Stress Disorder In Vietnam Veterans Research Articles

D2 dopamine recepter (DRD2) gene polymorphism and combat-related posttraumatic stress disorder in Vietnam veterans

D2 dopamine recepter (DRD2) gene polymorphism and combat-related posttraumatic stress disorder in Vietnam veterans

P.4.b.017 D2 dopamine receptor (DRD2) gene polymorphism and combat-related posttraumatic stress disorder in Vietnam veterans

In the past few decades, a number of studies have investigated the association of dopamine D2 receptor (DRD2) gene polymorphisms with mood disorders, but the findings are not always consistent. The aim of our study was to assess the association between DRD2 gene polymorphisms and mood disorders by using a meta-analysis.Data were collected from the following electronic databases: PubMed, Elsevier Science Direct, Cochrane Library, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang, with the last report up to June 2010. Meta-analysis was performed in a fixed/random effect model by using the software Review Manager 4.2.We identified 19 separate studies using search, but only 14 separate studies (2157 cases and 3272 controls) were included in the current study. Meta-analysis was performed for three DRD2 gene polymorphisms (-141Cins/del, Ser311/Cys311, and TaqI A1). We performed meta-analysis in overall, Caucasian, and Asian populations. We also performed disease-specific meta-analysis in unipolar disorder and bipolar disorder. We found no association between DRD2 gene -141Cins/del polymorphism and mood disorders in overall and Caucasian populations (P > 0.05). We also found no association between DRD2 gene Ser311/Cys311 polymorphism and mood disorders in overall, Caucasian, and Asian populations (P > 0.05). An association of DRD2 gene TaqI A1 polymorphism with mood disorders was found in overall population, and the individuals with A1A1 genotype were more susceptible to mood disorders in comparison to those with A2A1 and A2A2 genotypes (OR = 1.84, 95% CI = 1.07–3.17, P = 0.03).Meta-analysis is retrospective research that is subject to the methodological deficiencies of the included studies.This meta-analysis suggests that mood disorders may be associated with DRD2 gene TaqI A1 polymorphism, but not -141Cins/del and Ser311/Cys311.

Psychiatric Casualties of War

The prevalence of posttraumatic stress disorder in Vietnam veterans has been a controversial medical and political issue. A new analysis provides better data and more robust conclusions.

Trauma-focused group psychotherapy is not effective for posttraumatic stress disorder in Vietnam veterans

Schnurr PP, Friedman MJ, Foy DW et al. Randomized trial of trauma-focused group therapy for posttraumatic stress disorder. Results from a Department of Veterans Affairs cooperative study. Arch Gen Psychiatry2003...

Medical-care costs associated with posttraumatic stress disorder in Vietnam veterans

Medical-care costs associated with posttraumatic stress disorder in Vietnam veterans

Medical-care costs associated with posttraumatic stress disorder in Vietnam veterans.

This study examined the relationship between medical-care costs of Vietnam veterans and predictor factors, including posttraumatic stress disorder (PTSD). We merged medical-care cost data from the Department of Veterans' Affairs and the Health Insurance Commission with data from an epidemiological study of 641 Australian Vietnam veterans. Posttraumatic stress disorder and other factors were examined as predictors of medical-care cost using regression analysis. We found that a diagnosis of PTSD was associated with medical costs 60% higher than average. Those costs appeared to be partly associated with higher treatment costs for physical conditions in those with PTSD and also related mental health comorbidities. Major predictors of medical-care cost were age ($137 per year for each 5-year increase in age) and number of diagnoses reported ($81 to $112 per year for each diagnosis). Mental health factors such as depression ($14 per year for each symptom reported) and anxiety ($27 per year for each symptom reported) were also important predictors. The findings indicate that, however they are incurred, high healthcare and, presumably, also economic and personal costs are associated with PTSD. There is an important social obligation as well as substantial economic reasons to deal with these problems. From both perspectives, continued efforts to identify and implement effective prevention and treatment programs are warranted.

Childhood physical abuse and combat-related posttraumatic stress disorder in Vietnam veterans.

Early trauma in the form of childhood physical or sexual abuse has been associated with adult psychopathology. The purpose of this study was to compare rates of childhood abuse in Vietnam veterans with and without combat-related posttraumatic stress disorder (PTSD). Premilitary stressful and traumatic events including childhood abuse and other potential predisposing factors were assessed in Vietnam combat veterans who sought treatment for PTSD (N = 38) and Vietnam combat veterans without PTSD who sought treatment for medical disorders (N = 28). Stressful and traumatic events including childhood physical abuse were assessed with the Checklist of Stressful and Traumatic Events and a clinician-administered interview for the assessment of childhood abuse. Level of combat exposure was measured with the Combat Exposure Scale. Vietnam veterans with PTSD had higher rates of childhood physical abuse than Vietnam veterans without PTSD (26% versus 7%). The association between childhood abuse and PTSD persisted after controlling for the difference in level of combat exposure between the two groups. Patients with PTSD also had a significantly higher rate of total traumatic events before joining the military than patients without PTSD (mean = 4.6, SD = 4.5, versus mean = 2.8, SD = 2.9). These findings suggest that patients seeking treatment for combat-related PTSD have higher rates of childhood physical abuse than combat veterans without PTSD. Childhood physical abuse may be an antecedent to the development of combat-related PTSD in Vietnam combat veterans.

