PTSD) following this potentially traumatic...... event. Knowledge about risk factors related to PTSD may allow for preventive measures to be taken against the development of PTSD and reduce the large cost associated with the disorder. We investigated multiple predictors of PTSD severity in a highly representative Danish cohort study of bank employees...... exposed to robbery (N = 371, response rate = 73 %, dropout rate = 18 %). The results of a hierarchical regression analysis showed that 51 % of the variance in PTSD severity could be explained with only peritraumatic dissociation, acute stress disorder (ASD) severity, and negative cognitions about self...

  18. Summary scores captured changes in subjects' QoL as measured by the multiple scales of the EORTC QLQ-C30.

    Science.gov (United States)

    Phillips, Rachel; Gandhi, Mihir; Cheung, Yin Bun; Findlay, Michael P; Win, Khin Maung; Hai, Hoang Hoa; Yang, Jin Mo; Lobo, Rolley Rey; Soo, Khee Chee; Chow, Pierce K H

    2015-08-01

    To examine the performance of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) global health status/quality of life (QoL) scale and two summary scores to detect changes in the QoL profile over time, according to changes in the individual scales. Data came from 167 clinical trial patients with unresectable (advanced) hepatocellular carcinoma. The global health status/QoL scale of the questionnaire contained two items: overall health and overall QoL. Nordin and Hinz proposed summary scores for the questionnaire. A mixed-effect model was fitted to estimate trends in scores over time. Predominantly the individual scale scores declined over time; however, the global health status/QoL score was stable [rate of change = -0.3 per month; 95% confidence interval (CI): -1.2, 0.6]. Nordin's summary score, which gave equal weight to the 15 questionnaire scales, and Hinz's summary score, which gave equal weight to the 30 questionnaire items, showed a statistically significant decline over time, 3.4 (95% CI: -4.5, -2.4) and 4.2 (95% CI: -5.3, -3.0) points per month, respectively. In contrast to the global health status/QoL scale, the summary scores proposed by Nordin and Hinz detected changes in subjects' QoL profile described by the EORTC QLQ-C30 individual scales. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Child abuse predicts adult PTSD symptoms among individuals diagnosed with intellectual disabilities

    Directory of Open Access Journals (Sweden)

    Claudia eCatani

    2015-10-01

    Full Text Available Prior research has shown that people with intellectual disabilities (ID are more likely to experience child abuse as well as other forms of traumatic events later in life compared to the general population. Little is known however, about the association of these experiences with adult mental health in individuals with ID. The present study aimed to assess whether child abuse in families and institutions as well as other types of adverse life events, were associated with current Posttraumatic Stress Disorder (PTSD and depression symptoms in individuals with ID. We conducted clinical interviews which included standardized self-report measures for childhood abuse, PTSD, and depression in an unselected sample of 56 persons with a medical diagnosis of intellectual disability who were attending a specialized welfare center. The frequency of traumatic experiences was very high, with physical and emotional child abuse being the most common trauma types. 87% of the persons reported at least one aversive experience on the family violence spectrum, and 50% of the sample reported a violent physical attack later in adulthood. 25% were diagnosed with PTSD and almost 27% had a critical score on the depression scale. Physical and emotional child abuse was positively correlated with the amount of institutional violence and the number of general traumatic events, whereas childhood sexual abuse was related to the experience of intimate partner violence in adult life. A linear regression revealed child abuse in the family to be the only significant independent predictor of PTSD symptom severity. The current findings underscore the central role of child maltreatment in the increased risk of further victimization and in the development of mental health problems in adulthood in individuals with ID. Our data have important clinical implications and demonstrate the need for targeted prevention and intervention programs that are tailored to the specific needs of children

  20. Preliminary evaluation of PTSD Coach, a smartphone app for post-traumatic stress symptoms.

    Science.gov (United States)

    Kuhn, Eric; Greene, Carolyn; Hoffman, Julia; Nguyen, Tam; Wald, Laura; Schmidt, Janet; Ramsey, Kelly M; Ruzek, Josef

    2014-01-01

    PTSD Coach is a mobile application (app) designed to help individuals who have post-traumatic stress disorder (PTSD) symptoms better understand and self-manage their symptoms. It has wide-scale use (over 130,000 downloads in 78 countries) and very favorable reviews but has yet to be evaluated. Therefore, this study examines user satisfaction, perceived helpfulness, and usage patterns of PTSD Coach in a sample of 45 veterans receiving PTSD treatment. After using PTSD Coach for several days, participants completed a survey of satisfaction and perceived helpfulness and focus groups exploring app use and benefit from use. Data indicate that participants were very satisfied with PTSD Coach and perceived it as being moderately to very helpful with their PTSD symptoms. Analysis of focus group data resulted in several categories of app use: to manage acute distress and PTSD symptoms, at scheduled times, and to help with sleep. These findings offer preliminary support for the acceptability and perceived helpfulness of PTSD Coach and suggest that it has potential to be an effective self-management tool for PTSD. Although promising, future research is required to validate this, given study limitations. Reprint & Copyright © 2014 Association of Military Surgeons of the U.S.

  1. An investigation of PTSD's core dimensions and relations with anxiety and depression.

    Science.gov (United States)

    Byllesby, Brianna M; Durham, Tory A; Forbes, David; Armour, Cherie; Elhai, Jon D

    2016-03-01

    Posttraumatic stress disorder (PTSD) is highly comorbid with anxiety and depressive disorders, which is suggestive of shared variance or common underlying dimensions. The purpose of the present study was to examine the relationship between the latent factors of PTSD with the constructs of anxiety and depression in order to increase understanding of the co-occurrence of these disorders. Data were collected from a nonclinical sample of 186 trauma-exposed participants using the PTSD Checklist and Hospital Anxiety and Depression Scale. Confirmatory factor analyses were conducted to determine model fit comparing 3 PTSD factor structure models, followed by Wald tests comparing the relationships between PTSD factors and the core dimensions of anxiety and depression. In model comparisons, the 5-factor dysphoric arousal model of PTSD provided the best fit for the data, compared to the emotional numbing and dysphoria models of PTSD. Compared to anxious arousal, the dysphoric arousal and numbing factors of PTSD were more related to depression severity. Numbing, anxious arousal, and dysphoric arousal were not differentially related to the latent anxiety factor. The underlying factors of PTSD contain aspects of the core dimensions of both anxiety and depression. The heterogeneity of PTSD's associations with anxiety and depressive constructs requires additional empirical exploration because clarification regarding these relationships will impact diagnostic classification as well as clinical practice. (c) 2016 APA, all rights reserved).

  2. [Interpreting change scores of the Behavioural Rating Scale for Geriatric Inpatients (GIP)].

    Science.gov (United States)

    Diesfeldt, H F A

    2013-09-01

    The Behavioural Rating Scale for Geriatric Inpatients (GIP) consists of fourteen, Rasch modelled subscales, each measuring different aspects of behavioural, cognitive and affective disturbances in elderly patients. Four additional measures are derived from the GIP: care dependency, apathy, cognition and affect. The objective of the study was to determine the reproducibility of the 18 measures. A convenience sample of 56 patients in psychogeriatric day care was assessed twice by the same observer (a professional caregiver). The median time interval between rating occasions was 45 days (interquartile range 34-58 days). Reproducibility was determined by calculating intraclass correlation coefficients (ICC agreement) for test-retest reliability. The minimal detectable difference (MDD) was calculated based on the standard error of measurement (SEM agreement). Test-retest reliability expressed by the ICCs varied from 0.57 (incoherent behaviour) to 0.93 (anxious behaviour). Standard errors of measurement varied from 0.28 (anxious behaviour) to 1.63 (care dependency). The results show how the GIP can be applied when interpreting individual change in psychogeriatric day care participants.

  3. Couples Facing the Birth of a Newborn with a Congenital Anomaly: PTSD Symptoms in the First Year.

    Science.gov (United States)

    Bevilacqua, Francesca; Morini, Francesco; Zaccara, Antonio; De Marchis, Chiara; Braguglia, Annabella; Gentile, Simonetta; Bagolan, Pietro; Aite, Lucia

    2018-04-18

     The objective of this study was to assess the presence of posttraumatic stress disorder (PTSD) symptoms in parental couples of newborn requiring early surgery at 6 and 12 months after birth.  A longitudinal study was set up from January 2014 to June 2015. As a measure of PTSD, we used the Italian version of the Impact of Event Scale-Revised (IES-R).  Thirty-four couples form the object of the study. At 6 months, half of mothers (52.9%) and fathers (44.1%) reported traumatic stress symptoms above the clinical cutoff. Percentages remained stable at 12 months. When parental gender and length of follow-up were compared with two-factor analysis of variance, none had an impact on IES-R score, nor an interaction between these factors was found. A significant correlation of IES-R total score was present within the couple both at 6 and 12 months (6 months- r : 0.6842, p  stressful situation with persistent burden for both parents who are at high risk of developing PTSD symptoms. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  4. "Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans": Correction to Bovin et al. (2016).

    Science.gov (United States)

    2017-06-01

    Reports an error in "Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5) in veterans" by Michelle J. Bovin, Brian P. Marx, Frank W. Weathers, Matthew W. Gallagher, Paola Rodriguez, Paula P. Schnurr and Terence M. Keane ( Psychological Assessment , 2016[Nov], Vol 28[11], 1379-1391). In the article, the departments and affiliations were incorrectly listed for authors Michelle J. Bovin, Brian P. Marx, Matthew W. Gallagher, Paola Rodriguez, Paula P. Schnurr, and Terence M. Keane. The first department and affiliation for authors Michelle J. Bovin, Brian P. Marx, Matthew W. Gallagher, Paola Rodriguez, and Terence M. Keane and should have read "National Center for PTSD at VA Boston Healthcare System, Boston, Massachusetts". The first department and affiliation for author Paula P. Schnurr should have read "National Center for PTSD, White River Junction, Vermont." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2015-55809-001.) This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal

  5. The Utility and Comparative Incremental Validity of the MMPI-2 and Trauma Symptom Inventory Validity Scales in the Detection of Feigned PTSD

    Science.gov (United States)

    Efendov, Adele A.; Sellbom, Martin; Bagby, R. Michael

    2008-01-01

    The authors examined the comparative predictive capacity of the Trauma Symptom Inventory (TSI) Atypical Response Scale (ATR) and the standard set of Minnesota Multiphasic Personality Inventory-2 (MMPI-2) fake-bad validity scales (i.e., F, F[subscript B[prime

  6. The efficiency of parameter estimation of latent path analysis using summated rating scale (SRS) and method of successive interval (MSI) for transformation of score to scale

    Science.gov (United States)

    Solimun, Fernandes, Adji Achmad Rinaldo; Arisoesilaningsih, Endang

    2017-12-01

    Research in various fields generally investigates systems and involves latent variables. One method to analyze the model representing the system is path analysis. The data of latent variables measured using questionnaires by applying attitude scale model yields data in the form of score, before analyzed should be transformation so that it becomes data of scale. Path coefficient, is parameter estimator, calculated from scale data using method of successive interval (MSI) and summated rating scale (SRS). In this research will be identifying which data transformation method is better. Path coefficients have smaller varieties are said to be more efficient. The transformation method that produces scaled data and used in path analysis capable of producing path coefficients (parameter estimators) with smaller varieties is said to be better. The result of analysis using real data shows that on the influence of Attitude variable to Intention Entrepreneurship, has relative efficiency (ER) = 1, where it shows that the result of analysis using data transformation of MSI and SRS as efficient. On the other hand, for simulation data, at high correlation between items (0.7-0.9), MSI method is more efficient 1.3 times better than SRS method.

  7. Impulsive responding in threat and reward contexts as a function of PTSD symptoms and trait disinhibition.

    Science.gov (United States)

    Sadeh, Naomi; Spielberg, Jeffrey M; Hayes, Jasmeet P

    2018-01-01

    We examined current posttraumatic stress disorder (PTSD) symptoms, trait disinhibition, and affective context as contributors to impulsive and self-destructive behavior in 94 trauma-exposed Veterans. Participants completed an affective Go/No-Go task (GNG) with different emotional contexts (threat, reward, and a multidimensional threat/reward condition) and current PTSD, trait disinhibition, and risky/self-destructive behavior measures. PTSD interacted with trait disinhibition to explain recent engagement in risky/self-destructive behavior, with Veterans scoring high on trait disinhibition and current PTSD symptoms reporting the highest levels of these behaviors. On the GNG task, commission errors were also associated with the interaction of PTSD symptoms and trait disinhibition. Specifically, PTSD symptoms were associated with greater commission errors in threat vs. reward contexts for individuals who were low on trait disinhibition. In contrast, veterans high on PTSD and trait disinhibition exhibited the greatest number of commission errors in the multidimensional affective context that involved both threat and reward processing. Results highlight the interactive effects of PTSD and disinhibited personality traits, as well as threat and reward systems, as risk factors for impulsive and self-destructive behavior in trauma-exposed groups. Findings have clinical implications for understanding heterogeneity in the expression of PTSD and its association with disinhibited behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. PTSD, emotion dysregulation, and dissociative symptoms in a highly traumatized sample

    Science.gov (United States)

    Powers, Abigail; Cross, Dorthie; Fani, Negar; Bradley, Bekh

    2015-01-01

    Exposure to multiple traumas has been shown to result in many negative mental health outcomes, including posttraumatic stress disorder (PTSD). Dissociation, which involves disruptions in memory, identity, and perceptions, may be a component of PTSD, particularly among individuals who have experienced childhood trauma. Emotion regulation difficulties are also strongly associated with childhood trauma and emotion dysregulation may be a particularly important factor to consider in the development and maintenance of dissociative symptoms. The goal of the present study was to determine whether emotion dysregulation mediated the relationship between PTSD symptoms and dissociation in a sample of 154 (80% female, 97% African-American) adults recruited from a public, urban hospital. PTSD was measured using the Clinician Administered PTSD Scale, emotion dysregulation was measured using the Difficulties in Emotion Regulation Scale, and dissociation was measured using the Multiscale Dissociation Inventory. A linear regression analysis showed that both PTSD and emotion dysregulation were statistically significant predictors of dissociation even after controlling for trauma exposure. Alexithymia and an inability to use emotion regulation strategies in particular were predictive of dissociation above and beyond other predictor variables. Using bootstrapping techniques, we found that overall emotion dyregulation partially mediated the effect of PTSD symptoms on dissociative symptoms. Our results suggest that emotion dysregulation may be important in understanding the relation between PTSD and dissociative symptoms. Treatment approaches may consider a focus on training in emotional understanding and the development of adaptive regulation strategies as a way to address dissociative symptoms in PTSD patients. PMID:25573648

  9. National Institutes of Health Stroke Scale-Time Score Predicts Outcome after Endovascular Therapy in Acute Ischemic Stroke: A Retrospective Single-Center Study.

    Science.gov (United States)

    Todo, Kenichi; Sakai, Nobuyuki; Kono, Tomoyuki; Hoshi, Taku; Imamura, Hirotoshi; Adachi, Hidemitsu; Kohara, Nobuo

    2016-05-01

    Outcomes after successful endovascular therapy in acute ischemic stroke are associated with onset-to-reperfusion time (ORT) and the National Institutes of Health Stroke Scale (NIHSS) score. In intravenous recombinant tissue plasminogen activator therapy, the NIHSS-time score, calculated by multiplying onset-to-treatment time with the NIHSS score, has been shown to predict clinical outcomes. In this study, we assessed whether a similar combination of the ORT and the NIHSS score can be applied to predict the outcomes after endovascular therapy. We retrospectively reviewed the charts of 128 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy. We analyzed the association of the ORT, the NIHSS score, and the NIHSS-time score with good outcome (modified Rankin Scale score ≤ 2 at 3 months). Good outcome rates for patients with NIHSS-time scores of 84.7 or lower, scores higher than 84.7 up to 127.5 or lower, and scores higher than 127.5 were 72.1%, 44.2%, and 14.3%, respectively (P < .01). Multivariate logistic regression analysis revealed that the NIHSS-time score was an independent predictor of good outcomes (odds ratio, .372; 95% confidence interval, .175-.789) after adjusting for age, sex, internal carotid artery occlusion, plasma glucose level, ORT, and NIHSS score. The NIHSS-time score can predict good clinical outcomes after endovascular treatment. Copyright © 2016 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  10. Type D personality and the development of PTSD symptoms: a prospective study.

    Science.gov (United States)

    Rademaker, Arthur R; van Zuiden, Mirjam; Vermetten, Eric; Geuze, Elbert

    2011-05-01

    Psychological trauma and prolonged stress may cause mental disorders such as posttraumatic stress disorder (PTSD). Pretrauma personality is an important determinant of posttraumatic adjustment. Specifically, trait neuroticism has been identified as a risk factor for PTSD. Additionally, the combination of high negative affectivity or neuroticism with marked social inhibition or introversion, also called Type D personality (Denollet, 2000), may compose a risk factor for PTSD. There is no research available that examined pretrauma Type D personality in relation to PTSD. The present study examined the predictive validity of the Type D personality construct in a sample of Dutch soldiers. Data were collected prior to and 6 months after military deployment to Afghanistan. Separate multiple regression analyses were performed to examine the predictive validity of Type D personality. First, Type D personality was defined as the interaction between negative affect and social inhibition (Na × Si). In a second analysis, Type D was defined following cutoff criteria recommended by Denollet (2000). Results showed that negative affectivity was a significant predictor of PTSD symptoms. Social inhibition and the interaction Na × Si did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, negative affectivity, and prior psychological symptoms. A second analysis showed that Type D personality (dichotomous) did not add to the amount of explained variance in postdeployment PTSD scores over the effects of childhood abuse, and prior psychological symptoms. Therefore, Type D personality appears to be of limited value to explain development of combat-related PTSD symptoms.

  11. Daily-level associations between PTSD and cannabis use among young sexual minority women.

    Science.gov (United States)

    Dworkin, Emily R; Kaysen, Debra; Bedard-Gilligan, Michele; Rhew, Isaac C; Lee, Christine M

    2017-11-01

    Sexual minority women have elevated trauma exposure and prevalence of posttraumatic stress disorder (PTSD) compared to heterosexual women and they are also more likely to use cannabis, although no research has examined relationships between PTSD and cannabis use in this population. Daily-level methodologies are necessary to examine proximal associations between PTSD and use. This study included 90 trauma-exposed young adult women who identified as sexual minorities (34.4% identified as lesbian and 48.9% identified as bisexual) and evaluated daily-level associations between their PTSD symptoms and cannabis use. Participants were assessed at two measurement waves, one year apart, each consisting of 14 consecutive daily assessments. Cannabis use occurred on 22.8% of the days. Results from generalized linear mixed effects models showed that a person's mean level of PTSD symptom severity across days was strongly associated with same-day likelihood of cannabis use (OR=2.67 for 1 SD increase in PTSD score; p<0.001). However, daily deviation from one's average PTSD score was not associated with cannabis use on the same day. Findings suggest that PTSD severity may confer general risk for cannabis use, rather than being a state-dependent risk factor. Copyright © 2017. Published by Elsevier Ltd.

  12. Relationship between burnout and PTSD symptoms in firefighters: the moderating effects of a sense of calling to firefighting.

    Science.gov (United States)

    Jo, Insung; Lee, Songhee; Sung, Gyhye; Kim, Minkyoung; Lee, Sanghyuk; Park, Jooeon; Lee, Kangsoo

    2018-01-01

    Firefighting has been reported to lead to burnout and posttraumatic stress disorder (PTSD). However, burnout and PTSD symptoms may vary depending on personal characteristics, such as having a sense of calling. This study examined the role of calling in the association between burnout and PTSD symptoms. We hypothesized that burnout would be associated with more severe PTSD symptoms and calling would buffer the relationship between burnout and PTSD symptoms. The Korean version of the Maslach Burnout Inventory-General Survey, Sense of Calling Subscale of the Professionalism Scale, and the Impact of Event Scale-Revised-Korean version were used to measure burnout, calling, and PTSD symptoms. Data from 109 of 127 firefighters from Gyeonggi-do, South Korea were analyzed using hierarchical linear regression. Burnout was a significant predictor of PTSD symptoms. Furthermore, the interaction term between burnout and calling accounted for a significant variance in PTSD symptoms. Higher burnout was associated with severe PTSD symptoms, but this relationship differed by the level of calling. The increase in PTSD symptoms due to increased burnout in the high calling group was relatively higher than in the low and average calling groups. Calling, though perceived as a positive variable, can be hazardous to exhausted people. A sense of calling as part of one's job identity should not be encouraged until personal circumstances and characteristics, such burnout symptoms, are evaluated. Identifying context and variables associated with PTSD for interventions with firefighters and persons in other dangerous occupations should aid in their recovery from trauma exposure.

  13. A Comparative Study of Glasgow Coma Scale and Full Outline of Unresponsiveness Scores for Predicting Long-Term Outcome After Brain Injury.

    Science.gov (United States)

    McNett, Molly M; Amato, Shelly; Philippbar, Sue Ann

    2016-01-01

    The aim of this study was to compare predictive ability of hospital Glasgow Coma Scale (GCS) scores and scores obtained using a novel coma scoring tool (the Full Outline of Unresponsiveness [FOUR] scale) on long-term outcomes among patients with traumatic brain injury. Preliminary research of the FOUR scale suggests that it is comparable with GCS for predicting mortality and functional outcome at hospital discharge. No research has investigated relationships between coma scores and outcome 12 months postinjury. This is a prospective cohort study. Data were gathered on adult patients with traumatic brain injury admitted to urban level I trauma center. GCS and FOUR scores were assigned at 24 and 72 hours and at hospital discharge. Glasgow Outcome Scale scores were assigned at 6 and 12 months. The sample size was n = 107. Mean age was 53.5 (SD = ±21, range = 18-91) years. Spearman correlations were comparable and strongest among discharge GCS and FOUR scores and 12-month outcome (r = .73, p coma scores performed best for both tools, with GCS discharge scores predictive in multivariate models.

  14. Screening for HIV-related PTSD: Sensitivity and specificity of the 17 ...

    African Journals Online (AJOL)

    This study assessed the sensitivity and specificity of the 17-item Post traumatic Stress Diagnostic Scale (PDS), a self-report instrument, in the detection of HIVrelated PTSD. An adapted version of the PTSD module of the Composite International Diagnostic Interview (CIDI) served as the gold standard. Method: 85 HIV-positive ...

  15. A Controlled Trial of Topiramate Treatment for Alcohol Dependence in Veterans with PTSD

    Science.gov (United States)

    2015-10-01

    research on combined relapse prevention and exposure-based interventions in the treatment of AUD and PTSD. Presentation 4: Pharmacologic Therapies...psychological interviews to determine diagnostic eligibility [Structured Clinical Interview for DSM-IV (SCID) and the Clinician Administered PTSD Scale ...Psychology of Addictive Behaviors. PRESENTATION AT MOMRP SUSBSTANCE ABUSE IPR IN FT. DETRICK, MD: Presented overview & progress of study and pilot

  16. Biomarkers of PTSD: military applications and considerations

    OpenAIRE

    Amy Lehrner; Rachel Yehuda

    2014-01-01

    Background: Although there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk fo...

  17. Psychometric properties of the PTSD Checklist for DSM-5: a pilot study

    Directory of Open Access Journals (Sweden)

    Josefin Sveen

    2016-04-01

    Full Text Available Background: To date there is a lack of studies assessing the psychometric properties of the recently revised PTSD Checklist (PCL, the PTSD Checklist for DSM-5 (PCL-5. The aim of this pilot study was to examine the psychometric properties of the PCL-5 in parents of children with burns. Methods: The participating parents (N=62, mean age=38 completed self-report questionnaires, 0.8–5.6 years after their child's burn. Measures were the PCL-5, the Impact of Event Scale-Revised (IES-R, the Montgomery–Åsberg Depression Rating Scale (MADRS, and the Perceived Stress Scale (PSS. Burn severity of the child and sociodemographic variables was obtained. Results: The parents’ average PCL-5 scores were low to moderate. The internal consistency of the PCL-5 was satisfactory, with Cronbach's alpha ranging from 0.56 to 0.77 and mean inter-item correlations ranging from 0.22 to 0.73 for the four PCL-5 subscales and the PCL-5 total. The PCL-5 subscales were moderately to highly correlated with the corresponding IES-R subscales as well as MADRS and PSS (p<0.05, whereas associations with sociodemographics and burn severity were low to moderate. Conclusions: This study provides preliminary support for the use of PCL-5. The results indicate satisfactory psychometric properties of the PCL-5 as measured with internal consistency, test–retest reliability, and aspects of convergent validity.

  18. Feature: Post Traumatic Stres Disorder PTSD: A Growing Epidemic / Neuroscience and PTSD Treatments

    Science.gov (United States)

    ... Navigation Bar Home Current Issue Past Issues Feature PTSD PTSD: A Growing Epidemic Past Issues / Winter 2009 Table ... 20 percent of Iraqi war veterans Neuroscience and PTSD Treatments Dr. Barbara Rothbaum believes current research is ...

  19. Management of trauma and PTSD

    African Journals Online (AJOL)

    of post-traumatic stress disorder (PTSD). [1]. In the USA, the National .... Recent work suggests that an alternative approach could .... and the National Institute of Clinical. Excellence ..... American Psychiatric Association. Diagnostic and ...

  20. Association between facial expression and PTSD symptoms among young children exposed to the Great East Japan Earthquake: A pilot study

    Directory of Open Access Journals (Sweden)

    Takeo eFujiwara

    2015-10-01

    Full Text Available Emotional numbing is a symptom of post-traumatic stress disorder (PTSD characterized by a loss of interest in usually enjoyable activities, feeling detached from others, and an inability to express a full range of emotions. Emotional numbing is usually assessed through self-report, and is particularly difficult to ascertain among young children. We conducted a pilot study to explore the use of facial expression ratings in response to a comedy video clip, and to assess emotional reactivity among preschool children directly exposed to the Great East Japan Earthquake. This study included 23 child participants. Child PTSD symptoms were measured using a modified version of the Parent’s Report of the Child’s Reaction to Stress scale. Children were filmed while watching a 2-minute video compilation of natural scenes (‘baseline video’ followed by a 2-minute video clip from a television comedy (‘comedy video’. Children’s facial expressions were processed using Noldus FaceReader software, which implements the Facial Action Coding System (FACS. We investigated the association between PTSD symptom scores and facial emotion reactivity using linear regression analysis. Children with higher PTSD symptom scores showed a significantly greater proportion of neutral facial expressions, controlling for sex, age and baseline facial expression (p < .05. This pilot study suggests that facial emotion reactivity could provide an index against which emotional numbing could be measured in young children, using facial expression recognition software. This pilot study adds to the emerging literature on using experimental psychopathology methods to characterize children’s reactions to disasters.

  1. 2000-2010 Annual State-Scale Service and Domain Scores for Forecasting Well-Being from Service-Based Decisions

    Data.gov (United States)

    U.S. Environmental Protection Agency — 2000-2010 Annual State-Scale Service and Domain scores used to support the approach for forecasting EPA's Human Well-Being Index. A modeling approach was developed...

  2. Relationships between soldiers' PTSD symptoms and spousal communication during deployment.

    Science.gov (United States)

    Carter, Sarah; Loew, Benjamin; Allen, Elizabeth; Stanley, Scott; Rhoades, Galena; Markman, Howard

    2011-06-01

    Social support, including support from spouses, may buffer against posttraumatic stress disorder (PTSD) symptoms. The current study assessed whether the frequency of spousal communication during a recent deployment, a potentially important source of support for soldiers, was related to postdeployment PTSD symptoms. Data came from 193 married male Army soldiers who returned from military deployment within the past year. For communication modalities conceptualized as delayed (i.e., letters, care packages, and e-mails), greater spousal communication frequency during deployment was associated with lower postdeployment PTSD symptom scores, but only at higher levels of marital satisfaction (p = .009). At lower marital satisfaction, more delayed spousal communication during deployment was associated with more PTSD symptoms (p = .042). For communication modalities conceptualized as interactive (i.e., phone calls, instant messaging, instant messaging with video), the same general direction of effects was seen, but the interaction between communication frequency and marital satisfaction predicting PTSD symptoms did not reach significance. Copyright © 2011 International Society for Traumatic Stress Studies.

  3. Seeing the Forest for the Trees: Prevalence of Low Scores on the Wechsler Intelligence Scale for Children, Fourth Edition (WISC-IV)

    Science.gov (United States)

    Brooks, Brian L.

    2010-01-01

    Low scores across a battery of tests are common in healthy people and vary by demographic characteristics. The purpose of the present article was to present the base rates of low scores for the Wechsler Intelligence Scale for Children, fourth edition (WISC-IV; D. Wechsler, 2003). Participants included 2,200 children and adolescents between 6 and…

  4. Sentiment analysis for PTSD signals

    CERN Document Server

    Kagan, Vadim; Sapounas, Demetrios

    2013-01-01

    This book describes a computational framework for real-time detection of psychological signals related to Post-Traumatic Stress Disorder (PTSD) in online text-based posts, including blogs and web forums. Further, it explores how emerging computational techniques such as sentiment mining can be used in real-time to identify posts that contain PTSD-related signals, flag those posts, and bring them to the attention of psychologists, thus providing an automated flag and referral capability.

  5. Do Multidimensional Pain Inventory scale score changes indicate risk of receiving sick leave benefits 1 year after a pain rehabilitation programme?

    DEFF Research Database (Denmark)

    Nyberg, Vanja E; Novo, Mehmed; Sjölund, Bengt H

    2011-01-01

    To study whether scale score changes in the Multidimensional Pain Inventory (MPI) can predict which persons disabled by pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme.......To study whether scale score changes in the Multidimensional Pain Inventory (MPI) can predict which persons disabled by pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme....

