ABSTRACT
The question whether depression is related to trauma as part of posttraumatic stress disorder (PTSD) itself or whether it represents autonomous symptoms occurring separately (from PTSD) has not been answered. We addressed two issues: (a) What is the relationship between PTSD and depression as measured by continuous measures on outcomes? and (b) By removing depression components from the PTSD diagnosis, what is the impact on standard outcomes? Older veterans from World War II or Korea were interviewed and given self-report measures on PTSD and depression. The CAPS-1 and the MMPI-D were used as the continuous measures for PTSD and depression. The outcome measures were health status, overall adjustment, social support, and physiological status. Results showed that depression influenced health status and social support: PTSD did not contribute to the equation. The CAPS-1 also was further divided into CAPS-PTSD and CAPS-D (depression) based on item content. For adjustment and health status, PTSD asserted a greater influence; for social support and heart rate, depression was the greater influence. Discussion addressed the fact that depression is an important consideration in the expression of PTSD.
Subject(s)
Combat Disorders/psychology , Depressive Disorder/psychology , Veterans/psychology , Adaptation, Psychological , Aged , Arousal , Combat Disorders/diagnosis , Depressive Disorder/diagnosis , Health Status , Heart Rate , Humans , Middle Aged , Personality Inventory , PrognosisABSTRACT
A study of the posttraumatic stress disorder (PTSD) among older combat veterans of World War II and the Korean Conflict was conducted. The Clinician-Administered PTSD Scale (CAPS) was given to 125 older combat veterans, along with a computerized variant of the Structured Clinical Interview for DSM-III-R for PTSD, the SCID-DTREE. (The SCID-DTREE was itself validated against the full SCID). Results showed the CAPS to be a good discriminator of PTSD: Out of the 125 cases, only 9 were misclassified using the SCID-DTREE as the base measure, a 93% efficiency. An alpha on the full CAPS was .95. This suggests that the CAPS is an appropriate scale for use with older combat veterans.
Subject(s)
Combat Disorders/diagnosis , Personality Assessment/statistics & numerical data , Veterans/psychology , Aged , Combat Disorders/psychology , Europe , Humans , Korea , Male , Middle Aged , Psychometrics , Reproducibility of ResultsABSTRACT
Little is known about how individuals who develop chronic posttraumatic stress disorder (PTSD) cope with recurring trauma memories, or how enduring personality characteristics influence such coping. Focusing on 110 hospitalized Vietnam combat veterans with chronic PTSD, this exploratory study assessed the relative frequency of using eight ways of coping with war memories, and associations between relative use of these strategies and eight dysfunctional personality styles. As a secondary issue, associations between coping strategies, combat exposure, and PTSD severity were also examined. Consistent with prior findings, these veterans predominantly used emotion-focused and avoidant strategies to cope with war memories. Differing personality styles and relative use or nonuse of particular coping strategies were also associated in psychologically coherent ways. These preliminary findings are discussed in relation to methodologic and future research issues.
Subject(s)
Adaptation, Psychological , Memory , Personality , Stress Disorders, Post-Traumatic/prevention & control , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology , Adult , Chronic Disease , Georgia/ethnology , Hospitalization , Humans , Male , Psychological Tests , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , VietnamABSTRACT
Twenty-five veterans suffering from combat-related posttraumatic stress disorder were studied for 1-4 nights with all-night polysomnography. All subjects had sleep complaints. Analysis reveals that nineteen (76%) of the patients were found to have clinically significant periodic limb movements of sleep (PLMs) by the second night of study. PLMs are associated with sleep complaints in normals. For this reason the common assumption that sleep complaints in posttraumatic stress disorder are related only to the psychiatric disorder itself are challenged.
