-
[show abstract]
[hide abstract]
ABSTRACT: We examined possible gender differences in psychological distress in a sample of treatment-seeking Irritable Bowel Syndrome (IBS) patients.
A total of 341 IBS patients (238 females, 83 males) were studied. Structured psychiatric interviews were available on 250 participants.
We found significantly higher scores for females than males on the Beck Depression Inventory (BDI), Trait Anxiety of the State-Trait Anxiety Inventory (STAI), and Scales 2 and 3 of the MMPI. However, there were no differences in the percentages of the two samples meeting criteria for one or more Axis I psychiatric disorders, with 65.6% of the total sample meeting these criteria.
Gender differences in psychological distress appear to be a function of method of measurement.
Journal of Psychosomatic Research 06/2001; 50(5):271-5. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In light of Delahanty et al.'s (1997) identification of attribution of responsibility for a motor vehicle accident (MVA) as a powerful determinant of initial level of distress from the trauma and of early remission of PTSD, we reexamined data from Blanchard and Hickling's (1997) prospective follow-up of 158 MVA survivors. Despite differences between the two samples (Delahanty sample recruited from hospitals 2-3 weeks post-MVA and predominantly male; our sample recruited from outpatient care 1-4 months post-MVA and predominantly female) we replicated Delahanty's findings: those with PTSD who blame themselves for the MVA are less symptomatic initially and recover more rapidly in the first 6 months than those with PTSD who blame another party for the accident.
Journal of Traumatic Stress 05/1999; 12(2):345-53. · 2.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: In order to investigate the effects of the initiation of litigation and its settlement on victims of motor vehicle accidents (MVAs), we followed up 132 MVA victims from an initial assessment 1 to 4 months post-MVA for 1 year. Of the 67 who had initiated litigation, 18 (27%) settled within the 12 months, while 49 still had litigation pending; 65 never initiated litigation. Those who initiated litigation had more severe injuries and higher initial levels of posttraumatic stress (PTS) symptoms. All three groups improved in major role function and had reduced PTS symptoms over the 1 year follow-up. Those whose suits were still pending, as well as those whose suits had been settled, showed no reduction in measures of anxiety or depression, whereas the nonlitigants did show improvement on these measures.
Journal of Traumatic Stress 05/1998; 11(2):337-54. · 2.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: One hundred forty five individuals who sought medical attention as a result of a motor vehicle accident (MVA), and who were initially assessed 1 to 4 months post-MVA, were followed up prospectively for 6 months to determine how many of the 55 with posttraumatic stress disorder (PTSD) and the 43 with sub-syndromal PTSD would remit and what variables would predict remission. Thirty (55%) of those with initial PTSD had remitted at least in part by 6 months while 67% of those with sub-syndromal PTSD had remitted (and 5% had worsened). Four variables, including severity of initial symptoms, degree of initial physical injury, relative degree of physical recovery by 4 months and whether a close family member suffered a trauma during the follow-up interval, combined to classify 6-month clinical status of 84% of those with initial PTSD secondary to MVAs.
Journal of Traumatic Stress 05/1997; 10(2):215-34. · 2.72 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: One-hundred and thirty-two victims of motor vehicle accidents (MVAs), who sought medical attention as a result of the MVA, were assessed at three points in time: 1-4 months post-MVA, 6 months later, and 12 months later. Of the 48 who met the full criteria for Post-Traumatic Stress Disorder (PTSD) initially, half had remitted at least in part by the 6-month follow-up point and two-thirds had remitted by the 1-yr follow-up. Using logistic regression, 3 variables combined to correctly identify 79% of remitters and non-remitters at the 12-month follow-up point: initial scores on the irritability and foreshortened future symptoms of PTSD and the initial degree of vulnerability the subject felt in a motor vehicle after the MVA. Four variables combined to predict 64% of the variance in the degree of post-traumatic stress symptoms at 12 months: presence of alcohol abuse and/or an Axis-II disorder at the time of the initial assessment as well as the total scores on the hyperarousal and on avoidance symptoms of PTSD present at the initial post-MVA assessment.