  6. COMT Val158Met polymorphism moderates the association between PTSD symptom severity and hippocampal volume.

    Science.gov (United States)

    Hayes, Jasmeet P; Logue, Mark W; Reagan, Andrew; Salat, David; Wolf, Erika J; Sadeh, Naomi; Spielberg, Jeffrey M; Sperbeck, Emily; Hayes, Scott M; McGlinchey, Regina E; Milberg, William P; Verfaellie, Mieke; Stone, Annjanette; Schichman, Steven A; Miller, Mark W

    2017-03-01

    Memory-based alterations are among the hallmark symptoms of posttraumatic stress disorder (PTSD) and may be associated with the integrity of the hippocampus. However, neuroimaging studies of hippocampal volume in individuals with PTSD have yielded inconsistent results, raising the possibility that various moderators, such as genetic factors, may influence this association. We examined whether the catechol-O-methyltransferase (COMT) Val158Met polymorphism, which has previously been shown to be associated with hippocampal volume in healthy individuals, moderates the association between PTSD and hippocampal volume. Recent war veterans underwent structural MRI on a 3 T scanner. We extracted volumes of the right and left hippocampus using FreeSurfer and adjusted them for individual differences in intracranial volume. We assessed PTSD severity using the Clinician-Administered PTSD Scale. Hierarchical linear regression was used to model the genotype (Val158Met polymorphism) × PTSD severity interaction and its association with hippocampal volume. We included 146 white, non-Hispanic recent war veterans (90% male, 53% with diagnosed PTSD) in our analyses. A significant genotype × PTSD symptom severity interaction emerged such that individuals with greater current PTSD symptom severity who were homozygous for the Val allele showed significant reductions in left hippocampal volume. The direction of proposed effects is unknown, thus precluding definitive assessment of whether differences in hippocampal volume reflect a consequence of PTSD, a pre-existing characteristic, or both. Our findings suggest that the COMT polymorphism moderates the association between PTSD and hippocampal volume. These results highlight the role that the dopaminergic system has in brain structure and suggest a possible mechanism for memory disturbance in individuals with PTSD.

  7. Trauma exposure, resilience, social support, and PTSD construct validity among former prisoners of war.

    Science.gov (United States)

    Gold, P B; Engdahl, B E; Eberly, R E; Blake, R J; Page, W F; Frueh, B C

    2000-01-01

    The aim of this study was to investigate predictors of persistent symptoms of posttraumatic stress disorder (PTSD) and to examine the construct validity of PTSD in a national sample of 270 World War II and Korean Conflict prisoners of war (POWs). POWs were interviewed at two points in time (1965 and 1990). Predictors included PTSD symptomatology measured in 1965 by items from the Cornell Medical Index (CMI), severity of captivity trauma, resilience factors, and post-trauma social support. The criterion, symptomatology in the early 1990s, was evaluated with the PTSD module of the Structured Clinical Interview for DSM (SCID). The CMI provided only partial coverage of PTSD criteria and appeared to provide only a general index of distress. Clustering of SCID items in two-dimensional space via multidimensional scaling analysis offers some construct validation for the DSM's differentiation of PTSD symptoms into criterion groups, although there was not a perfect match. Trauma severity is best related to PTSD symptomatology experienced in 1990, mitigated in part by greater education level and age at the time of trauma exposure. Surprisingly, 1965 distress added only a modest amount to the prediction of current distress, while post-trauma social support added none. These findings support previous work showing the severe psychological sequelae of POW status 40-50 years after captivity, and indicate that trauma severity during captivity is the best predictor of current PTSD symptomatology. Results also add to our understanding of the conceptual differentiation of PTSD symptoms into separate and distinct symptom clusters.

  8. Adolescent behavior and PTSD 6–7 years after the World Trade Center terrorist attacks of September 11, 2001

    Science.gov (United States)

    Mann, Mana; Li, Jiehui; Farfel, Mark R; Maslow, Carey B; Osahan, Sukhminder; Stellman, Steven D

    2014-01-01

    Behavioral problems and psychopathologies were reported in children exposed to the World Trade Center (WTC) attacks in New York City within 2–3 y post-disaster. Little is known of subsequent 9/11 related behavioral and emotional problems. We assessed risk factors for behavioral difficulties and probable posttraumatic stress disorder (PTSD) in 489 adolescent enrollees ages 11–18 y of age in the World Trade Center Health Registry cohort using the Strengths and Difficulties Questionnaire (SDQ) and DISC Predictive Scales (DPS), respectively, as reported by the adolescents. Associations between parental PTSD and adolescent PTSD and behavioral problems were studied in a subset of 166 adolescent-parent pairs in which the parent was also a Registry enrollee. Nearly one-fifth (17.4%) of the adolescents, all of whom were 5–12 y old at the time of the attacks, scored in the abnormal (5.7%) or borderline (11.7%) range of total SDQ. Problems were more frequent in minority, low-income, and single-parent adolescents. Abnormal and borderline SDQ scores were significantly associated with direct WTC exposures and with WTC-related injury or death of a family member. Adolescent PTSD was significantly associated with WTC exposure and with fear of one's own injury or death, and with PTSD in the parent (OR = 5.6; 95% CI 1.1–28.4). This adolescent population should be monitored for persistence or worsening of these problems. Co-occurrence of parent and child mental health symptoms following a disaster may have implications for healthcare practitioners and for disaster response planners. PMID:28229007

  9. CORRELATION OF MOBILE PHONE ADDICTION SCALE (MPAS) SCORE WITH CRANIOVERTEBRAL ANGLE, SCAPULAR INDEX AND BECKS DEPRESSION INVENTORY SCORE IN YOUNG ADULTS

    OpenAIRE

    Rupali Salvi; Sneha Battin

    2018-01-01

    Background: Mobile phone usage has become increasingly common in today’s youth. Its heavy use often leads to an addiction. Dependency on these devices could lead to postural dysfunctions as well as produce an adverse effect on psychology. Hence, this study is done to correlate mobile addiction with the craniovertebral angle, scapular index and Beck’s depression inventory score in young adults. Methods: An observational study was performed on 100 subjects out of which 51 were males and 49 w...

  10. Comparison of the Full Outline of UnResponsiveness score and the Glasgow Coma Scale in predicting mortality in critically ill patients*.

    Science.gov (United States)

    Wijdicks, Eelco F M; Kramer, Andrew A; Rohs, Thomas; Hanna, Susan; Sadaka, Farid; O'Brien, Jacklyn; Bible, Shonna; Dickess, Stacy M; Foss, Michelle

    2015-02-01

    Impaired consciousness has been incorporated in prediction models that are used in the ICU. The Glasgow Coma Scale has value but is incomplete and cannot be assessed in intubated patients accurately. The Full Outline of UnResponsiveness score may be a better predictor of mortality in critically ill patients. Thirteen ICUs at five U.S. hospitals. One thousand six hundred ninety-five consecutive unselected ICU admissions during a six-month period in 2012. Glasgow Coma Scale and Full Outline of UnResponsiveness score were recorded within 1 hour of admission. Baseline characteristics and physiologic components of the Acute Physiology and Chronic Health Evaluation system, as well as mortality were linked to Glasgow Coma Scale/Full Outline of UnResponsiveness score information. None. We recruited 1,695 critically ill patients, of which 1,645 with complete data could be linked to data in the Acute Physiology and Chronic Health Evaluation system. The area under the receiver operating characteristic curve of predicting ICU mortality using the Glasgow Coma Scale was 0.715 (95% CI, 0.663-0.768) and using the Full Outline of UnResponsiveness score was 0.742 (95% CI, 0.694-0.790), statistically different (p = 0.001). A similar but nonsignificant difference was found for predicting hospital mortality (p = 0.078). The respiratory and brainstem reflex components of the Full Outline of UnResponsiveness score showed a much wider range of mortality than the verbal component of Glasgow Coma Scale. In multivariable models, the Full Outline of UnResponsiveness score was more useful than the Glasgow Coma Scale for predicting mortality. The Full Outline of UnResponsiveness score might be a better prognostic tool of ICU mortality than the Glasgow Coma Scale in critically ill patients, most likely a result of incorporating brainstem reflexes and respiration into the Full Outline of UnResponsiveness score.

  11. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART(®)).

    Science.gov (United States)

    Kip, Kevin E; Elk, Carrie A; Sullivan, Kelly L; Kadel, Rajendra; Lengacher, Cecile A; Long, Christopher J; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F; Street, Jennifer D; Girling, Sue Ann; Diamond, David M

    2012-06-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART(®)) that incorporates the use of eye movements administered in a brief treatment period (1-5 one-hour sessions within three weeks). Eighty adults aged 21-60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants' mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD.

  12. Brief Treatment of Symptoms of Post-Traumatic Stress Disorder (PTSD) by Use of Accelerated Resolution Therapy (ART®)

    Science.gov (United States)

    Kip, Kevin E.; Elk, Carrie A.; Sullivan, Kelly L.; Kadel, Rajendra; Lengacher, Cecile A.; Long, Christopher J.; Rosenzweig, Laney; Shuman, Amy; Hernandez, Diego F.; Street, Jennifer D.; Girling, Sue Ann; Diamond, David M.

    2012-01-01

    Post-Traumatic Stress Disorder (PTSD) is a prevalent, disabling anxiety disorder. This prospective cohort study reports on a new exposure-based therapy known as Accelerated Resolution Therapy (ART®) that incorporates the use of eye movements administered in a brief treatment period (1–5 one-hour sessions within three weeks). Eighty adults aged 21–60 years with symptoms of PTSD were recruited from the Tampa Bay area. The ART-based psychotherapy was designed to minimize anxiety and body sensations associated with recall of traumatic memories and to replace distressing images with favorable ones. Participants’ mean age was 40 years, 77% were female, and 29% were Hispanic. Participants underwent a median of three ART sessions, 66 of 80 (82.5%) completed treatment, and 54 of 66 (81.8%) provided 2-month follow-up data. Mean scores pre- and post-ART and at 2-month follow-up were: PTSD Checklist: 54.5 ± 12.2 vs. 31.2 ± 11.4 vs. 30.0 ± 12.4; Brief Symptom Inventory: 30.8 ± 14.6 vs. 10.1 ± 10.8 vs. 10.1 ± 12.1; Center for Epidemiologic Studies Depression Scale: 29.5 ± 10.9 vs. 11.8 ± 11.1 vs. 13.5 ± 12.1; Trauma Related Growth Inventory-Distress scale: 18.9 ± 4.1 vs. 7.4 ± 5.9 vs. 8.2 ± 5.9 (p ART vs. post-ART and 2-month comparisons). No serious adverse events were reported. ART appears to be a brief, safe, and effective treatment for symptoms of PTSD. PMID:25379218

  13. PTSD: An Elusive Definition.

    Science.gov (United States)

    Kirkbride, Jared F

    2012-01-01

    The Global War on Terrorism became the longest standing conflict in United States military history on June 7, 2010. It is estimated that 1.64 million U.S. troops have been deployed in support of Operation Enduring Freedom and Operation Iraqi Freedom (p xix).1 Both conflicts have produced high numbers of casualties as the result of ground combat. The amount of casualties though has been relatively low compared to other conflicts. Some of this can be attributed to the advances in body armor and emergency medicine that allow many servicemembers to survive conditions that previously led to death. Conversely, surviving these situations leaves those same members with memories that are psychologically difficult to live with and cause chronic difficulties. Unlike an amputee, or the victim of severe burns where the signs and symptoms of their injuries are obvious, patients with psychological disorders can have a range of signs and symptoms common in many other mental disorders, making it difficult to diagnose and treat Soldiers suffering from Post-traumatic Stress Disorder (PTSD). 2012.

  14. Possible Contribution of PTSD to Altered Cortisol Activity in Young Adult Obese African-American Women.

    Science.gov (United States)

    Taylor, Teletia R; Van Kirk, Kendra; Tapscott, Denia; Bernard, Monet; Llano, Juliana; Mellman, Thomas A

    2015-06-01

    African-Americans have been found to experience increased rates of post-traumatic stress disorder (PTSD), obesity, and flatter diurnal cortisol slopes compared to other demographic groups. Further exploration, however, is needed to understand how PTSD impacts diurnal cortisol activity in obese African-American women. The purpose of the current study is to examine the relationship between salivary cortisol levels and PTSD in a sample of obese young adult African-American women and to examine how depression and insomnia influence the relationship. Thirty-four young adult African-American women (mean age = 24.0 years; mean BMI = 37.4 kg/m(2), 6/34 of the sample had a score of 40 or above on the PTSD Checklist (PCL) representing clinically significant PTSD) filled out questionnaires assessing PTSD, lifetime exposure to traumatic events, insomnia severity, and depression. A home-based assessment of salivary cortisol was provided upon awakening at 30 min and 1, 3, 6, and 12 h. There was a significant interaction between PTSD status and diurnal cortisol activity (p cortisol levels at awakening (p cortisol was attenuated by co-varying for depression and insomnia (p > 0.05). PTSD, influenced by depression and insomnia symptoms, has an impact on diurnal cortisol activity in obese young adult African-American women.

  15. Anxiety, depression and PTSD-related symptoms in spouses and close relatives of burn survivors: When the supporter needs to be supported.

    Science.gov (United States)

    Bond, Suzie; Gourlay, Catherine; Desjardins, Alexandra; Bodson-Clermont, Paule; Boucher, Marie-Ève

    2017-05-01

    The aim of the study was to assess the prevalence of anxiety, depression and PTSD-related symptoms reported by spouses and close relatives of adult burn survivors. Potential associations between these symptoms and variables such as the severity of the burn were also explored. Participants were spouses (n=31) and close relatives (n=25) of hospitalized patients with acute burns. Anxiety and depression symptoms were assessed by the Hospital Distress Anxiety and Depression Scale and PTSD-related symptoms by the Modified PTSD Symptom Scale at both admission to and discharge from the burn unit. At admission, 77% of spouses and 56% of close relatives of burn patients reported anxiety, depression or PTSD-related symptoms in the clinical range. While spouses had higher scores than close relatives on symptom measures, significant differences were only established for anxiety symptoms (p<.02). A significant effect was found for gender, with women reporting more anxiety (p=.01) and depression (p=.02) symptoms than men. Results also showed a main effect for time, with anxiety (p<.0001), depression (p<.0001) and PTSD-related (p<.0001) symptoms being higher at admission than at discharge. Variables associated with the index patient, such as total body surface area burned, length of stay, number of ventilated days, facial burns, or level of care at admission, were not associated with outcome measures. Spouses and close relatives of burn survivors showed high levels of psychological distress in the first few days following admission, and more than a quarter still reported symptoms in the clinical range at discharge. Our analysis points to the need to offer psychological support and guidance to family members so that they can in turn provide effective support to the burn survivor. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  16. Prolonged exposure therapy for the treatment of patients diagnosed with psychogenic non-epileptic seizures (PNES) and post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Myers, Lorna; Vaidya-Mathur, Urmi; Lancman, Marcelo

    2017-01-01

    Although there is general consensus that psychogenic non-epileptic seizures (PNES) are treated with psychotherapy, the effectiveness of most psychotherapeutic modalities remains understudied. In this treatment series of 16 patients dually diagnosed with PNES and post-traumatic stress disorder (PTSD), we evaluated the effect of prolonged exposure therapy (PE) on reduction of PNES. Secondary measures included Beck Depression Inventory (BDI-II) and Post-Traumatic Disorder Diagnostic Scale (PDS). Subjects diagnosed with video EEG-confirmed PNES and PTSD confirmed through neuropsychological testing and clinical interview were treated with traditional PE psychotherapy with certain modifications for the PNES. Treatment was conducted over the course of 12-15 weekly sessions. Seizure frequency was noted in each session by examining the patients' seizure logs, and mood and PTSD symptomatology was assessed at baseline and on the final session. Eighteen subjects enrolled, and 16 (88.8%) completed the course of treatment. Thirteen of the 16 (81.25%) therapy completers reported no seizures by their final PE session, and the other three reported a decline in seizure frequency (Z=-3.233, p=0.001). Mean scores on scales of depression (M=-13.56, SD=12.27; t (15)=-4.420, pPTSD symptoms (M=-17.1875, SD=13.01; t (15)=-5.281, pPTSD reduced the number of PNES and improved mood and post traumatic symptomatology. Follow-up revealed that gains made in seizure control on the last day of treatment were maintained over time. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  17. Prevalence and psychosocial risk factors of PTSD: 18 months after Kashmir earthquake in Pakistan.

    Science.gov (United States)

    Naeem, Farooq; Ayub, Muhammad; Masood, Khadija; Gul, Huma; Khalid, Mahwish; Farrukh, Ammara; Shaheen, Aisha; Waheed, Waquas; Chaudhry, Haroon Rasheed

    2011-04-01

    On average in a year 939 earthquakes of a magnitude between 5 and 8 on the Richter scale occur around the world. In earthquakes developing countries are prone to large-scale destruction because of poor structural quality of buildings, and preparedness for earthquakes. On 8th October 2005, a major earthquake hit the remote and mountainous region of northern Pakistan and Kashmir. We wanted to find out the rate of PTSD in a randomly selected sample of participants living in earthquake area and the correlates of the PTSD. The study was conducted 18 months after the earthquake. We selected a sample of men and women living in the houses and tents for interviews. Using well established instruments for PTSD and general psychiatric morbidity we gathered information from over 1200 people in face to face interviews. We gathered information about trauma exposure and loss as well. 55.2% women and 33.4% men suffered from PTSD. Living in a joint family was protective against the symptoms of PTSD. Dose of exposure to trauma was associated with the symptoms of PTSD. Living in a tent was associated with general psychiatric morbidity but not with PTSD. We used questionnaire instead of interviews to detect the symptoms of psychiatric disorders. The symptoms of PTSD are common 18 months after the earthquake and they are specifically associated with the dose of trauma exposure. This may have implications for rehabilitation of this population. Copyright © 2010 Elsevier B.V. All rights reserved.

  18. Examination of the heterogeneity in PTSD and impulsivity facets: A latent profile analysis.

    Science.gov (United States)

    Contractor, Ateka A; Caldas, Stephanie; Weiss, Nicole H; Armour, Cherie

    2018-04-15

    The experience of traumatizing events and resulting posttraumatic stress disorder (PTSD) symptomology relates to a range of impulsive behaviors. While both PTSD and impulsivity are heterogeneous and multidimensional constructs, no research has used person-centered approaches to examine subgroups of individuals based on these response endorsements. Hence, our study examined PTSD-impulsivity typologies and their construct validity in two samples: university students ( n = 412) and community participants recruited through Amazon's MTurk ( n = 346). Measures included the Stressful Life Events Screening Questionnaire (PTEs), PTSD Checklist for DSM-5 (PTSD severity), UPPS Impulsive Behavior Scale (negative urgency, lack of premeditation, lack of perseverance, sensation seeking). Dimensions of Anger Reaction Scale (anger), and the Patient Health Questionnaire-9 (depression). For both samples, results of latent profile analyses indicated a best-fitting 3-class solution: High, Moderate, and Low PTSD-Negative Urgency. Negative urgency was the most distinguishing impulsivity facet. Anger and depression severity significantly predicted membership in the more severe symptomatology classes. Thus, individuals can be meaningfully categorized into three subgroups based on PTSD and impulsivity item endorsements. We provide some preliminary evidence for a negative urgency subtype of PTSD characterized by greater depression and anger regulation difficulties; and underscore addressing emotional regulation skills for these subgroup members.

  19. The Use of Quality Control and Data Mining Techniques for Monitoring Scaled Scores: An Overview. Research Report. ETS RR-12-20

    Science.gov (United States)

    von Davier, Alina A.

    2012-01-01

    Maintaining comparability of test scores is a major challenge faced by testing programs that have almost continuous administrations. Among the potential problems are scale drift and rapid accumulation of errors. Many standard quality control techniques for testing programs, which can effectively detect and address scale drift for small numbers of…

  20. Trauma-related altered states of consciousness in women with BPD with or without co-occurring PTSD

    Directory of Open Access Journals (Sweden)

    Paul Frewen

    2014-08-01

    Full Text Available Background: A “4-D model” was recently described as a theoretical framework for categorizing trauma-related symptoms into four phenomenological dimensions (the experience of time, thought, body, and emotion that can present either in the form of normal waking consciousness (NWC or as dissociative experiences, that is, trauma-related altered states of consciousness (TRASC. Methods: The present study examined the predictions of the 4-D model in 258 persons with borderline personality disorder (BPD with (n=126 versus without (n=132 posttraumatic stress disorder (PTSD. Results: As measured by the Borderline Symptom List, consistent with the predictions of the 4-D model, in comparison with symptom endorsements theorized to be associated with NWC, measures of TRASC were less frequent, and more strongly correlated with both Dissociative Experience Scale scores and severity of childhood emotional neglect, particularly in persons with both BPD and PTSD. Our prediction that symptoms of TRASC would be less intercorrelated in comparison with distress associated with NWC symptoms, however, was not supported. Conclusions: Findings are discussed as they pertain to the symptomatology of BPD, PTSD, and dissociation.

  1. Food addiction as a proxy for eating disorder and obesity severity, trauma history, PTSD symptoms, and comorbidity.

    Science.gov (United States)

    Brewerton, Timothy D

    2017-06-01

    Food addiction (FA) is a newly defined yet still controversial condition that has important etiological, developmental, treatment, prevention, and social policy implications. In this review, the case is made that FA (or high scores on the Yale Food Addiction Scale) may be used as a proxy measure for a matrix of interrelated clinical features, including greater eating disorder severity, greater obesity severity, more severe trauma histories, greater symptoms of posttraumatic stress disorder (PTSD), greater psychiatric comorbidity, as well as greater medical morbidity and mortality. A Medline search was undertaken using the following terms: food addiction cross-referenced with eating disorders (anorexia nervosa, bulimia nervosa, binge eating disorder, and binge eating), obesity, trauma, posttraumatic stress disorder, and comorbidity. The thesis is that the identification and acknowledgment of the concept of FA, when integrated into an overall, trauma-focused and transdiagnostic treatment approach, are supported and can be useful in understanding clinically the "big picture." Food addiction (FA) may be used as a proxy for (1) bulimic eating disorder severity, (2) complex trauma histories, (3) severity of PTSD and PTSD symptoms, (4) intensity of psychiatric comorbidity, (5) severity of obesity, as well as (6) their combination. Implications for developing treatment strategies are discussed. The case for a comprehensive management that requires careful attention to medical and psychiatric assessment and integrated care that incorporates trauma-focused treatment is made.

  2. Preliminary Psychometric examination of the Davidson Trauma Scale: A study on chileans adolescent

    Directory of Open Access Journals (Sweden)

    Cristobal Guerra

    2013-12-01

    Full Text Available Davidson Trauma Scale (DTS measures the frequency and severity of the posttraumatic Stress Disorder pTSD. Since chile has limited data about validity and reliability of instruments to measure pTSD, this study evaluated psychometric properties of the scale in a sample of 130 adolescents between 13 and 18 years (M= 15,78; DT= 1,40. Some of them were traumatized patients and others were from general population. They answered the DTS, a depression and an anxiety scale. The scale obtained adequate internal consistency scores, showed convergent validity (DTS score was associated moderately, directly and significantly with depression and anxiety scores, and discriminated between clinical sample and general population. DTS seems to be a valid and reliable instrument in chilean adolescents.

  3. The use of the SF-36 questionnaire in adult survivors of childhood cancer: evaluation of data quality, score reliability, and scaling assumptions

    Directory of Open Access Journals (Sweden)

    Winter David L

    2006-10-01

    Full Text Available Abstract Background The SF-36 has been used in a number of previous studies that have investigated the health status of childhood cancer survivors, but it never has been evaluated regarding data quality, scaling assumptions, and reliability in this population. As health status among childhood cancer survivors is being increasingly investigated, it is important that the measurement instruments are reliable, validated and appropriate for use in this population. The aim of this paper was to determine whether the SF-36 questionnaire is a valid and reliable instrument in assessing self-perceived health status of adult survivors of childhood cancer. Methods We examined the SF-36 to see how it performed with respect to (1 data completeness, (2 distribution of the scale scores, (3 item-internal consistency, (4 item-discriminant validity, (5 internal consistency, and (6 scaling assumptions. For this investigation we used SF-36 data from a population-based study of 10,189 adult survivors of childhood cancer. Results Overall, missing values ranged per item from 0.5 to 2.9 percent. Ceiling effects were found to be highest in the role limitation-physical (76.7% and role limitation-emotional (76.5% scales. All correlations between items and their hypothesised scales exceeded the suggested standard of 0.40 for satisfactory item-consistency. Across all scales, the Cronbach's alpha coefficient of reliability was found to be higher than the suggested value of 0.70. Consistent across all cancer groups, the physical health related scale scores correlated strongly with the Physical Component Summary (PCS scale scores and weakly with the Mental Component Summary (MCS scale scores. Also, the mental health and role limitation-emotional scales correlated strongly with the MCS scale score and weakly with the PCS scale score. Moderate to strong correlations with both summary scores were found for the general health perception, energy/vitality, and social functioning

  4. Mental health and functional impairment outcomes following a 6-week intensive treatment programme for UK military veterans with post-traumatic stress disorder (PTSD): a naturalistic study to explore dropout and health outcomes at follow-up.

    Science.gov (United States)

    Murphy, Dominic; Hodgman, Georgina; Carson, Carron; Spencer-Harper, Lucy; Hinton, Mark; Wessely, Simon; Busuttil, Walter

    2015-03-20

    Combat Stress, a UK national charity for veterans with mental health problems, has been funded by the National Health Service (NHS) to provide a national specialist service to deliver treatment for post-traumatic stress disorder (PTSD). This paper reports the efficacy of a PTSD treatment programme for UK veterans at 6 months follow-up. A within subject design. UK veterans with a diagnosis of PTSD who accessed Combat Stress. 246 veterans who received treatment between late 2012 and early 2014. An intensive 6-week residential treatment programme, consisting of a mixture of individual and group sessions. Participants were offered a minimum of 15 individual trauma-focused cognitive behavioural therapy sessions. In addition, participants were offered 55 group sessions focusing on psychoeducational material and emotional regulation. Clinicians completed measures of PTSD and functional impairment and participants completed measures of PTSD, depression, anger and functional impairment. We observed significant reductions in PTSD scores following treatment on both clinician completed measures (PSS-I: -13.0, 95% CI -14.5 to -11.5) and self-reported measures (Revised Impact of Events Scale (IES-R): -16.5, 95% CI -19.0 to -14.0). Significant improvements in functional impairment were also observed (eg, Health of the Nation Outcome Scales (HONOS): -6.85, 95% CI -7.98 to -5.72). There were no differences in baseline outcomes between those who completed and those who did not complete the programme, or post-treatment outcomes between those we were able to follow-up at 6 months and those lost to follow-up. In a naturalistic study we observed a significant reduction in PTSD scores and functional impairment following treatment. These improvements were maintained at 6 month follow-up. Our findings suggest it may be helpful to take a closer look at combining individual trauma-focused cognitive behaviour therapy and group sessions when treating veterans with PTSD. This is the first

  5. Social relationship satisfaction and PTSD: which is the chicken and which is the egg?

    Directory of Open Access Journals (Sweden)

    Sara A. Freedman

    2015-12-01

    Full Text Available Background: Impaired social relationships are linked with higher levels of posttraumatic stress disorder (PTSD, but the association's underlying dynamics are unknown. PTSD may impair social relationships, and, vice versa, poorer relationship quality may interfere with the recovery from PTSD. Objective: This work longitudinally evaluates the simultaneous progression of PTSD symptoms and social relationship satisfaction (SRS in a large cohort of recent trauma survivors. It also explores the effect of cognitive behavior therapy (CBT on the association between the two. Method: Consecutive emergency department trauma admissions with qualifying PTSD symptoms (n=501 were assessed 3 weeks and 5 months after trauma admission. The World Health Organization Quality of Life evaluated SRS and the Clinician Administered PTSD Scale evaluated PTSD symptom severity. Ninety-eight survivors received CBT between measurement sessions. We used Structural Equation Modeling to evaluate cross-lagged effects between the SRS and PTSD symptoms. Results: The cross-lagged effect of SRS on PTSD was statistically significant (β=−0.12, p=0.01 among survivors who did not receive treatment whilst the effect of PTDS on SRS was nil (β=−0.02, p=0.67. Both relationships were non-significant among survivors who received CBT. Discussion: SRS and PTSD are highly associated, and this study shows that changes in SRS in the early aftermath of traumatic events contribute to changes in PTSD, rather than vice versa. SRS impacts natural recovery, but not effective treatment. This study suggests that being satisfied with one's relationships might be considered as an important factor in natural recovery from trauma, as well as in intervention.

  6. Impulsivity interacts with momentary PTSD symptom worsening to predict alcohol use in male veterans.

    Science.gov (United States)

    Black, Anne C; Cooney, Ned L; Sartor, Carolyn E; Arias, Albert J; Rosen, Marc I

    2018-04-11

    Posttraumatic stress disorder (PTSD) is prevalent among veterans who served post-9/11, and co-occurs with problem alcohol and substance use. Studies using ecological momentary assessment have examined the temporal association between time-varying PTSD symptoms and alcohol use. Results suggest individual differences in these associations. We tested hypotheses that alcohol use measured by momentary assessment would be explained by acute increases in PTSD symptoms, and the PTSD-alcohol association would be moderated by trait impulsivity. A sample of 28 male post-9/11-era veterans who reported past-month PTSD symptoms and risky alcohol use were enrolled. On a quasi-random schedule, participants completed three electronic assessments daily for 28 days measuring past 2-h PTSD symptoms, alcohol, and substance use. At baseline, trait impulsivity was measured by the Barratt Impulsiveness Scale. Past-month PTSD symptoms and alcohol use were measured. Using three-level hierarchical models, number of drinks recorded by momentary assessment was modeled as a function of change in PTSD symptoms since last assessment, controlling for lag-1 alcohol and substance use and other covariates. A cross-level interaction tested moderation of the within-time PTSD-alcohol association by impulsivity. A total of 1,522 assessments were completed. A positive within-time association between PTSD symptom change and number of drinks was demonstrated. The association was significantly moderated by impulsivity. Results provide preliminary support for a unique temporal relationship between acute PTSD symptom change and alcohol use among veterans with trait impulsiveness. If replicated in a clinical sample, results may have implications for a targeted momentary intervention.

