African Americans

African Americans and PTSD

PTSD and Black Americans

Title: Substance abuse, post-traumatic stress, and ethnicity.

Author(s)/Editor(s): Wilcox, James A.; Briones, David F.; Suess, Larry

Source/Citation: Journal of Psychoactive Drugs; Vol 23(1) Jan-Mar 1991, US:

Haight-Ashbury Publications; 1991, 83-84

Abstract/Review/Citation: Examined the prevalence of substance use (SA) among 59

male veterans (61% Hispanic Whites, 25% non-Hispanic Whites, 8% Blacks, and 5%

Asian-Americans) with combat-related posttraumatic stress disorder (PTSD).

Findings suggest that SA may accompany PTSD in many cases, and that

psychological distress (PD) was much higher in Hispanic Ss than others. The

association of SA and PD among Hispanic Ss suggests that cultural factors may

play a role in the development of this problem.

Title: The psychological consequences of community violence exposure: What
variables protect children in urban settings?
Author(s)/Editor(s): Ulschmid, Nancy Kaczmarek
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 62(7-A) Feb 2002, US: University Microfilms
International; 2002, 2354
Abstract/Review/Citation: This study examined the psychological consequences of
community violence exposure in 121 students (11-15 years of age) attending
public school in a Midwest urban area. The results indicate that students had
been exposed to significant levels of community violence in their lifetime
that included hearing about or witnessing violence, or direct victimization.
Violent events ranged from beatings and serious threats to stabbings,
shootings, and killings. Consistent with earlier studies, community violence
exposure predicted trauma symptomology in both boys and girls. In general,
girls reported a wider range of trauma symptomology than boys. Community
violence exposure also predicted a wider range of self-reported psychological
maladjustment in girls including sensation-seeking, atypicality, somatization,
social stress and inadequacy. Surprisingly, community violence exposure was
not predictive of teacher-rated problems, including externalizing,
internalizing, or learning problems. Using a model of stress, risk and
resiliency, a few risk factors were identified that appear to increase degree
of symptomology. Being female and repeated exposure to community violence
appeared as important risk factors. Other demographic variables did not appear
influential, although being African-American predicted nearly all
teacher-rated problems. Protective or resiliency factors including individual,
familial and external factors appeared to influence degree of symptomology as
well. A high level of self-reported personal resources (self-reliance,
interpersonal relations, and relations with parents) predicted a lower level
of trauma symptomology. In addition, attitude toward life, school and self
effected level of symptomology. Specifically, negative attitudes were
predictive of greater PTSD symptomology. Further analyses were conducted to
examine possible moderating or mediating effects of these variables. The
results suggest that self-reported personal resources had a direct and
separate effect on trauma symptomology regardless of violence exposure. In
contrast, self-reported negative attitudes about life, school and self appear
to have mediated the effects of community violence exposure on trauma
symptomology. Study limitations and implications for intervention are
discussed.
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Title: Sickle cell disease and posttraumatic stress disorder.
Author(s)/Editor(s): Alao, Adekola O.; Soderberg, Maureen
Author Affiliation: SUNY Upstate Medical U, Syracuse, NY, US
Source/Citation: International Journal of Psychiatry in Medicine; Vol 32(1)
2002, US: Baywood Publishing; 2002, 97-101
Abstract/Review/Citation: Reports the case of a 24 yr old African American
female with comorbid sickle cell disease (SCD) and posttraumatic stress
disorder (PTSD). The patient was evaluated after referral for psychiatric
consultation, and expressed depressed mood with suicidal ideation. The PTSD
was related to a painful hospitalization crisis during treatment for SCD. The
authors describe this as the 1st case of a patient with coexisting PTSD and SCD.
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Title: Factors that influence functional status in intentionally injured women.
Author(s)/Editor(s): Glass, Nancy Ellen
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(10-B) May 2002, US: Univ Microfilms International;
2002, 4465
Abstract/Review/Citation: Background. Interpersonal violence results in severe
injuries requiring treatment in emergency departments and trauma units.
Previous studies indicate that women who seek care for intentional injuries
are more likely than women who seek care for nonintentional injuries to be
discharged without further treatment. Women's opportunities to obtain
resources to ensure follow-up services in the community may be limited. Women
who survive intentional injuries are discharged with histories of
victimization, physical and psychological symptoms, and few resources to
assist them to address the sequelae of violence. Few studies have examined how
these factors influence functional status.  Objective. To identify and explore
factors that influence functional status in women who survived an intentional
injury by an intimate or ex-intimate partner or another person. Design. A
retrospective cohort design. Measures. The Women's Health Questionnaire was
developed with previously validated instruments on severity of violence,
physical and psychological symptoms, substance abuse, trauma recurrence,
social support, and functional status.  Setting. R Adams Cowley Shock Trauma
Center, University of Maryland Medical System.  Participants. Most of the 76
participants were young (18-45 years), African-American (70%), and living in
poverty; 74% reported annual incomes of less than $15,000.  Results. The
effects of violence (physical, psychological, psychosocial) explained 23.8% of
the variance in functional status. Almost 60% of the women screened positive
for posttraumatic stress disorder (PTSD), 36.8% reported a lifetime history of
drug use, and 64.5% reported a lifetime history of intimate partner violence.
Women reported that health care providers gave little attention to the mental
health effects of violence and their capacity to fully participate in life;
62% of women assaulted by an intimate or ex-intimate partner were not referred
to a domestic violence program or shelter. Conclusions. The effects of
violence were the strongest predictor of functional status in intentionally
injured women. Women reported serious PTSD symptoms, substantial substance
abuse, and multiple traumatic events. They also reported that they had not
been provided adequate resources to address the effects of violence. This
study should challenge nurses and other health care professional to assess
survivors of violence, intervene, and refer the survivors to community-based
services that will enable them to maintain optimal functioning.
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Title: Psychological effects of community violence of symptoms of trauma on
African American and Hispanic children.
Author(s)/Editor(s): Aviles, Dianibel
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(10-B) May 2002, US: Univ Microfilms International;
2002, 4771
Abstract/Review/Citation: The purpose of this researcher is to assess whether
and to what extent minority inner city children are adversely affected with
regard to their psychological health when subjected to the traumas of violence
in their homes and communities. The researcher's aim required initiating a
dialogue with 61 children who have been exposed directly or indirectly to
community violence. The findings support the view that our sample of minority
children does not experience traumatic events differently from the comparison
group. Further, findings support that Hispanic children endorsed the highest
levels of physiological/somatic cues from PTSD symptomatology. The importance
of assessing minority children exposed to traumas and ethnocultural issues are
discussed.
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Title: Predictors of willingness to consider medication and psychosocial
treatment for panic disorder in primary care patients.
Author(s)/Editor(s): Hazlett-Stevens, Holly; Craske, Michelle G.; Roy-Byrne, Peter P.; Sherbourne, Cathy D.; Stein, Murray B.; Bystritsky, Alexander
Author Affiliation: U California, Los Angeles, CA, US U Washington, Seattle, WA,
US RAND Corp, Los Angeles, CA, US U California, San Diego, CA, US U
California, Los Angeles, CA, US
Source/Citation: General Hospital Psychiatry; Vol 24(5) Sep-Oct 2002, US:
Elsevier Science Publishing; 2002, 316-321
Abstract/Review/Citation: Identified demographic and clinical patient
characteristics related to willingness to consider panic disorder treatments
in the primary care setting. A sample of 4,198 patients (mean age 40.67 yrs)
from primary care settings completed a brief questionnaire containing
questions about demographic characteristics, physical health status, and
symptoms of panic disorder, social phobia and PTSD. The 1,043 patients
 indicating a recent panic attack episode answered additional questions about
their willingness to consider both medication and psychosocial forms of
intervention for panic. Of these panic patients, 64% reported willingness to
consider medication and 67% reported willingness to consider a psychosocial
intervention for their panic. Logistic regression analyses for these panic
patients revealed that willingness to consider medication treatment for panic
was associated with older age, lower education, poorer health status and the
presence of social phobia and/or PTSD symptoms. In addition, Asian and African
American patients were less likely than Caucasian patients to indicate
willingness to consider medication treatment for their panic. However, only
the presence of comorbid social phobia and PTSD symptoms predicted willingness
to consider a psychosocial intervention.
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Title: Impact of life events, trauma, interpersonal conflict and substance abuse
on pregnancy outcomes of inner city women.
Author(s)/Editor(s): Caldwell, Barbara Ann
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(12-B) 2002, US: Univ Microfilms International; 2002,
5955
Abstract/Review/Citation: The purpose of the study was to explore the impact of
life stress, trauma, interpersonal conflict and substance use on pregnancy
outcomes for women living in an inner-city. Pregnant women living in
inner-city environments experience complex burden associated with poverty,
discrimination, community and interpersonal violence and chronic stressors.
The risk for mortality and low birth weight is two times greater in African
American infants. Structural equation modeling (SEM) was utilized to analyze data collected on 193 pregnant women attending an inner-city obstetric clinic.
SEM analysis found life stress and substance abuse significantly predicted
negative pregnancy outcomes. Symptoms of PTSD were found in almost 70% of the
participants. Clinical and research implications are presented related to the
health of women and their families.
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Title: Violence exposure and child behavioral and emotional problems: The
moderating role of maternal acceptance.
Author(s)/Editor(s): Nordstrom-Klee, Beth Ann
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(12-B) 2002, US: Univ Microfilms International; 2002,
5999
Abstract/Review/Citation: Children in the United States are exposed to a great
deal of violence, and this exposure has been linked to child outcomes.
Violence within the home has been associated with emotional and behavioral
difficulties in children, as has exposure to community violence, even when
violence is simply witnessed. However, not all exposed children experience
negative outcomes. Recent research has focused on factors that buffer children
from negative consequences of violence exposure. The purpose of the study was
to examine the potential buffering (moderating) role of one factor, maternal
acceptance, in the relationship between exposure to violence and internalizing
and externalizing problems. It was hypothesized that both home and community
violence exposure would impact internalizing and externalizing problems, and
