Interaction Between Psychiatric Symptoms and History of Mild TBI When Evaluating Postconcussion Syndrome in Veterans.

INTRODUCTION: Symptoms of postconcussive syndrome (PCS) after mild TBI (mTBI) have been shown to resolve quickly, yet new research raises questions about possible long-term effects of this condition. It is not clear how best to address assessment and treatment when someone reports lingering symptoms of PCS. One self-report measure used by the VA and the DoD is the Neurobehavioral Symptom Inventory (NSI), but this measure may be affected by underlying psychiatric symptoms. We investigated whether the NSI is sensitive to mTBI after considering a number of psychiatric and demographic factors. METHODS: This study examined which factors are associated with NSI scores in a Veteran sample (n = 741) that had recently returned from deployment. RESULTS: Post-traumatic stress disorder (PTSD) and depression accounted for most of the variance on the NSI. Although history of mTBI was initially related to NSI, this association was no longer significant after other covariates were considered. CONCLUSIONS: The NSI score was primarily explained by symptoms of PTSD and depression, suggesting that the NSI is not specific to the experience of a brain injury. We recommend cautious interpretation when this measure is used in the chronic phase after mTBI, especially among patients with comorbid depression or PTSD.

Not supposed to feel this: traditional masculinity in psychotherapy with male veterans returning from Afghanistan and Iraq.

Traditional masculine socialization presents challenges in psychotherapy, for example, by decreasing the likelihood of help-seeking and by making emotion-laden content more difficult to address. While this has been established in civilian populations, more intense forms of masculine socialization found in military settings may amplify such issues in male veteran populations. Male veterans returning from and Afghanistan (OEF) and Iraq (OIF) exhibit strong traditional masculine socialization and generally present in a unique manner. It is posited that OEF/OIF male veterans' unique presentation is in large part because of an interaction between high degrees of endorsement of traditional masculine gender role norms, relative youth, recency of distressing events, and recent experience in the social context of the military where traditional masculinity is reinforced. The impact of these variables on the psychotherapeutic process for male OEF/OIF veterans is significant and likely adds to ambivalence about change and increases dropout from psychotherapy. Modifications of traditional psychotherapeutic approaches designed to address traditional masculine gender role norms and their many interactions with other variables are discussed.

Enhanced post-learning memory consolidation is influenced by arousal predisposition and emotion regulation but not by stimulus valence or arousal.

Emotionally arousing stimuli are more memorable than neutral ones and arousal induced after learning enhances later retrieval. However, there is as yet little study of how stimulus qualities might interact with induced arousal and how individual differences might influence the modulation of memory. Thus, the present study examined the effect of arousal induced after learning on memory for words that varied in both arousal and valence quality, as well as the influence of three individual differences factors that are known to influence arousal response: emotional suppression, emotional reappraisal, and arousal predisposition. Seventy-six adults (57 female) viewed and rated 60 words that normatively ranged from high to low in arousal and valence. Ten minutes later, they viewed a 3-min comedic or neutral video clip. Arousal induced after learning enhanced 1-week delayed memory, spanning the lengthy task without preference for word type or serial position, contrasting with reports of arousal effects interacting with stimulus qualities. Importantly, being predisposed to arousal led to greater enhancement of long-term memory modulation, while the use of emotional reappraisal, which reduces arousal responding, inhibited the ability of arousal to induce memory enhancement. Thus, individual differences that influence arousal responding can contribute to or interfere with memory modulation.

Illness by suggestion: expectancy, modeling, and gender in the production of psychosomatic symptoms.

BACKGROUND: Expectancy and modeling have been cited as factors in mass psychogenic illness (MPI), which reportedly affects more women than men. PURPOSE: The purpose of the study is to assess the effects of expectancy and modeling in a controlled laboratory analogue of MPI. METHODS: Students were randomly assigned to inhale or not inhale an inert placebo described as a suspected environmental toxin that had been linked to four symptoms typical of reported instances of MPI. Half of the students observed a female confederate inhale the substance and subsequently display the specified symptoms. RESULTS: Students who inhaled the placebo reported greater increases in symptoms, and the increase was significantly greater for the specified symptoms than for other symptoms. Observation of the confederate displaying symptoms increased specified symptoms significantly among women but not among men. Changes in reported symptoms were significantly associated with changes in unobtrusively observed behavior. CONCLUSIONS: Symptoms typical of clinical reports of MPI can be induced by manipulating response expectancies, and the effects are specific rather than generalized. Among women, this effect is enhanced by observing another participant (who in this study is also female) display symptoms. This suggests that the preponderance of women showing symptoms in outbreaks of MPI may be due to gender-linked differences in the effects of modeling on psychogenic symptoms.

Patterns of cohesion in the families of offspring of addicted parents: examining a nonclinical sample of college students.

This study was designed to examine patterns of family functioning among college students who are offspring of addicted parents. 218 undergraduate psychology students were administered a series of measures assessing family functioning, dissociation, parental addiction, and a history of child abuse. As predicted, offspring of addicted parents reported significantly lower Cohesion in their families of origin (F1,161 = 10.16, p =.002), and described significantly greater dissatisfaction with the cohesion they experienced in their families of origin, when compared to their college peers (F1,135 = 10.24, p= .002). However, these groups reported comparable Adaptability in their families of origin (F1,161 = 1.74, ns). These data show that, although offspring of addicted parents college students appear to share commonalities with their student peers in terms of the adaptability in their families of origin, they still share some key characteristics with clinical populations of offspring of addicted parents, which distinguish them as a group.