Subject(s)
Leg , Movement , Periodicity , Sleep , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology , Warfare , Adult , Humans , Male , Middle Aged , Sleep Apnea Syndromes/psychologyABSTRACT
After a long history of both scientific and political debate, the notion that extreme psychological traumatic experiences, in and of themselves, could result in a severe, even malignant, psychiatric disorder is now established. In 1980 posttraumatic stress disorder finally became an officially classified anxiety disorder. Since then, the few controlled treatment outcome studies that have been carried out appear to indicate that the most effective treatment for PTSD is some form of exposure therapy. This is not surprising in light of the fact that several other types of anxiety disorders respond well to this form of behavioral treatment. However, PTSD may be more complex than the other types of anxiety disorders, especially with regard to the variety of symptoms involved. In its chronic form or in combat-related PTSD, no one type of treatment tested so far has been successful in reducing all the symptoms of the disorder. Psychophysiological overarousal to imaginal facsimiles of the traumatic event is especially difficult to influence with treatment. Identifying techniques that reduce or at least control this arousal will likely be grist for the research mill for many years. Theoretical and conceptual formulations regarding both the etiology and treatment of the disorder are in early stages of development. It is hoped that these efforts will eventually mature our understanding of the disorder as researchers explore important issues such as (1) predisposing factors; (2) how the nature and intensity of the stressor relates to the severity of the disorder; and (3) how biological, psychological, social, and cultural variables interact to result in PTSD and to either ameliorate or exacerbate its symptoms.
Subject(s)
Behavior Therapy/methods , Stress Disorders, Post-Traumatic/therapy , Adult , Child , Clinical Trials as Topic , Combat Disorders/diagnosis , Combat Disorders/psychology , Combat Disorders/therapy , Combined Modality Therapy , Female , Humans , Male , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Treatment OutcomeABSTRACT
The relationship of the NEO-PI to personality disorders was evaluated in a clinical population. Eighty subjects with post-traumatic stress disorder (PTSD) were given this measure, along with the MCMI-II and PTSD and combat scales. Two questions were addressed: (1) What is the relationship of NEO-PI domains and facets to personality disorders?; and (2) What is this scale's relationship to PTSD problems? Results support previous studies that employed a clinical population, but with lower correlation coefficients. For the most part, then, the NEO-PI domains and facets correlated in expected ways with the MCMI-II. On PTSD measures, N accounted for the majority of the variance, but other domains were entered when independent regression equations were calculated to account for different personality disorders.
Subject(s)
Combat Disorders/diagnosis , Personality Disorders/diagnosis , Personality Inventory/statistics & numerical data , Veterans/psychology , Adult , Aggression/psychology , Chronic Disease , Combat Disorders/psychology , Combat Disorders/rehabilitation , Hospitals, Veterans , Hostility , Humans , Male , Middle Aged , Patient Admission , Personality Disorders/psychology , Personality Disorders/rehabilitationABSTRACT
A cluster analysis was used to identify groups of inpatients with confirmed post-traumatic stress disorder (PTSD) due to combat. In Study 1 the MCMI was administered to 256 subjects, in addition to the MMPI, PTSD measures, and background variables. Three clusters resulted: a Traumatic Personality (8-2), Schizoid Influence (8-2-1), and Antisocial Influence (8-6). Comparison on the MCMI symptom scales, MMPI, and PTSD scales showed that the Antisocial Influence cluster was "healthier" on all measures. The Schizoid Influence was most psychopathological. In Study 2 the MCMI-II was administered to 136 new subjects who met the same criteria as in Study 1. Four clusters resulted: Global (1-2-6A-6B-8A-8B), Subclinical (1), Aggressive (6A-6B-8A), and Detached/Self-defeating (1-2-8A-8B).
Subject(s)
Combat Disorders/diagnosis , Personality Inventory/statistics & numerical data , Veterans/psychology , Adult , Chronic Disease , Cluster Analysis , Combat Disorders/classification , Combat Disorders/psychology , Comorbidity , Humans , MMPI/statistics & numerical data , Male , Middle Aged , Patient Admission , Personality Disorders/classification , Personality Disorders/diagnosis , Personality Disorders/psychology , Psychometrics , VietnamABSTRACT
A sample of 135 Vietnam veteran inpatients with combat-related PTSD was sorted into three groups, depending upon the presence of concurrent psychiatric disorders: Depression (n = 68), Psychosis (n = 31), and Other (n = 36). Pairwise comparisons were made on the MMPI with respect to the validity indicators, clinical scales, four relevant Harris-Lingoes subscales, the Psychoticism content scale, and the MMPI-PTSD subscale. Results indicate variations in scale elevations as a function of comorbid diagnosis. Various items and scales appear to differentiate the Psychosis group due to greater psychopathology. In general, the results spotlight the heterogeneous aspects that comorbidity brings to PTSD assessment.