that child report of maternal acceptance would moderate these relationships.
Subjects were 268 urban African American first graders living with their
biological mothers, and tested in a research facility. Hypotheses were
generally supported. Using regression analysis, home violence exposure
(measured by the Conflict Tactics Scale) predicted internalizing and
externalizing problems (measured by Achenbach Teacher and Parent Report Forms,
and child report of PTSD), after control for significant confounders including
child abuse. Community violence exposure (measured by Things I Have Seen and
 eard and Survey of Children's Exposure to Community Violence) also correlated
with internalizing and externalizing problems after control for demographic
factors, maternal mental health, and general life stress. Correlations varied
by source of report, and maternal psychopathology was found to mediate the
relationships. Using a test of homogeneity of regression slopes for stratified
analyses, maternal acceptance moderated the relationship between home violence
exposure and child outcomes: children with higher levels of maternal
acceptance (measured by the Pictoral Scale of Perceived Competence and Social
Acceptance) were found to be more adversely affected by home violence
exposure. However, children with the lowest levels of maternal acceptance were
most impacted by community violence exposure. In this sample of urban first
graders, rates of violence exposure were high and associated with increased
internalizing and externalizing problems. Additionally, maternal acceptance
was found to buffer children from the adverse outcomes associated with
community violence exposure.
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Title: Racial differences in psychotic symptoms among combat veterans with PTSD.
Author(s)/Editor(s): Frueh, B. Christopher; Hamner, Mark B.; Bernat, Jeffrey A.; Turner, Samuel M.; Keane, Terence M.; Arana, George W.
Author Affiliation: Medical U of South Carolina, Veterans Affairs Medical Ctr,
Charleston, SC, US Medical U of South Carolina, Veterans Affairs Medical Ctr,
Charleston, SC, US U Maryland, College Park, MD, US Boston U School of
Medicine, Veteran Affairs Medical Ctr, Boston, MA, US Medical U of South
Carolina, Veterans Affairs Medical Ctr, Charleston, SC, US
Source/Citation: Depression & Anxiety; Vol 16(4) 2002, US: John Wiley &
Sons; 2002, 157-161
Abstract/Review/Citation: We tested the hypothesis that race may influence
clinical presentation and symptomatology in combat veterans with posttraumatic
stress disorder (PTSD). Fifty-three African-American and Caucasian veterans
(mean age 49.6 yrs) were administered the Psychotic Screen Module of the
Structured Clinical Interview for DSM, Minnesota Multiphasic Personality
Inventory-2 (MMPI-2), and other psychometric measures at a Veterans Affairs
outpatient PTSD clinic. Subjects were consecutive referrals who were not
matched for level of combat trauma or preexisting trauma; however, there were
no group differences in other relevant demographic or diagnostic variables.
Significant racial differences, with modest effect sizes, were found on
clinician ratings of psychotic symptoms, MMPI-2 scale 6 ('paranoia'), and a
measure of dissociation. No significant differences were found for the MMPI-2
scale 8 ('schizophrenia'), or on measures that might suggest comorbid
depression or anxiety. African-Americans with PTSD endorsed more items
suggesting positive symptoms of psychosis, without higher rates of primary
psychosis, depression, or anxiety than Caucasians.
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Title: Prevalence and patterns of Post-Traumatic Stress Disorder among persons
with severe mental illness.
Author(s)/Editor(s): Albert, David Brian
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 63(4-B) Oct 2002, US: Univ Microfilms International;
2002, 2048
Abstract/Review/Citation: This study investigated the prevalence and patterns of
Post-Traumatic Stress Disorder (PTSD) in a multi-site stratified probability
sample of 1,005 psychiatric aftercare patients in Chicago, Illinois. The
results of this study confirm that PTSD disproportionately afflicts persons
with severe mental disorders: the rate of 12-month PTSD in our sample was
21.12%. This study also confirms that PTSD is grossly underdiagnosed in
clinical settings that serve persons with severe mental disorders: only 2.69%
of our subjects had a chart diagnosis of PTSD. Rates of current PTSD were
significantly associated with gender, race/ethnicity, and psychiatric
diagnosis. Female subjects were significantly more likely than male subjects
to have PTSD (26.89% vs. 15.42%). Hispanic subjects had the highest rate of
PTSD (29.11%), followed by African-American subjects (20.15%), and
non-Hispanic white subjects (12.60%). Rates of PTSD were highest among
subjects with Bipolar Disorder (37.40%), followed by Obsessive-Compulsive
Disorder (36.13%), Psychotic Disorder (32.51%), and Major Depressive Disorder
(29.96%). Overall, seven demographic and diagnostic factors emerged as
significant risk factors for PTSD (and for underdiagnosis): (1) female gender;
2) African-American race/ethnicity; (3) Hispanic race/ethnicity; (4) a
comorbid Bipolar Disorder; (5) comorbid Obsessive-Compulsive Disorder; (6) a
comorbid Psychotic Disorder; and (7) a comorbid Major Depressive Disorder.
Three other notable findings emerged. First, the relationship between PTSD and
Hispanic race/ethnicity could largely be accounted for by subjects who
identified themselves as Puerto Rican, who had nearly twice the rate of
current PTSD compared with non-Puerto Rican Hispanics. Second, the
disproportionately high rate of PTSD among female subjects could be partially
explained by higher reported rates of rape and sexual molestation relative to
male subjects. Third, there was no significant relationship between Alcohol or
Drug Abuse/Dependence and PTSD in our sample. The implications of these
findings for treatment, public health policy, and further research are discussed.
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Title: Exploring a feminist-relational model of the mental health effects of
interpersonal violence among incarcerated women.
Author(s)/Editor(s): Davino, Katrina Marie
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 61(7-B) Feb 2001, US: Univ Microfilms International;
2001, 3838
Abstract/Review/Citation: Interpersonal violence, defined as sexual or physical
abuse in childhood or adulthood, is prevalent in the lives of women,
especially those in clinical and incarcerated populations. A variety of
negative mental health outcomes have been associated with interpersonal
violence. Conceptual frameworks for understanding these symptoms have been
developed including those focusing on PTSD intrusion and avoidance symptoms
and broader frameworks that incorporate the self, relational, and mood
difficulties often experienced by survivors of interpersonal violence.
Empirical research has begun to explore factors that predict differential
mental health outcomes following the experience of interpersonal violence.
Primarily, these have included characteristics of the abuse event (e.g., age
of onset, duration of abuse, degree of violence), but more recently
environmental and relational variables have begun to be explored (e.g., social
support at the time of disclosure). Despite these advances in the research on
the negative mental health outcomes associated with the experience of
interpersonal violence, few theoretically based models that account for the
range of symptoms and predictors have been developed. This study proposed a
'feminist relational model' of interpersonal violence that integrated
empirical research with a relational model of women's development. The model
was empirically explored in a sample of 175 incarcerated, primarily
African-American and poor, women.  Data included self-reported surveys and
clinician-rated interviews. Overall, the women reported very high rates of
interpersonal violence, primarily of a severe nature and perpetrated by people
important in their lives. They reported a high rate of symptoms in the area of
connections to others, while they appeared surprisingly nonsymptomatic in the
area of self-concept. A multidimensional model of symptoms was developed and
explored; it provided support for previously proposed conceptual frameworks
for the negative mental health outcomes that have been associated with
experiences of interpersonal violence. Predictive models were developed based
on the application of a feminist-relational theory of women's development to
the experience of childhood interpersonal violence. These models provided
support for the importance of subjective relational factors in predicting
differential mental health outcomes following the experience of interpersonal
violence. The women who participated in this study appeared to have a
'Relational PTSD' in which trauma experiences were generalized to
hypervigilance in and avoidance of intimate relationships.
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Title: Acute dissociative reactions in veterans with PTSD.
Author(s)/Editor(s): Koopman, Cheryl; Drescher, Kent; Bowles, Stephen; Gusman, Fred; Blake, Dudley; Dondershine, Harvey; Chang, Vickie; Butler, Lisa D.; Spiegel, David
Source/Citation: Journal of Trauma & Dissociation: Special Issue:  ; Vol
2(1) 2001, US: Haworth Medical Press; 2001, 91-111
Abstract/Review/Citation: Examined the prevalence of acute dissociative
reactions to a recent stressful event among 102 male Vietnam veterans seeking
help for posttraumatic stress disorder (PTSD) at a Veterans Affairs treatment
center. Prior to treatment, patients completed a battery of questionnaires,
including the Stanford Acute Stress Reaction Questionnaire to assess acute
dissociative experiences in reaction to a recent stressful event. Most (80%)
combat veterans reported experiencing 5 acute dissociative symptoms in the
evious month in reaction to this event. These symptoms were positively
associated with being African American or Hispanic/Latino, having been
physically abused in childhood, choosing a combat-related intrusion experience
as the most stressful recent event, combat-related traumatic stress symptoms,
and having service connected disability. It is concluded that these results
have both theoretical and clinical implications.
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Title: Mental health outcomes and coping in battered women: The role of social
support.
Author(s)/Editor(s): Kocot, Thomas Gregory
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 61(8-B) Mar 2001, US: Univ Microfilms International;
2001, 4410
Abstract/Review/Citation: The present study sought to determine the contribution
of domestic violence and social support variables to mental health and coping
outcomes in a sample of 180 predominantly African American, court-involved
women. Multiple regression analyses indicated that psychological abuse was an
important contributor to PTSD symptoms, depression, and problem-focused coping
even when controlling for the effects of physical abuse. Physical abuse was
positively associated with PTSD symptoms, depression, and problem-focused
coping; however, in the context of psychological abuse, physical abuse
contributed uniquely only to PTSD symptoms. Various dimensions of social
support were shown to contribute differentially to PTSD symptoms, depression,
and problem-focused coping. Contrary to hypotheses, social support was not
shown to moderate the relationship between domestic violence (physical abuse
and psychological abuse) and mental health outcomes (PTSD symptoms and
depression). However, additional analyses suggested that: (1) emotional and
tangible social support may mediate the association between domestic violence
and PTSD symptoms, and between domestic violence and depression; and, (2)
emotional social support may moderate the association between problem-focused
coping and mental health outcomes (PTSD symptoms and depression). Implications
for practice and research are discussed.
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Title: Traumatic life events, posttraumatic stress disorder, and health outcomes
in a low-income, primary care population.
Author(s)/Editor(s): Applegate, Bradford West
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 61(8-B) Mar 2001, US: Univ Microfilms International;
2001, 4387