  7. Symptom structure of PTSD following breast cancer.

    Science.gov (United States)

    Cordova, M J; Studts, J L; Hann, D M; Jacobsen, P B; Andrykowski, M A

    2000-04-01

    Identification of posttraumatic stress disorder (PTSD) symptoms and diagnoses in survivors of cancer is a growing area of research, but no published data exist regarding the symptom structure of PTSD in survivors of malignant disease. Findings from investigations of the PTSD symptom structure in other trauma populations have been inconsistent and have not been concordant with the re-experiencing, avoidance/numbing, and arousal symptom clusters specified in DSM-IV. The present study employed confirmatory factor analysis to evaluate the extent to which the implied second-order factor structure of PTSD was replicated in a sample of 142 breast cancer survivors. PTSD symptoms were measured using the PTSD Checklist--Civilian Version (PCL-C). Fit indices reflected a moderate fit of the symptom structure implied by the DSM-IV. These findings provide some tentative support for the DSM-IV clustering of PTSD symptoms and for the validity of cancer-related PTSD.

  8. Trauma, PTSD, and the Developing Brain.

    Science.gov (United States)

    Herringa, Ryan J

    2017-08-19

    PTSD in youth is common and debilitating. In contrast to adult PTSD, relatively little is known about the neurobiology of pediatric PTSD, nor how neurodevelopment may be altered. This review summarizes recent neuroimaging studies in pediatric PTSD and discusses implications for future study. Pediatric PTSD is characterized by abnormal structure and function in neural circuitry supporting threat processing and emotion regulation. Furthermore, cross-sectional studies suggest that youth with PTSD have abnormal frontolimbic development compared to typically developing youth. Examples include declining hippocampal volume, increasing amygdala reactivity, and declining amygdala-prefrontal coupling with age. Pediatric PTSD is characterized by both overt and developmental abnormalities in frontolimbic circuitry. Notably, abnormal frontolimbic development may contribute to increasing threat reactivity and weaker emotion regulation as youth age. Longitudinal studies of pediatric PTSD are needed to characterize individual outcomes and determine whether current treatments are capable of restoring healthy neurodevelopment.

  9. Scoring correction for MMPI-2 Hs scale with patients experiencing a traumatic brain injury: a test of measurement invariance.

    Science.gov (United States)

    Alkemade, Nathan; Bowden, Stephen C; Salzman, Louis

    2015-02-01

    It has been suggested that MMPI-2 scoring requires removal of some items when assessing patients after a traumatic brain injury (TBI). Gass (1991. MMPI-2 interpretation and closed head injury: A correction factor. Psychological assessment, 3, 27-31) proposed a correction procedure in line with the hypothesis that MMPI-2 endorsement may be affected by symptoms of TBI. This study assessed the validity of the Gass correction procedure. A sample of patients with a TBI (n = 242), and a random subset of the MMPI-2 normative sample (n = 1,786). The correction procedure implies a failure of measurement invariance across populations. This study examined measurement invariance of one of the MMPI-2 scales (Hs) that includes TBI correction items. A four-factor model of the MMPI-2 Hs items was defined. The factor model was found to meet the criteria for partial measurement invariance. Analysis of the change in sensitivity and specificity values implied by partial measurement invariance failed to indicate significant practical impact of partial invariance. Overall, the results support continued use of all Hs items to assess psychological well-being in patients with TBI. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Catalytic activity of autoantibodies toward myelin basic protein correlates with the scores on the multiple sclerosis expanded disability status scale.

    Science.gov (United States)

    Ponomarenko, Natalia A; Durova, Oxana M; Vorobiev, Ivan I; Belogurov, Alexey A; Telegin, Georgy B; Suchkov, Sergey V; Misikov, Victor K; Morse, Herbert C; Gabibov, Alexander G

    2006-02-28

    Autoantibodies toward myelin basic protein (MBP) evidently emerge in sera and cerebrospinal fluid of the patients with multiple sclerosis (MS), as well as in a MS rodent model, i.e., experimental autoimmune encephalomyelitis (EAE). The studies of the last two decades have unveiled somewhat controversial data on the diagnostic applicability of anti-MBP autoantibodies as a disease' marker. Here, we present the results of new functional analysis of the anti-MBP autoantibodies isolated from MS (in patients) and EAE (in mice) sera, based on their proteolytic activity against the targeted autoantigen. The activity was shown to be the intrinsic property of the IgG molecule. No activity was found in the sera-derived antibody fraction of healthy donors and control mice. Sera of 24 patients with clinically proven MS at different stages of the disease, and 20 healthy controls were screened for the anti-MBP antibody-mediated proteolytic activity. The activity correlated with the scores on the MS expanded disability status scale (EDSS) (r(2)=0.85, P<0.001). Thus, the anti-MBP autoantibody-mediated proteolysis may be regarded as an additional marker of the disease progression.

  11. Effect of Prolonged Exposure Therapy Delivered Over 2 Weeks vs 8 Weeks vs Present-Centered Therapy on PTSD Symptom Severity in Military Personnel: A Randomized Clinical Trial.

    Science.gov (United States)

    Foa, Edna B; McLean, Carmen P; Zang, Yinyin; Rosenfield, David; Yadin, Elna; Yarvis, Jeffrey S; Mintz, Jim; Young-McCaughan, Stacey; Borah, Elisa V; Dondanville, Katherine A; Fina, Brooke A; Hall-Clark, Brittany N; Lichner, Tracey; Litz, Brett T; Roache, John; Wright, Edward C; Peterson, Alan L

    2018-01-23

    Effective and efficient treatment is needed for posttraumatic stress disorder (PTSD) in active duty military personnel. To examine the effects of massed prolonged exposure therapy (massed therapy), spaced prolonged exposure therapy (spaced therapy), present-centered therapy (PCT), and a minimal-contact control (MCC) on PTSD severity. Randomized clinical trial conducted at Fort Hood, Texas, from January 2011 through July 2016 and enrolling 370 military personnel with PTSD who had returned from Iraq, Afghanistan, or both. Final follow-up was July 11, 2016. Prolonged exposure therapy, cognitive behavioral therapy involving exposure to trauma memories/reminders, administered as massed therapy (n = 110; 10 sessions over 2 weeks) or spaced therapy (n = 109; 10 sessions over 8 weeks); PCT, a non-trauma-focused therapy involving identifying/discussing daily stressors (n = 107; 10 sessions over 8 weeks); or MCC, telephone calls from therapists (n = 40; once weekly for 4 weeks). Outcomes were assessed before and after treatment and at 2-week, 12-week, and 6-month follow-up. Primary outcome was interviewer-assessed PTSD symptom severity, measured by the PTSD Symptom Scale-Interview (PSS-I; range, 0-51; higher scores indicate greater PTSD severity; MCID, 3.18), used to assess efficacy of massed therapy at 2 weeks posttreatment vs MCC at week 4; noninferiority of massed therapy vs spaced therapy at 2 weeks and 12 weeks posttreatment (noninferiority margin, 50% [2.3 points on PSS-I, with 1-sided α = .05]); and efficacy of spaced therapy vs PCT at posttreatment. Among 370 randomized participants, data were analyzed for 366 (mean age, 32.7 [SD, 7.3] years; 44 women [12.0%]; mean baseline PSS-I score, 25.49 [6.36]), and 216 (59.0%) completed the study. At 2 weeks posttreatment, mean PSS-I score was 17.62 (mean decrease from baseline, 7.13) for massed therapy and 21.41 (mean decrease, 3.43) for MCC (difference in decrease, 3.70 [95% CI,0.72 to 6.68]; P = .02

  12. Quantifying Risk of Financial Incapacity and Financial Exploitation in Community-dwelling Older Adults: Utility of a Scoring System for the Lichtenberg Financial Decision-making Rating Scale.

    Science.gov (United States)

    Lichtenberg, Peter A; Gross, Evan; Ficker, Lisa J

    2018-06-08

    This work examines the clinical utility of the scoring system for the Lichtenberg Financial Decision-making Rating Scale (LFDRS) and its usefulness for decision making capacity and financial exploitation. Objective 1 was to examine the clinical utility of a person centered, empirically supported, financial decision making scale. Objective 2 was to determine whether the risk-scoring system created for this rating scale is sufficiently accurate for the use of cutoff scores in cases of decisional capacity and cases of suspected financial exploitation. Objective 3 was to examine whether cognitive decline and decisional impairment predicted suspected financial exploitation. Two hundred independently living, non-demented community-dwelling older adults comprised the sample. Participants completed the rating scale and other cognitive measures. Receiver operating characteristic curves were in the good to excellent range for decisional capacity scoring, and in the fair to good range for financial exploitation. Analyses supported the conceptual link between decision making deficits and risk for exploitation, and supported the use of the risk-scoring system in a community-based population. This study adds to the empirical evidence supporting the use of the rating scale as a clinical tool assessing risk for financial decisional impairment and/or financial exploitation.

  13. Differences in pain measures by mini-mental state examination scores of residents in aged care facilities: examining the usability of the Abbey pain scale-Japanese version.

    Science.gov (United States)

    Takai, Yukari; Yamamoto-Mitani, Noriko; Ko, Ayako; Heilemann, Marysue V

    2014-03-01

    The validity and reliability of the Abbey Pain Scale-Japanese version (APS-J) have been examined. However, the range of cognitive levels for which the APS-J can be accurately used in older adults has not been investigated. This study aimed to examine the differences between total/item scores of the APS-J and Mini-Mental State Examination (MMSE) scores of residents in aged care facilities who self-reported the presence or absence of pain. This descriptive study included 252 residents in aged care facilities. Self-reported pain, MMSE scores, and item/total APS-J scores for pain intensity were collected. The MMSE scores were used to create four groups on the basis of the cognitive impairment level. Self-reports of pain and the APS-J scores were compared with different MMSE score groups. The total APS-J score for pain intensity as well as scores for individual items such as "vocalization" and "facial expression" were significantly higher in those who reported pain than in those reporting no pain across all MMSE groups. The total APS-J score and item scores for "vocalization," "change in body language," and "behavioral changes" showed significant differences in the four MMSE groups. Pain intensity tended to be overestimated by the APS-J, especially among those with low MMSE scores. The APS-J can be used to assess pain intensity in residents despite their cognitive levels. However, caution is required when using it to compare scores among older adults with different cognitive capacity because of the possibility of overestimation of pain among residents with low cognitive capacity. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Post-Traumatic Stress Disorder (PTSD) Following Childbirth: Prevalence and Contributing Factors.

    Science.gov (United States)

    Shaban, Zainab; Dolatian, Mahrokh; Shams, Jamal; Alavi-Majd, Hamid; Mahmoodi, Zohreh; Sajjadi, Homeira

    2013-03-01

    Childbirth might be a traumatic event for some women. This study was conducted with the objective of investigating the prevalence of Post-Traumatic Stress Disorder (PTSD) following childbirth. The study was designed using a descriptive correlation scheme. The participants were selected from the women referred to the healthcare centers affiliated with Zahedan University of Medical Sciences, Zahedan, Iran. Personal interviews were conducted with 600 women who were 6-8 weeks postpartum and had been undergone to this center for postpartum and child care. One hundred and three (17. 2%) women had symptoms of PTSD following childbirth based on the PTSD Symptom Scale (PSS). The results of logistic regression analysis revealed a significant correlation between maternal occupation (P = 0.01), depression level (P childbirth. PTSD from childbirth occurs in some women. Early identification of risk factors should lead to early therapeutic intervention in the mothers at risk of PTSD.

  15. BRAVEMIND: Advancing the Virtual Iraq/Afghanistan PTSD Exposure Therapy for MST

    Science.gov (United States)

    2017-08-01

    including psychological history, suicidality , and alcohol/substance abuse/dependence, and ability to wear VR headset were briefly reviewed according to a...There were no significant differences between study completers and study non- completers on pre-treatment measures of PTSD and depression . See Table 1...participants in the VRET group would show statistically and clinically meaningful reductions in PTSD and depression (PCL-5, CAPS, PHQ-9 scores and

  16. Anger, hostility, and aggression among Iraq and Afghanistan War veterans reporting PTSD and subthreshold PTSD.

    Science.gov (United States)

    Jakupcak, Matthew; Conybeare, Daniel; Phelps, Lori; Hunt, Stephen; Holmes, Hollie A; Felker, Bradford; Klevens, Michele; McFall, Miles E

    2007-12-01

    Iraq and Afghanistan War veterans were grouped by level of posttraumatic stress disorder (PTSD) symptomatology and compared on self-report measures of trait anger, hostility, and aggression. Veterans who screened positive for PTSD reported significantly greater anger and hostility than those in the subthreshold-PTSD and non-PTSD groups. Veterans in the subthreshold-PTSD group reported significantly greater anger and hostility than those in the non-PTSD group. The PTSD and subthreshold-PTSD groups did not differ with respect to aggression, though both groups were significantly more likely to have endorsed aggression than the non-PTSD group. These findings suggest that providers should screen for anger and aggression among Iraq and Afghanistan War veterans who exhibit symptoms of PTSD and incorporate relevant anger treatments into early intervention strategies.

  17. The effect of rater training on scoring performance and scale-specific expertise amongst occupational therapists participating in a multicentre study

    DEFF Research Database (Denmark)

    Hansen, Tina; Elholm Madsen, Esben; Sørensen, Annette

    2016-01-01

    Gill Ingestive Skills Assessment (MISA) they observe, interpret and record occupational performance of dysphagic clients participating in a meal. This is a highly complex task, which might introduce unwanted variability in measurement scores. A 2-day rater training programme was developed and this builds...... of the training on scoring performance and scale-specific expertise amongst raters. METHOD: During 2 days of rater training, 81 occupational therapists (OTs) were qualified to observe and score dysphagic clients' mealtime performance according to the criteria of 36 MISA-items. The training effects were evaluated...... deficient mealtime performance appeared most difficult to score. The OTs scale-specific expertise improved significantly (knowledge: Z = -7.857, p performance when using the Danish MISA as well as their perceived...

  18. Evidence for the Psychometric Validity, Internal Consistency and Measurement Invariance of Warwick Edinburgh Mental Well-being Scale Scores in Scottish and Irish Adolescents.

    Science.gov (United States)

    McKay, Michael T; Andretta, James R

    2017-09-01

    Mental well-being is an important indicator of current, but also the future health of adolescents. The 14-item Warwick Edinburgh Mental Well-being Scale (WEMWBS) has been well validated in adults world-wide, but less work has been undertaken to examine the psychometric validity and internal consistency of WEMWBS scores in adolescents. In particular, little research has examined scores on the short 7-item version of the WEMWBS. The present study used two large samples of school children in Scotland and Northern Ireland and found that for both forms of the WEMWBS, scores were psychometrically valid, internally consistent, factor saturated, and measurement invariant by country. Using the WEMWBS full form, males reported significantly higher scores than females, and Northern Irish adolescents reported significantly higher scores than their Scottish counterparts. Last, the lowest overall levels of well-being were observed among Scottish females. Copyright © 2017. Published by Elsevier B.V.

  19. AN OBSERVATIONAL CLINICAL STUDY OF ASSESSING THE UTILITY OF PSS (POISON SEVERITY SCORE AND GCS (GLASGOW COMA SCALE SCORING SYSTEMS IN PREDICTING SEVERITY AND CLINICAL OUTCOMES IN OP POISONING

    Directory of Open Access Journals (Sweden)

    S. Chandrasekhar

    2017-05-01

    Full Text Available BACKGROUND Organophosphorus compound poisoning is the most common poisonings in India because of easy availability often requiring ICU care and ventilator support. Clinical research has indicated that respiratory failure is the most important cause of death due to organophosphorus poisoning. It results in respiratory muscle weakness, pulmonary oedema, respiratory depression, increased secretions and bronchospasm. These complications and death can be prevented with timely institution of ventilator support. MATERIALS AND METHODS Hundred consecutive patients admitted with a history of organophosphorus poisoning at Kurnool Medical College, Kurnool, were taken for study after considering the inclusion and exclusion criteria. Detailed history, confirmation of poisoning, examination and other than routine investigations, serum pseudocholinesterase and arterial blood gas analysis was done. The severity and clinical outcomes in OP poisoning is graded by PSS (poison severity score and GCS (Glasgow coma scale scoring systems. RESULTS This study was conducted in 100 patients with male preponderance. Majority of poisoning occurred in 21-30 age group (n=5. Most common compound consumed in our study was methyl parathion and least common was phosphoran. Slightly more than half of the patients consumed less than 50 mL of poison. 21 patients consumed between 50 to 100 mL. Distribution of poison severity score of patients studied showed 45 cases of grade 1 poisoning. 26 cases of grade 2 poisoning, 23 cases of grade 3 poisoning and 6 cases of grade 4 poisoning (death within first 24 hours. Distribution of GCS score of patients studied GCS scores were <10 in 25 patients at admission and 24 patients after 24 hours. GCS scores were ≥10 in 75 patients at admission and 76 patients after 24 hours. Poison severity score is not prognostic, but merely defines severity of OP poisoning at a given time. CONCLUSION Both Glasgow coma scale and poison severity scoring systems

  20. Predicting persistent posttraumatic stress disorder (PTSD) in UK military personnel who served in Iraq: a longitudinal study.

    Science.gov (United States)

    Rona, Roberto J; Jones, Margaret; Sundin, Josefin; Goodwin, Laura; Hull, Lisa; Wessely, Simon; Fear, Nicola T

    2012-09-01

    In a longitudinal study we assessed which baseline risk factors are associated with persistent and partially remitted PTSD in comparison to fully remitted PTSD. 6427 (68%) of a randomly selected sample of UK service personnel completed the PTSD checklist (PCL) between 2004 and 2006 (Phase 1) and between 2007 and 2009 (Phase 2). 230 (3.9%) had possible PTSD at baseline. 66% of those with possible PTSD at baseline remitted (PCL score perception of poor or fair health (OR 2.84, 95% CI 1.28-6.27), older age and perception of risk to self (increasing with the number of events reported, p = 0.04). Deploying but not with a parent unit and psychological distress were associated in the partially remitted PTSD when compared to the fully remitted group. The positive and negative likelihood ratios for the factors most highly associated with persistent PTSD indicated they were of marginal value to identify those whose presumed PTSD would be persistent. Many factors contribute to the persistence of PTSD but none alone is useful for clinical prediction. Copyright © 2012 Elsevier Ltd. All rights reserved.

  1. Shame versus trauma-related guilt as mediators of the relationship between PTSD symptoms and aggression among returning veterans.

    Science.gov (United States)

    Crocker, Laura D; Haller, Moira; Norman, Sonya B; Angkaw, Abigail C

    2016-07-01

    It is well established that posttraumatic stress disorder (PTSD) is associated with various forms of aggression, though the mechanisms by which PTSD is related to aggression are not fully understood. Some research suggests that the tendency to experience shame, but not guilt, contributes to aggression in individuals with a history of interpersonal trauma. This study tested the hypothesis that trait shame but not trauma-related guilt would mediate the relationship between PTSD symptoms and verbal and physical aggression in veterans with combat/military-related trauma seeking PTSD treatment. In a sample of 127 returning veterans (95% male, mean age = 32.93), negative binomial path analyses tested multiple mediational models in which shame versus trauma-related guilt (separate models entered the effects of global guilt, guilt cognitions, and guilt distress) were examined as mediators of PTSD symptoms on verbal and physical aggression separately. Results indicated that shame partially mediated the association of PTSD symptoms with verbal aggression but not physical aggression when accounting for trauma-related guilt. Although PTSD symptoms were associated with higher scores on all aspects of trauma-related guilt, guilt did not significantly mediate relations between PTSD symptoms and verbal or physical aggression when accounting for shame. These results indicate that it is worthwhile to examine whether addressing shame in PTSD treatment may also reduce verbal aggression in returning veterans. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  2. Eleven Years of Data on the Jefferson Scale of Empathy-Medical Student Version (JSE-S): Proxy Norm Data and Tentative Cutoff Scores.

    Science.gov (United States)

    Hojat, Mohammadreza; Gonnella, Joseph S

    2015-01-01

    This study was designed to provide typical descriptive statistics, score distributions and percentile ranks of the Jefferson Scale of Empathy-Medical Student version (JSE-S) of male and female medical school matriculants to serve as proxy norm data and tentative cutoff scores. The participants were 2,637 students (1,336 women and 1,301 men) who matriculated at Sidney Kimmel (formerly Jefferson) Medical College between 2002 and 2012, and completed the JSE at the beginning of medical school. Information extracted from descriptive statistics, score distributions and percentile ranks for male and female matriculants were used to develop proxy norm data and tentative cutoff scores. The score distributions of the JSE tended to be moderately skewed and platykurtic. Women obtained a significantly higher mean score (116.2 ± 9.7) than men (112.3 ± 10.8) on the JSE-S (t2,635 = 9.9, p norm data. The tentative cutoff score to identify low scorers was ≤ 95 for men and ≤ 100 for women. Our findings provide norm data and cutoff scores for admission decisions under certain conditions and for identifying students in need of enhancing their empathy. © 2015 S. Karger AG, Basel.

  3. Psychometrics of the Overall Anxiety Severity and Impairment Scale (OASIS) in a sample of women with and without trauma histories.

    Science.gov (United States)

    Norman, Sonya B; Allard, Carolyn B; Trim, Ryan S; Thorp, Steven R; Behrooznia, Michelle; Masino, Tonya T; Stein, Murray B

    2013-04-01

    Many women have unidentified anxiety or trauma histories that can impact their health and medical treatment-seeking behavior. This study examined the sensitivity, specificity, efficiency, and sensitivity to change of the Overall Anxiety Severity and Impairment Scale (OASIS) for identifying an anxiety disorder in a female sample with and without trauma history related to intimate partner violence (IPV). Forty-three women with full or partial PTSD from IPV and 41 women without PTSD completed the OASIS. All participants with trauma history completed the Clinician Administered PTSD Scale. This report is a secondary analysis of a study on the neurobiology of psychological trauma in survivors of IPV recruited from the community. A cut-score of 5 best discriminated those with PTSD from those without, successfully classifying 91% of the sample with 93% sensitivity and 90% specificity. The measure showed strong sensitivity to change in a subsample of 20 participants who completed PTSD treatment and strong convergent and divergent validity in the full sample. This study suggests that the OASIS can identify the presence of an anxiety disorder among a female sample of IPV survivors when PTSD is present.

  4. Pattern analysis of total item score and item response of the Kessler Screening Scale for Psychological Distress (K6 in a nationally representative sample of US adults

    Directory of Open Access Journals (Sweden)

    Shinichiro Tomitaka

    2017-02-01

    Full Text Available Background Several recent studies have shown that total scores on depressive symptom measures in a general population approximate an exponential pattern except for the lower end of the distribution. Furthermore, we confirmed that the exponential pattern is present for the individual item responses on the Center for Epidemiologic Studies Depression Scale (CES-D. To confirm the reproducibility of such findings, we investigated the total score distribution and item responses of the Kessler Screening Scale for Psychological Distress (K6 in a nationally representative study. Methods Data were drawn from the National Survey of Midlife Development in the United States (MIDUS, which comprises four subsamples: (1 a national random digit dialing (RDD sample, (2 oversamples from five metropolitan areas, (3 siblings of individuals from the RDD sample, and (4 a national RDD sample of twin pairs. K6 items are scored using a 5-point scale: “none of the time,” “a little of the time,” “some of the time,” “most of the time,” and “all of the time.” The pattern of total score distribution and item responses were analyzed using graphical analysis and exponential regression model. Results The total score distributions of the four subsamples exhibited an exponential pattern with similar rate parameters. The item responses of the K6 approximated a linear pattern from “a little of the time” to “all of the time” on log-normal scales, while “none of the time” response was not related to this exponential pattern. Discussion The total score distribution and item responses of the K6 showed exponential patterns, consistent with other depressive symptom scales.

  5. Biomarkers of PTSD: military applications and considerations

    Directory of Open Access Journals (Sweden)

    Amy Lehrner

    2014-08-01

    Full Text Available Background: Although there are no established biomarkers for posttraumatic stress disorder (PTSD as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk for PTSD following trauma exposure, and predict or identify recovery. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers. Objective: This article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications. Method: Literature on applications of PTSD biomarkers and on potential ethical and legal implications will be reviewed. Results: Biologically informed research findings hold promise for prevention, assessment, treatment planning, and the development of prophylactic and treatment interventions. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers. Conclusions: Potential clinical applications of PTSD biomarkers hold promise for clinicians, patients, and employers. The search for biomarkers of PTSD should occur in tandem with an interdisciplinary discussion regarding the potential implications of applying biological findings in clinical and employment settings.

  6. Biomarkers of PTSD: military applications and considerations.

    Science.gov (United States)

    Lehrner, Amy; Yehuda, Rachel

    2014-01-01

    Although there are no established biomarkers for posttraumatic stress disorder (PTSD) as yet, biological investigations of PTSD have made progress identifying the pathophysiology of PTSD. Given the biological and clinical complexity of PTSD, it is increasingly unlikely that a single biomarker of disease will be identified. Rather, investigations will more likely identify different biomarkers that indicate the presence of clinically significant PTSD symptoms, associate with risk for PTSD following trauma exposure, and predict or identify recovery. While there has been much interest in PTSD biomarkers, there has been less discussion of their potential clinical applications, and of the social, legal, and ethical implications of such biomarkers. This article will discuss possible applications of PTSD biomarkers, including the social, legal, and ethical implications of such biomarkers, with an emphasis on military applications. Literature on applications of PTSD biomarkers and on potential ethical and legal implications will be reviewed. Biologically informed research findings hold promise for prevention, assessment, treatment planning, and the development of prophylactic and treatment interventions. As with any biological indicator of disorder, there are potentially positive and negative clinical, social, legal, and ethical consequences of using such biomarkers. Potential clinical applications of PTSD biomarkers hold promise for clinicians, patients, and employers. The search for biomarkers of PTSD should occur in tandem with an interdisciplinary discussion regarding the potential implications of applying biological findings in clinical and employment settings.

  7. Effectiveness of Group-Delivered Cognitive Therapy and Treatment Length in Women Veterans with PTSD

    Directory of Open Access Journals (Sweden)

    Diane T. Castillo

    2014-01-01

    Full Text Available The effectiveness and length of group-delivered cognitive treatment for Posttraumatic Stress Disorder (PTSD was examined in a sample of women veterans. The sample included 271 primarily non-Hispanic white (61% and Hispanic (25% women veterans treated in 8-, 10-, or 12-group length sessions with manualized cognitive therapy for PTSD. Outcome was measured with the PTSD Symptom Checklist (PCL in an intention-to-treat analysis (N = 271, in completer subjects (n = 172, and with group as the unit of analysis (n = 47 groups. Significant decreases in PTSD were found in the full sample (effect size [ES] range = 0.27 to 0.38, completers (ES range = 0.37 to 0.54, and group as the unit of analysis (ES range = 0.71 to 0.92, suggesting effectiveness of cognitive group treatment for PTSD. PCL scores significantly improved in the 8, 10, and 12 group lengths, with no differences between each. Clinical improvement showed a third decreasing 10 or more PCL points and 22% no longer meeting PTSD diagnostic criteria, with the best results in the 10-session group. The results suggest group-delivered cognitive therapy is an effective, efficient, time-limited treatment for PTSD.

  8. Neuroticism Increases PTSD Symptom Severity by Amplifying the Emotionality, Rehearsal, and Centrality of Trauma Memories.

    Science.gov (United States)

    Ogle, Christin M; Siegler, Ilene C; Beckham, Jean C; Rubin, David C

    2017-10-01

    Although it is well established that neuroticism increases the risk of posttraumatic stress disorder (PTSD), little is known about the mechanisms that promote PTSD in individuals with elevated levels of neuroticism. Across two studies, we examined the cognitive-affective processes through which neuroticism leads to greater PTSD symptom severity. Community-dwelling adults with trauma histories varying widely in severity (Study 1) and clinically diagnosed individuals exposed to DSM-IV-TR A1 criterion traumas (Study 2) completed measures of neuroticism, negative affectivity, trauma memory characteristics, and PTSD symptom severity. Longitudinal data in Study 1 showed that individuals with higher scores on two measures of neuroticism assessed approximately three decades apart in young adulthood and midlife reported trauma memories accompanied by more intense physiological reactions, more frequent involuntary rehearsal, and greater perceived centrality to identity in older adulthood. These properties of trauma memories were in turn associated with more severe PTSD symptoms. Study 2 replicated these findings using cross-sectional data from individuals with severe trauma histories and three additional measures of neuroticism. Results suggest that neuroticism leads to PTSD symptoms by magnifying the emotionality, availability, and centrality of trauma memories as proposed in mnemonic models of PTSD. © 2016 Wiley Periodicals, Inc.

