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Trauma and post-traumatic stress symptoms in former German child soldiers of World War II.

Int Psychogeriatr. 2008 Oct;20(5):1014-8

Authors: Kuwert P, Spitzer C, Rosenthal J, Freyberger HJ

BACKGROUND: The aim of the study was to determine the amount of trauma impact and significant post-traumatic stress symptoms, which can indicate a possible post-traumatic stress disorder (PTSD), in a sample of former German child soldiers of World War II. METHODS: 103 participants were recruited through the press, then administered a modified Post-traumatic Diagnostic Scale (PDS). RESULTS: Subjects reported a high degree of trauma exposure, with 4.9% reporting significant post-traumatic stress symptoms after WW II, and 1.9% reporting that these symptoms persist to the present. CONCLUSION: In line with other studies on child soldiers in actual conflict settings, our data document a high degree of trauma exposure during war. Surprisingly, the prevalence of significant post-traumatic stress symptoms indicating a possible PTSD was low compared to other groups of aging, long-term survivors of war trauma. Despite some limitations our data highlight the need for further studies to identify resilience and coping factors in traumatized child soldiers.

PMID: 18341750 [PubMed - indexed for MEDLINE]

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An examination of the impact of “the Maudsley eating disorder collaborative care skills workshops” on the well being of carers: a pilot study.

Soc Psychiatry Psychiatr Epidemiol. 2008 Jul;43(7):584-91

Authors: Sepulveda AR, Lopez C, Todd G, Whitaker W, Treasure J

BACKGROUND: Carers of people with eating disorders experience high levels of distress due to the difficulties in their care giving role and their perceived lack of resources to help their relative. This paper describes an intervention where some of the skills used by specialist nurses and other staff from an eating disorder intensive care setting are taught to carers to improve their sense of competency and alleviate their distress. The aim of this study was to examine the feasibility and acceptability of “the Maudsley eating disorder collaborative care skills workshops” programme among care givers and whether the difficulties and distress involved in caring for a person with an eating disorder were reduced. METHODS: Thirty-five carers from 30 families were invited to participate in this programme, which consisted of a total of six workshops, delivered in 2-h sessions over 3 months. Assessments were undertaken at baseline (T0), at the end of the workshops (T1) and 3 months later (T2). RESULTS: The level of carer distress (GHQ) fell significantly after the intervention. The level of general care giving burden (ECI) also reduced as did the specific difficulties caused by eating disorder symptoms (EDSIS). These changes were maintained over time (T2). CONCLUSIONS: The transfer of specialist skills within the programme was highly valued by the carers and lessened their stress and care giving difficulties.

PMID: 18360732 [PubMed - indexed for MEDLINE]

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[Psychological assistance to medical students: 21 years of experience]

Rev Assoc Med Bras. 2008 Jan-Feb;54(1):90-4

Authors: Millan LR, Arruda PC

The purpose of this article is to report on the 21-year experience of the Group of Psychological Assistance to Students at the School of Medicine of the São Paulo University (GRAPAL). First, the authors briefly introduce historical aspects of the psychological assistance provided to medical students, followed by the organization of GRAPAL in 1983 and the beginning of activities in 1986. Major reasons for medical students to seek psychological assistance, obstacles found by the institution, the work team and students are presented. Then, several works published by the Service, which approach the personality traits of medical students, their choice for Medicine and the suicide problem, are listed. Finally, the authors present some suggestions made by students to improve assistance services and measures to be taken by the GRAPAL team to carry out such suggestions.

PMID: 18392493 [PubMed - indexed for MEDLINE]

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Delusions and hallucinations in students compared to the general population.

Psychol Psychother. 2008 Sep;81(Pt 3):231-5

Authors: Lincoln TM, Keller E

The Peters Delusions Inventory and the Launay-Slade Hallucination Scale were used to assess psychotic experiences in the population (N=359) and in students (N=78). Students revealed more delusional beliefs and more distress and preoccupation associated with beliefs than persons from the general population. The differences disappeared when samples were matched for age.

PMID: 18426692 [PubMed - indexed for MEDLINE]

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Hasty decision-making in a variety of tasks: does it contribute to the development of delusions?

Psychol Psychother. 2008 Sep;81(Pt 3):237-45

Authors: Ziegler M, Rief W, Werner SM, Mehl S, Lincoln TM

OBJECTIVES: The finding that persons with delusions tend to jump-to-conclusions ( JTC) in the beads task has often been replicated. This study investigates whether hasty decision-making in the beads task is associated with hasty decisions in tasks with more relevance for everyday decision-making. Furthermore, it is hypothesized that hasty decisions in these tasks will be associated with subclinical delusional beliefs. DESIGN: A correlational study. METHODS: A sample of students (N=85) completed the beads task and three additional non-probabilistic decision-tasks. Subclinical delusional beliefs were assessed using the Peters et al. delusions inventory (PDI; Peters, Joseph, & Garety, 1999). RESULTS: In support of the hypothesis, participants with hasty decisions in the beads task also made hasty decisions in two of the other tasks. Hasty decisions were only associated with higher subclinical delusional beliefs in one of the tasks (a letter recognition task). CONCLUSIONS: Decision-making in the beads task can be generalized to decisions in other contexts. Other decision-making tasks may be more closely related to delusions than the beads task.

PMID: 18426693 [PubMed - indexed for MEDLINE]

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Hypnosis for smoking cessation: a randomized trial.