Abstract/Review/Citation: Research suggests that individuals with Posttraumatic
Stress Disorder (PTSD) have significant dysregulation in a number of
physiological indices, especially the sympathetic nervous system (SNS) and
hypothalamic-pituitary-adrenal (HPA) axis. Biological theories of PTSD propose
that prolonged SNS and HPA axis dysregulation places individuals with PTSD at
risk for development of medical morbidity and impairments in health status. 
The present study examined the following research questions: (a) what is the
prevalence of traumatic life events and PTSD in a low-income primary care
population? (b) does PTSD predict impairments in self-reported health status
after controlling for age, alcohol abuse, tobacco use, and obesity? and (c)
does PTSD predict the presence of physician diagnosed medical disease?  The
sample included 431 randomly selected adult patients recruited from primary
care clinics at a public teaching hospital in the state of Louisiana. The
sample consisted predominately of uninsured, African-American, low-income
females. The results indicated that prevalence of at least one traumatic life
event (88%) was similar to that of community surveys. For females, the
lifetime prevalence of PTSD was significantly higher than in community
samples. The same was not true for males, however. Individuals with PTSD were
likely to have at least one other comorbid mental disorder. The median
duration of symptoms for those with a PTSD diagnosis was 12 months, but
considerable variability in remission rates was found as a function of
traumatic event type. Individuals who developed PTSD from some type of
interpersonal violence had a median symptom duration of 48 months, compared to
12 months for either other events directly experienced, or events experienced
by a close friend or loved one.  Logistic regression analyses revealed that
PTSD was predictive of impairments in self-reported health status, but only
when compared to control subjects with no history of mental disorder. Logistic
regression analyses also revealed that PTSD was predictive of presence of
circulatory system disease, but only when compared to control subjects with no
history of mental disorder. Results provided tentative support for the notion
that PTSD, like other psychiatric conditions, is associated with increased
risk of impaired health status and medical disease.
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Title: Sex differences in symptoms of posttraumatic stress: Does culture play a
role?
Author(s)/Editor(s): Norris, Fran H.; Perilla, Julia L.; Ibanez, Gladys E.; Murphy, Arthur D.
Source/Citation: Journal of Traumatic Stress: Special Issue Vol 14(1) Jan
2001, US: Kluwer Academic/Plenum Publishers; 2001, 7-28
Abstract/Review/Citation: Investigated whether gender differences in
posttraumatic stress disorder (PTSD) are greater in societies that foster
traditional views of masculinity and femininity than in societies that adhere
to these traditions less rigidly. Data were collected 6 mo after Hurricanes
Paulina (Acapulco;  N = 200) and Andrew (Miami; White  n = 135; Black  n =
135). Data were collected with PTSD symptoms and proximity of death rating
scales. Regression analyses indicate that group interactions emerged for the
total scale and for subscales of Intrusion, Avoidance, and Remorse. Only a sex
main effect (women higher) emerged for Arousal. The results indicate that
Mexican culture amplified, whereas African American culture attenuated,
differences in the posttraumatic stress of male and female disaster victims.
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Title: Effects of gender and ethnicity on duty-related posttraumatic stress
symptoms among urban police officers.
Author(s)/Editor(s): Pole, Nnamdi; Best, Suzanne R.; Weiss, Daniel S.; Metzler, Thomas; Liberman, Akiva M.; Fagan, Jeffrey; Marmar, Charles R.
Source/Citation: Journal of Nervous & Mental Disease: Special Issue:  ; Vol
189(7) Jul 2001, US: Lippincott Williams & Wilkins; 2001, 442-448
Abstract/Review/Citation: Studied 655 urban police officers (21% female, 48%
White, 24% Black, and 28% Hispanic) to assess ethnic and gender differences in
duty-related symptoms of posttraumatic stress disorder (PTSD). Self-report
measures of the following were obtained: (1) posttraumatic stress disorder
(PTSD) symptoms, (2) peritraumatic dissociation, (3) exposure to duty-related
critical incidents, (4) general psychiatric symptoms, (5) response bias due to
social desirability, and (6) demographic variables. It was found that
self-identified Hispanic-American officers evidenced greater PTSD symptoms
than both self-identified European-American and self-identified
African-American officers. These effects were small in size but they persisted
even after controlling for differences in other relevant variables. Contrary
to expectation, no gender differences in PTSD symptoms were found. It is
stated that these findings are of note because 1) they replicate a previous
finding of greater PTSD among Hispanic-American military personnel and 2) they
fail to replicate the well-established finding of greater PTSD symptoms among
civilian women.
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Title: Treatment of a 50-year-old African American woman whose chronic
posttraumatic stress disorder went undiagnosed for over 20 years. .
Author(s)/Editor(s): Cooke, Alice L.; Shear, M. Katherine
Electronic Access: http://ajp.psychiatryonline.org/cgi/content/full/158/6/866
Source/Citation: American Journal of Psychiatry: Special Issue:  ; Vol 158(6)
Jun 2001, US: American Psychiatric Assn; 2001, 866-870
Abstract/Review/Citation: Presents the case of an African-American woman who met
Mental Disorders-IV (DSM-IV) criteria for posttraumatic stress disorder (PTSD)
and was treated at a mental health clinic serving low-income African
Americans. The diagnosis of PTSD was first made 22 yrs after the initial
presentation, and only then did she reveal her experience of having been held
hostage, bound, beaten, and repeatedly raped, narrowly escaping with her life.
The PTSD diagnosis was made only after the patient underwent a structured
diagnostic interview and a targeted treatment was provided under the auspices
of a research project. The S was originally treated for panic disorder with
agoraphobia, and then obsessive-compulsive disorder, before the accurate
diagnosis of PTSD was given and the S was able to discuss her traumatic experience. The PTSD treatment course included in-session re-experiencing
exposure to the traumatic event and between-session in vivo exposure to feared
situations.
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Title: Group psychotherapy for adolescent survivors of homicide victims: A pilot study.
Author(s)/Editor(s): Salloum, Alison; Avery, Lisa; McClain, Ronald P.
Source/Citation: Journal of the American Academy of Child & Adolescent
Psychiatry; Vol 40(11) Nov 2001, US: Lippincott Williams & Wilkins; 2001,
1261-1267
Abstract/Review/Citation: Evaluated the effectiveness of a time-limited
psychotherapy group model to decrease traumatic symptoms among adolescent
survivors of homicide victims. 45 inner-city adolescents aged 11-19 yrs
participated in community-based, time-limited therapy groups that were
specifically designed for youths who had a loved one die because of violence.
The therapy groups were based on a 10-wk treatment model for adolescent
survivors of homicide victims with the goals of providing grief education,
facilitating thoughts and feelings about grief, and reducing traumatic
symptoms. On completion of group therapy, the Ss reported an overall
significant decrease in traumatic symptoms on an index of posttraumatic
stress, especially in the areas of reexperiencing and avoidance symptoms. The
mean difference between pre- and posttest was a 10.03 decrease in the sum of
the Child PTSD Reaction Index scores. The results of this pilot study indicate
that group therapy may be helpful in reducing PTSD symptoms among inner-city,
African-American adolescent survivors of homicide victims. Although validity
is limited by the lack of a comparison group, such a brief trauma/grief
psychotherapy group may be applicable for suburban and rural adolescent
survivors of homicide victims as well.
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Title: Trauma exposure, PTSD, and substance abuse in urban adolescents.
Author(s)/Editor(s): Shuman, Paul Gray
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(2-B) Aug 2001, US: Univ Microfilms International;
2001, 1099
Abstract/Review/Citation: This study was designed to assess the relationship
between community violence, posttraumatic stress disorder, and substance abuse
in urban adolescents. The participants consisted of 617 adolescents aged 14 to
21 years from three inner city high schools and one suburban high school in a
large southwestern metropolitan area. Ethnicity of the participants included
Latino/a, African-American, Asian-American, and Caucasian. The relationship
between substance abuse relative to ethnicity, gender, grade level, and age
was also studied. Adolescents were administered the Los Angeles Symptom
Checklist (LASC), and the Survey of Children's Exposure to Community Violence
(SCECV). The PTSD subscale of the LASC and the SCECV were correlated with two
items on the LASC that measured substance abuse. As hypothesized, there was a
significant relationship between PTSD and substance abuse. Additionally, the
hypothesis that predicted a significant relationship between substance abuse
and community violence was supported by the data. The results indicated no
significant differences with regard to ethnicity. These findings are an
important step in highlighting the importance of identifying the relationship
between substance abuse and community violence in adolescents of all
ethnicities.
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Title: The experience of depression in major depressive disorder alone versus
comorbid major depression and PTSD.
Author(s)/Editor(s): Weiss, Hillary Pearl
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(3-B) Sep 2001, US: Univ Microfilms International;
2001, 1605
Abstract/Review/Citation: The primary purpose of this study was to assess how
the experience of depression in patients with comorbid Major Depressive
Disorder/Post Traumatic Stress Disorder (MDD/PTSD) compares to the experience
of depression in patients with Major Depressive Disorder (MDD) alone. MMD
patients with comorbid Substance Use Disorders (MDD/SUD) were used as a
control group in order to determine if differences observed between MDD and
MDD/PTSD groups are the result the combination of these two specific disorders
rather than comorbidity in general.  This is an important question because the
comorbidity of MDD and PTSD is quite high: Concurrent MDD and PTSD occurs in
approximately 10% to 60% of participants in various samples. There is evidence
that MDD and PTSD share a number of common etiological, and the two disorders
also share some of the same diagnostic criteria, suggesting that the
experience of depression may be exacerbated when it occurs with versus without
PTSD. Nevertheless, little is known about the presentation of depression in
MDD versus MDD/PTSD.  Participants (n = 54) were part of a larger sample of
500 outpatients of several mental health facilities in the Boston area: 47% of
the sample were women, 33.3% were minorities (most were African-American); 11
were diagnosed with MDD, 29 with MDD/PTSD, and 14 with MDD/SUD. MMPI-2 scales
related to depressive experience as well as to trauma-related symptomatology
were compared for patients with MDD alone versus comorbid MDD/PTSD and
comorbid MDD/SUD. Findings were that the MDD/PTSD group showed significantly
more depressive experience in terms of numbers well as severity of symptoms
than the group with MDD alone. Patients with MDD/SUD presented with more
depressive experience than patients with MDD alone, although not to a
statistically significant degree. They presented with less depressive
experience than patients with comorbid MDD/PTSD, indicating that MDD/PTSD
comorbidity has a clinical presentation distinct from that of other disorders
co-occurring with MDD. Further research on this comorbid presentation is
necessary because individuals with MDD/PTSD tend to be more severely and
chronically debilitated than individuals with MDD alone and, as well, pose, a
greater risk of suicide.
========================================