  9. New DSM-5 PTSD guilt and shame symptoms among Italian earthquake survivors: Impact on maladaptive behaviors.

    Science.gov (United States)

    Carmassi, Claudia; Bertelloni, Carlo Antonio; Gesi, Camilla; Conversano, Ciro; Stratta, Paolo; Massimetti, Gabriele; Rossi, Alessandro; Dell'Osso, Liliana

    2017-05-01

    Important changes were introduced concerning posttraumatic-stress disorder (PTSD) by the DSM-5 recognizing the role of negative emotions such as guilt and shame, but little evidence is yet available on their prevalence in population assessed by means of DSM-5 criteria. In this study we explored the rates of guilt and shame DSM-5 PTSD diagnostic symptoms among Italian survivors to a massive earthquake and their possible correlation with PTSD and maladaptive behaviors. 869 residents of the town of L'Aquila exposed to the earthquake of April 6th, 2009 were investigated by the Trauma and Loss Spectrum-Self Report (TALS-SR) with particular attention to guilt and shame feelings. DSM-5 symptomatological PTSD was reported by 41.7% of survivors, further 11.6% endorsed at least one guilt/shame symptoms, with significantly higher rates of endorsement were in PTSD respect to No-PTSD subjects, and in the subgroup with at least one maladaptive behavior respect to those with none. There was a significant main effects of PTSD and at least one guilt/shame symptom on TALS-SR symptomatological domains. Mean TALS-SR Maladaptive coping domain score appeared significantly higher in the subgroup with at least one guilt/shame symptom. Further study are needed to investigate guilt and shame feelings in survivors to a natural disaster. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  10. One-year follow up of PTSD and depression in elderly aboriginal people in Taiwan after Typhoon Morakot.

    Science.gov (United States)

    Chen, Yi-Lung; Hsu, Wen-Yau; Lai, Chung-Sheng; Tang, Tze-Chun; Wang, Peng-Wei; Yeh, Yi-Chung; Huang, Mei-Feng; Yen, Cheng-Fang; Chen, Cheng-Sheng

    2015-01-01

    This paper describes a 1-year follow-up of post-traumatic stress disorder (PTSD) symptomatology and depression in an elderly minority population who experienced Typhoon Morakot in Taiwan. The PTSD Symptom Scale--Interview and the 10-item short form Center for Epidemiological Studies Depression Scale were used to examine PTSD symptomatology and depression in 120 victims at 3-6 months and in 88 victims (73.3% reinterview rate) at 11-12 months after the disaster. Further, we looked for associations between stress, prognosis, and development of PTSD symptomatology and depression. The prevalence of PTSD symptomatology decreased from 29.2% (35/120) at 3-6 months to 15.9% (14/88) at 11-12 months. The prevalence of depression, however, increased from 43.3% (52/120) to 46.6% (41/88). No factor was associated with follow-up PTSD symptomatology, and only the level of education was related to follow-up depression. Generally, the risk factors of age, sex, symptomatology of PTSD and depression at baseline, and stressor of unemployment predicted new-onset or chronic PTSD symptomatology and depression. Delayed-onset depression 48.0% (24/50) was more common than delayed-onset PTSD symptomatology 11.3% (7/62). Chronic and delayed-onset PTSD symptomatology were more easily developed with depression. Although PTSD and depression were separate consequences of trauma, they emerged and affected mental health together. We documented the courses of PTSD and depression among elderly aboriginal people, and the possible effects of demographic, symptomatology, and adverse life stressors were discussed. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

  11. Prevalence of traumatic events and PTSD symptoms among secondary school students in Baghdad

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    Ashraf Al-Hadethe

    2014-11-01

    Full Text Available Background: People in Iraq have been more or less continually exposed to war for more than three decades. Studies with Iraqi participants report high prevalence rates of posttraumatic stress disorder (PTSD and related problems. Methods: The aim of this study is to measure the prevalence of traumatic events and to screen the prevalence of PTSD symptoms among Iraqi secondary school students. Four self-report scales were administered to 403 secondary school students, aged 16–19 (61% male and 31% female. These scales were Baghdad Trauma History Screen, the Scale of Posttraumatic Stress Symptoms (SPTSS, Social Support Scale, and Scale of Religious Coping. Results: The results showed that 84% of participants experienced at least one traumatic event. Of these, 61% fully met the criteria for PTSD; 65% of the females and 58% of the males. PTSD symptoms were correlated with 20 positive religious coping but not with social support. Conclusions: It’s clear that traumatic events were speared widely among the participants and the result showed that the vast majority of participants were exposed to different types of traumatic events. In addition, many of the participants have met full PTSD criteria and others had partial PTSD.

  12. Present status of severe head injured patients with an admission glasgow coma scale score of 3 based on the Japan neurotrauma data bank

    International Nuclear Information System (INIS)

    Uzura, Masahiko

    2011-01-01

    Severe head injured patients presenting with Glasgow Coma Scale (GCS) score of 3 have been hesitated to treat aggressively. We analyzed present status of patients with GCS score of 3 from the Project 2004 in the Japan Neurotrauma Data Bank. Among 1,101 cases registered, 805 cases with GCS score of 8 or less on admission. Of those, 215 cases with GCS score of 3 were classified the survival group (51 cases) and the dead group (164 cases) and compared each group. These results showed that the characteristics associated with favorable outcome including absence of cardiopulmonary arrest, no abnormality of pupil findings, stable condition of respiration and circulation, serum glucose level (less than 184 mg/dl), absence of initial CT findings including skull base fracture, pneumocephalus and subarachnoid hemorrhage, no serious extracranial injures including Injury Severity Scale score of less than 25, critic al care including intracranial pressure monitoring and temperature management. We suggest that it is important to treat brain and systemic problems aggressively in severe head injured patients with GCS score of 3. (author)

  13. The Predictive Validity of the PTSD Checklist in a Nonclinical Sample of Combat-Exposed National Guard Troops

    Science.gov (United States)

    Arbisi, Paul A.; Kaler, Matthew E.; Kehle-Forbes, Shannon M.; Erbes, Christopher R.; Polusny, Melissa A.; Thuras, Paul

    2012-01-01

    After returning from an extended combat deployment to Iraq, 348 National Guard soldiers were administered the PTSD Checklist (PCL-M), and the Beck Depression Inventory II (BDI-II) followed, on average, 3 months later by structured diagnostic interviews including the Clinician-Administered PTSD Scale (CAPS) for the "Diagnostic and Statistical…

  14. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples.

    Science.gov (United States)

    Stammel, Nadine; Abbing, Eva M; Heeke, Carina; Knaevelsrud, Christine

    2015-01-01

    The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD) diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11). The present study investigated the impact of these changes in two different post-conflict samples. Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV). Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample) compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample). Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety) compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

  15. Examining the Impact of Unscorable Item Responses on the Validity and Interpretability of MMPI-2/MMPI-2-RF Restructured Clinical (RC) Scale Scores

    Science.gov (United States)

    Dragon, Wendy R.; Ben-Porath, Yossef S.; Handel, Richard W.

    2012-01-01

    This article examined the impact of unscorable item responses on the psychometric validity and practical interpretability of scores on the Restructured Clinical (RC) Scales of the Minnesota Multiphasic Personality Inventory-2/Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2/MMPI-2-RF). In analyses conducted with five…

  16. The Reverse of Social Anxiety Is Not Always the Opposite: The Reverse-Scored Items of the Social Interaction Anxiety Scale Do Not Belong

    Science.gov (United States)

    Rodebaugh, Thomas L.; Woods, Carol M.; Heimberg, Richard G.

    2007-01-01

    Although well-used and empirically supported, the Social Interaction Anxiety Scale (SIAS) has a questionable factor structure and includes reverse-scored items with questionable utility. Here, using samples of undergraduates and a sample of clients with social anxiety disorder, we extend previous work that opened the question of whether the…

  17. Long-Term Stability of Scores on the Wechsler Intelligence Scale for Children-Fourth Edition in Children with Learning Disabilities

    Science.gov (United States)

    Lander, Jenny

    2010-01-01

    The present investigation explored the stability of scores on the Wechsler Intelligence Scale for Children-IV (WISC-IV) over approximately a three-year period. Previous research has suggested that some children with Learning Disabilities (LD) do not demonstrate long-term stability of intelligence. Legally, school districts are no longer required…

  18. Posttraumatic stress disorder (PTSD) symptoms in PTSD patients' families of origin.

    Science.gov (United States)

    Watson, C G; Anderson, P E; Gearhart, L P

    1995-10-01

    Posttraumatic stress disorder (PTSD) patients, psychiatric controls, and hospital employee controls rated their father, mother, and oldest sibling of each sex on 14 PTSD Interview (PTSD-I) symptom ratings. The stress disorder patients assigned their relatives significantly higher PTSD-I ratings than the control group members did in 35 of 120 comparisons. The number of significant differences was nearly identical in the fathers, mothers, sisters, and brothers. Differences were particularly frequent on items pertaining to intrusive thoughts, impoverished relationships, and guilt. The results suggest that a trauma survivor's risk for PTSD may be related to his family's history for PTSD-like behaviors.

  19. A study of the effect of a visual arts-based program on the scores of Jefferson Scale for Physician Empathy.

    Science.gov (United States)

    Yang, Kuang-Tao; Yang, Jen-Hung

    2013-10-25

    The effect of visual arts interventions on development of empathy has not been quantitatively investigated. A study was conducted on the effect of a visual arts-based program on the scores of the Jefferson Scale for Physician Empathy (JSPE). A total of 110 clerks (n = 92) and first-year postgraduate residents (PGY1s) (n = 18) participating in the program were recruited into this study. The 4-hr program covered the subjects of learning to interpret paintings, interpreting paintings relating to medicine, illness and human suffering, the related-topics of humanitarianism and the other humanities fields and values and meaning. The JSPE was completed at the beginning (pretest) and the end (posttest) of the program. There was no significant difference between the pretest and posttest JSPE scores. The average of the scores for the pretest was lower in the subgroup of PGY1s than the subgroup of clerks (p = 0.0358). An increased but not significantly mean posttest JESPE score was noted for the subgroup of PGY1s. Neither the females nor the males had higher posttest JSPE scores than the pretest scores. Although using a structured visual arts-based program as an intervention may be useful to enhance medical students' empathy, our results failed to show a positive effect on the JSPE Scores for a group of clerks and PGY1s. This suggests that further experimental studies are needed if quantitative evaluation of the effectiveness of visual-arts based programs on empathy is to be investigated.

  20. Standardized Total Average Toxicity Score: A Scale- and Grade-Independent Measure of Late Radiotherapy Toxicity to Facilitate Pooling of Data From Different Studies

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, Gillian C., E-mail: gillbarnett@doctors.org.uk [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Cancer Research-UK Centre for Genetic Epidemiology and Department of Oncology, Strangeways Research Laboratories, Cambridge (United Kingdom); West, Catharine M.L. [School of Cancer and Enabling Sciences, Manchester Academic Health Science Centre, University of Manchester, Christie Hospital, Manchester (United Kingdom); Coles, Charlotte E. [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Pharoah, Paul D.P. [Cancer Research-UK Centre for Genetic Epidemiology and Department of Oncology, Strangeways Research Laboratories, Cambridge (United Kingdom); Talbot, Christopher J. [Department of Genetics, University of Leicester, Leicester (United Kingdom); Elliott, Rebecca M. [School of Cancer and Enabling Sciences, Manchester Academic Health Science Centre, University of Manchester, Christie Hospital, Manchester (United Kingdom); Tanteles, George A. [Department of Clinical Genetics, University Hospitals of Leicester, Leicester (United Kingdom); Symonds, R. Paul [Department of Cancer Studies and Molecular Medicine, University Hospitals of Leicester, Leicester (United Kingdom); Wilkinson, Jennifer S. [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Dunning, Alison M. [Cancer Research-UK Centre for Genetic Epidemiology and Department of Oncology, Strangeways Research Laboratories, Cambridge (United Kingdom); Burnet, Neil G. [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Bentzen, Soren M. [University of Wisconsin, School of Medicine and Public Health, Department of Human Oncology, Madison, WI (United States)

    2012-03-01

    Purpose: The search for clinical and biologic biomarkers associated with late radiotherapy toxicity is hindered by the use of multiple and different endpoints from a variety of scoring systems, hampering comparisons across studies and pooling of data. We propose a novel metric, the Standardized Total Average Toxicity (STAT) score, to try to overcome these difficulties. Methods and Materials: STAT scores were derived for 1010 patients from the Cambridge breast intensity-modulated radiotherapy trial and 493 women from University Hospitals of Leicester. The sensitivity of the STAT score to detect differences between patient groups, stratified by factors known to influence late toxicity, was compared with that of individual endpoints. Analysis of residuals was used to quantify the effect of these covariates. Results: In the Cambridge cohort, STAT scores detected differences (p < 0.00005) between patients attributable to breast volume, surgical specimen weight, dosimetry, acute toxicity, radiation boost to tumor bed, postoperative infection, and smoking (p < 0.0002), with no loss of sensitivity over individual toxicity endpoints. Diabetes (p = 0.017), poor postoperative surgical cosmesis (p = 0.0036), use of chemotherapy (p = 0.0054), and increasing age (p = 0.041) were also associated with increased STAT score. When the Cambridge and Leicester datasets were combined, STAT was associated with smoking status (p < 0.00005), diabetes (p = 0.041), chemotherapy (p = 0.0008), and radiotherapy boost (p = 0.0001). STAT was independent of the toxicity scale used and was able to deal with missing data. There were correlations between residuals of the STAT score obtained using different toxicity scales (r > 0.86, p < 0.00005 for both datasets). Conclusions: The STAT score may be used to facilitate the analysis of overall late radiation toxicity, from multiple trials or centers, in studies of possible genetic and nongenetic determinants of radiotherapy toxicity.

  1. Minnesota multiphasic personality inventory-2 restructured form (MMPI-2-RF) scale score differences in bariatric surgery candidates diagnosed with binge eating disorder versus BMI-matched controls.

    Science.gov (United States)

    Marek, Ryan J; Ben-Porath, Yossef S; Ashton, Kathleen; Heinberg, Leslie J

    2014-04-01

    Binge Eating Disorder (BED) is among the most common psychiatric disorders in bariatric surgery candidates. The Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) is a broadband, psychological test that includes measures of emotional and behavioral dysfunction, which have been associated with BED behaviors in bariatric surgery candidates; however these studies have lacked appropriate controls. In the current study, we compared MMPI-2-RF scale scores of bariatric surgery patients diagnosed with BED (BED+) with BMI-matched controls without BED (BED-). Three-hundred and seven BED+ participants (72.64% female and 67.87% Caucasian; mean BMI of 51.36 kg/m(2) [SD = 11.94]) were drawn from a large, database (N = 1304). Three-hundred and seven BED- participants were matched on BMI and demographics (72.64% female, 68.63% Caucasian, and mean BMI of 51.30 kg/m(2) [SD = 11.70]). The BED+ group scored significantly higher on measures of Demoralization, Low Positive Emotions, and Dysfunctional Negative Emotions and scored lower on measures of Antisocial Behaviors, reflecting behavioral constraint. Optimal T-Score cutoffs were below the traditional 65 T score for several MMPI-2-RF scales. MMPI-2-RF externalizing measures also added incrementally to differentiating between the groups beyond the Binge Eating Scale (BES). BED+ individuals produced greater elevations on a number of MMPI-2-RF internalizing scales and externalizing scales. Use of the test in conjunction with a clinical interview and other self-report data can further aid the clinician in guiding patients to appropriate treatment to optimize outcome. Copyright © 2013 Wiley Periodicals, Inc.

  2. Factor structure of PTSD, and relation with gender in trauma survivors from India

    Science.gov (United States)

    Charak, Ruby; Armour, Cherie; Elklit, Ask; Angmo, Disket; Elhai, Jon D.; Koot, Hans M.

    2014-01-01

    Background The factor structure of posttraumatic stress disorder (PTSD) has been extensively studied in Western countries. Some studies have assessed its factor structure in Asia (China, Sri Lanka, and Malaysia), but few have directly assessed the factor structure of PTSD in an Indian adult sample. Furthermore, in a largely patriarchal society in India with strong gender roles, it becomes imperative to assess the association between the factors of PTSD and gender. Objective The purpose of the present study was to assess the factor structure of PTSD in an Indian sample of trauma survivors based on prevailing models of PTSD defined in the DSM-IV-TR (APA, 2000), and to assess the relation between PTSD factors and gender. Method The sample comprised of 313 participants (55.9% female) from Jammu and Kashmir, India, who had experienced a natural disaster (N=200) or displacement due to cross-border firing (N=113). Results Three existing PTSD models—two four-factor models (Emotional Numbing and Dysphoria), and a five-factor model (Dysphoric Arousal)—were tested using Confirmatory Factor Analysis with addition of gender as a covariate. The three competing models had similar fit indices although the Dysphoric Arousal model fit significantly better than Emotional Numbing and Dysphoria models. Gender differences were found across the factors of Re-experiencing and Anxious arousal. Conclusions Findings indicate that the Dysphoric Arousal model of PTSD was the best model; albeit the fit indices of all models were fairly similar. Compared to males, females scored higher on factors of Re-experiencing and Anxious arousal. Gender differences found across two factors of PTSD are discussed in light of the social milieu in India. PMID:25413575

  3. Factor structure of PTSD, and relation with gender in trauma survivors from India.

    Science.gov (United States)

    Charak, Ruby; Armour, Cherie; Elklit, Ask; Angmo, Disket; Elhai, Jon D; Koot, Hans M

    2014-01-01

    The factor structure of posttraumatic stress disorder (PTSD) has been extensively studied in Western countries. Some studies have assessed its factor structure in Asia (China, Sri Lanka, and Malaysia), but few have directly assessed the factor structure of PTSD in an Indian adult sample. Furthermore, in a largely patriarchal society in India with strong gender roles, it becomes imperative to assess the association between the factors of PTSD and gender. The purpose of the present study was to assess the factor structure of PTSD in an Indian sample of trauma survivors based on prevailing models of PTSD defined in the DSM-IV-TR (APA, 2000), and to assess the relation between PTSD factors and gender. The sample comprised of 313 participants (55.9% female) from Jammu and Kashmir, India, who had experienced a natural disaster (N=200) or displacement due to cross-border firing (N=113). Three existing PTSD models-two four-factor models (Emotional Numbing and Dysphoria), and a five-factor model (Dysphoric Arousal)-were tested using Confirmatory Factor Analysis with addition of gender as a covariate. The three competing models had similar fit indices although the Dysphoric Arousal model fit significantly better than Emotional Numbing and Dysphoria models. Gender differences were found across the factors of Re-experiencing and Anxious arousal. Findings indicate that the Dysphoric Arousal model of PTSD was the best model; albeit the fit indices of all models were fairly similar. Compared to males, females scored higher on factors of Re-experiencing and Anxious arousal. Gender differences found across two factors of PTSD are discussed in light of the social milieu in India.

  4. Factor structure of PTSD, and relation with gender in trauma survivors from India

    Directory of Open Access Journals (Sweden)

    Ruby Charak

    2014-11-01

    Full Text Available Background: The factor structure of posttraumatic stress disorder (PTSD has been extensively studied in Western countries. Some studies have assessed its factor structure in Asia (China, Sri Lanka, and Malaysia, but few have directly assessed the factor structure of PTSD in an Indian adult sample. Furthermore, in a largely patriarchal society in India with strong gender roles, it becomes imperative to assess the association between the factors of PTSD and gender. Objective: The purpose of the present study was to assess the factor structure of PTSD in an Indian sample of trauma survivors based on prevailing models of PTSD defined in the DSM-IV-TR (APA, 2000, and to assess the relation between PTSD factors and gender. Method: The sample comprised of 313 participants (55.9% female from Jammu and Kashmir, India, who had experienced a natural disaster (N=200 or displacement due to cross-border firing (N=113. Results: Three existing PTSD models—two four-factor models (Emotional Numbing and Dysphoria, and a five-factor model (Dysphoric Arousal—were tested using Confirmatory Factor Analysis with addition of gender as a covariate. The three competing models had similar fit indices although the Dysphoric Arousal model fit significantly better than Emotional Numbing and Dysphoria models. Gender differences were found across the factors of Re-experiencing and Anxious arousal. Conclusions: Findings indicate that the Dysphoric Arousal model of PTSD was the best model; albeit the fit indices of all models were fairly similar. Compared to males, females scored higher on factors of Re-experiencing and Anxious arousal. Gender differences found across two factors of PTSD are discussed in light of the social milieu in India.

  5. Aggression inoculates against PTSD symptom severity—insights from armed groups in the eastern DR Congo

    Directory of Open Access Journals (Sweden)

    Tobias Hecker

    2013-05-01

    Full Text Available Background: In the ongoing conflict in the Democratic Republic of the Congo (DRC, combatants are exposed to massive forms of violence and other traumatic stressors. Nevertheless, many combatants do not suffer from trauma-related disorders, although they have experienced numerous traumatizing events. Perceiving aggressive behavior as fascinating and arousing might be a defense against trauma-related disorders in the violent environment of war and conflict. Objective: Thus, in this study we investigated the relationship between the exposure to traumatic stressors, appetitive aggression, and posttraumatic stress disorder (PTSD symptom severity. We hypothesized that cumulative traumatic experiences correlated positively and appetitive aggression negatively with PTSD symptom severity. Method: In total, 105 voluntary male combatants from different armed groups in the eastern DRC took part in this study. In a semistructured interview, respondents were questioned about their exposure to traumatic stressors, the extent of appetitive aggression (Appetitive Aggression Scale and their PTSD symptom severity (PTSD Symptom Scale - Interview. Results: A multiple sequential regression analysis showed that traumatic events were positively related to PTSD symptom severity. For participants with low to medium PTSD symptom severity, appetitive aggression correlated negatively with PTSD symptom severity. Conclusions: The results of this study provide further support for earlier findings that repeated exposure to traumatic stressors cumulatively heightens the risk of PTSD and revealed that appetitive aggression buffers the risk of developing PTSD symptoms under certain circumstances. Thus, the perception of aggressive behavior as fascinating and arousing seem to help combatants to adapt to violent environments but may also be one reason for recurrent failure of reintegration programs for excombatants.

  6. Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

    Directory of Open Access Journals (Sweden)

    Marylène Cloitre

    2014-09-01

    Full Text Available Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD is distinct from Borderline Personality Disorder (BPD when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning.

  7. Contributions of polygenic risk for obesity to PTSD-related metabolic syndrome and cortical thickness.

    Science.gov (United States)

    Wolf, Erika J; Miller, Danielle R; Logue, Mark W; Sumner, Jennifer; Stoop, Tawni B; Leritz, Elizabeth C; Hayes, Jasmeet P; Stone, Annjanette; Schichman, Steven A; McGlinchey, Regina E; Milberg, William P; Miller, Mark W

    2017-10-01

    Research suggests that posttraumatic stress disorder (PTSD) is associated with metabolic syndrome (MetS) and that PTSD-associated MetS is related to decreased cortical thickness. However, the role of genetic factors in these associations is unclear. This study evaluated contributions of polygenic obesity risk and PTSD to MetS and of MetS and polygenic obesity risk to cortical thickness. 196 white, non-Hispanic veterans of the wars in Iraq and Afghanistan underwent clinical diagnostic interviews, physiological assessments, and genome-wide genotyping; 168 also completed magnetic resonance imaging scans. Polygenic risk scores (PRSs) for obesity were calculated from results of a prior genome-wide association study (Speliotes et al., 2010) and PTSD and MetS severity factor scores were obtained. Obesity PRS (β=0.15, p=0.009) and PTSD (β=0.17, p=0.005) predicted MetS and interacted such that the association between PTSD and MetS was stronger in individuals with greater polygenic obesity risk (β=0.13, p=0.02). Whole-brain vertex-wise analyses suggested that obesity PRS interacted with MetS to predict decreased cortical thickness in left rostral middle frontal gyrus (β=-0.40, pobesity genetic risk increases stress-related metabolic pathology, and compounds the ill health effects of MetS on the brain. Genetic proclivity towards MetS should be considered in PTSD patients when prescribing psychotropic medications with adverse metabolic profiles. Results are consistent with a growing literature suggestive of PTSD-related accelerated aging. Published by Elsevier Inc.

  8. Computed tomography and magnetic resonance imaging of mild head injury - is it appropriate to classify patients with glasgow coma scale score of 13 to 15 as 'mild injury'?

    International Nuclear Information System (INIS)

    Uchino, Y.; Saeki, N.; Yamaura, A.; Okimura, Y.; Tanaka, M.

    2001-01-01

    Objective. The purpose of this study is to examine the relation between Glasgow coma scale (GCS) score and findings on computed tomography (CT) and magnetic resonance (MR) imaging of patients with mild head injury presenting GCS Scores between 13 and 15. Methods. Data were collected from all consecutive patients with mild head injury who were referred to our hospital between July 1 and October 31, 1999. All patients were recommended to undergo CT and MR imaging examinations. Patients younger than 14 years of age were excluded. Results. Ninety patients were recruited into this study. CT scans were obtained in 88 patients and MR imaging were obtained in 65 patients. Of those 90 patients, 2 patients scored 13 points, 5 scored 14 points and 83 (92.2 %) 15 points. Patients with GCS score of 13 points demonstrated parenchymal lesions an both CT and MR imaging. Those with 14 points revealed absence of parenchymal abnormality an CT, but presence of parenchymal lesions an MR imaging. Patients in advanced age (chi square test, p < 0.0001), and those with amnesia (p = 0005, not significant), although scoring 15 points, revealed a tendency to abnormal intracranial lesions on CT scans. Conclusion. It is doubtful whether patients with GCS score 13 should be included in the mild head injury category, due to obvious brain damage on CT scans. MR imaging should be performed on patients with GCS score 14, since the parenchymal lesions are not clearly demonstrated an CT scans. Even if patients scored GCS 15, patients which amnesia or of advanced age should undergo CT scans at minimum, and MR imaging when available. (author)

  9. Predictors of long-term treatment outcome in combat and peacekeeping veterans with military-related PTSD.

    Science.gov (United States)

    Richardson, J Don; Contractor, Ateka A; Armour, Cherie; St Cyr, Kate; Elhai, Jon D; Sareen, Jitender

    2014-11-01

    Posttraumatic stress disorder (PTSD) is a significant psychiatric condition that may result from exposure to combat; it has been associated with severe psychosocial dysfunction. This study examined the predictors of long-term treatment outcomes in a group of veterans with military-related PTSD. The study consisted of a retrospective chart review of 151 consecutive veterans treated at an outpatient clinic for veterans with psychiatric disorders resulting from their military operations between January 2002 and May 2012. The diagnosis of PTSD was made using the Clinician-Administered PTSD Scale. As part of treatment as usual, all patients completed the PTSD Checklist-Military version and Beck Depression Inventory (BDI-II) at intake and at each follow-up appointment, the Short-Form Health Survey (SF-36) at intake, and either the SF-36 or the 12-item Short-Form Health Survey at follow-up. All patients received psychoeducation about PTSD and combined pharmacotherapy and psychotherapy. Analyses demonstrated a significant and progressive improvement in PTSD severity over the 2-year period ([n = 117] Yuan-Bentler χ²40 = 221.25, P loss of probable PTSD diagnosis, is possible in an outpatient setting for veterans with chronic military-related PTSD. © Copyright 2014 Physicians Postgraduate Press, Inc.

  10. The responsiveness of the International Prostate Symptom Score, Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scale-21 in patients with lower urinary tract symptoms.

    Science.gov (United States)

    Choi, Edmond P H; Chin, Weng Yee; Lam, Cindy L K; Wan, Eric Y F

    2015-08-01

    To examine the responsiveness of a combined symptom severity and health-related quality of life measure, condition-specific health-related quality of life measure and mental health measure in patients with lower urinary tract symptoms. To establish the responsiveness of measures that accurately capture the change in health status of patients is crucial before any longitudinal studies can be appropriately planned and evaluated. Prospective longitudinal observational study. 402 patients were surveyed at baseline and 1-year using the International Prostate Symptom Score, the Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scales-21. The internal and external responsiveness were assessed. Surveys were conducted from March 2013-July 2014. In participants with improvements, the internal responsiveness for detecting positive changes was satisfactory in males and females for all scales, expect for the Depression subscale. The health-related quality of life question of the International Prostate Symptom Score was more externally responsive than the Incontinence Impact Questionnaire-7. The International Prostate Symptom Score and Anxiety and Stress subscales were more responsive in males than in females. The symptom questions of the International Prostate Symptom Score and Anxiety and Stress subscales were not externally responsive in females. The health-related quality of life question of the International Prostate Symptom Score outperformed the Incontinence Impact Questionnaire-7 in both males and females, in terms of external responsiveness. © 2015 John Wiley & Sons Ltd.

  11. Prevalence rate of post-traumatic stress disorders (PTSD and other psychological disorders among Saudi firefighters

    Directory of Open Access Journals (Sweden)

    Mohammed Alghamd

    2013-08-01

    Full Text Available Background: Firefighters have a high probability of being exposed to a variety of traumatic events. Potentially traumatic events can occur during a single rescue such as: providing aid to seriously injured or helpless victims. Moreover, firefighters who are injured in the line of duty may have to retire as a consequence of their injury. The psychological cost of this exposure may increase the risk of long-term problems, such as post-traumatic stress disorder (PTSD symptoms, depression, and anxiety. Objective: The purpose of this study was to investigate the prevalence of PTSD symptoms, depression, anxiety, and assess related variables such as coping strategies and social support among Saudi firefighters. Method: Two hundred firefighters completed the Fire-fighter Trauma History Screen (FTHS to measure the number of traumatic events, Screen for Post-traumatic Stress Symptoms (SPTSS scale to assess the prevalence of PTSD symptoms, Hospital Anxiety and Depression Scales (HADS to assess depression and anxiety, Brief Cope (BC scale to measure coping strategies used, and Social Support scale was used to evaluate the firefighter's support received. Results: The results showed that 84% (169/200 of firefighters were exposed to at least one traumatic event. The result presented that 57% (96/169 of exposure firefighters fully met the DSM-IV criteria for PTSD with high levels of depression and anxiety; 39% (66/169 partially met the PTSD criteria. However, only 4% participants have not met the PTSD criteria. The results also revealed that adaptive coping strategies and higher perceived social support was associated with lower levels of PTSD. Conclusion: The high prevalence rate of PTSD related to the type and severity of the traumatic events and years of experience in the job. Accordingly, many firefighters were severely affected by their experiences, and we should be developing methods to help them.