Behaviour Research and Therapy 11/1996; 34(10):775-86. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Psychophysiological assessment data, including heart rate (HR), blood pressure, and frontal electromyogram (EMG) responses to mental arithmetic, idiosyncratic audiotape descriptions of motor vehicle accidents (MVAs), and a standard videotape of MVAs, were collected on 105 injured victims of recent MVAs and 54 non-MVA controls. Their data replicated data from an earlier report (Blanchard et al., 1994) and support the utility of HR response to the audiotaped description of the MVA as useful in distinguishing MVA victims with PTSD from those with subsyndromal PTSD and non-PTSD. At a 1-year follow-up, the psychophysiological assessment was repeated on 125 MVA victims; results showed a general diminution of psychophysiological responding. Initial psychophysiological assessment results predicted 1-year follow-up clinical status (continued PTSD or full or partial remission) for 37 or 48 individuals who initially met criteria for PTSD.
Journal of Consulting and Clinical Psychology 09/1996; 64(4):742-51. · 4.85 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Within 1 to 4 months of their motor vehicle accident (MVA), we assessed 158 MVA victims who sought medical attention as a result of the MVA. Using the Clinician-Administered PTSD Scale (CAPS: Blake, Weathers, Nagy, Kaloupek, Klauminzer, Charney & Keane, 1990. National Center for Post-Traumatic Stress Disorder, Boston, MA)., we found that 62 (39%) met DSM-III-R (American Psychiatric Association, 1987. Washington, DC: American Psychiatric Press) criteria for Post-Traumatic Stress Disorder. Using variables from the victim's account of the accident and its sequelae, pre-MVA psychosocial functioning, demographic variables, pre-MVA psychopathology and degree of physical injury, we found that 70% of the subjects could be classified as PTSD or not with 4 variables: prior major depression, fear of dying in the MVA, extent of physical injury and whether litigation had been initiated. Using multiple regression to predict the continuous variable of total CAPS score, as a measure of post-traumatic stress symptoms, we found that 8 variables combined to predict 38.1% of variance (Multiple R = 0.617).
Behaviour Research and Therapy 01/1996; 34(1):1-10. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: The primary purpose of this report was to determine the extent of psychiatric morbidity and comorbidity among a sample of recent victims of motor vehicle accidents (MVAs) in comparison to a nonaccident control population. Victims of recent MVAs (N = 158), who sought medical attention as a result of the MVA, were assessed in a University-based research clinic, 1 to 4 months after the accident for acute psychiatric and psychosocial consequences as well as for pre-MVA psychopathology using structured clinical interviews (Clinician-Administered PTSD Scale, SCID, SCID-II, LIFE Base). Age- and gender-matched controls (N = 93) who had had no MVAs in the past year served as controls. Sixty-two MVA victims (39.2%) met DSM-III-R criteria for posttraumatic stress disorder (PTSD), and 55 met DSM-IV criteria. The MVA victims who met the criteria for PTSD were more subjectively distressed and had more impairment in role function (performance at work/school/homemaking, relationships with family or friends) than the MVA victims who did not meet the PTSD criteria or the controls. A high percentage (53%) of the MVA-PTSD group also met the criteria for current major depression, with most of that developing after the MVA. A prior history of major depression appears to be a risk factor for developing PTSD after an MVA (p = .0004): 50% of MVA victims who developed PTSD had a history of previous major depression, as compared with 23% of those with a less severe reaction to the MVA. A prior history of PTSD from earlier trauma also is associated with developing PTSD or a subsyndromal form of it (25.2%) (p = .0012). Personal injury MVAs exact substantial psychosocial costs on the victims. Early intervention, especially in vulnerable populations, might prevent some of this.
Journal of Nervous & Mental Disease 09/1995; 183(8):495-504. · 1.68 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: For 98 victims of recent (1 to 4 months post-accident) motor vehicle accidents who sought medical attention as a result of the accident, we obtained data on the extent of physical injury using blind ratings with the Abbreviated Injury Scale (AIS), as well as victims reports of their perceptions of how much danger they perceived at the time of the accident and the degree of life threat (fear of dying) they perceived. AIS scores significantly predicted (P < 0.01) development of post-traumatic stress disorder (PTSD) (r point biserial = 0.302) and development of post-traumatic stress symptoms (PTSS) (r = 0.311) as did perception of life threat (r point biserial = 0.294 for PTSD and r = 0.229 for PTSS). A multiple regression equation combining AIS and life threat accounted for 12.2% of variance in PTSS scores.