Title: The traumatic effects of witnessing domestic violence on children's
emotional functioning.
Author(s)/Editor(s): Leonard, Hasse A.
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 62(3-B) Sep 2001, US: Univ Microfilms International;
2001, 1585
Abstract/Review/Citation: This study assessed Posttraumatic Stress Disorder in
children who have witnessed domestic violence. Past literature has just begun
to ask this question and has failed to include projective stories with this
population, as well as include a representative sample of children of color.
This study has included these two formerly, important, neglected areas. 
Thirty women who were in an abusive relationship, and their children who
witnessed at least two events of violence between their mother and father,
were included in this study. Participants were recruited from an agency that
helps women obtain restraining orders against their batterers and a women's
shelter through fliers and presentations. The mothers' ages ranged from 26-56
years and the children's age ranged from 7-12 years of age. Although
African-American and Caucasian women were included in this study, 70% of the
women and children that participated were Latino.  The following measures were
cluded in this study: a questionnaire for mothers; a mini-structured
interview for children; The Conflict Tactic Scale Form RC-Revised (CTS); The
Brief Symptom Inventory (BSI); the Child Behavior Checklist 4/18 (CBCL); and,
the Tell Me A Story (TEMAS). Results from this study were consistent with
children who experience PTSD. Children's affect was avoidant and restricted
when stories elicited fearful responses. The four significant results in this
study were as follows: (1) as frequency of domestic violence increased a
child's ability to control his/her aggressive impulses decreased, (2) severity of violence witnessed predicted problems in children's reality testing, (3)
mothers' overall psychological functioning was negatively correlated with
children's emotional functioning, as mothers' problems with psychological
functioning increased their children's emotional functioning decreased, and
(4) boys differed from girls on their ability to delay gratification. Other
areas of interest were a child's resiliency to witnessing violence and
cultural comparisons, neither of which could be assessed because of lack of
data. Clinical implications emphasize the need for more awareness in the
psychological field about this population and the need for more bilingual
(Spanish/English) therapists to provide services to this population.
========================================