  12. Optimization of MRI-based scoring scales of brain injury severity in children with unilateral cerebral palsy

    International Nuclear Information System (INIS)

    Pagnozzi, Alex M.; Fiori, Simona; Boyd, Roslyn N.; Guzzetta, Andrea; Doecke, James; Rose, Stephen; Dowson, Nicholas; Gal, Yaniv

    2016-01-01

    Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach. (orig.)

  13. Optimization of MRI-based scoring scales of brain injury severity in children with unilateral cerebral palsy.

    Science.gov (United States)

    Pagnozzi, Alex M; Fiori, Simona; Boyd, Roslyn N; Guzzetta, Andrea; Doecke, James; Gal, Yaniv; Rose, Stephen; Dowson, Nicholas

    2016-02-01

    Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach.

  14. Optimization of MRI-based scoring scales of brain injury severity in children with unilateral cerebral palsy

    Energy Technology Data Exchange (ETDEWEB)

    Pagnozzi, Alex M. [Royal Brisbane and Women' s Hospital, CSIRO Digital Productivity and Services Flagship, The Australian e-Health Research Centre, Herston, QLD (Australia); The University of Queensland, School of Medicine, Brisbane (Australia); Fiori, Simona [Stella Maris Scientific Institute, Pisa (Italy); Boyd, Roslyn N. [The University of Queensland, Queensland Cerebral Palsy and Rehabilitation Research Centre, School of Medicine, Brisbane (Australia); Guzzetta, Andrea [Stella Maris Scientific Institute, Pisa (Italy); University of Pisa, Department of Clinical and Experimental Medicine, Pisa (Italy); Doecke, James; Rose, Stephen; Dowson, Nicholas [Royal Brisbane and Women' s Hospital, CSIRO Digital Productivity and Services Flagship, The Australian e-Health Research Centre, Herston, QLD (Australia); Gal, Yaniv [The University of Queensland, Centre for Medical Diagnostic Technologies in Queensland, Brisbane (Australia)

    2016-02-15

    Several scoring systems for measuring brain injury severity have been developed to standardize the classification of MRI results, which allows for the prediction of functional outcomes to help plan effective interventions for children with cerebral palsy. The aim of this study is to use statistical techniques to optimize the clinical utility of a recently proposed template-based scoring method by weighting individual anatomical scores of injury, while maintaining its simplicity by retaining only a subset of scored anatomical regions. Seventy-six children with unilateral cerebral palsy were evaluated in terms of upper limb motor function using the Assisting Hand Assessment measure and injuries visible on MRI using a semiquantitative approach. This cohort included 52 children with periventricular white matter injury and 24 with cortical and deep gray matter injuries. A subset of the template-derived cerebral regions was selected using a data-driven region selection algorithm. Linear regression was performed using this subset, with interaction effects excluded. Linear regression improved multiple correlations between MRI-based and Assisting Hand Assessment scores for both periventricular white matter (R squared increased to 0.45 from 0, P < 0.0001) and cortical and deep gray matter (0.84 from 0.44, P < 0.0001) cohorts. In both cohorts, the data-driven approach retained fewer than 8 of the 40 template-derived anatomical regions. The equal or better prediction of the clinically meaningful Assisting Hand Assessment measure using fewer anatomical regions highlights the potential of these developments to enable enhanced quantification of injury and prediction of patient motor outcome, while maintaining the clinical expediency of the scoring approach. (orig.)

  15. A higher score on the Aging Males' Symptoms scale is associated with insulin resistance in middle-aged men.

    Science.gov (United States)

    Hamanoue, Nobuya; Tanabe, Makito; Tanaka, Tomoko; Akehi, Yuko; Murakami, Junji; Nomiyama, Takashi; Yanase, Toshihiko

    2017-05-30

    An age-associated androgen decrease and its pathological conditions are defined as late-onset hypogonadism (LOH). Among the various symptoms associated with LOH, a visceral fat increase is strongly associated with relatively low levels of testosterone. However, few studies have investigated the relationship between the Aging Males' Symptoms (AMS) scores and metabolic abnormalities. Thus, we aimed to clarify this relationship by investigating the relationship between AMS scores and various markers in blood. During routine health examinations in 241 middle-aged males (52.7±7.5 years of age, mean±SD), 150 males (62.2%) displayed higher AMS values than normal. No statistical association was observed between total AMS scores and any testosterone value. All mental, physical and sexual AMS subscales were significantly positively correlated with insulin levels and HOMA-IR. Only sexual subscale scores were significantly inversely associated with free or bioavailable testosterone level. Males with insulin resistance (HOMA-IR≥2.5) demonstrated significantly higher AMS scores than those with normal insulin sensitivity (HOMA-IRinsulin and HOMA-IR values. Interestingly, univariate and multivariate analyses revealed that HOMA-IR≥2.5 was a significant predictor for detection of moderately severe AMS values (AMS≥37), whereas AMS≥37 was not a predictor of metabolic syndrome by International Diabetes Federation (IDF) criterion. In conclusion, almost 60% of healthy male subjects displayed abnormal AMS scores. AMS values were not associated with testosterone values but rather were related to insulin resistance, particularly in subjects with moderately severe AMS values. Insulin resistance-related general unwellness might be reflected by AMS values.

  16. Mother's IPV, Child Maltreatment Type and the Presence of PTSD in Children and Adolescents.

    Science.gov (United States)

    Castro, Maravillas; Alcántara-López, Mavi; Martínez, Antonia; Fernández, Visitación; Sánchez-Meca, Julio; López-Soler, Concepción

    2017-09-17

    This correlational cross-sectional study was designed to investigate whether the intimate partner violence (IPV) suffered by mothers (physical and psychological maltreatment), child eyewitness of psychological and physical maltreatment suffered by the mother, the neglect suffered by children, and the maltreatment (physical and psychological) directly suffered by children are statistically associated to post-traumatic stress disorder (PTSD) symptoms exhibited by the child. In addition, the prevalence of child PTSD was estimated, as well as the concordance between the PTSD symptoms assessed by the Child PTSD Symptom Scale (CPSS) and the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria for child PTSD. The sample consisted of 152 Spanish children aged 8 to 17 and their mothers, who were recruited from Centers of Specialized Assistance for Women Victims of IPV. PTSD prevalence was 20.4%. The results of a canonical correlation analysis showed that the two types of maltreatment with the largest contribution to the canonical variable were physical maltreatment directly suffered by the child, and child eyewitness of physical maltreatment suffered by the mother. The potential developmental pathway of PTSD when both children and mothers suffer severe maltreatment needs to be examined, and this will contribute to the choice of the most effective type of specialized intervention.

  17. Utility of the Mild Brain Injury Atypical Symptoms Scale to detect symptom exaggeration: an analogue simulation study.

    Science.gov (United States)

    Lange, Rael T; Edmed, Shannon L; Sullivan, Karen A; French, Louis M; Cooper, Douglas B

    2013-01-01

    Brief self-report symptom checklists are often used to screen for postconcussional disorder (PCD) and posttraumatic stress disorder (PTSD) and are highly susceptible to symptom exaggeration. This study examined the utility of the five-item Mild Brain Injury Atypical Symptoms Scale (mBIAS) designed for use with the Neurobehavioral Symptom Inventory (NSI) and the PTSD Checklist-Civilian (PCL-C). Participants were 85 Australian undergraduate students who completed a battery of self-report measures under one of three experimental conditions: control (i.e., honest responding, n = 24), feign PCD (n = 29), and feign PTSD (n = 32). Measures were the mBIAS, NSI, PCL-C, Minnesota Multiphasic Personality Inventory-2, Restructured Form (MMPI-2-RF), and the Structured Inventory of Malingered Symptomatology (SIMS). Participants instructed to feign PTSD and PCD had significantly higher scores on the mBIAS, NSI, PCL-C, and MMPI-2-RF than did controls. Few differences were found between the feign PCD and feign PTSD groups, with the exception of scores on the NSI (feign PCD > feign PTSD) and PCL-C (feign PTSD > feign PCD). Optimal cutoff scores on the mBIAS of ≥8 and ≥6 were found to reflect "probable exaggeration" (sensitivity = .34; specificity = 1.0; positive predictive power, PPP = 1.0; negative predictive power, NPP = .74) and "possible exaggeration" (sensitivity = .72; specificity = .88; PPP = .76; NPP = .85), respectively. Findings provide preliminary support for the use of the mBIAS as a tool to detect symptom exaggeration when administering the NSI and PCL-C.

  18. New scoring methodology improves the sensitivity of the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) in clinical trials.

    Science.gov (United States)

    Verma, Nishant; Beretvas, S Natasha; Pascual, Belen; Masdeu, Joseph C; Markey, Mia K

    2015-11-12

    As currently used, the Alzheimer's Disease Assessment Scale-Cognitive subscale (ADAS-Cog) has low sensitivity for measuring Alzheimer's disease progression in clinical trials. A major reason behind the low sensitivity is its sub-optimal scoring methodology, which can be improved to obtain better sensitivity. Using item response theory, we developed a new scoring methodology (ADAS-CogIRT) for the ADAS-Cog, which addresses several major limitations of the current scoring methodology. The sensitivity of the ADAS-CogIRT methodology was evaluated using clinical trial simulations as well as a negative clinical trial, which had shown an evidence of a treatment effect. The ADAS-Cog was found to measure impairment in three cognitive domains of memory, language, and praxis. The ADAS-CogIRT methodology required significantly fewer patients and shorter trial durations as compared to the current scoring methodology when both were evaluated in simulated clinical trials. When validated on data from a real clinical trial, the ADAS-CogIRT methodology had higher sensitivity than the current scoring methodology in detecting the treatment effect. The proposed scoring methodology significantly improves the sensitivity of the ADAS-Cog in measuring progression of cognitive impairment in clinical trials focused in the mild-to-moderate Alzheimer's disease stage. This provides a boost to the efficiency of clinical trials requiring fewer patients and shorter durations for investigating disease-modifying treatments.

  19. Common paths to ASD and PTSD

    DEFF Research Database (Denmark)

    Hansen, Maj; Armour, Cherie; Wittmann, Lutz

    Numerous studies have investigated the prediction of acute and long term posttraumatic symptoms following traumatic exposure. As a result several factors have been shown to be predictive of Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) respectively. Furthermore, research...... suggests a strong relationship between ASD severity and subsequent PTSD severity. However, little is known in relation to whether there are common pathways to the development of ASD and PTSD. Peritraumatic responses to trauma are found to be associated with both the development of ASD and PTSD. Although...... of peritraumatic factors such as symptoms of tonic immobility, panic, and dissociation on the development of ASD (N = 458) and PTSD (n = 378) symptoms in a national study of Danish bank robbery victims. The estimated ASD rate was 11.1 % (n = 41) and the estimated PTSD rate was 6.2 % (n = 23). The results...

  20. ASD and PTSD in Rape Victims

    DEFF Research Database (Denmark)

    Elklit, Ask; Christiansen, Dorte M

    2010-01-01

    In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims...... shortly after the rape or attempted rape. The PTSD diagnosis based solely on the three core symptom clusters was best identified by a subclinical ASD diagnosis based on all ASD criteria except dissociation. However, a full PTSD diagnosis including the A2 and F criteria was best identified by classifying...... on ASD severity and sexual problems following the rape accounted for only 28% of the PTSD severity variance. In conclusion, the ASD diagnosis is not an optimal method for identifying those most at risk for PTSD. It remains to be seen whether a better way can be found....

  1. Increased Resilience is Associated with Positive Treatment Outcomes for Veterans with Comorbid PTSD and Substance Use Disorders.

    Science.gov (United States)

    McGuire, Adam P; Mota, Natalie P; Sippel, Lauren M; Connolly, Kevin M; Lyons, Judith A

    2018-04-18

    Resilience has been associated with less severe psychiatric symptomatology and better treatment outcomes among individuals with posttraumatic stress disorder (PTSD) and substance use disorders. However, it remains unknown whether resilience increases during psychotherapy within the comorbid PTSD and substance use disorder population with unique features of dual diagnosis, including trauma cue-related cravings. We tested whether veterans seeking psychotherapy for comorbid PTSD and substance use disorder reported increased resilience from pre- to posttreatment. We also tested whether increased resilience was associated with greater decreases in posttreatment PTSD and substance use disorder symptoms. Participants were 29 male veterans (M age = 49.07 years, SD = 11.24 years) receiving six-week residential day treatment including cognitive processing therapy for PTSD and cognitive behavioral therapy for substance use disorder. Resilience, PTSD symptoms, and trauma cue-related cravings were assessed at pre- and posttreatment. Veterans reported a large, significant increase in resilience posttreatment (M diff = 14.24, t = -4.22, p resilience were significantly associated with fewer PTSD symptoms (β = -0.37, p = .049, sr = -.36) and trauma-cued cravings (β = -0.39, p = .006, sr = -.38) posttreatment when controlling for pretreatment scores and baseline depressive symptoms. Results suggest that evidence-based psychotherapy for comorbid PTSD and substance use disorder may facilitate strength-based psychological growth, which may further promote sustained recovery.

  2. Clinical study on HAT and SEDAN score scales and related risk factors for predicting hemorrhagic transformation following thrombolysis in acute ischemic stroke

    Directory of Open Access Journals (Sweden)

    Heng WEI

    2015-03-01

    Full Text Available Objective To investigate the value of HAT and SEDAN score scales in predicting hemorrhagic transformation (HT following the recombinant tissue-type plasminogen activator (rt-PA intravenous thrombolysis in acute ischemic stroke patients and risk factors affecting HT.  Methods A total of 143 patients with acute ischemic stroke underwent rt-PA intravenous thrombolysis within 4.50 h of onset and their clinical data were collected. According to head CT after thrombolysis, patients were divided into HT group (18 cases and non-HT group (125 cases. Single factor analysis was used to assess differences in HAT and SEDAN score scales and related risk factors of ischemic stroke in 2 groups, and further Logistic regression analysis was used to investigate independent predictors of HT. Receiver operating characteristic (ROC curve was used to evaluate the sensitivity and specificity of HAT and SEDAN score scales in predicting HT.  Results Univariate Logistic regression analysis showed that history of atrial fibrillation (AF, admission systolic blood pressure (SBP, admission blood glucose level, early low density of head CT, thrombolytic time window, National Institute of Health Stroke Scale (NIHSS, HAT and SEDAN scores were all risk factors for HT after thrombolysis (P < 0.05, for all. Multivariate Logistic regression analysis showed that history of AF (OR = 1.677, 95% CI: 1.332-2.111; P = 0.000, admission SBP (OR = 1.102, 95% CI: 1.009-1.204; P = 0.031, admission blood glucose level (OR = 1.870, 95% CI: 1.119-3.125; P = 0.017, thrombolysis time window (OR = 1.030, 95%CI: 1.009-1.052; P = 0.005, NIHSS score (OR = 1.574, 95%CI: 1.186-2.090; P = 0.002, HAT score (OR = 2.515, 95%CI: 1.273-4.970;P = 0.008 and SEDAN score (OR = 2.413, 95%CI: 1.123-5.185; P = 0.024 were risk factors for HT after thrombolysis. ROC curve analysis showed that HAT score could predict HT with 94.40% sensitivity and 41.60% specificity, and area under curve (AUC was 0.70. SEDAN

  3. CUMULATIVE TRAUMAS AND RISK THRESHOLDS: 12-MONTH PTSD IN THE WORLD MENTAL HEALTH (WMH) SURVEYS

    Science.gov (United States)

    Karam, Elie G.; Friedman, Matthew J.; Hill, Eric D.; Kessler, Ronald C.; McLaughlin, Katie A.; Petukhova, Maria; Sampson, Laura; Shahly, Victoria; Angermeyer, Matthias C.; Bromet, Evelyn J.; de Girolamo, Giovanni; de Graaf, Ron; Demyttenaere, Koen; Ferry, Finola; Florescu, Silvia E.; Haro, Josep Maria; He, Yanling; Karam, Aimee N.; Kawakami, Norito; Kovess-Masfety, Viviane; Medina-Mora, María Elena; Browne, Mark A. Oakley; Posada-Villa, José A.; Shalev, Arieh Y.; Stein, Dan J.; Viana, Maria Carmen; Zarkov, Zahari; Koenen, Karestan C.

    2014-01-01

    Background Clinical research suggests that posttraumatic stress disorder (PTSD) patients exposed to multiple traumatic events (TEs) rather than a single TE have increased morbidity and dysfunction. Although epidemiological surveys in the United States and Europe also document high rates of multiple TE exposure, no population-based cross-national data have examined this issue. Methods Data were analyzed from 20 population surveys in the World Health Organization World Mental Health Survey Initiative (n 51,295 aged 18+). The Composite International Diagnostic Interview (3.0) assessed 12-month PTSD and other common DSM-IV disorders. Respondents with 12-month PTSD were assessed for single versus multiple TEs implicated in their symptoms. Associations were examined with age of onset (AOO), functional impairment, comorbidity, and PTSD symptom counts. Results 19.8% of respondents with 12-month PTSD reported that their symptoms were associated with multiple TEs. Cases who associated their PTSD with four or more TEs had greater functional impairment, an earlier AOO, longer duration, higher comorbidity with mood and anxiety disorders, elevated hyper-arousal symptoms, higher proportional exposures to partner physical abuse and other types of physical assault, and lower proportional exposure to unexpected death of a loved one than cases with fewer associated TEs. Conclusions A risk threshold was observed in this large-scale cross-national database wherein cases who associated their PTSD with four or more TEs presented a more “complex” clinical picture with substantially greater functional impairment and greater morbidity than other cases of PTSD. PTSD cases associated with four or more TEs may merit specific and targeted intervention strategies. Depression and Anxiety 31:130–142, 2014. PMID:23983056

  4. Serum concentrations of TNF-α and its soluble receptors during psychotherapy in German soldiers suffering from combat-related PTSD.

    Science.gov (United States)

    Himmerich, Hubertus; Willmund, Gerd D; Zimmermann, Peter; Wolf, Jörg-Egbert; Bühler, Antje H; Kirkby, Kenneth C; Dalton, Bethan; Holdt, Lesca M; Teupser, Daniel; Wesemann, Ulrich

    2016-09-01

    Changes in serum concentrations of tumor necrosis factor-α (TNF-α) and its soluble receptors (sTNF-R) p55 and p75 have been shown to be associated with various psychiatric treatments. Before and after treatment, serum levels of TNF-α, sTNF-R p55 and sTNF-R p75 were measured in 38 German soldiers who had been deployed abroad and suffered from combat-related post-traumatic stress disorder (PTSD). Patients were randomized either to inpatient psychotherapy (N=21) including eye movement desensitization and reprocessing (EMDR) or to outpatient clinical management (N=17). Symptoms of PTSD were measured using the Post-traumatic Stress Diagnostic Scale (PDS). The PDS score significantly decreased across time in both groups. Serum concentrations of TNF-α increased, while sTNF-R p55 and sTNF-R p75 levels decreased significantly. After the treatment period, we could not detect any significant difference regarding TNF-α, sTNF-R p55 or sTNF-R p75 levels between the inpatient psychotherapy group and the outpatient clinical management control group. This relatively small clinical study suggests that specific inpatient psychotherapy but also non-specific supportive outpatient treatment for PTSD are associated with changes in the TNF-α system. This may represent an immunological effects or side effects of psychotherapy.

  5. A Study of the Effect of a Child's Physical Attractiveness upon Verbal Scoring of the Wechsler Intelligence Scale for Children (Revised) and upon Personality Attributions

    OpenAIRE

    Wheeler, Paula Theisler

    1985-01-01

    The purpose of this research was to investigate possible examiner bias in scoring the Verbal subtests of the Wechsler Intelligence Scale for Children (Revised) due to the level of facial attractiveness of the child. Sex of the child and sex of the research subject were also included as independent variables. No main effect for attractiveness or sex x attractiveness interactions were found. Thus, little evidence emerged to suggest attractiveness stereotyping effects in an intelligence testing ...

  6. Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) processing speed scores as measures of noncredible responding: The third generation of embedded performance validity indicators.

    Science.gov (United States)

    Erdodi, Laszlo A; Abeare, Christopher A; Lichtenstein, Jonathan D; Tyson, Bradley T; Kucharski, Brittany; Zuccato, Brandon G; Roth, Robert M

    2017-02-01

    Research suggests that select processing speed measures can also serve as embedded validity indicators (EVIs). The present study examined the diagnostic utility of Wechsler Adult Intelligence Scale-Fourth Edition (WAIS-IV) subtests as EVIs in a mixed clinical sample of 205 patients medically referred for neuropsychological assessment (53.3% female, mean age = 45.1). Classification accuracy was calculated against 3 composite measures of performance validity as criterion variables. A PSI ≤79 produced a good combination of sensitivity (.23-.56) and specificity (.92-.98). A Coding scaled score ≤5 resulted in good specificity (.94-1.00), but low and variable sensitivity (.04-.28). A Symbol Search scaled score ≤6 achieved a good balance between sensitivity (.38-.64) and specificity (.88-.93). A Coding-Symbol Search scaled score difference ≥5 produced adequate specificity (.89-.91) but consistently low sensitivity (.08-.12). A 2-tailed cutoff on the Coding/Symbol Search raw score ratio (≤1.41 or ≥3.57) produced acceptable specificity (.87-.93), but low sensitivity (.15-.24). Failing ≥2 of these EVIs produced variable specificity (.81-.93) and sensitivity (.31-.59). Failing ≥3 of these EVIs stabilized specificity (.89-.94) at a small cost to sensitivity (.23-.53). Results suggest that processing speed based EVIs have the potential to provide a cost-effective and expedient method for evaluating the validity of cognitive data. Given their generally low and variable sensitivity, however, they should not be used in isolation to determine the credibility of a given response set. They also produced unacceptably high rates of false positive errors in patients with moderate-to-severe head injury. Combining evidence from multiple EVIs has the potential to improve overall classification accuracy. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  7. A Comparison of Low IQ Scores from the Reynolds Intellectual Assessment Scales and the Wechsler Adult Intelligence Scale--Third Edition

    Science.gov (United States)

    Umphress, Thomas B.

    2008-01-01

    Twenty people with suspected intellectual disability took the Reynolds Intellectual Assessment Scales (RIAS; C. R. Reynolds & R. W. Kamphaus, 1998) and the Wechsler Adult Intelligence Scale--3rd Edition (WAIS-III; D. Wechsler, 1997) to see if the 2 IQ tests produced comparable results. A t test showed that the RIAS Composite Intelligence Index…

  8. Conversion Between Mini-Mental State Examination, Montreal Cognitive Assessment, and Dementia Rating Scale-2 Scores in Parkinson’s Disease

    Science.gov (United States)

    van Steenoven, Inger; Aarsland, Dag; Hurtig, Howard; Chen-Plotkin, Alice; Duda, John E.; Rick, Jacqueline; Chahine, Lama M.; Dahodwala, Nabila; Trojanowski, John Q.; Roalf, David R.; Moberg, Paul J.; Weintraub, Daniel

    2015-01-01

    Cognitive impairment is one of the earliest, most common, and most disabling non-motor symptoms in Parkinson’s disease (PD). Thus, routine screening of global cognitive abilities is important for the optimal management of PD patients. Few global cognitive screening instruments have been developed for or validated in PD patients. The Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Dementia Rating Scale-2 (DRS-2) have been used extensively for cognitive screening in both clinical and research settings. Determining how to convert the scores between instruments would facilitate the longitudinal assessment of cognition in clinical settings and the comparison and synthesis of cognitive data in multicenter and longitudinal cohort studies. The primary aim of this study was to apply a simple and reliable algorithm for the conversion of MoCA to MMSE scores in PD patients. A secondary aim was to apply this algorithm for the conversion of DRS-2 to both MMSE and MoCA scores. The cognitive performance of a convenience sample of 360 patients with idiopathic PD was assessed by at least two of these cognitive screening instruments. We then developed conversion scores between the MMSE, MoCA, and DRS-2 using equipercentile equating and log-linear smoothing. The conversion score tables reported here enable direct and easy comparison of three routinely used cognitive screening assessments in PD patients. PMID:25381961

  9. Treatment of OSA with CPAP Is Associated with Improvement in PTSD Symptoms among Veterans

    Science.gov (United States)

    Orr, Jeremy E.; Smales, Carolina; Alexander, Thomas H.; Stepnowsky, Carl; Pillar, Giora; Malhotra, Atul; Sarmiento, Kathleen F.

    2017-01-01

    Study Objectives: Posttraumatic stress disorder (PTSD) is common among veterans of the military, with sleep disturbance as a hallmark manifestation. A growing body of research has suggested a link between obstructive sleep apnea and PTSD, potentially due to obstructive sleep apnea (OSA) related sleep disruption, or via other mechanisms. We examined the hypothesis that treatment of OSA with positive airway pressure would reduce PTSD symptoms over 6 months. Methods: A prospective study of Veterans with confirmed PTSD and new diagnosis of OSA not yet using PAP therapy were recruited from a Veteran's Affairs sleep medicine clinic. All subjects were instructed to use PAP each night. Assessments were performed at 3 and 6 months. The primary outcome was a reduction in PTSD symptoms at 6 months. Results: Fifty-nine subjects were enrolled; 32 remained in the study at 6 months. A significant reduction in PTSD symptoms, measured by PCL-S score was observed over the course of the study (60.6 ± 2.7 versus 52.3 ± 3.2 points; p J Clin Sleep Med. 2017;13(1):57–63. PMID:27707436

  10. Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach.

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

    Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post whiplash

  11. Attachment typologies and posttraumatic stress disorder (PTSD), depression and anxiety: a latent profile analysis approach

    Science.gov (United States)

    Armour, Cherie; Elklit, Ask; Shevlin, Mark

    2011-01-01

    Background Bartholomew (1990) proposed a four category adult attachment model based on Bowlby's (1973) proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS). In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. Objective The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990). Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. Method A large sample of Danish trauma victims (N=1577) participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. Results The three class solution was considered optimal. Class one was termed Fearful (18.6%), Class two Preoccupied (34.5%), and Class three Secure (46.9%). The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. Conclusions The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display

  12. Attachment typologies and posttraumatic stress disorder (PTSD, depression and anxiety: a latent profile analysis approach

    Directory of Open Access Journals (Sweden)

    Cherie Armour

    2011-12-01

    Full Text Available Bartholomew (1990 proposed a four category adult attachment model based on Bowlby's (1973 proposal that attachment is underpinned by an individual's view of the self and others. Previous cluster analytic techniques have identified four and two attachment styles based on the Revised Adult Attachment Scale (RAAS. In addition, attachment styles have been proposed to meditate the association between stressful life events and subsequent psychiatric status. The current study aimed to empirically test the attachment typology proposed by Collins and Read (1990. Specifically, LPA was used to determine if the proposed four styles can be derived from scores on the dimensions of closeness/dependency and anxiety. In addition, we aimed to test if the resultant attachment styles predicted the severity of psychopathology in response to a whiplash trauma. A large sample of Danish trauma victims (N=1577 participated. A Latent Profile Analysis was conducted, using Mplus 5.1, on scores from the RAAS scale to ascertain if there were underlying homogeneous attachment classes/subgroups. Class membership was used in a series of one-way ANOVA tests to determine if classes were significantly different in terms of mean scores on measures of psychopathology. The three class solution was considered optimal. Class one was termed Fearful (18.6%, Class two Preoccupied (34.5%, and Class three Secure (46.9%. The secure class evidenced significantly lower mean scores on PTSD, depression, and anxiety measures compared to other classes, whereas the fearful class evidenced significantly higher mean scores compared to other classes. The results demonstrated evidence of three discrete classes of attachment styles, which were labelled secure, preoccupied, and fearful. This is in contrast to previous cluster analytic techniques which have identified four and two attachment styles based on the RAAS.In addition, Securely attached individuals display lower levels of psychopathology post

  13. Depression and Dissociation as Predictors of Physical Health Symptoms Among Female Rape Survivors with PTSD

    Science.gov (United States)

    Scioli-Salter, Erica R.; Johnides, Benjamin D.; Mitchell, Karen S.; Smith, Brian N.; Resick, Patricia A.; Rasmusson, Ann M.