Subject(s)
Combat Disorders/diagnosis , MMPI/statistics & numerical data , Mental Disorders/diagnosis , Veterans/psychology , Adult , Anxiety Disorders/classification , Anxiety Disorders/diagnosis , Anxiety Disorders/psychology , Bipolar Disorder/classification , Bipolar Disorder/diagnosis , Bipolar Disorder/psychology , Combat Disorders/classification , Combat Disorders/psychology , Comorbidity , Depressive Disorder/classification , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Humans , Male , Mental Disorders/classification , Mental Disorders/psychology , Middle Aged , Psychometrics , Psychotic Disorders/classification , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , VietnamABSTRACT
A sample of 47 Vietnam veterans with the diagnosis of combat-related Post-Traumatic Stress Disorder (PTSD) was administered the MMPI and MMPI-2. Pairwise comparisons were performed on the clinical scales, Harris Lingoes subscales, and scales relevant to the assessment of PTSD. Correlational analyses were performed as well. Hit rates of high-point pairs were compared across the tests. The results suggest a high degree of congruence between tests. Differences were seen on evaluations of some scales between tests that may influence interpretation and treatment.
Subject(s)
Combat Disorders/diagnosis , MMPI/statistics & numerical data , Veterans/psychology , Adult , Combat Disorders/classification , Combat Disorders/psychology , Humans , Male , Middle Aged , Psychometrics , Reproducibility of Results , VietnamABSTRACT
Interest in dissociation has been renewed, and its relationship to Post-traumatic Stress Disorder is especially intriguing. In this study 57 consecutively admitted chronic, combat-related Posttraumatic Stress Disorder sufferers were grouped by scores on a dissociative scale (Dissociative Experiences Scale). The three groups (high, medium, and low) were compared on personality measures (MMPI basic scales and subscales, and Millon's MCMI), Posttraumatic Stress Disorder measures, and a psychophysiological index of heart rate under baseline trauma conditions. The results showed that the survivors with more dissociative experiences show distinctive and higher symptom levels--excessive fearfulness, symptoms of strange experiences, and high tonic psychophysiological states--as well as greater severity of ratings of Posttraumatic Stress Disorder (on the Mississippi Scale). The discussion addressed the possible role of dissociation in Posttraumatic Stress Disorder.
Subject(s)
Combat Disorders/psychology , Dissociative Disorders/psychology , Veterans/psychology , Adult , Arousal , Combat Disorders/diagnosis , Dissociative Disorders/diagnosis , Humans , Male , Personality Inventory/statistics & numerical data , PsychometricsABSTRACT
One hundred Vietnam veterans with combat-related PTSD were administered the NEO Personality Inventory (NEO-PI) and the Combat Exposure Scale and were sorted into three groups based on trauma exposure level. Results indicate no significant differences among the personality profiles of the three trauma-exposed groups. A normative NEO-PI profile for persons diagnosed with combat-related PTSD is presented, characterized by an extremely high Neuroticism score (T > 75) and an extremely low Agreeableness score (T < 25).
Subject(s)
Combat Disorders/diagnosis , Life Change Events , Personality Inventory , Adult , Combat Disorders/classification , Combat Disorders/psychology , Factor Analysis, Statistical , Female , Humans , Male , Models, Psychological , Personality/classification , Personality Assessment , Personality Inventory/standards , Personality Inventory/statistics & numerical data , Psychiatric Status Rating Scales , Severity of Illness Index , VietnamABSTRACT
This study addressed two issues, the interrelationship between the Millon Clinical Multiaxial Inventory (MCMI) and the Millon II (MCMI-II) and the value of the new personality scales, Aggressive and Self-defeating, in a sample with diagnoses of combat-related Posttraumatic Stress Disorder. 100 confirmed cases of combat-related Posttraumatic Stress Disorder were given a battery of measures including both Millon inventories and the Minnesota Multiphasic Personality Inventory (basic scales and selected subscales). They were rated on discharge status during a structured treatment program. Basic treatment and background information were also obtained. Analysis showed scores on the MCMI-II scales were higher but generally reflective of MCMI scales and that the Self-defeating personality style tends to be reflective of greater psychopathology, suicidal problems, treatment/disposition difficulties, overreporting of symptoms, and intensity of problems. Discussion encouraged the use of the MCMI-II with special emphasis given to the Self-defeating style in this group with Posttraumatic Stress Disorder.