Title: Treating low-income and African American women with posttraumatic stress
disorder: A case series.
Author(s)/Editor(s): Feske, Ulrike
Source/Citation: Behavior Therapy; Vol 32(3) Sum 2001, US: Assn for Advancement
of Behavior Therapy; 2001, 585-601
Abstract/Review/Citation: The present uncontrolled case series was designed to
examine the feasibility of prolonged exposure (PE) for posttraumatic stress
disorder (PTSD) with low-income and African-American women. Five of 10
eligible women completed PE and showed significant improvements in symptoms of
PTSD, general anxiety, and depression. Clinical observations suggest that the
addition of interventions aimed at improving interpersonal problems might lead
to a more complete recovery in this population of women with complex trauma
and psychiatric histories and that a priming intervention focused on teaching
affect-regulation skills might enhance the effectiveness of PE. The removal of
structural barriers (e.g., lack of transportation and child care) appears to
be necessary in order to boost the benefits of traditional treatment
interventions in disadvantaged women.
========================================

Title: Childhood maltreatment, PTSD and suicidal behavior among African American
females.
Author(s)/Editor(s): Thompson, Martie P.; Kaslow, Nadine J.; Lane, Danielle Bradshaw; Kingree, J. B.
Source/Citation: Journal of Interpersonal Violence; Vol 15(1) Jan 2000, US: Sage
Publications Inc; 2000, 3-15
Abstract/Review/Citation: The independent and combined roles of childhood
maltreatment (physical abuse, sexual abuse, emotional abuse, emotional
neglect, and physical neglect) and current post-traumatic stress disorder
(PTSD) were examined in predicting nonfatal suicide attempts among 335 African
American women. It was hypothesized that suicide attempters (n = 157) would
evidence higher rates of all forms of childhood maltreatment and higher rates
of current PTSD than controls. The authors predicted that women with both
current PTSD and a lifetime history of child maltreatment would be at greatest
risk for making a nonfatal suicide attempt. Results revealed that current PTSD
and all 5 forms of childhood maltreatment were independently related to risk
for suicide attempts. PTSD in combination with any of the 5 forms of childhood
maltreatment increased a woman's risk for making a nonfatal suicide attempt.
========================================

Title: "Approach" and "avoidance" coping and PTSD symptoms
in inner-city youth.
Author(s)/Editor(s): Dempsey, Margaret; Overstreet, Stacy; Moely, Barbara
Source/Citation: Current Psychology: Developmental, Learning, Personality,
Social; Vol 19(1) Spr 2000, US: Transaction Periodicals Consortium; 2000,
28-45
Abstract/Review/Citation: Examined the function of approach and avoidant coping
on the relations between exposure to violence and posttraumatic stress
disorder (PTSD) symptoms. The sample included 70 African-American, inner-city
children (aged 11-14). Tests of moderating effects investigated the mechanism
of 2 avoidant coping strategies, cognitive distraction, and behavioral
avoidance. Cognitive distraction was found to moderate the level of violence
exposure such that, as violence increased, the use of cognitive distraction
was related to an increased frequency of cognitive arousal. Behavioral
avoidance moderated violence such that, under higher exposure to violence, the
lowered use of behavioral avoidance was related to an increased frequency of
behavioral arousal. Tests of moderating effects examined the function of 2
approach strategies, problem-solving and social support. Neither strategy
showed significant effects. This study provided a 1st-step in the examination
of coping within inner-city children.
========================================

Title: Group therapy program for African-American veterans with posttraumatic
stress disorder.
Author(s)/Editor(s): Jones, Lemanuel; Brazel, Donna; Peskind, Elaine R.; Morelli, Thomas; Raskind, Murray A.
Source/Citation: Psychiatric Services; Vol 51(9) Sep 2000, US: American
Psychiatric Association; 2000, 1177-1179
Abstract/Review/Citation: Discusses a Vet Center's group therapy treatment
program for African American veterans with posttraumatic stress disorder
(PTSD) that has met regularly and expanded since it was established in 1984.
Program attributes described by participants as particularly helpful include
facilitating open communication of thoughts and feelings among
African-American men; providing support for coping with the intrapsychic,
social, and economic effects of racism; increasing knowledge about the causes,
consequences, and treatment of PTSD; and decreasing emotional and social
isolation. It is concluded that the program appears to be a useful treatment
for African-American veterans with PTSD.
========================================

Title: Interpersonal violence and posttraumatic symptomatology: The effects of
ethnicity, gender, and exposure to violent events.
Author(s)/Editor(s): McGruder-Johnson, Anita K.; Davidson, Emily S.; Gleaves, David H.; Stock, Wendy; Finch, John F.
Source/Citation: Journal of Interpersonal Violence; Vol 15(2) Feb 2000, US: Sage
Publications Inc; 2000, 205-221
Abstract/Review/Citation: A sample of 222 African American, Mexican American, or
European American undergraduate students completed questionnaires assessing
lifetime exposure to interpersonal violence and current levels of
psychological distress. The frequency of interpersonal violence was high:
39.2% of the students reported direct exposure to at least 1 violent,
nonsexual life event and 43.7% reported at least 1 violent sexual experience.
14 percent of the participants had lifetime diagnoses of posttraumatic stress
disorder (PTSD), with the highest reported rate occurring for the African
Americans, who also reported more violent sexual and nonsexual experiences and
higher levels of psychological distress. Women reported more direct sexual
experiences whereas men reported more nonsexual violent events. Covariance
analyses suggested that degree of exposure to violence explained most, but not
all of the ethnic and gender differences found in terms of posttraumatic
symptomatology. Thus, exposure to life-threatening events, rather than ethnic
or gender group per se was most directly related to psychological distress.

========================================

Title: The impact of violence on school achievement and behavior of
African-American children.
Author(s)/Editor(s): Thompson, Theodore Jr.
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 60(8-A) Mar 2000, US: Univ Microfilms
International; 2000, 3139
Abstract/Review/Citation: The effects of violence and traumatic events on school
achievement and behavior of African-American school children was the focus of
this study. An assessment tool designed to examine levels of family,
community, and witnessing violence was compiled. The questionnaire also
 utilized a modified version of the Conflict Tactics Scale for Children
(Straus, 1985). In addition, PTSD and social support was examined using two
existing measures for children: The Extended Childhood PTSD Reaction Index
(Nader & Pynoos, 1988), and The Survey of Children's Social Support (Dubow
& Ullman, 1989). This study utilized both quantitative and qualitative
methods. A total of 110 children completed the questionnaire and five children
were seen for open-ended interviews. The students in this study were all sixth
graders between the ages of 11 and 13 from inner-city Chicago neighborhood
schools. Academic achievement was measured by scores on the Iowa Test of Basic  Skills and behavior was measured by The Achenbach Child Behavior Checklist
(1981). The findings revealed most forms of violence were significantly
related to behavior; how ever social support was not found to be significantly
related to any of the variables in this study. PTSD was found to be a
significant predictor of other forms of violence when placed in several path
models. Children in this study continue to manifest pain and suffering in
terms of past memories of violent and traumatic events after a years time. The
neighborhood characteristics and family relationships may play an important
role in the levels of violence and traumatic events that African-American
school children suffer.
========================================

Title: Family environment, exposure to community violence and the development of
Posttraumatic Stress Disorder.
Author(s)/Editor(s): Nejman-Muhlmeister, Jordana Faye
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 60(8-B) Mar 2000, US: Univ Microfilms International;
2000, 4241
Abstract/Review/Citation: This study examined the interrelationships among
perceived family environment variables, levels of exposure to community
violence, and posttraumatic stress disorder (PTSD) symptomatology in a
school-based clinic sample comprised of fifty-five urban, Hispanic
adolescents. The study was undertaken in order to clarify the relationships
between stressful conditions both at home and in the community and severity of
posttraumatic stress symptoms. While these variables have been addressed in
other studies, the populations looked at in the past have been younger (ages
7-12), and with primarily African-American or mixed African-American, Latino
samples. As hypothesized, perceived family conflict was positively correlated
 with both total exposure to community violence and PTSD symptomatology.
Similarly, an inverse relationship was found between perceived family cohesion
and PTSD symptomatology. However, the hypothesis that those who perceived
higher levels of family cohesion would report lower levels of total community
violence exposure was not supported. Additionally, no differences were found
among the three levels of community violence exposure in relation to reported
PTSD symptoms. This study provides a rationale for future research exploring
various aspects of family functioning as they impact populations chronically
exposed to violent/traumatic events.
========================================