    2016-01-01

    Objective To investigate the relative contributions of depression and dissociation, as well as PTSD, to physical health symptoms and to examine the relationships among somatic symptoms, PTSD, depression, and dissociation in relation to childhood and adult trauma exposure. Method Cross-sectional data are from 132 female rape survivors with PTSD assessed prior to engaging in a study of trauma-focused cognitive therapy for PTSD. Measures included the Pennebaker Inventory of Limbic Languidness, Clinician Administered PTSD Scale, Beck Depression Inventory, Trauma Symptom Inventory-Dissociation Subscale, Childhood Sexual Abuse Exposure Questionnaire, and Assessing Environments-III-Physical Punishment Scale. Results Hierarchical regression analyses revealed that only dissociative and depression symptoms contributed significantly to physical health symptoms. Similarly, among the subsample of women with either childhood sexual or physical abuse, depression and dissociation were significant predictors of somatic symptoms. However, among women without childhood abuse, only dissociation significantly predicted somatic symptoms. Conclusion Understanding the psychological and biological mechanisms that link childhood versus adult trauma exposure, PTSD, and comorbid depression or dissociation to physical health symptoms may aid development of individualized treatments for the physical and psychological consequences of trauma. PMID:27149157

  14. Effect of image compression and scaling on automated scoring of immunohistochemical stainings and segmentation of tumor epithelium

    Directory of Open Access Journals (Sweden)

    Konsti Juho

    2012-03-01

    Full Text Available Abstract Background Digital whole-slide scanning of tissue specimens produces large images demanding increasing storing capacity. To reduce the need of extensive data storage systems image files can be compressed and scaled down. The aim of this article is to study the effect of different levels of image compression and scaling on automated image analysis of immunohistochemical (IHC stainings and automated tumor segmentation. Methods Two tissue microarray (TMA slides containing 800 samples of breast cancer tissue immunostained against Ki-67 protein and two TMA slides containing 144 samples of colorectal cancer immunostained against EGFR were digitized with a whole-slide scanner. The TMA images were JPEG2000 wavelet compressed with four compression ratios: lossless, and 1:12, 1:25 and 1:50 lossy compression. Each of the compressed breast cancer images was furthermore scaled down either to 1:1, 1:2, 1:4, 1:8, 1:16, 1:32, 1:64 or 1:128. Breast cancer images were analyzed using an algorithm that quantitates the extent of staining in Ki-67 immunostained images, and EGFR immunostained colorectal cancer images were analyzed with an automated tumor segmentation algorithm. The automated tools were validated by comparing the results from losslessly compressed and non-scaled images with results from conventional visual assessments. Percentage agreement and kappa statistics were calculated between results from compressed and scaled images and results from lossless and non-scaled images. Results Both of the studied image analysis methods showed good agreement between visual and automated results. In the automated IHC quantification, an agreement of over 98% and a kappa value of over 0.96 was observed between losslessly compressed and non-scaled images and combined compression ratios up to 1:50 and scaling down to 1:8. In automated tumor segmentation, an agreement of over 97% and a kappa value of over 0.93 was observed between losslessly compressed images and

  15. Impact of DSM-5 PTSD and gender on impaired eating behaviors in 512 Italian earthquake survivors.

    Science.gov (United States)

    Carmassi, Claudia; Antonio Bertelloni, Carlo; Massimetti, Gabriele; Miniati, Mario; Stratta, Paolo; Rossi, Alessandro; Dell Osso, Liliana

    2015-01-30

    Considerable comorbidity rates between Post-traumatic Stress Disorder (PTSD) and eating disorders have been recently reported, as well as increased obesity and underweight conditions. The aim of the present study was to investigate the possible associations between DSM-5 PTSD, gender and impaired eating habits in a sample of 512 Italian earthquake survivors evaluated by the Trauma and Loss Spectrum-Self Report (TALS-SR) and the Mood Spectrum-Self Report (MOODS-SR). Alterations in eating behaviors were assessed by means of four MOODS-SR items: n=150 (…there was no food that appealed to you or tasted good to you?), n=151 (…you constantly craved sweets or carbohydrates?), n=152 (…your appetite or weight decreased?), n=153 (…your appetite or weight increased?). In a Decision Tree procedure subjects with PTSD with respect to those without and, in the No-PTSD subgroup, females with respect to males, had a significantly higher ratio of at least one MOODS-SR eating behavior item (MOODS-SR EB). In the No-PTSD subgroup only, subjects with at least one MOODS-SR EB presented a significantly higher mean TALS-SR symptomatological domains total score with respect to those without MOODS-SR EB. In conclusion, alterations in eating behaviors were associated with PTSD after the L׳Aquila earthquake; among survivors without PTSD significant a correlation emerged between MOODS-SR EB and PTSD symptoms. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  16. Basal blood DHEA-S/cortisol levels predicts EMDR treatment response in adolescents with PTSD.

    Science.gov (United States)

    Usta, Mirac Baris; Gumus, Yusuf Yasin; Say, Gokce Nur; Bozkurt, Abdullah; Şahin, Berkan; Karabekiroğlu, Koray

    2018-04-01

    In literature, recent evidence has shown that the hypothalamic-pituitary-adrenal (HPA) axis can be dysregulated in patients with post-traumatic stress disorder (PTSD) and HPA axis hormones may predict the psychotherapy treatment response in patients with PTSD. In this study, it was aimed to investigate changing cortisol and DHEA-S levels post-eye movement desensitization and reprocessing (EMDR) therapy and the relationship between treatment response and basal cortisol, and DHEA-S levels before treatment. The study group comprised 40 adolescents (age, 12-18 years) with PTSD. The PTSD symptoms were assessed using the Child Depression Inventory (CDI) and Child Post-traumatic Stress Reaction Index (CPSRI) and the blood cortisol and DHEA-S were measured with the chemiluminescence method before and after treatment. A maximum of six sessions of EMDR therapy were conducted by an EMDR level-1 trained child psychiatry resident. Treatment response was measured by the pre- to post-treatment decrease in self-reported and clinical PTSD severity. Pre- and post-treatment DHEA-S and cortisol levels did not show any statistically significant difference. Pre-treatment CDI scores were negatively correlated with pre-treatment DHEA-S levels (r: -0.39). ROC analysis demonstrated that the DHEA-S/cortisol ratio predicts treatment response at a medium level (AUC: 0.703, p: .030, sensitivity: 0.65, specificity: 0.86). The results of this study suggested that the DHEA-S/cortisol ratio may predict treatment response in adolescents with PTSD receiving EMDR therapy. The biochemical parameter of HPA-axis activity appears to be an important predictor of positive clinical response in adolescent PTSD patients, and could be used in clinical practice to predict PTSD treatment in the future.

  17. Return to work: Police personnel and PTSD

    NARCIS (Netherlands)

    Plat, Marie-Christine J.; Westerveld, Gre J.; Hutter, Renée C.; Olff, Miranda; Frings-Dresen, Monique H. W.; Sluiter, Judith K.

    2013-01-01

    This study i) describes the number of police personnel with PTSD who are working and those who are on sick leave before and after an out-patient-clinic treatment program and ii) examines which factors are related to return to work. Police personnel treated for PTSD (n=121). In this retrospective

  18. Efficacy of Adjunctive Sleep Interventions for PTSD

    Science.gov (United States)

    2009-03-01

    MURI; BAA 08-019: Topic #1; PI: M. Hall, University of Pittsburgh). This multidisciplinary translational project focuses on investigating sleep...rate variability (high & low frequency) CAPS Part 2 PTSD symptom checklist (civilian version) Beck Depression Inventory Beck Anxiety...be completed by a CNRC RN) PTSD symptom checklist (civilian version) Beck Depression Inventory Beck Anxiety Inventory Inventory of

  19. ASD and PTSD in Rape Victims

    Science.gov (United States)

    Elklit, Ask; Christiansen, Dorte M.

    2010-01-01

    In recent years, a number of studies have investigated the prediction of posttraumatic stress disorder (PTSD) through the presence of acute stress disorder (ASD). The predictive power of ASD on PTSD was examined in a population of 148 female rape victims who visited a center for rape victims shortly after the rape or attempted rape. The PTSD…

  20. Sexual Revictimization and PTSD: An Exploratory Study.

    Science.gov (United States)

    Arata, Catalina M.

    1999-01-01

    This study examines the relationship between adult/adolescent sexual revictimization and the development of Post Traumatic Stress Disorder (PTSD) in women with histories of child sexual abuse (N=41). Results show that women with repeated victimization were significantly more likely to have a lifetime diagnosis of PTSD, and the majority of repeated…

  1. Effects of TimeSlips on Cornell Scale for Depression in Dementia scores of senile dementia patients

    Directory of Open Access Journals (Sweden)

    Hui-Ying Chen

    2016-03-01

    Conclusion: TimeSlips is beneficial to relieve depressive symptoms and ameliorate the emotions of mild or moderate senile dementia patients, thus improving their life quality and reducing the burden of their caregivers. A large-scale experimental research on TimeSlips with rigorous design is proposed for further studies.

  2. An Operational Definition of Learning Disabilities (Cognitive Domain) Using WISC Full Scale IQ and Peabody Individual Achievement Test Scores.

    Science.gov (United States)

    Brenton, Beatrice White; Gilmore, Doug

    An operational index of discrepancy between ability and achievement using the Wechsler Intelligence Scale for Children and the Peabody Individual Achievement Test (PIAT) was tested with 50 male and 10 female legally identified learning disabled (LD) children (mean age 9 years 2 months). Use of the index identified 74% of the males and 30% of the…

  3. PTSD in older bereaved people

    DEFF Research Database (Denmark)

    O'Connor, Maja

    2010-01-01

      Late life bereavement has been associated with psychological problems, mainly depression. A few studies indicated that Posttraumatic Stress Disorder (PTSD) was an important issue to investigate in late life bereavement reactions. This study aimed to assess the prevalence of PTSD in recently...... bereaved elderly people compared to married controls and to investigate whether the loss of a spouse in old age, in contrast with earlier assumptions, could lead to PTSD. Two hundred and ninety six Danish elderly bereaved people (mean age 73 years, 113 males) were chosen from national registers and were...... subsequently assessed two months post-bereavement. They were compared with a control group of 276 married elderly people. The prevalence of PTSD and depression were measured through a self-report questionnaire. Results showed that 16% of the bereaved and 4% of the control group had a PTSD diagnosis (ES=.35...

  4. Genetic and serum biomarker evidence for a relationship between TNFα and PTSD in Vietnam war combat veterans.

    Science.gov (United States)

    Bruenig, Dagmar; Mehta, Divya; Morris, Charles P; Harvey, Wendy; Lawford, Bruce; Young, Ross McD; Voisey, Joanne

    2017-04-01

    Posttraumatic stress disorder (PTSD) is associated with increased inflammation and comorbid medical conditions. However, study findings for individual inflammatory marker levels have been inconsistent. Some research suggests that resilience may play a role in decreased inflammation. A polymorphism in the promoter region of the tumor necrosis factor α gene (TNFα), TNFA -308 (rs1800629) is associated with psychiatric illness but its role in PTSD is yet to be elucidated. This study investigates a key inflammatory marker, TNFα, for its role in PTSD severity. In a cohort of trauma-exposed Vietnam War veterans (n=299; 159 cases, 140 controls) TNF α serum levels and TNFα polymorphism rs1800629 were correlated with PTSD severity and resilience scores. The polymorphism was associated with PTSD severity (p=0.045). There were significant group differences between cases and controls with regards to serum TNFα levels (p=0.036). Significant correlations were found between PTSD severity and elevated TNFα levels (r=0.153; p=0.009), and between resilience and decreased TNFα levels at a trend level (p=0.08) across the entire cohort. These relationships were non-significant after controlling for covariates. In the PTSD diagnostic group, a correlation of TNFα and PTSD severity was observed on a trend level (p=0.06), the relationship between TNFα and resilience remained non-significant. To our knowledge, this is the first time rs1800629 has been investigated in PTSD contributing to a growing body of literature that identifies the GG as a risk genotype for psychiatric disorders in Caucasian cohorts. However, more research is needed to replicate our results in larger, equally well-characterized cohorts. The relationship between serum TNFα levels and PTSD severity and resilience requires further investigation. Crown Copyright © 2017. Published by Elsevier Inc. All rights reserved.

  5. Creating a brief rating scale for the assessment of learning disabilities using reliability and true score estimates of the scale's items based on the Rasch model.

    Science.gov (United States)

    Sideridis, Georgios; Padeliadu, Susana

    2013-01-01

    The purpose of the present studies was to provide the means to create brief versions of instruments that can aid the diagnosis and classification of students with learning disabilities and comorbid disorders (e.g., attention-deficit/hyperactivity disorder). A sample of 1,108 students with and without a diagnosis of learning disabilities took part in study 1. Using information from modern theory methods (i.e., the Rasch model), a scale was created that included fewer than one third of the original battery items designed to assess reading skills. This best item synthesis was then evaluated for its predictive and criterion validity with a valid external reading battery (study 2). Using a sample of 232 students with and without learning disabilities, results indicated that the brief version of the scale was equally effective as the original scale in predicting reading achievement. Analysis of the content of the brief scale indicated that the best item synthesis involved items from cognition, motivation, strategy use, and advanced reading skills. It is suggested that multiple psychometric criteria be employed in evaluating the psychometric adequacy of scales used for the assessment and identification of learning disabilities and comorbid disorders.

  6. Associations of scores on the White-Campbell Psychological Birth Order Inventory and the Kern Lifestyle Scale.

    Science.gov (United States)

    White, J; Campbell, L; Stewart, A

    1995-12-01

    This study investigated the relations among psychological birth order, actual birth order, and lifestyle. The study also further examined the convergent validity of the White-Campbell Psychological Birth Order Inventory. This inventory and Kern's Lifestyle Scale were administered to 126 individuals in a southeastern urban university. The several analyses of variance and canonical correlation analysis (1) supported a stronger relationship between psychological birth order and lifestyle than between actual birth order and lifestyle, (2) identified differential relationships between particular birth-order positions and lifestyle scales that were predicted and in accord with Adlerian theory, and (3) further supported the validity of the inventory. The results reaffirmed the lifestyle pattern and birth-order characterizations of Adlerian theory.

  7. Score of Inattention Subscale of ADHD Rating Scale-IV is Significantly Higher for AD/HD than PDD.

    OpenAIRE

    Fujibayashi, Hiromi; Kitayama, Shinji; Matsuo, Masafumi

    2010-01-01

    Attention-deficit/hyperactivity disorder (AD/HD) and pervasive developmental disorder (PDD) must be differentiated because the respective treatments are different. However, they are difficult to distinguish because they often show similar symptoms. At our hospital, we have the rearer of a patient answer both the ADHD Rating Scale-IV (ADHD-RS) and the Autism Spectrum Screening Questionnaire (ASSQ), and use the results as an aid for the diagnosis of AD/HD or PDD. These results were compared wit...

  8. Influence of Deep Breathing on Heart Rate Variability in Parkinson's Disease: Co-relation with Severity of Disease and Non-Motor Symptom Scale Score.

    Science.gov (United States)

    Bidikar, Mukta Pritam; Jagtap, Gayatri J; Chakor, Rahul T

    2014-07-01

    Dysautonomia and non-motor symptoms (NMS) in Parkinson's disease (PD) are frequent, disabling and reduce quality of life of patient. There is a paucity of studies on autonomic dysfunction in PD in Indian population. The study aimed to evaluate autonomic dysfunction in PD patients and co-relate the findings with severity of PD and Non-Motor Symptoms Scale (NMSS) score. We evaluated autonomic function in 30 diagnosed patients of PD (age 55-70 years) and 30 healthy age-matched controls by 3 min deep breathing test (DBT). NMSS was used to identify non-motor symptoms and Hoehn and Yahr (HY) Scale to grade severity of PD. The DBT findings were co-related with severity of PD (HY staging) and NMSS score. DBT was found to be abnormal in 40% while it was on borderline in 33.3% of PD patients. There was a statistically significant difference (psymptom. A negative co-relation was found between results of deep breathing test and clinical severity of disease and NMSS score. Abnormalities of autonomic function and NMS were integral and present across all the stages of PD patients. Early recognition and treatment of these may decrease morbidity and improve quality of life of PD patients.

  9. Lord-Wingersky Algorithm Version 2.0 for Hierarchical Item Factor Models with Applications in Test Scoring, Scale Alignment, and Model Fit Testing.

    Science.gov (United States)

    Cai, Li

    2015-06-01

    Lord and Wingersky's (Appl Psychol Meas 8:453-461, 1984) recursive algorithm for creating summed score based likelihoods and posteriors has a proven track record in unidimensional item response theory (IRT) applications. Extending the recursive algorithm to handle multidimensionality is relatively simple, especially with fixed quadrature because the recursions can be defined on a grid formed by direct products of quadrature points. However, the increase in computational burden remains exponential in the number of dimensions, making the implementation of the recursive algorithm cumbersome for truly high-dimensional models. In this paper, a dimension reduction method that is specific to the Lord-Wingersky recursions is developed. This method can take advantage of the restrictions implied by hierarchical item factor models, e.g., the bifactor model, the testlet model, or the two-tier model, such that a version of the Lord-Wingersky recursive algorithm can operate on a dramatically reduced set of quadrature points. For instance, in a bifactor model, the dimension of integration is always equal to 2, regardless of the number of factors. The new algorithm not only provides an effective mechanism to produce summed score to IRT scaled score translation tables properly adjusted for residual dependence, but leads to new applications in test scoring, linking, and model fit checking as well. Simulated and empirical examples are used to illustrate the new applications.

  10. Wechsler Intelligence Scale for Children 4th edition-Chinese version index scores in Taiwanese children with attention-deficit/hyperactivity disorder.

    Science.gov (United States)

    Yang, Pinchen; Cheng, Chung-Ping; Chang, Chen-Lin; Liu, Tai-Ling; Hsu, Hsiu-Yi; Yen, Cheng-Fang

    2013-02-01

    The Wechsler Intelligence Scale for Children 4th edition-Chinese version (WISC-IV-Chinese) has been in clinical use in Taiwan since 2007. Research is needed to determine how the WISC-IV, modified from its earlier version, will affect its interpretation in clinical practice in a Mandarin-speaking context. We attempted to use WISC-IV-Chinese scores to identify the cognitive strengths and weaknesses in 334 Taiwanese children with attention-deficit/hyperactivity disorder (ADHD). Comparison of cognitive profiles of WISC-IV-Chinese scores between subtypes of ADHD was also performed. The results indicated that the four-factor model of the WISC-IV-Chinese fitted well for Taiwanese children with ADHD. The profiles showed that performance in the index score of the Processing Speed Index was the weakness domain for the Taiwanese children with ADHD, as confirmed by two different kinds of analytic methods. Cognitive profile analysis of ADHD subtypes revealed children with inattentive subtypes to have a greater weakness in processing speed performance. The implications of the profiles of the index scores on the WISC-IV-Chinese version for Taiwanese children with ADHD were explored. © 2013 The Authors. Psychiatry and Clinical Neurosciences © 2013 Japanese Society of Psychiatry and Neurology.

  11. Effect of Age on Glasgow Coma Scale in Patients with Moderate and Severe Traumatic Brain Injury: An Approach with Propensity Score-Matched Population

    Directory of Open Access Journals (Sweden)

    Cheng-Shyuan Rau

    2017-11-01

    Full Text Available Background: The most widely used methods of describing traumatic brain injury (TBI are the Glasgow Coma Scale (GCS and the Abbreviated Injury Scale (AIS. Recent evidence suggests that presenting GCS in older patients may be higher than that in younger patients for an equivalent anatomical severity of TBI. This study aimed to assess these observations with a propensity-score matching approach using the data from Trauma Registry System in a Level I trauma center. Methods: We included all adult patients (aged ≥20 years old with moderate to severe TBI from 1 January 2009 to 31 December 2016. Patients were categorized into elderly (aged ≥65 years and young adults (aged 20–64 years. The severity of TBI was defined by an AIS score in the head (AIS 3‒4 and 5 indicate moderate and severe TBI, respectively. We examined the differences in the GCS scores by age at each head AIS score. Unpaired Student’s t- and Mann–Whitney U-tests were used to analyze normally and non-normally distributed continuous data, respectively. Categorical data were compared using either the Pearson chi-square or two-sided Fisher’s exact tests. Matched patient populations were allocated in a 1:1 ratio according to the propensity scores calculated using NCSS software with the following covariates: sex, pre-existing chronic obstructive pulmonary disease, systolic blood pressure, hemoglobin, sodium, glucose, and alcohol level. Logistic regression was used to evaluate the effects of age on the GCS score in each head AIS stratum. Results: The study population included 2081 adult patients with moderate to severe TBI. These patients were categorized into elderly (n = 847 and young adults (n = 1234: each was exclusively further divided into three groups of patients with head AIS of 3, 4, or 5. In the 162 well-balanced pairs of TBI patients with head AIS of 3, the elderly demonstrated a significantly higher GCS score than the young adults (14.1 ± 2.2 vs. 13.1 ± 3

  12. A randomized, controlled pilot study of MDMA (± 3,4-Methylenedioxymethamphetamine)-assisted psychotherapy for treatment of resistant, chronic Post-Traumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Oehen, Peter; Traber, Rafael; Widmer, Verena; Schnyder, Ulrich

    2013-01-01

    Psychiatrists and psychotherapists in the US (1970s to 1985) and Switzerland (1988-1993) used MDMA legally as a prescription drug, to enhance the effectiveness of psychotherapy. Early reports suggest that it is useful in treating trauma-related disorders. Recently, the first completed pilot study of MDMA-assisted psychotherapy for PTSD yielded encouraging results. Designed to test the safety and efficacy of MDMA-assisted psychotherapy in patients with treatment-resistant PTSD; our randomized, double-blind, active-placebo controlled trial enrolled 12 patients for treatment with either low-dose (25 mg, plus 12.5 mg supplemental dose) or full-dose MDMA (125 mg, plus 62.5 mg supplemental dose). MDMA was administered during three experimental sessions, interspersed with weekly non-drug-based psychotherapy sessions. Outcome measures used were the Clinician-Administered PTSD Scale (CAPS) and the Posttraumatic Diagnostic Scale (PDS). Patients were assessed at baseline, three weeks after the second and third MDMA session (end of treatment), and at the 2-month and 1-year follow-ups. We found that MDMA-assisted psychotherapy can be safely administered in a clinical setting. No drug-related serious adverse events occurred. We did not see statistically significant reductions in CAPS scores (p = 0.066), although there was clinically and statistically significant self-reported (PDS) improvement (p = 0.014). CAPS scores improved further at the 1-year follow-up. In addition, three MDMA sessions were more effective than two (p = 0.016).

  13. The Relationship Between Post Traumatic Stress Disorder (PTSD) Symptoms and Career Outcomes of Army Enlisted Servicemembers

    Science.gov (United States)

    2015-01-01

    genetic analysis on the serotonin transporter gene 5-HTTLPR. Researchers found evidence to suggest that servicemembers with low-transcription...after exposure to trauma, suggesting a servicemember’s likelihood for developing PTSD may change throughout time regardless of genetic ...Training Requirements and Resources System (ATRRS), this automated promotion system generates a final promotion score. Table 3.2 presents the rubric

  14. Cross-cultural and factorial validity of PTSD check list-military version (PCL-M) in Sinhalese language.

    Science.gov (United States)

    Semage, Saveen N; Sivayogan, Sivagurunadan; Forbes, David; O'Donnell, Meaghan; Monaragala, Roshan M M; Lockwood, Emma; Dunt, David

    2013-01-01

    There are currently no validated instruments to assess the burden of combat-related Posttraumatic Stress Disorder (PTSD) in Sinhalese-the main spoken language in Sri Lanka. The purpose of this research was to establish the cross-cultural and structural validity of the PTSD Check List-Military Version (PCL-M) translated into Sinhalese. Expert committee consensus generation as well as translation-back translation approaches were used to establish the semantic, conceptual, and content equivalence of the Sinhalese and English versions of the PCL-M. Four translations of each item were made. In the absence of any "gold standard" psychometric instrument in Sinhalese to establish the criterion validity for the PCL-M (SIN), the study utilized more informal checks for assessment of validity and Sri Lankan cutoffs for caseness for PTSD to establish the psychometric strength of the translated instrument along with standard reliability analysis. Confirmatory factor analysis was performed on PCL-M scoring of a random sample of 1,586 soldiers to examine construct validity. Thirteen of the 17 items were selected by popular vote, and the remaining 4 through discussion and consensus. Reliability measured by Cronbach's-α was 0.944 for the total scale and 0.812, 0.869, and 0.895 for the three DSM-IV sub-scales (re-experiencing, avoidance/numbing, and hyperarousal), respectively. The desired cutoff point for the translated instrument was determined to be 44. The five-factor model by Elhai et al. and the four-factor model by King et al. fitted best, demonstrating good fit to all three fit indices, while the four-factor model and the DSM-IV three-factor model by Simms et al. only had acceptable levels of fit for root mean squared error of approximation. χ(2) difference test comparing the two better-fitting models suggests that the five-factor model by Elhai et al. has the better fit. The PCL-M (SIN) version is suitable for use in the study of PTSD in the Sri Lankan military forces, as

  15. Validation of post-traumatic stress disorder (PTSD) and complex PTSD using the International Trauma Questionnaire.

    Science.gov (United States)

    Hyland, P; Shevlin, M; Brewin, C R; Cloitre, M; Downes, A J; Jumbe, S; Karatzias, T; Bisson, J I; Roberts, N P

    2017-09-01

    The 11th version of the International Classification of Diseases (ICD-11) has proposed two related trauma diagnoses: Post-traumatic stress disorder (PTSD) and Complex PTSD (CPTSD). Using a newly developed, disorder-specific measure of PTSD and CPTSD called the International Trauma Questionnaire (ITQ) the current study will (i) assess the factorial validity of ICD-11 PTSD and CPTSD; (ii) provide the first test of the discriminant validity of these constructs; and (iii) provide the first comparison of ICD-11, and Diagnostic and Statistical Manual, Fifth Edition (DSM-5), PTSD diagnostic rates using disorder-specific measures. ICD-11 and DSM-5 PTSD-specific measures were completed by a British clinical sample of trauma-exposed patients (N = 171). The structure and validity of ICD-11 PTSD and CPTSD were assessed by means of factor analysis and assessing relationships with criterion variables. Diagnostic rates under ICD-11 were significantly lower than those under DSM-5. A two-factor second-order model reflecting the distinction between PTSD and CPTSD best represented the data from the ITQ; and the PTSD and CPTSD factors differentially predicted multiple psychological variables. The factorial and discriminant validity of ICD-11 PTSD and CPTSD was supported, and ICD-11 produces fewer diagnostic cases than DSM-5. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. PTSD

    African Journals Online (AJOL)

    Bullying. Abuse. Loss. Pain. In South Africa, trauma has been described as a regular ... for Pharmaceutical Sciences, Division of Pharmacology, Faculty of Health Sciences, North-West University, .... Diagnostic and statistical manual of mental.

  17. Predictors of PTSD symptoms in Brazilian police officers: the synergy of negative affect and peritraumatic dissociation

    Science.gov (United States)

    Maia, Deborah B.; Marmar, Charles R.; Henn-Haase, Clare; Nóbrega, Augusta; Fiszman, Adriana; Marques-Portella, Carla; Mendlowicz, Mauro V.; Coutinho, Evandro S.F.; Figueira, Ivan

    2013-01-01

    Background Exposure to traumatic events is a necessary but not a sufficient condition for the development of posttraumatic stress disorder (PTSD). Pretrauma, peritrauma and posttrauma factors interact to impact on symptom severity. The aim of the present study is to determine risk factors for PTSD symptoms in Brazilian police officers. Method In a cross-sectional sample of active duty officers (n = 212), participants were asked to complete a socio-demographic questionnaire and self-report scales on affective traits, cumulative critical incident exposure, peritraumatic distress and dissociation, PTSD symptoms, and social support. Hierarchical linear regression analysis was conducted to examine predictors of PTSD symptoms. Results Variables related to negative affect, job duration, frequency of critical incident exposure, peritraumatic dissociation, and lack of social support remained significant in the final model and explained 55% of the variance in PTSD symptoms. When interaction terms were evaluated, a synergistic effect between negative affect and peritraumatic dissociation was found. Conclusions The risk factors found in this study provide clues on how to elaborate primary prevention strategies regarding PTSD symptoms in police officers. Such initiatives may lessen the impact of repeated exposure to traumatic events on police officers over the course of their careers. PMID:22189925

  18. The Alcohol Use Disorders Identification Scale (AUDIT) normative scores for a multiracial sample of Rhodes University residence students.

    Science.gov (United States)

    Young, Charles; Mayson, Tamara

    2010-06-01

    The objective of this research is to obtain accurate drinking norms for students living in the university residences in preparation for future social norms interventions that would allow individual students to compare their drinking to an appropriate reference group. Random cluster sampling was used to obtain data from 318 residence students who completed the Alcohol Use Disorders Identification Test (AUDIT), a brief, reliable and valid screening measure designed by the World Health Organisation (Babor et al. 2001). The Cronbach alpha coefficient of 0.83 reported for this multicultural sample is high, suggesting that the AUDIT may be reliably used in this and similar contexts. Normative scores are reported in the form of percentiles. Comparisons between the portions of students drinking safely and hazardously according to race and gender indicate that while male students are drinking no more hazardously than female students, white students drink far more hazardously than black students. These differences suggest that both race- and gender-specific norms would be essential for an effective social norms intervention in this multicultural South African context. Finally, the racialised drinking patterns might reflect an informal segregation of social space at Rhodes University.

  19. Reference Values for the Marx Activity Rating Scale in a Young Athletic Population: History of Knee Ligament Injury Is Associated With Higher Scores.

    Science.gov (United States)

    Cameron, Kenneth L; Peck, Karen Y; Thompson, Brandon S; Svoboda, Steven J; Owens, Brett D; Marshall, Stephen W

    2015-01-01

    Activity-related patient-reported outcome measures are an important component of assessment after knee ligament injury in young and physically active patients; however, normative data for most activity scales are limited. To present reference values by sex for the Marx Activity Rating Scale (MARS) within a young and physically active population while accounting for knee ligament injury history and sex. Cross-sectional study. Level 2. All incoming freshman entering a US Service Academy in June of 2011 were recruited to participate in this study. MARS was administered to 1169 incoming freshmen (203 women) who consented to participate within the first week of matriculation. All subjects were deemed healthy and medically fit for military service on admission. Subjects also completed a baseline questionnaire that asked for basic demographic information and injury history. We calculated means with standard deviations, medians with interquartile ranges, and percentiles for ordinal and continuous variables, and frequencies and proportions for dichotomous variables. We also compared median scores by sex and history of knee ligament injury using the Kruskal-Wallis test. MARS was the primary outcome of interest. The median MARS score was significantly higher for men when compared with women (χ(2) = 13.22, df = 1, P MARS scores between men and women (χ(2) = 0.47, df = 1, P = 0.493) who reported a history of injury. Overall, median MARS scores were significantly higher among those who reported a history of knee ligament injury when compared with those who did not (χ(2) = 9.06, df = 1, P = 0.003). Assessing activity as a patient-reported outcome after knee ligament injury is important, and reference values for these instruments need to account for the influence of prior injury and sex. © 2015 The Author(s).