Psychophysiological Responses in the Diagnosis of Posttraumatic Stress Disorder in Vietnam Veterans

In one sample of 104 male Vietnam combat veterans, we found that five heart rate parameters from a psychophysiological assessment could correctly discriminate 75% of the sample into those with PTSD and those without it. Using a stepwise approach, we found adding 10 blood pressure parameters increased discrimination to 80%, while adding five parameters from frontal electromyograms did not increase discrimination. Cross-validation of the heart rate parameters on a new sample of 96 veterans resulted in 83% correct discrimination.

Duration and Intensity of Combat Exposure and Posttraumatic Stress Disorder in Vietnam Veterans

We assessed whether a relationship exists between posttraumatic stress disorder (PTSD) and two quantitative aspects of war trauma: the duration of exposure to combat (expressed in months) and the intensity of combat (measured by ratings on the Laufer Combat Scale). These stressor characteristics were measured in relation to PTSD prevalence and persistence. Eighty-four veterans, inducted during the Vietnam War, who attended an orthopedic clinic participated in the study. A significant association was found between duration of combat exposure and prevalence and persistence of PTSD. The longest duration of combat exposure was found in patients who still suffered from PTSD. This duration was shorter for patients in remission and still shorter for patients who had never developed PTSD. Similarly, a significant association was found between combat scale ratings and PTSD. The highest rating was observed in subjects who still had PTSD. The rating was lower in patients in remission and still lower in those who had never experienced PTSD. Having been wounded, which is one of the Laufer Combat Scale items and could be considered particularly traumatic, was strongly associated with PTSD. The findings are discussed in relation to the reliability and validity of the PTSD construct and to the contribution of factors other than stressor characteristics to PTSD symptom expression.

MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans

This study investigated the systems of Minnesota Multiphasic Personality Inventory (MMPI) configural interpretation of Skinner and Jackson (1978) and Kunce (1979) with Vietnam veterans with posttraumatic stress disorder (PTSD). MMPI profiles of four groups differing in combat exposure were compared on four MMPI configural variables from Kunce (1979) and Skinner and Jackson (1978). The four groups were (a) PTSD sufferers, (b) Vietnam combat veterans without PTSD, (c) Vietnam noncombat veterans, and (d) Vietnam era veterans. All groups were further divided into hospitalized versus nonhospitalized subgroups. Dependent variables were Skinner and Jackson's (a) sociopathic modal profile, (b) neurotic profile, (c) psychotic profile, and (d) Kunce's emotional expression (enthusiastic-reserved) dimension. Results indicated that hospitalized PTSD subjects had significantly higher scores on Skinner and Jackson's neurotic profile; both hospitalized and nonhospitalized PTSD subjects had higher scores on the psychotic profile and were more "reserved" on Kunce's emotional expression dimension. Results were interpreted in terms of configural MMPI interpretation systems and the adjustment of Vietnam veterans with PTSD. PTSD was viewed as exhibiting cognitive, somatic, and affective features.

MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans

MMPI Configural Interpretation as Applied to Posttraumatic Stress Disorder in Vietnam Veterans

War stressors and symptom persistence in posttraumatic stress disorder

Abstract This study focused on delineating aspects of war stressors associated with risk for posttraumatic stress disorder in Vietnam veterans. Findings from 191 Vietnam war veterans are presented, addressing which elements of the war experience predicted PTSD in remission or persistent PTSD. Some experiences, like loss and injury, predicted having had PTSD symptoms in the past, while other experiences, such as exposure to grotesque death, predicted current (persistent) PTSD. Discriminant analysis showed that the more extreme/intense the stressor experiences, the higher the risk for developing PTSD and for persistent symptoms. These findings provide empirical support for the PTSD diagnosis and additional data for refining the PTSD stressor criterion.

Antisocial behavior and post-traumatic stress disorder in Vietnam veterans.

Assessment data from 118 Vietnam-era veterans seeking psychological services at two Los Angeles Veterans Administration Medical Centers were analyzed to examine the potential relationships between number of preadult and adult antisocial behaviors, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III; American Psychiatric Association, 1980) criteria for antisocial personality disorder, level of combat exposure, and development of combat-related post-traumatic stress disorder (PTSD). Results of hierarchical regression analyses indicated that combat exposure level was related significantly to PTSD symptomatology, whereas number of preadult antisocial behaviors was not. However, both combat exposure level and preadult behaviors, which were not correlated significantly, were related significantly to number of adult antisocial behaviors. There were no significant interaction effects. Results were consistent with a theoretical model of PTSD development that emphasizes the role of trauma vs. premorbid characterological factors. In addition, the significant association between combat exposure and adult antisocial behavior indicates that trauma may play a role in the development and/or maintenance of adult antisocial behaviors observed in some Vietnam veterans.