Title: Exposure to chronic community violence:  Formal kinship, informal
kinship, and spirituality as stress moderators for African American children.
Author(s)/Editor(s): Saunders, Janine Michelle
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 60(12-A) 2000, US: Univ Microfilms International;
2000, 4333
Abstract/Review/Citation: In many African American communities, violence and
poverty are often part of daily living. Due to exposure to chronically violent
conditions, children are at risk for difficulties in all aspect of their
lives, particularly their emotional well being. The purpose of this study was
to explore the relationship between exposure to Chronic Community Violence
(CCV) and the development of Complex Posttraumatic Stress Disorder (C-PTSD), a
constellation of symptoms that occur as a result of repeated exposure to
traumas. This issue was explored in the context of specific African American
cultural beliefs and values that have the potential to moderate the
development of maladaptive psychological functioning. Support through formal
kinship support, informal kinship support, and spirituality are among a few of
the coping mechanisms that are utilized by African Americans. It was
anticipated that the coping mechanisms would act as stress moderators, or
buffers, to the development of symptoms of C-PTSD.  Participants in the study
included 71 African American children between the ages of 9 and 11. They were
selected from 'neighborhood schools' in the midst of a high-crime,
high-poverty community in Houston, Texas. Self-report questionnaires were
orally administered to the children in the study. The self-report
questionnaires provided indices of the following: (a) exposure to chronic
community violence, (b) Complex PTSD, and (c) the coping mechanisms (formal
kinship, informal kinship, and spirituality) used by African American
children. Through multiple regression analyses, the coping mechanisms were
investigated in the context of exposure to chronic community violence and the
development of Complex PTSD. The results indicated that each of the coping
mechanisms alone were not enough to moderate the symptoms of Complex PTSD.
However, the combination of the three supports demonstrated buffering effects
on exposure to violence. Secondary analyses using the caregivers perceptions
of their child's supports revealed that utilizing formal kinship and
spirituality were each strong enough to buffer the effects of violence such
that fewer symptoms of C-PTSD were exhibited. The combination of the three
supports also demonstrated moderating effects. Thus, the coping mechanisms,
based in African American values, moderated the relationship between exposure
to violence and C-PTSD.
========================================

Title: Coping resources and quality of life in African American male Vietnam
veterans.
Author(s)/Editor(s): Carlton, Michael Antonio
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 61(2-B) Aug 2000, US: Univ Microfilms International;
2000, 1074
Abstract/Review/Citation: African American veterans have served in every major
war fought by the United States yet there is a paucity of information
regarding their resources for coping and perceived quality of life. The
present investigation examines the influence of coping resources, quality of
life and adjustment on outpatient African American Vietnam veterans with and
without the diagnosis of combat-related Posttraumatic Stress Disorder (PTSD).
Participants were 50 African American (25 PTSD diagnosed, 25 non-diagnosed
PTSD) veterans presenting for individual or group therapy at either a veteran
center, veteran clinic, or Veterans Affairs Medical Center PTSD program
located in the Southeastern United States. Willing participants were given the
Coping Resources Inventory (CRI), Quality of Life Inventory (QOLI), and
Symptom Checklist-90-Revised (SCL-90-R) respectively. Veterans with the
diagnosis of PTSD were found to have a significantly lower quality of life and
level of adjustment than veterans without the diagnosed disorder. Moreover,
results suggest that the quality of life in veterans with the diagnosis of
PTSD is related to their coping resources. Findings and implications for
treatment are discussed.
========================================

Title: An ethnocultural study of Posttraumatic Stress Disorder in
African-American and White American Vietnam War Veterans. .
Author(s)/Editor(s): Trent, Calvin R. Jr.; Rushlau, Matthew G.; Munley, Patrick H.; Bloem, William; Driesenga, Scott
Source/Citation: Psychological Reports; Vol 87(2) Oct 2000, US: Psychological
Reports; 2000, 585-592
Abstract/Review/Citation: Examined the intensity of posttraumatic stress
disorder (PTSD) symptoms as measured by the Mississippi Scale, the Keane (PK),
and the PTSD (PS) Scales of the MMPI-2 in a sample of 34 African-American
(mean age 46.5 yrs) and 34 White American (mean age 46.0 yrs) Vietnam War
Veterans who sought treatment in a Specialized Inpatient PTSD Unit. The scores
of the 2 groups on the Beck Depression Inventory and the clinical scales of
the MMPI-2 were also compared. The ethnoculturally different sample was
matched on intensity of combat exposure, marital status, employment status,
age, and education. No significant differences on the measures of PTSD
symptoms were noted and no significant differences were found on the Beck
scale or the MMPI-2 clinical scales.
========================================

Title: Direct, witnessed, and verbally-mediated exposure, fear of interpersonal
victimization, dissociation and emotional distress among a biethnic sample of
college students: A structural modeling analysis.
Author(s)/Editor(s): Mcgruder-Johnson, Anita Kay
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 61(4-B) Oct 2000, US: Univ Microfilms International;
2000, 2211
Abstract/Review/Citation: Structural Equation Modeling analyses (SEM) were used
to examine relationships among three modes of exposure to interpersonal
violence, dissociation, fear of victimization and distress in a biethnic
sample of 344 university students. A four-factor model (with direct exposure
is the exogenous variable) was specified on 239 African American and European
American females. In addition, the model was respecified (with witnessed
exposure and verbally-mediated exposure as the exogenous variables) on a
mixed-gender African American sample of the data. For all types of exposure,
the structural models supported mediation effects for dissociation. The data
suggest that dissociative experiences and subsequent PTSD-related distress are
sequelae of direct exposure, witnessed exposure and verbally-mediated exposure
to interpersonal violence. In addition, the data suggest that the relationship
between witnessed or verbally-mediated exposure to interpersonal violence,
dissociative experiences and PTSD-related distress was more relevant for the
African American students than European Americans students in our sample.
========================================

Title: Insult denied:  Traumatic brain injury in battered African American
women.
Author(s)/Editor(s): Oden, Tatia Malika
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 61(4-B) Oct 2000, US: Univ Microfilms International;
2000, 1864
Abstract/Review/Citation: Battered women endure head injuries that can result in
neuropsychological insults; these complications have grave medical, legal, and
psychiatric implications. This study investigated the impact of traumatic
brain injury (TBI) in battered women and specifically, among African American
women. To date there are no published studies that examine the
neuropsychological, physical, and psychiatric sequelae of traumatic brain
injury in battered women. This study sought to determine the nature of the
neuropsychological impact of TBI among self-identified battered women and
comparisons were made between non-head injured (NHI) battered women and head
injured battered women (HI). Sixty-four African American women participated in
the study. They were recruited from Bay Area shelters, programs for battered
women, and the community. Of the 64 subjects, 51 were classified as head
injured (HI) and the remaining 13 were non head injured (NHI). Comparison of
the HI and NHI groups was complicated by the difficulty in finding battered
women without head injuries. The women were between ages 18 and 56. Data was
generated from a demographic questionnaire, the Millon Clinical Multiaxial
Inventory-III (MCMI-III), semi-structured interview, and a series of
neuropsychological tests. The neuropsychological tests included the following:
Trail Making Test, Paced Auditory Serial Addition Test (PASAT), Ruff 2 & 7
Test, Rey Auditory-Verbal Learning Test (RAVLT), Stroop Color and Word Test,
Grooved Pegboard, Controlled Oral Word Association Test (COWAT), Ruff Figural
Fluency Test (RFFT).  The findings supported four of the five main hypotheses.
No significant differences were found between HI and NHI groups on
neuropsychological test scores. It was found that level of head injury was
related to neuropsychological functioning in the area of information
processing. Compared to NHI women, those with HI were found to be more
anxious, depressed, and more likely to suffer from PTSD. Depression was the
most prevalent psychiatric disorder among the HI women. Among all the women,
depression was related to deficits in recognition and motor tasks. Finally,
additional findings revealed neuropsychological impairment among both groups
(HI and NHI) when compared with published norms. Limitations, contributions,
and areas for future research are also discussed.
========================================

Title: Psychiatric disorders in African American men and women living with
HIV/AIDS.
Author(s)/Editor(s): Myers, Hector F.; Durvasula, Ramani S.
Source/Citation: Cultural Diversity & Ethnic Minority Psychology: Special
Issue: HIV/AIDS and ethnic minority women, families, and communities.; Vol
5(3) Aug 1999, US: Educational Publishing Foundation; 1999, 249-262
Abstract/Review/Citation: Assessed the prevalence of major psychiatric disorders
in African American men and women affected by HIV/AIDS and estimated the
relative contribution of demographics, substance use, burden of social strain,
and low social support in predicting psychiatric risk. Data are from analyses
conducted on a community sample of 234 African American men who have sex with
men (75 HIV negative and 159 HIV positive) and a sample of 135 African
American women (35 HIV negative and 100 HIV positive). Both samples were
relatively young and of low SES. Results indicated a high prevalence of
psychiatric disorders in both samples, with anxiety spectrum disorders (38%)
and mood disorders (23%), especially depression (20%), prevalent among the men
and depression (20%) and significant symptoms of posttraumatic stress disorder
(PTSD; 50%) prevalent among the women. Results testing the contributions of
risk factors were consistent with expectations, with role strains, low income,
current drug use, and low social support making contributions among the men.
Among the women, psychiatric disorders were associated with low social support
and low income, with weak contributions from low education and marijuana use.
========================================