Subject(s)
Aggression/psychology , Combat Disorders/psychology , Personality Disorders/diagnosis , Personality Inventory/statistics & numerical data , Self Concept , Veterans/psychology , Adult , Arousal , Chronic Disease , Combat Disorders/diagnosis , Humans , Male , Personality Disorders/psychology , Psychometrics , VietnamABSTRACT
The "personal characteristics" and "extreme event" hypotheses have been proposed as alternative explanations for the development of posttraumatic stress disorder (PTSD) among combat veterans. The person-event interaction model attempts to integrate both perspectives by hypothesizing that premilitary individual vulnerability characteristics play a greater role in influencing risk of PTSD or PTSD symptom severity at lower than at higher levels of exposure to traumatic combat stressors. Focusing on a sample of 57 Vietnam veterans undergoing inpatient treatment for diagnosed PTSD, we assessed this model by examining interactions between negative parenting behaviors in childhood (e.g., inconsistent love) and degree of combat exposure in predicting PTSD symptom severity. Hierarchical regression analyses supported the model, indicating that the father's negative parenting behaviors were more predictive of PTSD symptom severity at relatively lower levels of combat exposure. Implications of the findings for further research on multivariate, interactional models of PTSD etiology among Vietnam combat veterans are discussed.
Subject(s)
Parent-Child Relations , Parenting/psychology , Stress Disorders, Post-Traumatic/etiology , Warfare , Adaptation, Psychological , Adult , Father-Child Relations , Hostility , Humans , Life Change Events , Love , Male , Models, Psychological , Mother-Child Relations , Psychological Tests/statistics & numerical data , Regression Analysis , Severity of Illness Index , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/psychology , Veterans/psychologySubject(s)
Combat Disorders/therapy , Hospitalization , Mental Disorders/therapy , Psychiatric Status Rating Scales , Cohort Studies , Combat Disorders/diagnosis , Combat Disorders/psychology , Combined Modality Therapy , Humans , Male , Mental Disorders/diagnosis , Mental Disorders/psychology , Patient Readmission , VietnamABSTRACT
At the present time, The Mississippi Scale for Combat-Related PTSD (Mississippi Scale) is the best paper-and-pencil measure of this disorder. This study carried out a test-retest reliability on 52 chronic Vietnam veterans with PTSD and established three psychometric criteria for item retention in order to establish a short form of the Mississippi Scale. Ten items met these criteria and had a test-retest reliability coefficient of .66 (under the most stringent of conditions, treatment). This 10-item measure (Miss-10) then was applied to 95 new PTSD cases. This scale yielded two factors, guilt and numbing/anger. Discussion addressed its use as part of a screening battery or for monitoring change across time.
Subject(s)
Combat Disorders/diagnosis , Personality Inventory/statistics & numerical data , Veterans/psychology , Adult , Combat Disorders/psychology , Combat Disorders/therapy , Hospitalization , Humans , Male , PsychometricsABSTRACT
Alcohol use patterns among Vietnam combat veterans is an area with little research. This study evaluated three groups of Vietnam subjects on a chemical dependency unit who had a current Axis I diagnosis of alcohol abuse. No subject possessed a PTSD diagnosis. Two groups involved in-country veterans divided by presence or absence of PTSD based on the MMPI-PTSD scale (In-country and PTSD). The third group did not experience combat and was below the mean on the MMPI-PTSD scale (Noncombat). These groups were compared on the MMPI and the Alcohol Use Inventory (AUI), a measure of alcohol use patterns. Results showed that the PTSD Group had significantly higher scores on the MMPI and AUI reflective of deteriorated and binge drinking patterns. Discussion focused on the "hidden" dimension of PTSD among chemically dependent Vietnam veteran inpatients. The Relapse Prevention model was endorsed.
Subject(s)
Alcoholism/psychology , Alcoholism/rehabilitation , Combat Disorders/diagnosis , Combat Disorders/psychology , Hospitalization , Veterans/psychology , Alcohol Drinking/psychology , Combat Disorders/rehabilitation , Humans , MMPI/statistics & numerical data , Male , Psychometrics , VietnamABSTRACT
Suicidal behavior among Vietnam veterans with chronic Post-traumatic Stress Disorder (PTSD) was evaluated. Sixty chronic PTSD vets admitted to a Specialized PTSD Unit were divided into two groups based on the presence of suicidal behavior: 29 patients in a Suicide Group and 31 in a Non-suicide Group. Subjects were evaluated on symptoms, psychometric measures, military variables, adjustment factors, and pre-military parental patterns of discipline. Results showed that the Suicide Group possessed problems in paternal child-rearing patterns, current adjustment difficulties, and the PTSD symptoms of survival guilt and crying. In a regression analysis, paternal inconsistency of love, survivor guilt, and tendency to cry, in addition to age and sex, accounted for the significant variance of suicidal behavior.