  20. PTSD following childbirth: a prospective study of incidence and risk factors in Canadian women.

    Science.gov (United States)

    Verreault, Nancy; Da Costa, Deborah; Marchand, André; Ireland, Kierla; Banack, Hailey; Dritsa, Maria; Khalifé, Samir

    2012-10-01

    The goals of the present study were to estimate the incidence and course of full and partial Post-Traumatic Stress Disorder (PTSD) following childbirth and to prospectively identify factors associated with the development of PTSD symptoms at 1month following childbirth. The sample comprised 308 women, with assessments at four time points: 25-40weeks gestation, 4-6weeks postpartum, 3 and 6months postpartum. Current and prior PTSD were assessed by the Structured Clinical Interview for DSM-IV (SCID-I) and the Modified PTSD Symptom Scale Self-Report (MPSS-SR). Incidence rates of PTSD varied according to time of measurement and instrument used, with higher rates of full and partial PTSD using the MPSS-SR at 1month postpartum (7.6% and 16.6%, respectively). Multivariate logistic regression showed that higher anxiety sensitivity (OR=1.75; 95% CI=1.19‒2.57, p=.005), history of sexual trauma (OR=2.81; 95% CI=1.07‒7.37, p=.036), a more negative childbirth experience than expected (OR=0.96; 95% CI=0.94‒0.98, p=.001), and less available social support at 1month postpartum (OR=0.40; 95% CI=0.17‒0.96, p=.041) independently predicted full or partial PTSD at 1month following childbirth. Our results indicate that a history of sexual trauma and anxiety sensitivity can increase the probability of developing PTSD after childbirth. The findings highlight the importance of screening and providing more tailored services for women at high risk. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.

  1. Police trauma and cardiovascular disease: association between PTSD symptoms and metabolic syndrome.

    Science.gov (United States)

    Violanti, John M; Fekedulegn, Desta; Hartley, Tara A; Andrew, Michael E; Charles, Luenda E; Mnatsakanova, Anna; Burchfiel, Cecil M

    2006-01-01

    Although prior evidence exists concerning the association between posttraumatic stress disorder (PTSD) and cardiovascular disease, few studies have examined associations of PTSD symptomatology and the metabolic syndrome in the high stress occupation of police work. The metabolic syndrome is a clustering of cardiovascular disease risk factors that have also been independently associated with psychological conditions. The aim of this study was to examine associations between the PTSD symptoms and metabolic syndrome in police officers. A stratified sample of 115 police officers was randomly selected from the Buffalo, NY Police Department. PTSD symptoms were measured with the Impact of Event scale (IES), divided into categories of subclinical, mild, moderate and severe symptom levels. The metabolic syndrome was considered present if three or more of its component parameters (obesity, elevated blood pressure, reduced high density lipoprotein (HDL) cholesterol, elevated triglycerides, and abnormal glucose levels) were present in each officer. Results indicated a significantly increased prevalence of the metabolic syndrome among those officers in the severe PTSD symptom category compared with the lowest PTSD severity category (prevalence ratio (PR) = 3.31, 95% C.I. = 1.19 - 9.22). Adjustment for age did not alter the association appreciably (PR = 3.12, 95% C.I. = 1.15 - 8.50). Adjustment for several demographic and lifestyle factors (age, education, smoking, alcohol intake) reduced the magnitude of the prevalence ratio slightly for the severe versus subclinical PTSD category (PR = 2.69, 95% C.I. = 0. 79 - 9.13), with adjustment for age and education accounting for most of the attenuation (PR = 2.71, 95% C.I. = 0.99 - 7.37). Thus, officers with severe PTSD symptoms were approximately three times more likely to have the metabolic syndrome and education may account for some of this association.

  2. The Association of PTSD Symptom Severity with Localized Hippocampus and Amygdala Abnormalities

    Science.gov (United States)

    Akiki, Teddy J.; Averill, Christopher L.; Wrocklage, Kristen M.; Schweinsburg, Brian; Scott, J. Cobb; Martini, Brenda; Averill, Lynnette A.; Southwick, Steven M.; Krystal, John H.; Abdallah, Chadi G.

    2017-01-01

    Background The hippocampus and amygdala have been repeatedly implicated in the psychopathology of posttraumatic stress disorder (PTSD). While numerous structural neuroimaging studies examined these two structures in PTSD, these analyses have largely been limited to volumetric measures. Recent advances in vertex-based neuroimaging methods have made it possible to identify specific locations of subtle morphometric changes within a structure of interest. Methods In this cross-sectional study, we used high-resolution magnetic resonance imaging to examine the relationship between PTSD symptomatology, as measured using the Clinician Administered PTSD Scale for the DSM-IV (CAPS), and structural shape of the hippocampus and amygdala using vertex-wise shape analyses in a group of combat-exposed US Veterans (N = 69). Results Following correction for multiple comparisons and controlling for age and cranial volume, we found that participants with more severe PTSD symptoms showed an indentation in the anterior half of the right hippocampus and an indentation in the dorsal region of the right amygdala (corresponding to the centromedial amygdala). Post hoc analysis using stepwise regression suggest that among PTSD symptom clusters, arousal symptoms explain most of the variance in the hippocampal abnormality, whereas re-experiencing symptoms explain most of the variance in the amygdala abnormality. Conclusion The results provide evidence of localized abnormalities in the anterior hippocampus and centromedial amygdala in combat-exposed US Veterans suffering from PTSD symptoms. This novel finding provides a more fine-grained analysis of structural abnormalities in PTSD and may be informative for understanding the neurobiology of the disorder. PMID:28825050

  3. Predictive Accuracy of Violence Risk Scale-Sexual Offender Version Risk and Change Scores in Treated Canadian Aboriginal and Non-Aboriginal Sexual Offenders.

    Science.gov (United States)

    Olver, Mark E; Sowden, Justina N; Kingston, Drew A; Nicholaichuk, Terry P; Gordon, Audrey; Beggs Christofferson, Sarah M; Wong, Stephen C P

    2018-04-01

    The present study examined the predictive properties of Violence Risk Scale-Sexual Offender version (VRS-SO) risk and change scores among Aboriginal and non-Aboriginal sexual offenders in a combined sample of 1,063 Canadian federally incarcerated men. All men participated in sexual offender treatment programming through the Correctional Service of Canada (CSC) at sites across its five regions. The Static-99R was also examined for comparison purposes. In total, 393 of the men were identified as Aboriginal (i.e., First Nations, Métis, Circumpolar) while 670 were non-Aboriginal and primarily White. Aboriginal men scored significantly higher on the Static-99R and VRS-SO and had higher rates of sexual and violent recidivism; however, there were no significant differences between Aboriginal and non-Aboriginal groups on treatment change with both groups demonstrating close to a half-standard deviation of change pre and post treatment. VRS-SO risk and change scores significantly predicted sexual and violent recidivism over fixed 5- and 10-year follow-ups for both racial/ancestral groups. Cox regression survival analyses also demonstrated positive treatment changes to be significantly associated with reductions in sexual and violent recidivism among Aboriginal and non-Aboriginal men after controlling baseline risk. A series of follow-up Cox regression analyses demonstrated that risk and change score information accounted for much of the observed differences between Aboriginal and non-Aboriginal men in rates of sexual recidivism; however, marked group differences persisted in rates of general violent recidivism even after controlling for these covariates. The results support the predictive properties of VRS-SO risk and change scores with treated Canadian Aboriginal sexual offenders.

  4. www.common-metrics.org: a web application to estimate scores from different patient-reported outcome measures on a common scale.

    Science.gov (United States)

    Fischer, H Felix; Rose, Matthias

    2016-10-19

    Recently, a growing number of Item-Response Theory (IRT) models has been published, which allow estimation of a common latent variable from data derived by different Patient Reported Outcomes (PROs). When using data from different PROs, direct estimation of the latent variable has some advantages over the use of sum score conversion tables. It requires substantial proficiency in the field of psychometrics to fit such models using contemporary IRT software. We developed a web application ( http://www.common-metrics.org ), which allows estimation of latent variable scores more easily using IRT models calibrating different measures on instrument independent scales. Currently, the application allows estimation using six different IRT models for Depression, Anxiety, and Physical Function. Based on published item parameters, users of the application can directly estimate latent trait estimates using expected a posteriori (EAP) for sum scores as well as for specific response patterns, Bayes modal (MAP), Weighted likelihood estimation (WLE) and Maximum likelihood (ML) methods and under three different prior distributions. The obtained estimates can be downloaded and analyzed using standard statistical software. This application enhances the usability of IRT modeling for researchers by allowing comparison of the latent trait estimates over different PROs, such as the Patient Health Questionnaire Depression (PHQ-9) and Anxiety (GAD-7) scales, the Center of Epidemiologic Studies Depression Scale (CES-D), the Beck Depression Inventory (BDI), PROMIS Anxiety and Depression Short Forms and others. Advantages of this approach include comparability of data derived with different measures and tolerance against missing values. The validity of the underlying models needs to be investigated in the future.

  5. Social phobia and PTSD in Vietnam veterans.

    Science.gov (United States)

    Orsillo, S M; Heimberg, R G; Juster, H R; Garrett, J

    1996-04-01

    Posttraumatic stress disorder (PTSD) is the most prevalent psychological disorder experienced by Vietnam veterans. However, there are many other disorders and problems of adjustment, like social anxiety and social phobia, that have not been fully investigated in this population. This study examined the prevalence of social phobia and the comorbidity of social phobia and PTSD, and tested out a theory of the etiology of social anxiety in trauma victims. Forty one Vietnam combat veterans were interviewed and completed self-report measures assessing PTSD and social phobia. Adversity of homecoming was also assessed. Using a conservative multi-method assessment approach, 32% of the sample were found to be positive for both social phobia and PTSD. Veterans with PTSD were significantly more likely to carry an additional diagnosis of social phobia as compared to veterans without PTSD. Adversity of homecoming and shame about one's experience in Vietnam were significant predictors of current level of social anxiety over and above the effects of pre-military anxiety and severity of combat exposure. These observations suggest that social anxiety and social phobia may be significant problems among individuals with PTSD. Further, these findings offer preliminary support for the theory that posttrauma environment may impact upon the later development of social anxiety.

  6. Education-stratified base-rate information on discrepancy scores within and between the Wechsler Adult Intelligence Scale--Third Edition and the Wechsler Memory Scale--Third Edition.

    Science.gov (United States)

    Dori, Galit A; Chelune, Gordon J

    2004-06-01

    The Wechsler Adult Intelligence Scale--Third Edition (WAIS-III; D. Wechsler, 1997a) and the Wechsler Memory Scale--Third Edition (WMS-III; D. Wechsler, 1997b) are 2 of the most frequently used measures in psychology and neuropsychology. To facilitate the diagnostic use of these measures in the clinical decision-making process, this article provides information on education-stratified, directional prevalence rates (i.e., base rates) of discrepancy scores between the major index scores for the WAIS-III, the WMS-III, and between the WAIS-III and WMS-III. To illustrate how such base-rate data can be clinically used, this article reviews the relative risk (i.e., odds ratio) of empirically defined "rare" cognitive deficits in 2 of the clinical samples presented in the WAIS-III--WMS-III Technical Manual (The Psychological Corporation, 1997). ((c) 2004 APA, all rights reserved)

  7. Beyond symptom self-report: use of a computer "avatar" to assess post-traumatic stress disorder (PTSD) symptoms.

    Science.gov (United States)

    Myers, Catherine E; Radell, Milen L; Shind, Christine; Ebanks-Williams, Yasheca; Beck, Kevin D; Gilbertson, Mark W

    2016-11-01

    Post-traumatic stress disorder (PTSD) can occur in the wake of exposure to a traumatic event. Currently, PTSD symptoms are assessed mainly through self-report in the form of questionnaire or clinical interview. Self-report has inherent limitations, particularly in psychiatric populations who may have limited awareness of deficit, reduced attention span, or poor vocabulary and/or literacy skills. Diagnosis and evaluation of treatment efficacy would be aided by behavioral measures. A viable alternative may be virtual environments, in which the participant guides an on-screen "avatar" through a series of onscreen events meant to simulate real-world situations. Here, a sample of 82 veterans, self-assessed for PTSD symptoms was administered such a task, in which the avatar was confronted with situations that might evoke avoidant behavior, a core feature of PTSD. Results showed a strong correlation between PTSD symptom burden and task performance; in fact, the ability to predict PTSD symptom burden based on simple demographic variables (age, sex, combat exposure) was significantly improved by adding task score as a predictor variable. The results therefore suggest that virtual environments may provide a new way to assess PTSD symptoms, while avoiding at least some of the limitations associated with symptom self-report, and thus might be a useful complement to questionnaire or clinical interview, potentially facilitating both diagnosis and evaluation of treatment efficacy.

  8. Tonic immobility differentiates stress responses in PTSD.

    Science.gov (United States)

    Fragkaki, Iro; Stins, John; Roelofs, Karin; Jongedijk, Ruud A; Hagenaars, Muriel A

    2016-11-01

    Tonic immobility (TI) is a state of physical immobility associated with extreme stress and the development of posttraumatic stress disorder (PTSD). However, it is unknown whether TI is associated with a distinct actual stress response, i.e., objective immobility measured by a stabilometric platform. This study made a first step in exploring this as well as differences in body sway responses between PTSD patients and healthy controls. We hypothesized that PTSD would be related to increased body sway under stress, whereas TI would be related to decreased body sway under stress. Eye closure was selected as a PTSD-relevant stress induction procedure. Body sway and heart rate (HR) were measured in 12 PTSD patients and 12 healthy controls in four conditions: (1) maintaining a stable stance with eyes open, (2) with eyes closed, (3) during a mental arithmetic task with eyes open, and (4) with eyes closed. As predicted, PTSD patients showed increased body sway from eyes open to eyes closed compared to controls and this effect was eliminated by executing the arithmetic task. Most importantly, retrospective self-reported TI was associated with lower body sway increases in PTSD and higher body sway decreases in controls from eyes-open to eyes-closed conditions. These preliminary findings suggest that eye closure has a different effect on PTSD patients than controls and that high self-reported TI might indicate a distinct stress response pattern, i.e., a proneness for immobility. It may be relevant to take such individual differences in stress-response into account in PTSD treatment.

  9. Impact of baseline Diabetic Retinopathy Severity Scale scores on visual outcomes in the VIVID-DME and VISTA-DME studies.

    Science.gov (United States)

    Staurenghi, Giovanni; Feltgen, Nicolas; Arnold, Jennifer J; Katz, Todd A; Metzig, Carola; Lu, Chengxing; Holz, Frank G

    2017-10-19

    To evaluate intravitreal aflibercept versus laser in subgroups of patients with baseline Diabetic Retinopathy Severity Scale (DRSS) scores ≤43, 47, and ≥53 in VIVID-DME and VISTA-DME. Patients with diabetic macular oedema were randomised to receive intravitreal aflibercept 2 mg every 4 weeks (2q4), intravitreal aflibercept 2 mg every 8 weeks after five initial monthly doses (2q8), or macular laser photocoagulation at baseline with sham injections at every visit. These post hoc analyses evaluate outcomes based on baseline DRSS scores in patients in the integrated dataset. The 2q4 and 2q8 treatment groups were also pooled. 748 patients had a baseline DRSS score based on fundus photographs (≤43, n=301; 47, n=153; ≥53, n=294). At week 100, the least squares mean difference between treatment groups (effect of intravitreal aflibercept above that of laser, adjusting for baseline best-corrected visual acuity) was 8.9 (95% CI 5.99 to 11.81), 9.7 (95% CI 5.54 to 13.91), and 11.0 (95% CI 7.96 to 14.1) letters in those with baseline DRSS scores ≤43, 47, and ≥53, respectively. The proportions of patients with ≥2 step DRSS score improvement were greater in the intravitreal aflibercept group versus laser, respectively, for those with baseline DRSS scores of ≤43 (13% vs 5.9%), 47 (25.8% vs 4.5%), and ≥53 (64.5% vs 28.4%). Regardless of baseline DRSS score, functional outcomes were superior in intravitreal aflibercept-treated patients, demonstrating consistent treatment benefit across various baseline levels of retinopathy. NCT01331681 and NCT01363440, Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  10. Pharmacological interventions for preventing post-traumatic stress disorder (PTSD).

    Science.gov (United States)

    Amos, Taryn; Stein, Dan J; Ipser, Jonathan C

    2014-07-08

    ; age range 18 to 76 years). Participants were exposed to a variety of traumas, ranging from assault, traffic accidents and work accidents to cardiac surgery and septic shock. Seven studies were conducted at single centres. The seven RCTs included four hydrocortisone studies, three propranolol studies (of which one study had a third arm investigating gabapentin), and single trials of escitalopram and temazepam. Outcome assessment measures included the Clinician-Administered PTSD Scale (CAPS), the 36-Item Short-Form Health Survey (SF-36) and the Center for Epidemiological Studies - Depression Scale (CES-D).In four trials with 165 participants there was moderate quality evidence for the efficacy of hydrocortisone in preventing the onset of PTSD (risk ratio (RR) 0.17; 95% confidence interval (CI) 0.05 to 0.56; P value = 0.004), indicating that between seven and 13 patients would need to be treated with this agent in order to prevent the onset of PTSD in one patient. There was low quality evidence for preventing the onset of PTSD in three trials with 118 participants treated with propranolol (RR 0.62; 95% CI 0.24 to 1.59; P value = 0.32). Drop-outs due to treatment-emergent side effects, where reported, were low for all of the agents tested. Three of the four RCTs of hydrocortisone reported that medication was more effective than placebo in reducing PTSD symptoms after a median of 4.5 months after the event. None of the single trials of escitalopram, temazepam and gabapentin demonstrated evidence that medication was superior to placebo in preventing the onset of PTSD.Seven of the included RCTs were at a high risk of bias. Differential drop-outs between groups undermined the results of three studies, while one study failed to describe how the allocation of medication was concealed. Other forms of bias that might have influenced study results included possible confounding through group differences in concurrent medication and termination of the study based on treatment

  11. Traumatiske fødselsopplevelser og PTSD

    OpenAIRE

    Aashaug, Elisabeth

    2006-01-01

    ABSTRACT For a long time it has been known that a childbirth can bee traumatic for some women. With the changes in DSM-IV in 1994, the diagnosis of Posttraumatic Stress Disorder (PTSD) can be made based upon a traumatic birth experience. Based on a literature search, this paper look at the experience of a traumatic birth, and how it can develop into postnatal PTSD. It also looks at the incident, potential risk factors and treatment for postnatal PTSD. A MEDLINE, PSYCHLIT and COCHRANE...

  12. ICD-11 Trauma Questionnaires for PTSD and Complex PTSD: Validation among Civilians and Former Abducted Children in Northern Uganda

    DEFF Research Database (Denmark)

    Dokkedahl, Sarah Bøgelund; Oboke, Henry; Elklit, Ask

    2015-01-01

    Objectives: ICD-11 is expected to introduce a new diagnosis of C-PTSD, along with a revision of the current PTSD diagnosis. Are the suggested diagnostic tools for PTSD and C-PTSD valid in a developing country? Method: The tools have been tested on former abducted and regular civilians in northern...

  13. Deep brain stimulation of the basolateral amygdala for treatment-refractory combat post-traumatic stress disorder (PTSD): study protocol for a pilot randomized controlled trial with blinded, staggered onset of stimulation.

    Science.gov (United States)

    Koek, Ralph J; Langevin, Jean-Philippe; Krahl, Scott E; Kosoyan, Hovsep J; Schwartz, Holly N; Chen, James W Y; Melrose, Rebecca; Mandelkern, Mark J; Sultzer, David

    2014-09-10

    Combat post-traumatic stress disorder (PTSD) involves significant suffering, impairments in social and occupational functioning, substance use and medical comorbidity, and increased mortality from suicide and other causes. Many veterans continue to suffer despite current treatments. Deep brain stimulation (DBS) has shown promise in refractory movement disorders, depression and obsessive-compulsive disorder, with deep brain targets chosen by integration of clinical and neuroimaging literature. The basolateral amygdala (BLn) is an optimal target for high-frequency DBS in PTSD based on neurocircuitry findings from a variety of perspectives. DBS of the BLn was validated in a rat model of PTSD by our group, and limited data from humans support the potential safety and effectiveness of BLn DBS. We describe the protocol design for a first-ever Phase I pilot study of bilateral BLn high-frequency DBS for six severely ill, functionally impaired combat veterans with PTSD refractory to conventional treatments. After implantation, patients are monitored for a month with stimulators off. An electroencephalographic (EEG) telemetry session will test safety of stimulation before randomization to staggered-onset, double-blind sham versus active stimulation for two months. Thereafter, patients will undergo an open-label stimulation for a total of 24 months. Primary efficacy outcome is a 30% decrease in the Clinician Administered PTSD Scale (CAPS) total score. Safety outcomes include extensive assessments of psychiatric and neurologic symptoms, psychosocial function, amygdala-specific and general neuropsychological functions, and EEG changes. The protocol requires the veteran to have a cohabiting significant other who is willing to assist in monitoring safety and effect on social functioning. At baseline and after approximately one year of stimulation, trauma script-provoked 18FDG PET metabolic changes in limbic circuitry will also be evaluated. While the rationale for studying DBS

  14. Arthritis self-efficacy scale scores in knee osteoarthritis: a systematic review and meta-analysis comparing arthritis self-management education with or without exercise.

    Science.gov (United States)

    Brand, Emily; Nyland, John; Henzman, Cameron; McGinnis, Mark

    2013-12-01

    Systematic literature review and meta-analysis. To evaluate studies that used arthritis self-management education alone or with exercise to improve Arthritis Self-Efficacy Scale scores of patients with knee osteoarthritis. Increasing self-efficacy may improve patient knee osteoarthritis symptom management and function. MEDLINE (1946-March 2013), CINAHL (1981-March 2013), and PsycINFO (1967-March 2013) databases were searched. Twenty-four studies, including 3163 subjects (women, n = 2547 [80.5%]; mean ± SD age, 65.3 ± 6.5 years), met the inclusion criteria. A meta-analysis was performed to compare the standardized mean difference effect sizes (Cohen d) of randomized controlled studies that used the Arthritis Self-Efficacy Scale pain (13 studies, n = 1906), other symptoms (13 studies, n = 1957), and function (5 studies, n = 399) subscales. Cohen d effect sizes were also calculated for cohort studies that used the Arthritis Self-Efficacy Scale pain (10 studies, n = 1035), other symptoms (9 studies, n = 913), and function (3 studies, n = 141) subscales. Both randomized controlled studies and cohort studies were grouped by intervention type (intervention 1, arthritis self-management education alone; intervention 2, arthritis self-management education with exercise), and effect sizes were compared (Mann-Whitney U tests, Pmanagement education with exercise displayed higher methodological quality scale scores (76.8 ± 13.1 versus 61.6 ± 19.6, P = .03). Statistically significant standardized effect-size differences between intervention 1 and intervention 2 were not observed. Small to moderate effect sizes were observed regardless of whether the intervention included exercise. Exercise interventions used in conjunction with arthritis self-management education programs need to be developed to better enhance the self-efficacy of patients with knee osteoarthritis. Therapy, level 2b-.

  15. Predictors of PTSD and delayed PTSD after disaster: the impact of exposure and psychosocial resources.

    Science.gov (United States)

    Adams, Richard E; Boscarino, Joseph A

    2006-07-01

    In the present study we sought to identify factors associated with posttraumatic stress disorder (PTSD) following the World Trade Center Disaster (WTCD) and examine changes in PTSD status over time. Our data come from a two-wave, prospective cohort study of New York City adults who were living in the city on September 11, 2001. We conducted a baseline survey 1 year after the attacks (year 1), followed by a survey 1 year later (year 2). Overall, 2368 individuals completed the year 1 survey, and 1681 were interviewed at year 2. Analyses for year 1 indicated that being younger, being female, experiencing more WTCD events, reporting more traumatic events other than the WTCD, experiencing more negative life events, having low social support, and having low self-esteem increased the likelihood of PTSD. For year 2, being middle-aged, being Latino, experiencing more negative life events and traumas since the WTCD, and having low self-esteem increased the likelihood of PTSD. Exposure to WTCD events was not related to year 2 PTSD once other factors were controlled. Following previous research, we divided study respondents into four categories: resilient cases (no PTSD years 1 or 2), remitted cases (PTSD year 1 but not year 2), delayed cases (no PTSD year 1 but PTSD year 2), and acute cases (PTSD both years 1 and 2). Factors predicting changes in PTSD between year 1 and year 2 suggested that delayed PTSD cases were more likely to have been Latino, to have experienced more negative life events, and to have had a decline in self-esteem. In contrast, remitted cases experienced fewer negative life events and had an increase in self-esteem. We discuss these findings in light of the psychosocial context associated with community disasters and traumatic stress exposures.

  16. Nightmares that mislead to diagnosis of reactivation of PTSD

    OpenAIRE

    Roepke, Stefan; Hansen, Marie-Luise; Peter, Anita; Merkl, Angela; Palafox, Carla; Danker-Hopfe, Heidi

    2013-01-01

    Background: Sleep disturbance is a common characteristic of patients with post-traumatic stress disorder (PTSD). Besides the clinical descriptions of nightmares and insomnia, periodic limb movements (PLMs) are reported to co-occur in PTSD. Although the causal relationship between sleep disturbance and PTSD is not fully understood, sleep disturbance is an independent risk factor for the development and reactivation of PTSD. In contrast, the link between PTSD and REM sleep behaviour disorder (R...

  17. Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

    Energy Technology Data Exchange (ETDEWEB)

    Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio [Fukushima Medical Coll. (Japan)

    1998-02-01

    In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, p

  18. Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

    International Nuclear Information System (INIS)

    Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio

    1998-01-01

    In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, p< O.05) between LI values and the performance in Coding. It is suggested that decreased blood flow areas detected by SPECT might influence brain function. (author)

  19. Validation of a Novel Scoring System for Changes in Skeletal Manifestations of Hypophosphatasia in Newborns, Infants, and Children: The Radiographic Global Impression of Change Scale.

    Science.gov (United States)

    Whyte, Michael P; Fujita, Kenji P; Moseley, Scott; Thompson, David D; McAlister, William H

    2018-05-01

    Hypophosphatasia (HPP) is the heritable metabolic disease characterized by impaired skeletal mineralization due to low activity of the tissue-nonspecific isoenzyme of alkaline phosphatase. Although HPP during growth often manifests with distinctive radiographic skeletal features, no validated method was available to quantify them, including changes over time. We created the Radiographic Global Impression of Change (RGI-C) scale to assess changes in the skeletal burden of pediatric HPP. Site-specific pairs of radiographs of newborns, infants, and children with HPP from three clinical studies of asfotase alfa, an enzyme replacement therapy for HPP, were obtained at baseline and during treatment. Each pair was scored by three pediatric radiologists ("raters"), with nine raters across the three studies. Intrarater and interrater agreement was determined by weighted Kappa coefficients. Interrater reliability was assessed using intraclass correlation coefficients (ICCs) and by two-way random effects analysis of variance (ANOVA) and a mixed-model repeated measures ANOVA. Pearson correlation coefficients evaluated relationships of the RGI-C to the Rickets Severity Scale (RSS), Pediatric Outcomes Data Collection Instrument Global Function Parent Normative Score, Childhood Health Assessment Questionnaire Disability Index, 6-Minute Walk Test percent predicted, and Z-score for height in patients aged 6 to 12 years at baseline. Eighty-nine percent (8/9) of raters showed substantial or almost perfect intrarater agreement of sequential RGI-C scores (weighted Kappa coefficients, 0.72 to 0.93) and moderate or substantial interrater agreement (weighted Kappa coefficients, 0.53 to 0.71) in patients aged 0 to 12 years at baseline. Moderate-to-good interrater reliability was observed (ICC, 0.57 to 0.65). RGI-C scores were significantly (p ≤ 0.0065) correlated with the RSS and with measures of global function, disability, endurance, and growth in the patients aged 6 to 12 years at

  20. Applicability of the ICD-11 proposal for PTSD: a comparison of prevalence and comorbidity rates with the DSM-IV PTSD classification in two post-conflict samples

    Directory of Open Access Journals (Sweden)

    Nadine Stammel

    2015-05-01

    Full Text Available Background: The World Health Organization recently proposed significant changes to the posttraumatic stress disorder (PTSD diagnostic criteria in the 11th edition of the International Classification of Diseases (ICD-11. Objective: The present study investigated the impact of these changes in two different post-conflict samples. Method: Prevalence and rates of concurrent depression and anxiety, socio-demographic characteristics, and indicators of clinical severity according to ICD-11 in 1,075 Cambodian and 453 Colombian civilians exposed to civil war and genocide were compared to those according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV. Results: Results indicated significantly lower prevalence rates under the ICD-11 proposal (8.1% Cambodian sample and 44.4% Colombian sample compared to the DSM-IV (11.2% Cambodian sample and 55.0% Colombian sample. Participants meeting a PTSD diagnosis only under the ICD-11 proposal had significantly lower rates of concurrent depression and a lower concurrent total score (depression and anxiety compared to participants meeting only DSM-IV diagnostic criteria. There were no significant differences in socio-demographic characteristics and indicators of clinical severity between these two groups. Conclusions: The lower prevalence of PTSD according to the ICD-11 proposal in our samples of persons exposed to a high number of traumatic events may counter criticism of previous PTSD classifications to overuse the PTSD diagnosis in populations exposed to extreme stressors. Also another goal, to better distinguish PTSD from comorbid disorders could be supported with our data.