Title: The impact of relationship violence, HIV, and ethnicity on adjustment in
women.
Author(s)/Editor(s): Axelrod, Julie; Myers, Hector F.; Durvasula, Ramani S.; Wyatt, Gail Elizabeth; Cheng, Michelle
Source/Citation: Cultural Diversity & Ethnic Minority Psychology: Special
Issue: HIV/AIDS and ethnic minority women, families, and communities.; Vol
5(3) Aug 1999, US: Educational Publishing Foundation; 1999, 263-275
Abstract/Review/Citation: This study examined how relationship violence, HIV,
and ethnicity, moderated by social support, social undermining, and
relationship satisfaction, influence psychological distress and dysfunction. A
community sample of 415 African American, European American, and Latina women
(140 HIV negative, 275 HIV positive) participated in the University of
California, Los Angeles-Charles Drew Medical Center Women and Family Project.
Of the 415, 27% (n = 112, 79% HIV positive, 21% HIV negative) reported a
history of relationship violence. Results indicated that HIV-positive women
reported significantly more depressive symptoms, slightly more anxiety, but no
differences on posttraumatic stress disorder (PTSD) symptoms than HIV-negative
women. Women victimized by relationship violence also reported more depressive
symptoms and anxiety and evidenced significantly more PTSD symptoms than
nonabused women. Indeed, 58% of victimized women evidenced significant PTSD
symptoms. Contrary to expectations, however, there were no significant ethnic
differences on anxiety, but differences on depressive and PTSD symptoms
emerged and were moderated by social undermining. Social support and dyadic
satisfaction were not significant moderators of distress or dysfunction.
========================================

Title: Availability of family support as a moderator of exposure to community
violence.
Author(s)/Editor(s): Overstreet, Stacy; Dempsey, Margaret; Graham, Darnika; Moely, Barbara
Source/Citation: Journal of Clinical Child Psychology; Vol 28(2) Jun 1999, US:
Lawrence Erlbaum Assoc; 1999, 151-159
Abstract/Review/Citation: Examined the role of availability of family support in
moderating the negative effects of exposure to community violence on
internalizing symptoms. Participants were 75 low-income African American
inner-city children (10-15 yr olds). Two measures of availability of family
support (mother's presence in the home and family size) were evaluated as
moderators of the relations between exposure to community violence and
depression and posttraumatic stress disorder (PTSD) symptoms. After
controlling for age, sex, and concurrent life stress, mother's presence in the
home moderated the relation between exposure to community violence and
depressive symptoms but not the relation between exposure to community
violence and PTSD symptoms. Children living in mother-absent families were at
increased risk of depressive symptoms as exposure to community violence
increased. In addition, family size approached significance as a moderator of
depressive symptoms but not PTSD symptoms, revealing a trend toward children
from smaller families being at increased risk of depressive symptoms as
exposure to community violence increased. These findings suggest that although
availability of family support is an important moderator for depressive
symptoms, this is not the case for PTSD symptoms.
========================================

Title: Body dysmorphic disorder and a prosthesis.
Author(s)/Editor(s): Roskes, Erik
Source/Citation: Psychosomatics; Vol 40(5) Sep-Oct 1999, US: American
Psychiatric Press, Inc.; 1999, 436-437
Abstract/Review/Citation: Reports the case of 27-yr-old African American male
referred for psychiatric consultation. Six years prior to referral, the S was
a bystander in a shooting resulting in the loss of his right eye and the
subsequent placement of a prosthesis. Following the injury the S lost his
stereoscopic vision and had difficulty concentrating on his academic tasks
because of eye strain. This was followed by an inability to adjust mentally
and physically to life with one eye. At the time of the trial of his assailant
the S became profoundly depressed and was hospitalized voluntarily for 2 days.
Following a run-in with the law, the S was referred for consultation and
diagnosed with major depressive disorder, recurrent, severe posttraumatic
stress disorder (PTSD) by history, and body dysmorphic disorder. The author
notes that this is the first reported case of body dysmorphic disorder in
which the focus of the disorder is a prosthesis.
========================================

Title: Traumatic stress in HIV-infected women.
Author(s)/Editor(s): Kimerling, Rachel; Calhoun, Karen S.; Forehand, Rex; Armistead, Lisa; Morse, Edward; Morse, Patricia; Clark, Rebecca; Clark, Leslie
Source/Citation: AIDS Education & Prevention; Vol 11(4) Aug 1999, US:
Guilford Publications; 1999, 321-330
Abstract/Review/Citation: Assessed the prevalence of specific traumatic
stressors that meet criterion A for the Mental Disorders-IV (DSM-IV) diagnosis
of posttraumatic stress disorder (PTSD) and symptoms of PTSD in a
representative sample of HIV-infected women. The authors also assessed the
impact of these stressors and symptoms on the clinical progression of HIV
infection. The Life Stressor Checklist and the Impact of Events Scale-Revised
were administered via interview to 67 African-American women (aged 18-45 yrs)
beyond the initial stages of HIV infection. The ratio of C134 t-cells to CD8
t-cells were abstracted from medical records at dates that approximated
psychological interviews and were examined at 2 points in time 12 to 14 months
apart. The prevalence of traumatic stressors and PTSD symptoms were high among
HIV-infected women. Traumatic stressors were significantly associated with a
lower C134 to CD8 ratio at the 1-yr follow-up. Among women who reported a
traumatic event, those who also met criteria for PTSD evidenced a lower C134
to C138 ratio at the follow-up assessment. The study concludes that prevention
and treatment efforts targeted at HIV-infected women must take into account
traumatic stressors and PTSD symptoms and their potential impact on the course
of the disease.
========================================

Title: Clinical and sociocultural differences in african American and European
American patients with panic disorder and agoraphobia.
Author(s)/Editor(s): Smith, Lisa C.; Friedman, Steven; Nevid, Jeffrey
Source/Citation: Journal of Nervous & Mental Disease; Vol 187(9) Sep 1999,
US: Lippincott Williams & Wilkins; 1999, 549-560
Abstract/Review/Citation: Examined phenomenological differences between African
American and European American patients with panic disorder with or without
agoraphobia. 48 African American (mean age 40.9 yrs) and 33 European American
patients (mean age 39.7 yrs) with panic disorder were assessed by structured
interview and self-report questionnaires. African Americans evidenced a higher
rate of comorbid posttraumatic stress disorder (PTSD). European Americans
reported having their initial panic attack at an earlier age than African
Americans. In terms of discrete panic attack symptoms, African Americans
reported more intense levels of numbing/tingling in extremities as well as
greater fear of dying or going crazy than European Americans. African
Americans evidenced less satisfaction with social support, especially
financial support, than European Americans. African Americans employed coping
strategies such as counting one's blessings and religiosity more often than
European Americans but evidenced less self blame. This study extends previous
findings by showing that African Americans have a later age of onset as well
as different coping strategies than European American patients with panic
disorder.
========================================

Title: Sexual addiction as an adaptive response to post-traumatic stress
disorder in the African American community.
Author(s)/Editor(s): Robinson, Donald W.
Source/Citation: Sexual Addiction & Compulsivity; Vol 6(1) 1999, US:
Brunner/Mazel; 1999, 11-22
Abstract/Review/Citation: Presents to the therapeutic community variables that
are related to the need for culturally specific paradigms to assess, diagnose,
and treat sexual addictions among African Americans. The intent is to increase
awareness among treatment professionals that will promote research in relevant
diagnostic and treatment considerations related to race. Also discussed is the need for clinicians to develop culturally specific and culturally sensitive
approaches that address the avoidant and numbing strategies common in
post-traumatic stress disorder (PTSD). The historical aspects of slavery,
racism, and discrimination are related to the development of PTSD and the
mechanisms by which African Americans deal with its symptoms. (PsycINFO
========================================

Title: Interpersonal violence in a "normal" low-income control group.
Author(s)/Editor(s): Hien, Denise; Bukszpan, Claudia
Source/Citation: Women & Health; Vol 29(4) 1999, US: Haworth Press; 1999,
1-16
Abstract/Review/Citation: Examined the rates of interpersonal violence and
trauma (IVT) reported in a sample of 98 urban, low-income women (aged 19-54
yrs). Ss were predominantly of Latina or African-American descent,
constituting a "normal" control group for a larger study on drug
abuse and violence. Ss were screened for the absence of any Mental
Disorders-IV (DSM-IV) Axis I psychopathology disorders. Ss exhibited rates of
IVT markedly above estimates for women nationwide; compared to such national
figures, Ss were at higher risk for experiencing childhood physical and sexual
abuse and partner violence. Almost 25% of Ss met diagnostic criteria for
lifetime posttraumatic stress disorder (PTSD). 10-20% of Ss reported other
kinds of trauma, such as witnessing a murder, seeing parental violence, or
being homeless. Interestingly, Ss were more likely than women nationwide to
tell someone else of their abuse or trauma; it may be that disclosure of such
events to a supportive person has protected these women to a certain extent
from some of the longer-term potential effects of such negative experiences.
The data collected in this study underscore the need for mental health and
medical professionals to be sensitive to the high prevalence of certain kinds
of traumatic and violent experiences in the lives of inner-city, low-income,
minority women.
========================================