Subject(s)
Combat Disorders/psychology , Suicide/psychology , Veterans/psychology , Chronic Disease , Combat Disorders/diagnosis , Follow-Up Studies , Humans , Male , Personality Tests , Risk Factors , Vietnam , Suicide PreventionABSTRACT
The authors studied 227 inpatients from a large Veterans Administration Medical Center to evaluate whether alexithymia is associated with posttraumatic stress disorder (PTSD) and to assess the validity of the Minnesota Multiphasic Personality Inventory (MMPI) alexithymia scale. Three groups--a carefully diagnosed PTSD group (N = 76), an alcohol abuse group (N = 76), and a general psychiatric group (N = 75)--were given a battery of psychological tests, including the MMPI, the Millon Clinical Multiaxial Inventory, and the Beck Depression Inventory, along with several cognitive measures. PTSD veterans were also evaluated on psychophysiologic indices (including a stressor) and on their subjective ratings to these indices. Results showed that alexithymia was more characteristic of PTSD patients than of the other groups. Also, alexithymia was inversely related to heart rate. Alexithymia was not significantly correlated with the subjective experience of stressors. The authors discuss the importance of the construct of alexithymia among PTSD patients and recommend the use of the alexithymia scale for these patients. The independence of this measure from the psychophysiologic condition of hyperarousal and the subjective experience of this state were also addressed.
Subject(s)
Affective Symptoms/diagnosis , Stress Disorders, Post-Traumatic/psychology , Veterans/psychology , Adult , Affective Symptoms/physiopathology , Affective Symptoms/psychology , Arousal/physiology , Depressive Disorder/diagnosis , Depressive Disorder/psychology , Heart Rate , Humans , MMPI/standards , Male , Psychiatric Status Rating Scales , Psychometrics , Sensitivity and Specificity , Stress Disorders, Post-Traumatic/diagnosis , Stress Disorders, Post-Traumatic/physiopathologyABSTRACT
This study addresses two issues: treatment changes on the MCMI of Vietnam veterans with PTSD and test-retest reliability of the Millon Clinical Multiaxial Inventory (MCMI). Fifty Vietnam veterans carefully were identified for the diagnosis Post-Traumatic Stress Disorder (PTSD). They were admitted to a Special PTSD Treatment Unit that consisted of an intense 5-week period with focus on the revivified Vietnam experience. They also were given the MCMI at two points in time, treatment inception and 35 days later at discharge. Results show that 17 of 20 scales on the MCMI changed in the negative direction as a result of treatment. Also, the MCMI has adequate test-retest reliability, and the personality scales (with the exception of Borderline) have higher reliability coefficients than do symptom scales. The use of the MCMI is encourged both as a monitor of treatment for these veterans and for its stability.
Subject(s)
Combat Disorders/therapy , Personality Inventory , Stress Disorders, Post-Traumatic/therapy , Veterans/psychology , Combat Disorders/psychology , Follow-Up Studies , Humans , Male , Problem Solving , Psychiatric Department, Hospital , Psychotherapy, Group/methods , VietnamABSTRACT
The F-K index of the MMPI has been used as a marker of symptom overreporting. One population for which previous research has shown this pattern is Vietnam in-country veterans with PTSD. This study assessed the F-K index on 515 inpatients: 329 Vietnam in-country and 186 Vietnam-era patients. Normative data on psychiatric inpatients were presented. Also, a special MMPI subscale (MMPI-PTSD), a measure to identify PTSD among these veterans, was used. Results showed that all Vietnam veterans, especially in-country veterans, overreport symptoms to a high degree. The overall mean for in-country vets was 7.3. Also, when the special MMPI-PTSD subscale was used, a vast majority of in-country veterans who were in the PTSD range had high F-K index scores. Dissimulation as a symptom of PTSD was discussed.
