Characteristic psychiatric symptomatology of Post-Traumatic Stress Disorder in veterans: a three year follow-up

1989 ◽  
Vol 19 (4) ◽  
pp. 927-936 ◽  
Author(s):  
Zahava Solomon

SYNOPSISThis study assessed the clinical picture of two groups of Israeli veterans of the Lebanon war: (a) veterans who sustained a combat stress reaction (CSR) (N = 213), and (b) matched controls not so diagnosed (N = 116). Subjects were screened at three points – one, two, and three years after their participation in the war. The results indicated that Post-Traumatic Stress Disorder (PTSD) was correlated with a wider range of general psychiatric symptomatology, as measured by the SCL-90. Moreover, among PTSD veterans, those who suffered from an antecedent CSR reported wider and more severe symptomatology. This trend was observed at all three time points. The most salient symptoms were obsessive-compulsive tendencies and anxiety, followed by depression and hostility.

1987 ◽  
Vol 151 (2) ◽  
pp. 248-251 ◽  
Author(s):  
R. Garb ◽  
I. Kutz ◽  
A. Bleich ◽  
Z. Solomon

The use of an immunological metaphor allows the incorporation of established theoretical ideas about trauma and stress in an integrative way which enables delineation and illustration of several varieties of combat stress reaction, including subtle forms of that condition which do not often appear in post-traumatic stress disorder literature.


2016 ◽  
Vol 33 (S1) ◽  
pp. S636-S636
Author(s):  
H. Matson

Combat stress reaction is a mental health disorder first documented in the latter half of the 19th century. But it was not until World War 1 when men were put through the horrific ordeals of trench warfare that the term, “shell shocked” was coined. Many soldiers with shell shock then developed what is now called post-traumatic stress disorder (though the term was not defined until 1983) or acute stress disorder. The prevailing opinion was that these men who had often not suffered from any physical trauma were sufferers of cowardice. The British army created the PIE (proximity, immediacy, and expectancy) principles to get such men back to the trenches promptly where manpower was always needed. It was rarely regarded as a real psychiatric condition, which had two consequences. Firstly, that many soldiers progressed from shell shock to post-traumatic stress disorder and secondly, over 150 soldiers were executed by the British army for, “displaying cowardice” whilst in the grip of the illness. The diagnosis of “shell shock” was to be made increasingly frequently as wars became larger and more mechanized throughout the 20th century. Psychiatrists’ management of such patients initially was primitive and influenced by the zeitgeist that such servicemen were not ill, having never come across such a widespread prevalence of mental health problems until the Great War. These ranged from prescriptions of milk to lobotomies. Understanding how “shell shock” was understood, treated and learning from the mistakes made then, continues to inform management of our patients today.Disclosure of interestThe author has not supplied his/her declaration of competing interest.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Masato Nagai ◽  
Tetsuya Ohira ◽  
Masaharu Maeda ◽  
Seiji Yasumura ◽  
Itaru Miura ◽  
...  

AbstractPost-traumatic stress disorder (PTSD) and obesity share common risk factors; however, the effect of obesity on recovery from PTSD has not been assessed. We examined the association between body mass index (BMI) and recovery from PTSD after the Great East Japan Earthquake. We analyzed 4356 men and women with probable PTSD aged ≥ 16 years who were living in evacuation zones owing to the radiation accident in Fukushima, Japan. Recovery from probable PTSD was defined as Post-traumatic Stress Disorder Checklist-specific scores < 44. Using Poisson regression with robust error variance adjusted for confounders, we compared the prevalence ratios (PRs) and 95% confidence intervals (CIs) for this outcome in 2013 and 2014. Compared with point estimates for normal weight (BMI: 18.5–24.9 kg/m2), especially in 2013, those for underweight (BMI: < 18.5 kg/m2) and obesity (BMI: ≥ 30.0 kg/m2) tended to slightly increase and decrease, respectively, for recovery from probable PTSD. The multivariate-adjusted PRs (95% CIs) for underweight and obesity were 1.08 (0.88–1.33) and 0.85 (0.68–1.06), respectively, in 2013 and 1.02 (0.82–1.26) and 0.87 (0.69–1.09), respectively, in 2014. The results of the present study showed that obesity may be a useful predictor for probable PTSD recovery. Obese victims with PTSD would require more intensive support and careful follow-up for recovery.


2009 ◽  
Vol 2 (4) ◽  
pp. 243-255 ◽  
Author(s):  
Reginald D. V. Nixon ◽  
Leonard W. Kling

AbstractThe aim of this pilot study was to test whether a future-oriented expressive writing intervention is able to reduce post-traumatic stress disorder (PTSD) severity and associated symptoms such as depression and unhelpful trauma-related beliefs. In an uncontrolled pre-/ post-design participants attended 8 weeks of manualized therapy. Assessment was undertaken pre- and post-treatment, and participants also completed a 3-month follow-up assessment. Of the 17 participants who began therapy, 13 were treatment completers. Results indicated a significant decrease in PTSD severity, depression and unhelpful trauma-related cognitions from pre- to post-treatment and at 3-month follow-up. Clinically meaningful change was more modest; however, three participants reported PTSD remission at 3-month follow-up. It is concluded that expressive writing with a focus on achieving future goals and personal change may have some utility in reducing post-traumatic stress but future research will need to investigate this with greater methodological rigour before firm conclusions can be made.


