Children's responses to a nuclear waste disaster: PTSD symptoms and outcome prediction.

OBJECTIVE: To examine the psychological impact of living near a nuclear waste disaster that involved ongoing threat of radioactive contamination. METHOD: Participants were an exposed sample (residence within a 5-mile radius of the nuclear plant) of 120 children (7-15 years old) and their parents and a nonexposed comparison sample of 60 children and their parents. Parent and self-ratings of the children's psychological functioning and posttraumatic stress disorder (PTSD) symptoms were obtained, along with cognitive variables. RESULTS: Minimal differences between the 2 samples were found. In the exposed sample, stress responses for the child self-reports showed several age group by gender interactions. Girls' PTSD symptoms tended to increase with age while boys' symptoms decreased, with intrusion showing the strongest effects. While child and parent PTSD symptom ratings were correlated, children reported approximately twice as many symptoms. Cognitive understanding increased with age and was greater in boys. Exposure and parent functioning significantly predicted outcome. CONCLUSIONS: Age and gender effects after disaster might best be explored as an interaction. While disaster effects were mild, the psychological health of the parents may be an important determinant of psychological health in children in this type of disaster.

Children of disaster in the second decade: a 17-year follow-up of Buffalo Creek survivors.

OBJECTIVE: To conduct a long-term follow-up of child survivors of a devastating human-caused disaster. METHOD: Child survivors (2-15) of the Buffalo Creek dam collapse, first evaluated in 1974, 2 years postdisaster, were reevaluated 17 years postdisaster when they were adults. Of the original 207 children, 99 were located and reevaluated using ratings on the Psychiatric Evaluation Form, the Impact of Event Scale, and the SCL-90 and lifetime and current diagnoses from the Structured Clinical Interview for DSM-III-R. RESULTS: Ratings of psychiatric symptoms at the two points in time showed significant decreases in overall severity ratings and in anxiety, belligerence, somatic concerns, and agitation. A few symptoms, not present in the child sample, increased over time (substance abuse, suicidal ideation). The current rate of disaster-related post-traumatic stress disorder (PTSD) was 7%, down from a postflood rate of 32%. There were no differences by age group in current psychological status; however, women evidenced more PTSD-related symptoms than did men. All current PTSD cases were women. Comparisons with similar subjects from a nonexposed community showed no differences. CONCLUSIONS: The findings indicated that the children studied, although having shown earlier effects, had "recovered" from the event by the time of long-term follow-up.

Children and disaster: age, gender, and parental effects on PTSD symptoms.

Psychiatric reports of 179 children aged 2 to 15 who were exposed to the Buffalo Creek dam collapse in 1972 were rated for post-traumatic stress disorder (PTSD) symptoms 2 years after the disaster. Age and gender effects and the impact of the level of exposure and parental functioning were examined according to a conceptual model addressing factors contributing to adaptation to a traumatic event. Results showed fewer PTSD symptoms in the youngest age group and higher symptom levels for girls than boys. Approximately 37% of the children were given a "probable" diagnosis of PTSD. Multiple regression analysis showed that life threat, gender, parental psychopathology, and an irritable and/or depressed family atmosphere all contributed to the prediction of PTSD symptomatology in the children.

Risk factors for PTSD and other diagnoses in a general sample of Vietnam veterans.

This study examined the contribution of premilitary, military, and postmilitary risk factors to posttraumatic stress disorder (PTSD) and other postwar diagnoses in a sample of Vietnam veterans. PTSD was explained primarily by war stressors, including threat to life and exposure to grotesque death, but premilitary and postmilitary factors also contributed to the likelihood of a current diagnosis of PTSD. Panic disorder was also highly predicted by war experiences, whereas prewar functioning played a stronger role in several non-PTSD diagnoses. The study supported the notion that PTSD is specifically linked to intense stressors. Mechanisms for interactions among risk factors are discussed.

Buffalo Creek survivors in the second decade: stability of stress symptoms.

A follow-up study of 120 adult survivors of the Buffalo Creek dam collapse of 1972 showed group changes 14 years after the event. Decreased symptoms were noted in all areas, although significant psychopathology remained in about one-quarter of the survivors. A small group with delayed onset of symptoms was identified.

Multiple diagnosis in posttraumatic stress disorder. The role of war stressors.