Behaviour Research and Therapy 07/1995; 33(5):529-34. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We examined the effects of varying the scoring rules for the CAPS (Clinician Administered PTSD Scale) on the diagnosis of PTSD in a sample of 100 victims of recent motor vehicle accidents. This was done by assessing, for each scoring rule, the rate of categorical diagnosis and the effect on group mean scores on measures of subjective distress and role impairment. Changing from the most liberal to the most conservative scoring rule results in a change in diagnosis of PTSD from 44% to 29% of the sample. Comparisons of those included as PTSD under the most conservative scoring criteria vs those excluded (who had previously been included) reveal significantly greater subjective distress and role impairment among those who continue to be included in the PTSD category. Thus, changes in scoring rules have clinically significant effects on the incidence and severity of diagnosed PTSD. This indicates that the selection of scoring rules has important implications for epidemiological estimates of the prevalence of PTSD, and that PTSD studies using different scoring rules as inclusion criteria may be using somewhat different samples.
Behaviour Research and Therapy 06/1995; 33(4):471-5. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Fifty victims of recent motor vehicle accidents (MVAs), who had sought medical attention after their accidents, were assessed for possible psychological morbidity as a result of the accident. Forty age, gender-matched controls were also assessed with the same instruments. Forty-six percent of the MVA victims met the criteria for current post-traumatic stress disorders (PTSD) as a result of the accident while 20% showed a sub-syndromal version (the reexperiencing symptom cluster plus either the avoidance/numbing cluster or the over-arousal cluster) of PTSD. Although all MVA victims showed some form of driving reluctance, only 1 S met the criteria for driving phobia. Those MVA victims who met the criteria for PTSD or sub-syndromal PTSD were significantly more likely to have experienced previous trauma, other than a serious MVA, and were more likely (P = 0.008) to have previously met the criteria for PTSD as a result of that trauma. Forty-eight percent of MVA victims who met the criteria for current PTSD also met the criteria for current major depression. Significantly more current MVA-PTSDs had suffered previous major depressive episodes.
Behaviour Research and Therapy 04/1994; 32(3):283-90. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: Heart rate, BP, and electrodermal responses of four individuals with PTSD secondary to motor vehicle accidents (MVAs) were measured while they imagined two separate scenes related to their MVA. Results showed reliable HR responses to these images. In addition, SBP and DBP also showed some responsivity to the images while skin resistance level changed reliably in only 2 of 4 subjects. Psychophysiological measurement could play a role in the assessment and treatment of MVA-related PTSD.
Biofeedback and Self-Regulation 01/1992; 16(4):449-58.
-
[show abstract]
[hide abstract]
ABSTRACT: Nineteen of 27 patients suffering from Irritable Bowel Syndrome (IBS) who had completed a multicomponent treatment involving progressive muscle relaxation, thermal biofeedback, cognitive therapy and IBS education were located and evaluated 4 yr posttreatment. Seventeen of 19 (89.5, or 63% of the total original sample) rated themselves as more than 50% improved. Six of the 12 patients (50%) who submitted symptom monitoring diaries met our criteria for clinical improvement, i.e. achieving at least a 50% reduction in primary IBS symptom scores. The means on all measures at long-term follow-up were lower than those obtained prior to treatment. When follow-up symptom means were compared with pretreatment means, significant (P less than 0.05) reductions were obtained on abdominal pain/tenderness, diarrhea, nausea, and flatulence.
Behaviour Research and Therapy 02/1990; 28(4):331-5. · 3.30 Impact Factor
-
[show abstract]
[hide abstract]
ABSTRACT: We have examined data from 107 motor-vehicle accident (MVA) victims with regard to whether the presence of comorbid depression is important clinically, and with regard to whether the threshold for diagnosing the comorbid depression should be raised because of symptom overlap between posttraumatic stress disorder (PTSD) and major depression. Of the 62 MVA victims who met the criteria for PTSD 1 to 4 months post-MVA, 33 also met the criteria for major depression, with 27 cases for which the depression occurred post-MVA. A LISREL 8.12a analysis indicates that PTSD and major depression are correlated, but independent, responses to trauma. Those with PTSD and depression are more subjectively distressed, suffer more major role impairment, and remit less readily over the first 6 months of prospective follow-up than those with PTSD alone. The threshold for diagnosing comorbid depression (5 or 6 depressive symptoms versus 7 to 9 depressive symptoms) has no important effects on any of the indicators of "caseness."
Journal of Anxiety Disorders 12(1):21-37. · 2.96 Impact Factor
