Peritraumatic dissociation and posttraumatic stress in male Vietnam theater veterans.

OBJECTIVE: The aim of this study was to determine the reliability and validity of a proposed measure of peritraumatic dissociation and, as part of that effort, to determine the relationship between dissociative experiences during disturbing combat trauma and the subsequent development of posttraumatic stress disorder (PTSD). METHOD: A total of 251 male Vietnam theater veterans from the Clinical Examination Component of the National Vietnam Veterans Readjustment Study were examined to determine the relationship of war zone stress exposure, retrospective reports of dissociation during the most disturbing combat trauma events, and general dissociative tendencies with PTSD case determination. RESULTS: The total score on the Peritraumatic Dissociation Experiences Questionnaire--Rater Version was strongly associated with level of posttraumatic stress symptoms, level of stress exposure, and general dissociative tendencies and weakly associated with general psychopathology scales from the MMPI-2. Logistic regression analyses supported the incremental value of dissociation during trauma, over and above the contributions of level of war zone stress exposure and general dissociative tendencies, in accounting for PTSD case determination. CONCLUSIONS: These results provide support for the reliability and validity of the Peritraumatic Dissociation Experiences Questionnaire--Rater Version and for a trauma-dissociation linkage hypothesis: the greater the dissociation during traumatic stress exposure, the greater the likelihood of meeting criteria for current PTSD.

Problems in families of male Vietnam veterans with posttraumatic stress disorder.

Interviews were conducted with a nationally representative sample of 1,200 male Vietnam veterans and the spouses or co-resident partners of 376 of these veterans. The veteran interview contained questions to determine the presence of posttraumatic stress disorder (PTSD) and items tapping family and marital adjustment, parenting problems, and violence. The spouse or partner (S/P) interview assessed the S/P's view of these items, as well as her view of her own mental health, drug, and alcohol problems and behavioral problems of school-aged children living at home. Compared with families of male veterans without current PTSD, families of male veterans with current PTSD showed markedly elevated levels of severe and diffuse problems in marital and family adjustment, in parenting skills, and in violent behavior. Clinical implications of these findings are discussed.

Lifetime and current prevalence of specific psychiatric disorders among Vietnam veterans and controls.

To determine if Vietnam theater veterans were more likely than controls to have a specific psychiatric disorder other than posttraumatic stress disorder, the rates of specific psychiatric disorders were estimated using the Diagnostic Interview Schedule for national samples of veterans who served in Vietnam, other veterans of the Vietnam era, and matched civilian controls. Overall, there were few differences in rates of disorder between theater and other veterans; there were somewhat more differences between theater veterans and civilians. There were striking differences, however, in rates for most disorders, both lifetime and current, between male theater veterans with high levels of exposure to war zone stress and other male veterans or civilians. Female veterans exposed to high levels of war zone stress also had higher rates than other female respondents for several disorders.

The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. I. Background and introduction.

The Special Supplemental Food Program for Women, Infants, and Children (WIC) aims to improve the nutrition and health of low-income, nutritionally at-risk pregnant women and preschool children with supplemental food, nutrition education, and coordination of health care. Started in 1972, it recently served greater than 3.4 million persons monthly and at a cost of $1.66 billion annually. The National WIC Evaluation (NWE) consisted of four studies: The historical study estimated changes in birth outcome attributable to WIC from 1972 to 1980 in 19 states and the District of Columbia from WIC program data and vital statistics. The longitudinal study of pregnant women compared dietary intake, weight gain, anthropometry, duration of gestation, birth weight, and infant length and head circumference between a representative national sample of WIC participants and economically comparable women. The cross-sectional study of preschool children related WIC to dietary intake, anthropometry, and psychological development. The food expenditures study estimated the impact of WIC on family grocery and other food expenditures.

The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. IV. Study methodology and sample characteristics in the longitudinal study of pregnant women, the study of children, and the food expenditures study.

The longitudinal study of pregnant women enrolled a national probability sample of 5,205 women first certified for WIC and 1,358 comparable low-income pregnant women in 174 WIC clinics located in 58 areas in the contiguous 48 states and in 55 prenatal clinics without WIC programs in counties with low program coverage. The women completed 24-h dietary recalls, histories of food expenditures, health care utilization, health and sociodemographic status, and anthropometric assessment. At late-pregnancy follow-up 3,967 WIC and 1043 control women were interviewed and 853 WIC and 762 control women completed 1-wk food expenditure diaries. Birth outcome was abstracted (from hospital records) for 3,863 WIC and 1058 control women. Anthropometry, dietary intake, health, and use of health services were related to WIC among 2,619 random low-income preschoolers. Psychological development was assessed in 526 children aged 4 and 5 y. Control women had higher income, education, and employment status; therefore, WIC program benefits probably were underestimated.

