Manifestations Of Posttraumatic Stress Disorder Research Articles

Posttraumatic stress disorder in victimization-related trauma.

Symptom manifestations of posttraumatic stress disorder (PTSD) are explained in light of current research findings. Assessment methods for evaluating PTSD and trauma exposure are presented and implications for treatment are discussed.

Sexually and physically abused adolescents: An empirical search for PTSD

Recently, clinical manifestations of post-traumatic stress disorder (PTSD) in children and adolescents have been investigated, yet little is known about its assessment or diagnosis. Few empirically based studies appear in the PTSD literature on non-adult populations. Data were collected from 19 physically and sexually abused adolescents (aged 13-18 years) who were living in a group home setting. Subjects were administered the MMPI, Beck Depression Inventory (BDI), and Spielberger State Trait Anxiety Inventory (STAI). Results suggest that the subjects were moderately depressed and anxious, but that these adolescents did not manifest significant symptomatology of PTSD similar to that seen in adult, civilian PTSD populations using comparable MMPI measures. Implications of these findings for assessment purposes are discussed.

Suicide and guilt as manifestations of PTSD in Vietnam combat veterans

Although studies have suggested a disproportionate rate of suicide among war veterans, particularly those with postservice psychiatric illness, there has been little systematic examination of the underlying reasons. This study aimed to identify factors predictive of suicide among Vietnam combat veterans with posttraumatic stress disorder (PTSD). Of 187 veterans referred to the study through a Veterans Administration hospital, 100 were confirmed by means of a structured questionnaire and five clinical interviews as having had combat experience in Vietnam and as meeting the DSM-III criteria for PTSD. The analysis is based on these 100 cases. Nineteen of the 100 veterans had made a postservice suicide attempt, and 15 more had been preoccupied with suicide since the war. Five factors were significantly related to suicide attempts: guilt about combat actions, survivor guilt, depression, anxiety, and severe PTSD. Logistic regression analysis showed that combat guilt was the most significant predictor of both suicide attempts and preoccupation with suicide. For a significant percentage of the suicidal veterans, such disturbing combat behavior as the killing of women and children took place while they were feeling emotionally out of control because of fear or rage. In this study, PTSD among Vietnam combat veterans emerged as a psychiatric disorder with considerable risk for suicide, and intensive combat-related guilt was found to be the most significant explanatory factor. These findings point to the need for greater clinical attention to the role of guilt in the evaluation and treatment of suicidal veterans with PTSD.

Sleep disturbance as the hallmark of posttraumatic stress disorder.

The reexperiencing of a traumatic event in the form of repetitive dreams, memories, or flashbacks is one of the cardinal manifestations of posttraumatic stress disorder (PTSD). The dream disturbance associated with PTSD may be relatively specific for this disorder, and dysfunctional REM sleep mechanisms may be involved in the pathogenesis of the posttraumatic anxiety dream. Furthermore, the results of neurophysiological studies in animals suggest that CNS processes generating REM sleep may participate in the control of the classical startle response, which may be akin to the startle behavior commonly described in PTSD patients. Speculating that PTSD may be fundamentally a disorder of REM sleep mechanisms, the authors suggest several strategies for future research.

Survivors of imprisonment in the Pacific theater during World War II.

Data were obtained from 41 survivors of imprisonment by the Japanese during World War II. Interview data suggested that these individuals, despite the 40 years that had passed since their prisoner of war experiences, showed manifestations of posttraumatic stress disorder, notably a sleep disturbance marked by recurrent nightmares. MMPI data suggested significant pathology, characterized as an anxiety state, in this group. Half of the subjects met the full set of DSM-III criteria for posttraumatic stress disorder.