Nicotine Tob Res. 2008 May;10(5):811-8

Authors: Carmody TP, Duncan C, Simon JA, Solkowitz S, Huggins J, Lee S, Delucchi K

The purpose of this study was to determine whether hypnosis would be more effective in helping smokers quit than standard behavioral counseling when both interventions are combined with nicotine patches (NP). A total of 286 current smokers were enrolled in a randomized controlled smoking cessation trial at the San Francisco Veterans Affairs Medical Center. Participants in both treatment conditions were seen for two 60-min sessions, and received three follow-up phone calls and 2 months of NP. At 6 months, 29% of the hypnosis group reported 7-day point-prevalence abstinence compared with 23% of the behavioral counseling group (relative risk [RR] = 1.27; 95% confidence interval, CI 0.84-1.92). Based on biochemical or proxy confirmation, 26% of the participants in the hypnosis group were abstinent at 6 months compared with 18% of the behavioral group (RR = 1.44; 95% CI 0.91-2.30). At 12 months, the self-reported 7-day point-prevalence quit rate was 24% for the hypnosis group and 16% for the behavioral group (RR = 1.47; 95% CI 0.90-2.40). Based on biochemical or proxy confirmation, 20% of the participants in the hypnosis group were abstinent at 12 months compared with 14% of the behavioral group (RR = 1.40; 95% CI 0.81-2.42). Among participants with a history of depression, hypnosis yielded significantly higher validated point-prevalence quit rates at 6 and 12 months than standard treatment. It was concluded that hypnosis combined with NP compares favorably with standard behavioral counseling in generating long-term quit rates.

PMID: 18569754 [PubMed - indexed for MEDLINE]

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The impact of perfectionistic self-presentation on the cognitive, affective, and physiological experience of a clinical interview.

Psychiatry. 2008;71(2):93-122

Authors: Hewitt PL, Habke AM, Lee-Baggley DL, Sherry SB, Flett GL

Perfectionistic self-presentation is proposed as a deleterious interpersonal style that has an influence in clinical contexts that involves promoting a public image of perfection and avoiding displays and self-disclosures of imperfections. A sample of 90 clinical patients taking part in a clinical interview were assessed in terms of their levels of perfectionistic self-presentation and trait perfectionism and their affective, cognitive, and physiological reactions. Perfectionistic self-presentation dimensions were associated with (1) greater distress before and after the interview, (2) negative expectations and greater threat prior to the interview, and (3) post-interview dissatisfaction. Analyses of physiological data found that perfectionistic self-presentation was associated with higher levels of heart rate when discussing past mistakes, and, as expected, the need to avoid disclosing imperfections predicted higher levels of and greater change in heart rate when discussing past mistakes. Analyses that controlled for trait perfectionism and emotional distress showed that the need to avoid disclosing imperfections was a unique predictor of (1) appraisals of the interviewer as threatening before the interview and as dissatisfied after the interview; (2) negative pre and post self-evaluations of performance; and (3) greater change in heart rate when discussing mistakes. Perfectionistic self-presentation is discussed as an interpersonal style that can influence therapeutic alliance and treatment success.

PMID: 18573033 [PubMed - indexed for MEDLINE]

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Nonresponse and dropout rates in outcome studies on PTSD: review and methodological considerations.

Psychiatry. 2008;71(2):134-68

Authors: Schottenbauer MA, Glass CR, Arnkoff DB, Tendick V, Gray SH

Post-traumatic stress disorder (PTSD) represents a frequent consequence of a variety of extreme psychological stressors. Lists of empirically supported treatments for PTSD usually include cognitive behavioral therapy (CBT) and eye movement desensitization and reprocessing (EMDR), but nonresponse and dropout rates in these treatments often are high. We review the treatment dropout and nonresponse rates in 55 studies of empirically supported treatments for PTSD, review the literature for predictors of dropout and nonresponse, discuss methodological inconsistencies in the literature that make comparisons across studies difficult, and outline future directions for research. Dropout rates ranged widely and may have depended, at least in part, on the nature of the study population. It was not uncommon to find nonresponse rates as high as 50%. Standard methods of reporting dropout and nonresponse rates are needed for reporting outcomes. We suggest guidelines for collecting data to help identify characteristics and predictors of dropouts and nonresponders.

PMID: 18573035 [PubMed - indexed for MEDLINE]

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Eleven deaths of Mr. K.: contributing factors to suicide in narcissistic personalities.

Psychiatry. 2008;71(2):169-82

Authors: Ronningstam E, Weinberg I, Maltsberger JT

The objective of this paper is to discuss and illuminate the problem of abrupt suicide in relatively well-functioning individuals without a major DSM-IV mental illness. A case of a man diagnosed with narcissistic personality, who first allegedly staged a suicide attempt and later, without overt warning, killed himself in the context of financial losses and divorce, will be discussed. The paper addresses how and why a life event can generate an internal subjective experience that evokes a sudden deadly self-attack. Discussion of eleven explanatory hypotheses serves to further the understanding of these seemingly inexplicable events. We conclude that additional studies are necessary, especially of the interconnected interaction between life event, psychological functioning, and neurobiological correlates to expand understanding and develop proactive treatment strategies.

PMID: 18573036 [PubMed - indexed for MEDLINE]

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Is CIT today’s lobotomy?

J Am Acad Psychiatry Law. 2008;36(2):268-9

Authors: Lushbaugh DJ

PMID: 18583703 [PubMed - indexed for MEDLINE]

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