The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. V. Longitudinal study of pregnant women.

The major associations with the Special Supplemental Food Program for Women, Infants, and Children (WIC) in pregnancy were increased intake of protein, iron, calcium, and vitamin C (four of five targeted nutrients) and of energy, magnesium, phosphorus, thiamin, riboflavin, niacin, vitamin B-6, and vitamin B-12; reversal of low weight gain in early pregnancy; smaller fat stores in late pregnancy; reduced frequency of premature rupture of the uterine membranes; larger infant head circumference with no effect on birth weight and length; increased birth weight and head circumference with better program quality; and lower fetal mortality of appreciable but not significant magnitude. Incremental energy intake was comparable to that in most small-scale supplementation trials. There was no evidence of effects on frequency of prenatal care, use of alcohol or tobacco, the intention to breast-feed, or the rate of breast-feeding. Maternal alcohol intake was associated with depressed infant head circumference, over and above effects on birth weight and length.

The National WIC Evaluation: evaluation of the Special Supplemental Food Program for Women, Infants, and Children. VI. Study of infants and children.

The major associations with the Special Supplemental Food Program for Women, Infants, and Children (WIC) in preschool children were better dietary intake associated with current WIC participation, especially for Fe, vitamin A, and vitamin C, but there were no increases in energy intake and, after infancy, no residual benefits from past WIC participation; strongest dietary effects among children who were poor, black, or in single-parent or large families (children lost to WIC were as needy as those currently enrolled); shorter stature, suggesting effective targeting (with enrollment in utero there was no parallel deficit in head circumference, which is consistent with results for newborns); better immunization and more frequent regular source of health care but no more frequent use of preventive health services; and better vocabulary with WIC participation begun in utero; better digit memory with entry into the program after the first birthday (differences that emerged only after statistical adjustment for sociodemographic factors); and more advantageous child behavior (NS).

Personal versus telephone surveys for collecting household health data at the local level.

Personal and telephone interview surveys were conducted simultaneously during 1981 in the same area (four counties in the area of Tampa Bay, Florida) and utilizing the same interview schedule. Following completion of the surveys, validity checks were made with the medical providers reported by a subsample of respondents to each mode. The telephone survey yielded a lower response rate but cost less than half the personal interview. There was some evidence of nonresponse bias in the telephone survey, and some relatively minor differences in responses were found between the two modes, but there was no conclusive evidence that the response differences resulted from mode effects. Telephone respondents appeared to be somewhat more accurate in their reporting of visits to medical providers, although accuracy comparisons must be interpreted with caution in view of the disparate success experienced for the two modes in securing permission forms for the release of medical record information.

Aggression, deviance, and personality adaptation as antecedents and consequences of alienation and involvement in high school.

Alienation from, or involvement in, the social and educational systems of the high school are investigated in an effort to determine the extent that school experiences may influence aggressive and deviant behavior in school and personality styles or orientations. Drawing upon longitudinal data collected from 250 boys followed from grades 8 through 12, potential antecedent-consequence relationships between dimensions of alienation and involvement and these two basic types of student outcomes are examined by cross-lagged panel analyses. Differences between cross-lagged panel correlations provide evidence that student reactions and attachments to school manifest relationships with aggression, deviance, and personality, serving as both antecedents and consequences of these student adaptations. The major findings provide evidence that (1) boys who more frequently break school rules and engage in aggressive or deviant behavior may often come to have more negative attitudes toward school staff and less involvement in school; and (2) student involvement and participation in school life can influence certain aspects of adolescent personality. Possible evidence of reciprocal causation is presented and discussed, as are additional theoretical and methodological implications of the data.

Low adolescent self-esteem leads to multiple interpersonal problems: a test a social-adaptation theory.

This article reports the results of a study that annually monitored the self-esteem and interpersonal problems of over 100 boys during their sophomore, junior, and senior years of high school. Cross-lagged panel correlation differences show that low self-esteem leads to interpersonal problems in all three time lags when multiple interpersonal problems constitute the dependent variable but not when single interpersonal problem criteria constitute the dependent variable. These results are interpreted as supporting social-adaptation theory rather than self-perception theory. Implications for the conceptual status of personality variables as causal antecedents and for the assessment of individual differences are discussed.

School crime and disruption as a function of student-school fit: An empirical assessment.

A theoretical model is described which conceptualizes school crime and disruption as a function of the congruence or fit between the personal characteristics of students and the social environments of the schools they attend. In a direct empirical test of the model, indices representing 10 distinct dimensions of student-school fit are related to three composite measures of school misconduct: school crime, school avoidance, and class misbehavior. A number of significant relationships are found between dimensions of student-school fit and the three indices of school misbehavior, several of which manifest one of the nonlinear forms specified by the model, providing at least modest support for a person-environment fit theory of school crime and disruption.