Prior studies have shown that posttraumatic stress disorder (PTSD) in Vietnam veterans is associated with various aspects of war stressors and that other diagnoses often co-occur with PTSD in this population. The present report examines the prediction of other diagnoses, in combination with PTSD, from a variety of war stressor experiences in a broad sample of veterans recruited from clinical and nonclinical sources. The results show that PTSD with panic disorder is better explained by war stressors than other diagnostic combinations and that high-risk assignments and exposure to grotesque deaths were more salient than other stressor experiences in accounting for different diagnostic combinations. Implications of the findings for PTSD's placement in the DSM-III-R and for psychological and pharmacological treatments were discussed.

Parents view their adolescents' mental health.

A 40-item behavioral checklist was devised for use with adolescent patient and nonpatient samples. A comparable form is used to obtain information about the offspring from the parent or guardian. This report presents the responses of parents and compares them with those of their offspring in two samples. Parents of disturbed adolescents reported a significantly greater frequency of emotional-behavioral problems in their offspring than did parents of a medical sample, whereas the two samples of adolescents reported equivalent frequency of problems. Parental responses to items were clustered into six subscales. Effects of race and sex of the adolescent on subscale scores were investigated. Black parents in both samples reported fewer and less frequent problems than did white parents; in contrast, the black teenagers' reports were similar to the white except for the Affective Distress subscale. Parents and adolescents in both samples reported higher scores for girls than boys on this subscale.

Social alienation-personal disorganization assessment in disturbed and normal adolescents.

Two groups of adolescents seeking psychotherapy (N = 91 and N = 198) and a normative group (N = 112) provided 5-minute verbal behavior protocols which were content analyzed for social alienation-personal disorganization (SA-PD). The data supported the hypothesis that adolescents applying for help in 1974 to 1975 showed greater pathology than those seen in 1972 to 1973. The normative adolescents were significantly healthier than either of the two Adolescent Clinic groups. In the clinic samples, older adolescents were more disturbed than those in the younger ranges. The SA-PD scale is a useful addition to tools available for the assessment of emotional states of adolescents. The data support the idea that there appears to be an increasing severity in the problems presented by adolescents in very recent years.

Corrigenda to "estimation of stature from long limb bones of American Whites and Negroes," American Journal Physical Anthropology (1952).

The amount of disparity between the lengths of the radii and ulnae of 177 Negro female skeletons of the Terry Collection was questioned. An error was found and corrections have been made in the relevant statistics and tables.

Assessing assertion in the elderly: an application of the behavioral-analytic model of competence.

This study developed a behavioral measure of assertiveness for older adults. The behavioral assessment device was developed by use of procedures outlined by Goldfried and D'Zurilla (1969) and Price and Bouffard (1974). Four assertion-appropriate situations for older adults were developed. The situations were administered to 33 Ss. Their responses were scored two ways, for overall assertion and content assertion. Generalizability of the device was examined. Reliability of judges' ratings (for assertion and content) was high, as was test-retest reliability. Assertion was shown to be situation-specific since estimated individual by situation uninerse variance was relatively hight. The assessment device showed significant concurrent validity, although the evidence for construct validity was minimal. Despite the rigorousness of the methods involved, the behavioral-analytic model of competence (Goldfried & D'Zurilla, 1969) has both theoretical and practical advantages in constructing other assessment devices for the elderly.

Impact of psychosocial factors on the conduct of combined drug and psychotherapy research.

The effect of attitudes of therapists, patients and researchers on the conduct and outcome of combined drug and psychotherapy research was examined in a brief crisis-oriented psychotherapy clinic. Seventy-seven consecutive patients were given one of two anti-anxiety drugs or a placebo in conjunction with the typical psychoanalytically-oriented treatment used in the clinic. The therapists' attitudes favouring psychotherapy over drug therapy (and psychotherapy research) were clearly conveyed to the patients. Indicative of this are the following: (a) 82 per cent of the patients dropped out of drug taking, although a similar percentage remained in treatment; (b) only a third of the patients perceived it as being important to their therapists that they should take medication; (c) 87 per cent of the patients were rated as improved; and 75 per cent of patients completing forms considered that most or all of their improvement was attributable to talking. The research team, made up of members of the same department who therefore had similar values as the therapists, diligently collected outcome data, but ignored its responsibility to enforce drug-relation portions of the protocol. Overall, patients remained in therapy, improved and participated in completing forms, so that only the research goals of combined therapy were thwarted, while traditional clinic service and training goals proceeded as usual.