ABSTRACT
1. Cognitive processing, as measured by 15 subtest from the Wechsler Memory Scale (WMS) and the Wechsler Adult Intelligence Scale-Revised (WAIS-R) was assessed in 109 depressed inpatients who were classified as under age 65 (N = 54) or 65 or older (N = 55). Within each age group, patients were further classified according to whether they had no prior ECT (N = 40), one prior ECT series (N = 37), or two or more prior series of ECT (N = 32). 2. After examining the data set for possible sources of bias such as group differences in the severity of depression, time since last ECT series, unilateral vs. bilateral electrode placement, adjunctive use of psychotropic medication, gender, education and so forth, a MANCOVA and a series of 15 two (age) by three (ECT history) by two (gender) analyses of covariance (education served as the covariate) were used to examine the main effects of ECT history, age and their interaction on cognitive performance. 3. No generalized adverse effects of prior ECT treatment were found but older patients with two or more prior ECT series performed significantly more poorly than other subgroups on 4 of 15 cognitive tests: (1) Personal and Current Information from the WMS, (2) WMS Stories recall, (3) 30-minute delayed WMS Stories and (4) WAIS-R Similarities. 4. These findings suggest that the verbal-narrative memory functioning of depressed geriatric patients with a history of at least one prior ECT series is particularly vulnerable to disruption.
Subject(s)
Aging/psychology , Cognition/physiology , Electroconvulsive Therapy/adverse effects , Adolescent , Adult , Aged , Analysis of Variance , Depressive Disorder/psychology , Depressive Disorder/therapy , Education , Female , Humans , Male , Middle Aged , Multivariate Analysis , Sex Characteristics , Wechsler ScalesABSTRACT
Responses of 142 Vietnam veterans on two frequently employed measures of combat stress were factor analyzed. Four factors emerged, each of which represented an aspect of participation in activities within the Vietnam war zone. One factor in particular, abusive violence, was significantly related to postservice problems of adjustment and was the most powerful predictor of a diagnosis of combat-related posttraumatic stress disorder. Our data suggest that unidimensional models of war zone stress that focus exclusively on exposure to life threat in combat situations are inadequate for characterizing important features of the Vietnam theater that are related to subsequent psychopathology.
Subject(s)
Stress Disorders, Post-Traumatic/psychology , Adult , Humans , Male , Stress Disorders, Post-Traumatic/diagnosis , Veterans/psychology , VietnamABSTRACT
Sixty-one Vietnam veterans who had sought outpatient psychological services were evaluated for posttraumatic stress disorder (PTSD) during two independent diagnostic interviews. Data were analyzed from only those 48 subjects for whom the two diagnoses agreed upon the presence or absence of PTSD. Subjects were administered the Symptom Checklist-90-R, a modified version of the Impact of Event Scale, and two measures of combat stress: the Combat Scale Revised and the Vietnam Experience Scale. Some support was generated for the reliability and validity of the PTSD construct as outlined in DSM-III. In our sample the diagnosis of PTSD was associated with excessive arousal characterized by anxiety, anger, paranoid ideation, intrusive images, and avoidance of stimuli reminiscent of the traumatic stressor. The findings are discussed in relation to previous studies of combat-related PTSD and studies of traumatically stressed civilians.
