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ABSTRACT: To determine whether having received a Purple Heart (PH) or having been diagnosed with posttraumatic stress disorder (PTSD) affected mortality in older veterans.
We compared mortality rates of older veterans with a PH but without PTSD (PH+/PTSD-) to veterans with a PH and PTSD (PH+/PTSD+), veterans without a PH but with PTSD (PH-/PTSD+), and a comparison group without a PH or PTSD (PH-/PTSD-). Administrative data from the Veterans Integrated Service Network 16 were collected between 10/01/97 and 09/30/99 for veterans who were 65 years or older. Proportional hazards regression was used to compare the survival times for the four groups (n = 10,255) from entry into the study until death or study termination (9/30/2008). The Charleson co-morbidity index was used to control for potential co-morbid illness burden differences between the groups.
Older veterans with a PH (PH+/PTSD- and PH+/PTSD+) had significantly lower mortality rates than PH-/PTSD- veterans (hazard ratio [HR] = 0.6, 95% confidence interval [CI] 0.5 to 0.6, P<.0001; and HR = 0.5, 95% CI 0.4 to 0.7, P<.0001). The PH-/PTSD+ group had a higher mortality rate than the PH-/PTSD- group (HR = 1.1, 95% CI 1.0 to 1.2, P<.01).
Veterans who had PH citations and survived into their seventh decade had half the mortality rate of veterans without PH citations with or without PTSD. Veterans with PTSD but without a PH had a significantly higher mortality rate compared to (PH-/PTSD-). Veterans who suffer combat injury without developing PTSD may provide a useful study population for determining the factors that confer resilience.
Depression and Anxiety 07/2011; 28(12):1086-90. · 4.18 Impact Factor
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ABSTRACT: Posttraumatic stress disorder (PTSD) is one of the few psychiatric conditions in which a subjective decrease in emotional range serves as a diagnostic criterion. In order to investigate whether veterans with chronic PTSD also experienced objective limitations in emotional perception, the authors administered the Aprosodia Battery to a group of 11 veterans with chronic PTSD, nine subjects with right hemisphere damage, seven subjects with left hemisphere damage, and 12 comparison subjects. The patients with PTSD displayed significant deficiencies in the comprehension and discriminative components of affective speech, similar in severity and performance profile on the Aprosodia Battery to the individuals with focal right hemisphere damage due to ischemic infarction.
The Journal of neuropsychiatry and clinical neurosciences 02/2009; 21(1):52-8. · 2.34 Impact Factor
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ABSTRACT: Veteran subjects with chronic, combat-related posttraumatic stress disorder (PTSD) are frequently used as research subjects in the study of PTSD. However, questions have consistently been raised regarding PTSD symptom exaggeration in veteran populations due to the relationship between PTSD symptoms and disability payments within the Veterans Affairs (VA) system. We used a variety of standardized forensic instruments frequently utilized in measuring symptom exaggeration - including the MMPI-2, the Structured Interview for Reported Symptoms (SIRS), the Structured Inventory of Malingered Symptomatology (SIMS), and the Miller Forensic Assessment Test (MFAST) - to examine symptom report in a group of veterans presenting for treatment at a VA residential PTSD treatment program. The majority of Vietnam veteran subjects in our study (53%) exhibited clear symptom exaggeration by SIRS criteria. Within the entire subject group, total SIRS scores correlated significantly with reported PTSD symptom severity as measured by the Clinician Administered PTSD Scale (CAPS).
Psychiatry Research 05/2008; 158(3):374-80. · 2.52 Impact Factor
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ABSTRACT: In this study, single voxel proton magnetic resonance spectroscopic imaging ((1)H-MRS) and volumetric analysis of hippocampal magnetic resonance imaging (MRI) images were used to determine if any differences in hippocampal biochemistry or volume were present between former prisoners of war (POWs) with and without posttraumatic stress disorder (PTSD) and control subjects matched for age and education. This study did not find lower hippocampal concentrations of N-acetylaspartate (NAA), smaller hippocampal volumes, or more impaired memory function in older veterans with PTSD compared with a group matched for traumatic experience or a nontraumatized control group.
Psychiatry Research 02/2006; 146(1):59-64. · 2.52 Impact Factor
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ABSTRACT: Veterans diagnosed with combat-related posttraumatic stress disorder (PTSD) and comparison subjects underwent single voxel proton magnetic resonance spectroscopy (1H-MRS) of the medial temporal lobe (MTL). PTSD subjects were divided into combat and non-combat groups based on military records. Combat PTSD subjects did not have lower MTL levels of N-acetylaspartate compared with non-combat PTSD subjects.
Psychiatry Research 11/2005; 140(1):91-4. · 2.52 Impact Factor
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ABSTRACT: Previous studies have reported associations between apolipoprotein E (APOE) genotype, cognitive function, and psychopathology in psychiatric populations. The authors investigated the associations between APOE allele status, memory function, and posttraumatic stress disorder (PTSD) symptom severity in PTSD subjects. Presence of the APOE 2 allele was associated with significantly worse reexperiencing symptoms and impaired memory function in this population.
Journal of Neuropsychiatry 02/2005; 17(4):541-3. · 2.51 Impact Factor
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ABSTRACT: To examine the relationship of alcohol craving to symptoms of posttraumatic stress disorder (PTSD), 129 male veterans with chronic PTSD were asked to complete the Obsessive Compulsive Drinking Scale (OCDS), the Mississippi Scale for combat-related PTSD symptoms, and other instruments to assess general psychopathology and lifetime alcohol and substance use. No correlations were found between current PTSD symptoms and alcohol craving, although significant correlations were found between the OCDS and measures of lifetime alcohol and substance use.
Journal of Nervous & Mental Disease 06/2004; 192(5):389-90. · 1.68 Impact Factor
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ABSTRACT: An important risk factor for suicide is psychiatric illness, but only a limited amount of work has been directed at assessing the use of firearms and other weapons by select psychiatric populations at high risk for violent acts.
Patients with combat-related posttraumatic stress disorder (PTSD), patients with schizophrenia, and patients undergoing rehabilitation for substance abuse were asked to complete a weapons-use survey and measures of psychopathology.
The PTSD patients surveyed related owning more than four times as many firearms as other subjects and reported significantly higher levels of potentially dangerous firearm-related behaviors than the other psychiatric subjects surveyed.
High levels of aggression, impulsive and dangerous weapon use, and ready weapon availability may be significant factors in gun-related violence in the PTSD patient population. Additional prospective research is needed to determine whether gun ownership or certain types of weapon use in this population is associated with future acts of violence.
Southern Medical Journal 04/2003; 96(3):240-3. · 0.83 Impact Factor
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ABSTRACT: Proton magnetic resonance spectroscopy was used to compare medial temporal lobe (MTL) concentrations of N-acetylaspartate and choline between former prisoners of war (POWs) with and without posttraumatic stress disorder (PTSD). MTL N-acetylaspartate and reexperiencing symptoms correlated strongly in the POW subjects with PTSD, suggesting a relationship between reexperiencing symptoms and the integrity of MTL structures.
Journal of Neuropsychiatry 02/2003; 15(3):367-70. · 2.51 Impact Factor