Posttraumatic stress disorders in Vietnam veterans: Selected bibliographical addendum to Fairbank et al., Silver, and Arnold.

Posttraumatic stress disorders in Vietnam veterans: Selected bibliographical addendum to Fairbank et al., Silver, and Arnold.

Posttraumatic stress disorders in Vietnam veterans: Selected bibliographical addendum to Fairbank et al., Silver, and Arnold.

Fairbank, Langley, Jarvie, and Keane (1981) presented a selected bibliography on contributions relevant to PTSD in Vietnam veterans. Their selection included research and clinical reports found in psychological and medical journals, books and government publications, which were pertinent to epidemio

Psychometric detection of fabricated symptoms of combat-related post-traumatic stress disorder: a systematic replication.

Vietnam veterans with post-traumatic stress disorder (n = 11) and two other groups of Vietnam veterans (n = 24) instructed to fabricate symptoms of post-traumatic stress disorder completed the MMPI. A discriminant function analysis that used scale F and the post-traumatic stress disorder subscale correctly classified 91% of the subjects. This systematic replication supports the utility of the MMPI as a component in evaluating the validity of self-reported symptoms of post-traumatic stress disorder in Vietnam veterans.

Combat level and social support in the development of posttraumatic stress disorder in Vietnam veterans.

The purpose of the study was to investigate the influence of social support and exposure to combat on the development of posttraumatic stress disorder (PTSD) in Vietnam veterans. A second purpose was to examine the influence of premorbid psychological adjustment on PTSD. Questionnaires were mailed to a population of Vietnam veterans, yielding a sample of 52 veterans who were blocked into four groups in a 2 (social support) by 2 (combat level) design. Home interviews were conducted, and comparisons among the groups were made regarding presence of PTSD symptoms, depression, and other psychological disturbance. Results found that veterans who received high social support reported fewer symptoms, and veterans with high combat trauma reported more symptoms. Generally, a significant interaction between social support and combat level was not found. Premorbid functioning was not found to differ among the four groups, suggesting little relationship to PTSD symptoms.

Criminal behavior and post-traumatic stress disorder in Vietnam veterans

When a sample of Vietnam veterans who has been incarcerated in the state prisons of Iowa were compared with a sample of Vietnam veterans from the community, the prevalence of post-traumatic stress disorder (PTSD) was found to be roughly the same, 39% and 37%, respectively. Ratings of combat stress to which these veterans had been exposed were also similar, although high combat stress was associated with the development of PTSD in both groups. On the other hand, a greater proportion of veteran inmates were found to have antisocial personality disorder with an onset prior to military service. Thirty-six percent met criteria for antisocial personality compared to 7% of the control group. Alcohol and drug abuse were also identified more frequently among incarcerated veterans, particularly those with PTSD. In no instance was a direct relationship between post-traumatic stress disorder and crimes leading to imprisonment observed. The findings indicate that, although aggressive tendencies may result from combat exposure, post-traumatic stress disorder does not have an important causal relationship to felonious behavior.

Theoretical and empirical issues in the treatment of post-traumatic stress disorder in Vietnam veterans.

This article reviews the current status of research on the treatment of combat-related post-traumatic stress disorder (PTSD) in Vietnam veterans. Dynamic, behavioral, and biochemical models of treatment are presented, along with the findings of relevant treatment outcome studies. Examination of the treatment procedures employed in available studies revealed that direct therapeutic exposure to the memories of trauma emerged as the PTSD treatment technique common to all three theoretical models. The need for controlled investigations of the clinical efficacy of exposure-based interventions for combat-related PTSD is discussed. In addition, several other issues relevant to PTSD treatment research are presented and discussed, including the potential utility of studying untrained coping behavior in combat veterans; the effects of using heterogeneous subject samples in PTSD treatment research; and issues related to the measurement of treatment outcome.

Cardiac response to relevant stimuli as an adjunctive tool for diagnosing post-traumatic stress disorder in Vietnam veterans

The cardiac responses of 91 Vietnam combat veterans, who either met (n=57) or did not meet (n=34) the DSM-III criteria for post-traumatic stress disorder (PTSD), were examined to a neutral stressor of mental arithmetic or to a relevant stressor of progressively louder (40 to 80 db) combat sounds. Examination of individual subject data reveals that one can accurately identify 70.2% of PTSD veterans and 88.2% of combat veterans, with only 9.7% false positives, using a single cutoff score on the highest heart rate response to combat sounds.