  1. PTSD and key somatic complaints and cultural syndromes among rural Cambodians: the results of a needs assessment survey.

    Science.gov (United States)

    Hinton, Devon E; Hinton, Alexander L; Eng, Kok-Thay; Choung, Sophearith

    2012-09-01

    This article describes a culturally sensitive assessment tool for traumatized Cambodians, the Cambodian "Somatic Symptom and Syndrome Inventory" (SSI), and reports the outcome of a needs assessment conducted in rural Cambodia using the instrument. Villagers locally identified (N = 139) as still suffering the effects of the Pol Pot genocide were evaluated. All 139 had post-traumatic stress disorder (PTSD) as assessed by the PTSD Checklist (PCL), and they had elevated SSI scores. The severity of the SSI items varied by level of PTSD severity, and several items--for example, dizziness, dizziness on standing, khyâl (a windlike substance) attacks, and "thinking a lot"--were extremely elevated in those participants with higher levels of PTSD. The SSI was more highly correlated to self-perceived health (Short Form Health Survey-3) and past trauma events (Harvard Trauma Questionnaire) than was the PCL. The study shows the SSI items to be a core aspect of the Cambodian trauma ontology.

  2. Entorhinal cortex volume measured with 3T MRI is positively correlated with the Wechsler memory scale-revised logical/verbal memory score for healthy subjects

    International Nuclear Information System (INIS)

    Goto, Masami; Abe, Osamu; Takao, Hidemasa; Inano, Sachiko; Mori, Harushi; Kunimatsu, Akira; Ohtomo, Kuni; Miyati, Tosiaki; Yoshikawa, Takeharu; Hayashi, Naoto; Kabasawa, Hiroyuki; Aoki, Shigeki; Ino, Kenji; Iida, Kyouhito; Yano, Keiichi

    2011-01-01

    Previous studies revealed a correlation between local brain volume and cognitive function. The aim of the present study was to investigate the correlation between local gray matter volume and the Wechsler Memory Scale-Revised (WMS-R) logical/verbal memory (WMS-R-verbal) score in healthy adults using a 3 Tesla magnetic resonance scanner and voxel-based morphometry (VBM). T1-weighted magnetic resonance images were obtained in 1,169 healthy adults. The T1-weighted images in native space were bias-corrected, spatially normalized, and segmented into gray matter, white matter, and cerebrospinal fluid images with Statistical Parametric Mapping 5. To investigate regionally the specific effects of the WMS-R-verbal score on the gray matter images, simple regression analysis was performed by VBM treating age, total intracranial volume, and gender as confounding covariates. A P value of less than 0.05 corrected with false discovery rate in voxel difference was considered to be statistically significant. Our study showed a significant positive correlation between the WMS-R-verbal score and the bilateral entorhinal cortex volume. In the right entorhinal, T value is 4.75, and the size of the clusters is 155 voxels. In the left entorhinal, T value is 4.08, and the size of the clusters is 23 voxels. A significant negative correlation was not found. To our knowledge, this is the first VBM study showing that entorhinal cortex volume is positively correlated with the WMS-R-verbal score for healthy subjects. Therefore, in our structural neuroimaging study, we add evidence to the hypothesis that the entorhinal cortex is involved in verbal memory processing. (orig.)

  3. Entorhinal cortex volume measured with 3T MRI is positively correlated with the Wechsler memory scale-revised logical/verbal memory score for healthy subjects

    Energy Technology Data Exchange (ETDEWEB)

    Goto, Masami [University of Tokyo Hospital, Department of Radiological Technology, Graduate School of Medicine, Tokyo (Japan); Kanazawa University, Tsunomatyou, Graduate School of Medical Science, Kanazawa (Japan); Abe, Osamu; Takao, Hidemasa; Inano, Sachiko; Mori, Harushi; Kunimatsu, Akira; Ohtomo, Kuni [University of Tokyo Hospital, Department of Radiology, Tokyo (Japan); Miyati, Tosiaki [Kanazawa University, Tsunomatyou, Graduate School of Medical Science, Kanazawa (Japan); Yoshikawa, Takeharu; Hayashi, Naoto [University of Tokyo Hospital, Department of Computational Diagnostic Radiology and Preventive Medicine, Tokyo (Japan); Kabasawa, Hiroyuki [GE Healthcare, Japan Applied Science Laboratory, Hino (Japan); Aoki, Shigeki [Juntendo University, Department of Radiology, Tokyo (Japan); Ino, Kenji; Iida, Kyouhito; Yano, Keiichi [University of Tokyo Hospital, Department of Radiological Technology, Graduate School of Medicine, Tokyo (Japan)

    2011-08-15

    Previous studies revealed a correlation between local brain volume and cognitive function. The aim of the present study was to investigate the correlation between local gray matter volume and the Wechsler Memory Scale-Revised (WMS-R) logical/verbal memory (WMS-R-verbal) score in healthy adults using a 3 Tesla magnetic resonance scanner and voxel-based morphometry (VBM). T1-weighted magnetic resonance images were obtained in 1,169 healthy adults. The T1-weighted images in native space were bias-corrected, spatially normalized, and segmented into gray matter, white matter, and cerebrospinal fluid images with Statistical Parametric Mapping 5. To investigate regionally the specific effects of the WMS-R-verbal score on the gray matter images, simple regression analysis was performed by VBM treating age, total intracranial volume, and gender as confounding covariates. A P value of less than 0.05 corrected with false discovery rate in voxel difference was considered to be statistically significant. Our study showed a significant positive correlation between the WMS-R-verbal score and the bilateral entorhinal cortex volume. In the right entorhinal, T value is 4.75, and the size of the clusters is 155 voxels. In the left entorhinal, T value is 4.08, and the size of the clusters is 23 voxels. A significant negative correlation was not found. To our knowledge, this is the first VBM study showing that entorhinal cortex volume is positively correlated with the WMS-R-verbal score for healthy subjects. Therefore, in our structural neuroimaging study, we add evidence to the hypothesis that the entorhinal cortex is involved in verbal memory processing. (orig.)

  4. Ischemic Volume and Neurological Deficit: Correlation of Computed Tomography Perfusion with the National Institutes of Health Stroke Scale Score in Acute Ischemic Stroke.

    Science.gov (United States)

    Furlanis, Giovanni; Ajčević, Miloš; Stragapede, Lara; Lugnan, Carlo; Ridolfi, Mariana; Caruso, Paola; Naccarato, Marcello; Ukmar, Maja; Manganotti, Paolo

    2018-04-30

    The National Institutes of Health Stroke Scale (NIHSS) is the most adopted stroke patients' evaluation tool in emergency settings to assess the severity of stroke and to determine the patients' eligibility for specific treatments. Computed tomography perfusion (CTP) is crucial to identify salvageable tissue that can benefit from the reperfusion treatment. The aim of this study is to identify the relation between the NIHSS scores and the hypoperfused volumes evaluated by CTP in patients with hyperacute ischemic stroke. This retrospective study was conducted on 105 patients with ischemic stroke who underwent NIHSS assessment and CTP in the hyperacute phase. Hypoperfused volume was evaluated by CTP maps processed with semi-automatic algorithm. An analysis was conducted to determine the degree of correlation between the NIHSS scores and the ischemic lesion volumes and to investigate the relation between the anterior and the posterior circulation strokes, as well as between the right and the left hemispheric strokes. A significant correlation was found between ischemic volume and NIHSS score at baseline (r = .82; P correlation was identified in the anterior circulation stroke (r = .76; P correlated for the left and the right hemispheric strokes (r = .83 and .81; P correlation between the baseline NIHSS score and the ischemic volume estimated by CTP. We confirmed that NIHSS is a reliable predictor of perfusion deficits in acute ischemic stroke. CTP allows fast imaging assessment in the hyperacute phase. The results highlight the importance of these diagnostic tools in the assessment of stroke severity and in acute decision-making. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  5. External Validation of the Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale Score for Predicting Pneumonia After Stroke Using Data From the China National Stroke Registry.

    Science.gov (United States)

    Zhang, Runhua; Ji, Ruijun; Pan, Yuesong; Jiang, Yong; Liu, Gaifen; Wang, Yilong; Wang, Yongjun

    2017-05-01

    Pneumonia is an important risk factor for mortality and morbidity after stroke. The Prestroke Independence, Sex, Age, National Institutes of Health Stroke Scale (ISAN) score was shown to be a useful tool for predicting stroke-associated pneumonia based on UK multicenter cohort study. We aimed to externally validate the score using data from the China National Stroke Registry (CNSR). Eligible patients with acute ischemic stroke (AIS) and intracerebral hemorrhage (ICH) in the CNSR from 2007 to 2008 were included. The area under the receiver operating characteristic (AUC) curve was used to evaluate discrimination. The Hosmer-Lemeshow goodness of fit test and Pearson correlation coefficient were performed to assess calibration of the model. A total of 19,333 patients (AIS = 14400; ICH = 4933) were included and the overall pneumonia rate was 12.7%. The AUC was .76 (95% confidence interval [CI]: .75-.78) for the subgroup of AIS and .70 (95% CI: .68-.72) for the subgroup of ICH. The Hosmer-Lemeshow test showed the ISAN score with the good calibration for AIS and ICH (P = .177 and .405, respectively). The plot of observed versus predicted pneumonia rates suggested higher correlation for patients with AIS than with ICH (Pearson correlation coefficient = .99 and .83, respectively). The ISAN score was a useful tool for predicting in-hospital pneumonia after acute stroke, especially for patients with AIS. Further validations need to be done in different populations. Copyright © 2017 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  6. Premorbid functioning of patients with first-episode nonaffective psychosis: a comparison of deterioration in academic and social performance, and clinical correlates of Premorbid Adjustment Scale scores.

    Science.gov (United States)

    Monte, Ralph C; Goulding, Sandra M; Compton, Michael T

    2008-09-01

    Motivated by a previous study among male veterans [Allen, D.N., Frantom, L.V., Strauss, G.P., van Kammen, D.P., 2005. Differential patterns of premorbid academic and social deterioration in patients with schizophrenia. Schizophr. Res. 75, 389-397], the present analysis examined: (1) patterns of premorbid academic and social functioning during childhood, early adolescence, and late adolescence, and (2) associations between these premorbid functioning dimensions and a number of clinical variables. Data on premorbid functioning were collected using the Premorbid Adjustment Scale (PAS) in 95 hospitalized first-episode patients. Analyses were similar to those conducted by Allen and colleagues (2005). Deterioration was evident in both academic and social functioning from childhood to early adolescence, along with a pronounced/accelerated deterioration in academic functioning from early adolescence to late adolescence, occurring in both male and female patients. Age at onset of prodromal symptoms was predicted by childhood/early adolescent/late adolescent academic functioning scores, and age at onset of psychotic symptoms was significantly associated only with childhood academic functioning. Severity of negative symptoms was predicted by childhood and late adolescent social functioning scores, and severity of general psychopathology symptoms was predicted by late adolescent academic functioning, as well as childhood and late adolescent social functioning scores. Consistent with prior findings, deterioration in premorbid functioning appears to be more pronounced in the academic than social dimension of the PAS. Some PAS scores are predictive of ages at onset of prodrome/psychosis and severity of psychotic symptoms. Ongoing research on premorbid adjustment in schizophrenia may have implications for future prevention goals.

  7. Identification of PTSD in cancer survivors.

    Science.gov (United States)

    Alter, C L; Pelcovitz, D; Axelrod, A; Goldenberg, B; Harris, H; Meyers, B; Grobois, B; Mandel, F; Septimus, A; Kaplan, S

    1996-01-01

    The authors measured the rate and determinants of posttraumatic stress disorder (PTSD) in a group of cancer survivors. Patients who had a history of cancer diagnosis with at least 3 years since diagnosis, receiving no active treatment, such as chemotherapy or radiation, were interviewed (N = 27). Patients, who were part of the DSM-IV PTSD field trial, were compared with a community-based control group matched for age and socioeconomic status. One member of the survivor group (4%) and no members of the control group met criteria for current PTSD (NS). Six of the survivors (22%) and no control subjects met lifetime criteria (P Cancer patients have a higher rate of PTSD than found in the community. Symptoms closely resemble those of individuals who have experienced other traumatic events.

  8. Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD

    Directory of Open Access Journals (Sweden)

    Maksymilian Bielecki

    2017-09-01

    Full Text Available Emotional Stroop task (EST has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD. Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3 were included in the analysis, out of which 136 (70.1% were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented. Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.

  9. Age As Moderator of Emotional Stroop Task Performance in Posttraumatic Stress Disorder (PTSD).

    Science.gov (United States)

    Bielecki, Maksymilian; Popiel, Agnieszka; Zawadzki, Bogdan; Sedek, Grzegorz

    2017-01-01

    Emotional Stroop task (EST) has been extensively used to investigate attentional processes in posttraumatic stress disorder (PTSD). Even though aging significantly changes the dynamics of emotion-cognition interactions, very little is known about its role in shaping EST performance in PTSD patients. In the present study we tested a uniquely large sample of motor vehicle accident victims. Data of 194 participants (75.3% female; mean age = 36.64 years, SD = 12.3) were included in the analysis, out of which 136 (70.1%) were diagnosed with PTSD. Prior to the psychiatric assessment, participants completed the pictorial version of EST (neutral, positive, negative, and accidents photos were presented). Comparison of the PTSD and control groups revealed a specific increase in reaction times (RTs) related to the exposure of trauma-related material. At the same time, previously unreported, moderating effects of age were also discovered. Older participants, in contrast to the younger group, showed no increase in RTs and interference scores in trials where accident photos were presented. Our study points to the key role of age as a previously understudied factor modifying EST performance in PTSD patients.

  10. Veterans’ PTSD Symptoms and their Partners’ Desired Changes in Key Relationship Domains

    Science.gov (United States)

    LaMotte, Adam D.; Taft, Casey T.; Reardon, Annemarie F.; Miller, Mark W.

    2015-01-01

    There is a growing literature investigating the connection between veterans’ posttraumatic stress disorder (PTSD) symptoms and intimate relationship problems. Little to no work, however, has examined the connection between veterans’ PTSD symptoms and their partners’ perceptions of specific relationship areas in need of change. We examined associations between overall PTSD symptoms and symptom cluster scores with partners’ desired changes in the areas of intimacy, shared activities, and responsibilities. The sample consisted of 249 male veterans of different service eras and their female partners. Results indicated that veterans’ PTSD symptoms were associated with greater desired changes from their partners in the veterans’ intimacy behaviors and participation in shared activities. When examining the contribution of each symptom cluster individually, only the veterans’ emotional numbing symptoms emerged as a significant unique predictor and were associated with partners’ desired changes in intimacy. The findings suggest that intimacy and shared activities may be relevant areas to address in PTSD treatment for veterans and their partners, and highlight the particular significance of emotional numbing symptoms to intimacy in veterans’ relationships. PMID:26010109

  11. A Double-Blind Randomized Controlled Pilot Trial of N-Acetylcysteine in Veterans with PTSD and Substance Use Disorders

    Science.gov (United States)

    Back, Sudie E.; McCauley, Jenna L.; Korte, Kristina J.; Gros, Daniel F.; Leavitt, Virginia; Gray, Kevin M.; Hamner, Mark B.; DeSantis, Stacia M.; Malcolm, Robert; Brady, Kathleen T.; Kalivas, Peter W.

    2016-01-01

    Objective The antioxidant N-Acetylcysteine (NAC) is being increasingly investigated as a therapeutic agent in the treatment of substance use disorders. Preclinical and clinical findings suggest that NAC normalizes extracellular glutamate by restoring the activity of glutamate transporters and antiporters in the nucleus accumbens. This study explored the efficacy of NAC in the treatment of post-traumatic stress disorder (PTSD), which frequently co-occurs with substance use disorders (SUD) and shares impaired prefrontal cortex regulation of basal ganglia circuitry, in particular at glutamate synapses in the nucleus accumbens. Method Veterans with current PTSD and SUD (N=35) were randomly assigned to receive a double-blind, 8-week course of NAC (2400 mg/day) or placebo plus outpatient group cognitive-behavioral therapy for SUD. Primary outcome measures included PTSD symptoms (Clinician Administered PTSD Scale, PTSD Checklist-Military) and craving (Visual Analogue Scale). Depression (Beck Depression Inventory-II) and substance use (Timeline Follow Back, urine drug screens) were also assessed. Results Participants treated with NAC, as compared to placebo, evidenced significant improvements in PTSD symptoms, craving, and depression. Substance use at the start of treatment was low for both the NAC and placebo groups and no significant between-group differences were observed. NAC was well tolerated and retention was high. Conclusions This is the first randomized controlled trial to investigate NAC as a pharmacological treatment for PTSD. The findings show a significant treatment effect on symptoms of PTSD and drug craving, and provide initial support for the use of NAC in combination with cognitive-behavioral therapy among individuals with co-occurring PTSD and SUD. PMID:27736051

  12. Adaptive Disclosure: A Combat Specific PTSD Treatment

    Science.gov (United States)

    2017-03-31

    to determine whether AD is as least as effective as CPT, cognitive only version (CPT-C), in terms of its impact on deployment-related psychological ...operational stressors develop posttraumatic stress disorder (PTSD). Evidence-based interventions for treating PTSD, however, were not developed for...be used to determine treatment efficacy. 15. SUBJECT TERMS Active-duty, Marine Corps, Posttraumatic stress disorder, Cognitive Therapy 16

  13. Parents bereaved by infant death: PTSD symptoms up to 18 years after the loss.

    Science.gov (United States)

    Christiansen, Dorte M; Elklit, Ask; Olff, Miranda

    2013-01-01

    Losing an infant or fetus late in pregnancy, during birth or in the first year of life is a potentially traumatic event for parents. However, little is known about the factors contributing to chronic posttraumatic stress reactions in this population. The present study examined chronic posttraumatic stress disorder (PTSD) symptoms and potential correlates in 634 mothers and fathers up to 18 years (M=3.4 years) after the death of their infant. Members of a private national support organization for parents bereaved by infant death were contacted and asked to participate in the study. Participants filled out a questionnaire package including measures of PTSD (the Harvard Trauma Questionnaire), coping (the Coping Style Questionnaire), perceived social support (the Crisis Support Scale) and attachment (the Revised Adult Attachment Scale). Associations between variables were examined through the use of analyses of variance, correlation analyses and a regression analysis. We found an estimated PTSD prevalence of 12.3%. Type of loss (pre-, peri- or postnatal) did not have any effect on PTSD severity, but lower gestational age was associated with more symptoms. Time since the loss, female sex, attachment avoidance, attachment anxiety, emotion-focused coping, rational coping, feeling let down and social support satisfaction accounted for 42% of the variance in PTSD severity. The study highlights the long-term impact of infant loss and points to attachment, coping and social support as important contributors to the development and maintenance of posttraumatic stress symptoms. © 2013.

  14. EFT (Emotional Freedom Techniques) and Resiliency in Veterans at Risk for PTSD: A Randomized Controlled Trial.

    Science.gov (United States)

    Church, Dawson; Sparks, Terry; Clond, Morgan

    2016-01-01

    Prior research indicates elevated but subclinical posttraumatic stress disorder (PTSD) symptoms as a risk factor for a later diagnosis of PTSD. This study examined the progression of symptoms in 21 subclinical veterans. Participants were randomized into a treatment as usual (TAU) wait-list group and an experimental group, which received TAU plus six sessions of clinical emotional freedom techniques (EFT). Symptoms were assessed using the PCL-M (Posttraumatic Checklist-Military) on which a score of 35 or higher indicates increased risk for PTSD. The mean pretreatment score of participants was 39 ± 8.7, with no significant difference between groups. No change was found in the TAU group during the wait period. Afterward, the TAU group received an identical clinical EFT protocol. Posttreatment groups were combined for analysis. Scores declined to a mean of 25 (-64%, P < .0001). Participants maintained their gains, with mean three-month and six-month follow-up PCL-M scores of 27 (P < .0001). Similar reductions were noted in the depth and breadth of psychological conditions such as anxiety. A Cohen's d = 1.99 indicates a large treatment effect. Reductions in traumatic brain injury symptoms (P = .045) and insomnia (P = .004) were also noted. Symptom improvements were similar to those assessed in studies of PTSD-positive veterans. EFT may thus be protective against an increase in symptoms and a later PTSD diagnosis. As a simple and quickly learned self-help method, EFT may be a clinically useful element of a resiliency program for veterans and active-duty warriors. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Catestatin, vasostatin, cortisol, temperature, heart rate, respiratory rate, scores of the short form of the Glasgow composite measure pain scale and visual analog scale for stress and pain behavior in dogs before and after ovariohysterectomy.

    Science.gov (United States)

    Srithunyarat, Thanikul; Höglund, Odd V; Hagman, Ragnvi; Olsson, Ulf; Stridsberg, Mats; Lagerstedt, Anne-Sofie; Pettersson, Ann

    2016-08-02

    The stress reaction induced by surgery and associated pain may be detrimental for patient recovery and should be minimized. The neuropeptide chromogranin A (CGA) has shown promise as a sensitive biomarker for stress in humans. Little is known about CGA and its derived peptides, catestatin (CST) and vasostatin (VS), in dogs undergoing surgery. The objectives of this study were to investigate and compare concentrations of CGA epitopes CST and VS, cortisol, body temperature, heart rate, respiratory rate, scores of the short form of the Glasgow composite measure pain scale (CMPS-SF) and visual analog scales (VAS) for stress and pain behavior in dogs before and after ovariohysterectomy. Thirty healthy privately owned female dogs admitted for elective ovariohysterectomy were included. Physical examination, CMPS-SF, pain behavior VAS, and stress behavior VAS were recorded and saliva and blood samples were collected before surgery, 3 h after extubation, and once at recall 7-15 days after surgery. Dogs were premedicated with morphine and received carprofen as analgesia for 7 days during the postoperative period. At 3 h after extubation, CMPS-SF and pain behavior VAS scores had increased (p stress behavior VAS scores, temperature, respiratory rate (p stress and pain changed in dogs subjected to ovariohysterectomy. To further evaluate CST and VS usefulness as pain biomarkers, studies on dogs in acute painful situations are warranted.

  16. Rape survivors' trauma-related beliefs before and after Cognitive processing therapy: associations with PTSD and depression symptoms.

    Science.gov (United States)

    Iverson, Katherine M; King, Matthew W; Cunningham, Katherine C; Resick, Patricia A

    2015-03-01

    This study examined whether cognitive distortions (i.e., assimilated and overaccommodated thoughts) and realistic (i.e., accommodated) thoughts assessed from impact statements written 5-10 years after completing cognitive processing therapy (CPT) accurately predicted posttreatment maintenance or decline in treatment gains during the same period. The sample included 50 women diagnosed with posttraumatic stress disorder (PTSD) secondary to rape who participated in a randomized clinical trial of CPT for PTSD. Cognitions were assessed via coding and analyses of participants' written impact statements at three time points: beginning of treatment, end of treatment, and at 5-10 years follow-up. Primary mental health outcomes were symptoms of PTSD (Clinician-Administered PTSD Scale) and depression (Beck Depression Inventory). Changes in trauma-related beliefs between the end of treatment and long-term follow-up were associated with concomitant changes in PTSD and depression symptoms (effect sizes ranging from r = .35-.54). Declines in accommodated thinking and increases in overaccommodated thinking were associated with elevations in symptomatology. Improvement in accommodated thinking and declines in overaccommodated thinking were associated with lower PTSD and depression symptoms during this same time period. Findings provided support for the role of changes in accommodated and overaccommodated thinking being associated with level of PTSD and depression many years after participating in CPT. Published by Elsevier Ltd.

  17. PTSD and Sexual Dysfunction in Men and Women.

    Science.gov (United States)

    Yehuda, Rachel; Lehrner, Amy; Rosenbaum, Talli Y

    2015-05-01

    Difficulties in sexual desire and function often occur in persons with posttraumatic stress disorder (PTSD), but many questions remain regarding the mechanisms underlying the occurrence of sexual problems in PTSD. The aim of this review was to present a model of sexual dysfunction in PTSD underpinned by an inability to regulate and redirect the physiological arousal needed for healthy sexual function away from aversive hyperarousal and intrusive memories. A literature review pertaining to PTSD and sexual function was conducted. Evidence for the comorbidity of sexual dysfunction and PTSD is presented, and biological and psychological mechanisms that may underlie this co-occurrence are proposed. This manuscript presents evidence of sexual dysfunction in conjunction with PTSD, and of the neurobiology and neuroendocrinology of PTSD and sexual function. Sexual dysfunction following trauma exposure may be mediated by PTSD-related biological, cognitive, and affective processes. The treatment of PTSD must include attention to sexual dysfunction and vice versa. © 2015 International Society for Sexual Medicine.

  18. The relation of putamen nucleus 6-[18F]fluoro-L-m-tyrosine uptake to total Unified Parkinson's Disease Rating Scale scores

    International Nuclear Information System (INIS)

    Buchy, R.

    2002-01-01

    The contribution of dopaminergic deficiency in the striatum to the severity of locomotor disability in Parkinson's disease has been consistently shown with 6-[ 18 F]fluoro-L-DOPA in positron emission tomography. Recently, 6-[ 18 F]fluoro-L-m-tyrosine, an alternative tracer with similar distribution kinetics has been used to facilitate data analysis. Locomotor disability in Parkinson's disease can be measured using the Unified Parkinson's Disease Rating Scale. The Unified Parkinson's Disease Rating Scale was used in conjunction with 6-[ 18 F]fluoro-L-m-tyrosine -PET to clinically examine a group of five Parkinson's disease patients. An inverse relation similar to that previously demonstrated with 6-[ 18 F]fluoro-L-DOPA was found between the putamen nucleus 6-[ 18 F]fluoro-L-m-tyrosine influx constant and Unified Parkinson's Disease Rating Scale score. This finding suggests that like 6-[ 18 F]fluoro-L-m-tyrosine can be used to accurately measure the degree of locomotor disability caused by Parkinson's disease. (author)

  19. Vets prevail online intervention reduces PTSD and depression in veterans with mild-to-moderate symptoms.

    Science.gov (United States)

    Hobfoll, Stevan E; Blais, Rebecca K; Stevens, Natalie R; Walt, Lisa; Gengler, Richard

    2016-01-01

    Despite heightened rates of depression and posttraumatic stress disorder (PTSD) among in Iraq/Afghanistan veterans, the majority of distressed veterans will not receive mental health care. Overcoming barriers to mental health services requires innovative approaches to broaden the reach of evidence-based treatment. The current study examined the efficacy and acceptability of an innovative and dynamic online cognitive-behavioral therapy intervention for PTSD and depression called Vets Prevail. A randomized clinical trial conducted between 2011 and 2013 assessed changes in PTSD and depression in veterans with mild-to-moderate distress. Veterans randomized to Vets Prevail (n = 209) were aged 34.2 ± 7.6 years, mostly male (81.3%), and nonminority (73.7%). Veterans randomized to adjustment as usual (n = 94) were aged 34.7 ± 8.9, mostly male (81.9%), and White (67.0%). Veterans completed the PTSD Checklist-Military Version and the Center for Epidemiological Studies Depression scale (10-item version) postintervention and at 12-week follow-up. Veterans in the Vets Prevail condition reported significantly greater reductions in PTSD, t(250) = 3.24, p = .001 (Mreduction = 5.51, SD = 9.63), and depression, t(252) = 4.37, p = .001 (Mreduction = 2.31, SD = 5.34), at 12-week follow-up compared with veterans in the adjustment as usual condition (PTSD Mreduction = 1.00, SD = 7.32; depression Mreduction = 0.48, SD = 4.95), with moderate effect sizes for PTSD (Cohen's d = 0.42) and depression (Cohen's d = 0.56). Exploratory analysis shows that Vets Prevail may be effective regardless of combat trauma exposure, gender, and ethnic minority status. Vets Prevail circumvents many barriers to care and effectively addresses the dire mental health needs of veterans. (c) 2015 APA, all rights reserved).

  20. Internet-based guided self-help for posttraumatic stress disorder (PTSD): Randomized controlled trial.

    Science.gov (United States)

    Lewis, Catrin E; Farewell, Daniel; Groves, Vicky; Kitchiner, Neil J; Roberts, Neil P; Vick, Tracey; Bisson, Jonathan I

    2017-06-01

    There are numerous barriers that limit access to evidence-based treatment for posttraumatic stress disorder (PTSD). Internet-based guided self-help is a treatment option that may help widen access to effective intervention, but the approach has not been sufficiently explored for the treatment of PTSD. Forty two adults with DSM-5 PTSD of mild to moderate severity were randomly allocated to internet-based self-help with up to 3 h of therapist assistance, or to a delayed treatment control group. The internet-based program included eight modules that focused on psychoeducation, grounding, relaxation, behavioural activation, real-life and imaginal exposure, cognitive therapy, and relapse prevention. The primary outcome measure was reduction in clinician-rated traumatic stress symptoms using the clinician administered PTSD scale for DSM-V (CAPS-5). Secondary outcomes were self-reported PTSD symptoms, depression, anxiety, alcohol use, perceived social support, and functional impairment. Posttreatment, the internet-based guided self-help group had significantly lower clinician assessed PTSD symptoms than the delayed treatment control group (between-group effect size Cohen's d = 1.86). The difference was maintained at 1-month follow-up and dissipated once both groups had received treatment. Similar patterns of difference between the two groups were found for depression, anxiety, and functional impairment. The average contact with treating clinicians was 2½ h. Internet-based trauma-focused guided self-help for PTSD is a promising treatment option that requires far less therapist time than current first line face-to-face psychological therapy. © 2017 Wiley Periodicals, Inc.