2020 ◽  
Vol 50 (4) ◽  
pp. 542-555 ◽  
Author(s):  
Ifigeneia Mavranezouli ◽  
Odette Megnin-Viggars ◽  
Caitlin Daly ◽  
Sofia Dias ◽  
Nicky J. Welton ◽  
...  

AbstractBackgroundPost-traumatic stress disorder (PTSD) is a potentially chronic and disabling disorder affecting a significant minority of people exposed to trauma. Various psychological treatments have been shown to be effective, but their relative effects are not well established.MethodsWe undertook a systematic review and network meta-analyses of psychological interventions for adults with PTSD. Outcomes included PTSD symptom change scores post-treatment and at 1–4-month follow-up, and remission post-treatment.ResultsWe included 90 trials, 6560 individuals and 22 interventions. Evidence was of moderate-to-low quality. Eye movement desensitisation and reprocessing (EMDR) [standardised mean difference (SMD) −2.07; 95% credible interval (CrI) −2.70 to −1.44], combined somatic/cognitive therapies (SMD −1.69; 95% CrI −2.66 to −0.73), trauma-focused cognitive behavioural therapy (TF-CBT) (SMD −1.46; 95% CrI −1.87 to −1.05) and self-help with support (SMD −1.46; 95% CrI −2.33 to −0.59) appeared to be most effective at reducing PTSD symptoms post-treatment v. waitlist, followed by non-TF-CBT, TF-CBT combined with a selective serotonin reuptake inhibitor (SSRI), SSRIs, self-help without support and counselling. EMDR and TF-CBT showed sustained effects at 1–4-month follow-up. EMDR, TF-CBT, self-help with support and counselling improved remission rates post-treatment. Results for other interventions were either inconclusive or based on limited evidence.ConclusionsEMDR and TF-CBT appear to be most effective at reducing symptoms and improving remission rates in adults with PTSD. They are also effective at sustaining symptom improvements beyond treatment endpoint. Further research needs to explore the long-term comparative effectiveness of psychological therapies for adults with PTSD and also the impact of severity and complexity of PTSD on treatment outcomes.


2017 ◽  
Vol 53 (3) ◽  
pp. 189-196 ◽  
Author(s):  
Yung Y Chen ◽  
Min C Kao

Background Previous research has revealed mixed findings with regard to the effects of disclosure on trauma recovery. More recently, studies on psychological trauma have found associations among religion, meaning, and health. This study investigated prior disclosure as a moderator for the association between religious emotional expression and adaptive trauma processing, as measured by post-traumatic stress disorder (PTSD) symptoms. Methods Using Pennebaker’s written emotional expression paradigm, 105 participants were assigned to either a conventional trauma-writing condition or religious trauma-writing condition. PTSD symptoms were assessed at baseline and again at one-month post writing. Results A two-way interaction was found between prior disclosure and writing condition on PTSD symptoms at follow-up. For the religious trauma-writing condition only, there was a significant difference between low versus high disclosure participants in PTSD symptoms at follow-up, such that low prior disclosure participants registered fewer PTSD symptoms than high prior disclosure participants, while prior disclosure did not have such effect in the conventional trauma-writing condition. Limitations: This two-way interaction may be further qualified by other important psychosocial variables, such as differences in personality, coping style, social support, or use of prayer as a form of disclosure, which were not assessed in this study. Conclusion Religious emotional expression may encourage adaptive trauma processing, especially for individuals with low prior disclosure. These findings encourage further investigation of the conditions under which disclosure and religion may be a beneficial factor in trauma adaptation and treatment.


2018 ◽  
Vol 213 (4) ◽  
pp. 587-594 ◽  
Author(s):  
Jaco Rossouw ◽  
Elna Yadin ◽  
Debra Alexander ◽  
Soraya Seedat

BackgroundEmpirical evidence on the effectiveness of evidence-based treatments for adolescents with post-traumatic stress disorder (PTSD) in low-resource settings is needed.AimsTo evaluate the comparative effectiveness of prolonged exposure and supportive counselling in adolescents with PTSD.MethodSixty-three adolescents (13–18 years) with PTSD were randomly assigned to receive either of the interventions comprising 7–14 sessions of treatment (trial registration in the Pan African Clinical Trials Registry: PACTR201511001345372). The primary outcome measure was PTSD symptom severity, as independently assessed on the Child PTSD Symptom Scale at pre-treatment, post-treatment, and at 3- and 6-month follow-up.ResultsParticipants receiving prolonged exposure experienced greater improvement on the PTSD symptom severity scale than those receiving supportive counselling (between group differences at post-intervention, mean 12.49, 95% CI 6.82–18.17, P<0.001; d = 1.22). A similar effect size was maintained at 3-month (d = 0.85) and 6-month (d = 1.02) follow-up assessments.ConclusionsAdolescents with PTSD experienced greater benefit from prolonged exposure treatment when provided by non-specialist health workers (nurses) in a community setting.Declaration of interestNone.


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