Title: The psychological impact of child maltreatment: Symptom severity and
coping in physically abused, sexually abused, and neglected children.
Author(s)/Editor(s): Sheehan, Lisa Hessenauer
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 59(7-B) Jan 1999, US: Univ. Microfilms International;
1999, 3714
Abstract/Review/Citation: In this study, I explored the impact of child
maltreatment in terms of Post-Traumatic Stress Disorder (PTSD) and Depressive
symptom severity, and explored the existence of differential symptom
presentation across physically abused, sexually abused, and neglected
children. I also examined the types of coping strategies utilized by
maltreated children and the extent to which coping strategies and degree of
abuse (i.e., severity and chronicity) were related to symptom severity. One
hundred and forty six primarily African American, inner city, foster care
children participated. Three standardized instruments were employed: (1) the
Child Post-Traumatic Stress Reaction Index; (2) the Reynolds Child Depression
Scale; and (3) the Coping Scale for Children and Youth. These measures were
used to assess children's experience of PTSD symptoms, Depressive symptoms,
and coping strategy utilization, respectively. Findings indicated that
physically abused, sexually abused, and neglected children experienced
similar, relatively high levels of distress in terms of PTSD symptoms. As a
group, maltreated children tended to utilize a variety of coping strategies as
opposed to adopting a preferred coping strategy. Sexually abused children
reported the most frequent use of coping strategies. Additionally, greater
utilization of coping strategies was related to higher levels of PTSD and
Depressive symptom severity. Degree of abuse, on the other hand, was not found
to be related to symptom severity or coping strategy utilization. Thus, the
impact of maltreatment appears to fit well within a PTSD framework. The
relatively high level of PTSD symptoms observed across maltreatment groups,
however, points to the need to assess traumatic events from the child's
perspective and to explore further the role of other variables (e.g., other
psychosocial stressors) in determining adjustment. Additionally, the fact that
coping was related to higher levels of symptom severity emphasizes the
necessity of examining coping in relation to a specific stressor (e.g.,
stressors characterized by high vs. low levels of controllability), the
perceived effectiveness of one's coping efforts, and the overall context in
which coping strategies are implemented (e.g., middle class vs. inner city
environment).
========================================

Title: Predictors of posttraumatic stress disorder in a community sample of
women: Examination of the role of violence and ethnicity.
Author(s)/Editor(s): Vogel, Laura C. M.
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 59(7-B) Jan 1999, US: Univ. Microfilms International;
1999, 3776
Abstract/Review/Citation: The purpose of the current study was to examine
Dutton's (1992) model of moderating and mediating variables which may impact
the relationship of violence from an intimate partner with the development of
posttraumatic stress disorder (PTSD) symptoms. This model was tested within
three ethnic groups (African American, n = 303, Euro-American, n = 271, and
Mexican American, n = 260), of low income, community women in serious,
long-term relationships. Results indicated that the prevalence of PTSD in the
current sample was similar to rates found in samples of battered women drawn
from shelters or out-patient clinics as well as that of combat veterans and
natural disaster victims. The co-morbidity of suicidality with PTSD was also
examined within each ethnic group. Four phases of regression equations were
conducted to test Dutton's (1992) model within each ethnic group. A clear
distinction was made between mediating and moderating variables according to
assumptions outlined by Baron and Kenny (1986). During Phase One, the fear of
injury or death by one's partner was found to mediate the relationship of
violence and PTSD symptoms for African American and Mexican American women,
but not Euro-American women. When moderators were examined in Phase Two,
ethnic differences were also observed. Variables measuring susceptibility
factors in women's lives (e.g., past partner violence, childhood violence and
sexual assault) moderated the impact of violence on the development of PTSD
for African American women. Current environmental stressors (e.g., sense of
safety and frequency of crime in the neighborhood) moderated the impact of
violence on PTSD for Euro-American women, with no variable having moderating
effects for Mexican American women. Phase Three combined the predictors within
each of Dutton's (1992) moderating categories to understand the differential
impact of these variables within each ethnic group. Finally, Phase Four
equations examined the overall fit of the model for predicting PTSD symptoms
within each ethnic group. The importance of the differences and similarities
observed are discussed within a framework of the PTSD as well as domestic
violence literature.
========================================

Title: Association of traumatic event, chronicity, and developmental level to
posttraumatic symptomology.
Author(s)/Editor(s): Ward, Jody A.
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 59(8-B) Feb 1999, US: Univ. Microfilms International;
1999, 4492
Abstract/Review/Citation: The current study investigated factors which have been
clinically associated with posttraumatic symptomology. It was hypothesized
that increased severity of the traumatic event, increased chronicity of the
event, and younger age of the victim would be associated with higher
post-traumatic symptomology. Participants were college undergraduates (N =
140) with a mean age of 21.5, and 68% were female. Fifty five percent of the
subjects were Asian-American; 27%, Caucasian; 7%, Hispanic-American; 4%,
African-American; and 5.6% identified themselves as 'Other.' Participants
completed the Traumatic Events Questionnaire (TEQ), the Impact of Event Scale
(IES), and Purdue Post Traumatic Stress Disorder Scale - Revised (PPTSD-R)
based on their self-identified most traumatic event. A stepwise multiple
regression revealed the most traumatic event and chronicity to account for 9%
of the variance in IES scores, R2 =.25, F(3, 139) = 4.62, p < .01; 6% of
the variance in PPTSD-R scores since the event, R2 =.06, F(3, 139) = 4.62, p
< .01; and 9% of the variance in PPTSD-R scores within the last month, R2
=.09, F(3, 139) = 4.60, p < .01. Events too traumatic to discuss, child
physical or sexual abuse, 'other,' or unwanted sexual experiences as an adult
accounted for 25% of the variance in IES scores. Child physical and sexual
abuse, events too traumatic to discuss, and 'other' accounted for 17% of the
variance in PPTSD-R scores within the last month, and 13% since the event.
Non-disclosure of the traumatic event accounted for 5 to 10% of posttraumatic
symptomology. Although this amount appears small, it is considerable given the
myriad of variables inherent in the development of post-traumatic
symptomology. Disclosure of the traumatic event is particularly important to
mediate post-traumatic effects. Although research has suggested that
disclosing traumatic events in adulthood is associated with lower levels of
distress, childhood disclosure of trauma has been associated with higher
levels of psychological symptomology (Elliot & Briere, 1994; Lamb &
Edgar-Smith, 1994; Roesler & Wind, 1994). Disclosure of the traumatic
event seems to increase the psychological stress of children, but decreases
the amount of posttraumatic symptomology in adulthood.
========================================

Title: I'm in charge here: Exposure to community violence, perceptions of
control, and academic and aggressive outcome in inner-city youth.
Author(s)/Editor(s): Watt, David Ryan
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 59(9-B) Mar 1999, US: Univ. Microfilms International;
1999, 5117
Abstract/Review/Citation: The relationships between exposure to community
violence, perceived control, and academic and aggressive outcome in inner-city
youth were investigated. The effectiveness of an intervention targeting perceptions of control was also evaluated. The participants were 174
middle-school and high-school students of primarily African-American and
Latino ethnicity. Students were interviewed regarding their exposure to
violence, perceptions of control, educational aspirations, academic grades,
aggressive beliefs, and aggressive behaviors, both prior to and following
their participation in a 15-week counseling group. The results indicated that
perceptions of control were clearly related to psychosocial functioning, and
that there was a significant (albeit small) negative association between
exposure to community violence and academic grades. However, exposure to
violence was not related to students' perceptions of control or to any other
measure of psychosocial functioning. The findings also showed that the
intervention was somewhat effective in altering students' perceptions of
control and their academic performance. Finally, the results indicated that
students whose perceptions of internal control increased the most over the
course of the intervention were also most likely to have increased their
educational aspirations and decreased their aggressive behavior. The
importance of extending previous knowledge regarding perceived control to this
population is discussed, particularly in light of previous research suggesting
that exposure to violence can affect perceptions of control. It is argued that
interventions focused on increasing inner-city students' perceptions of
internal control, as well as decreasing their perceptions that powerful others
are in control and their confusion regarding the factors that determine their
success and failure, are likely to be effective in improving students'
psychosocial functioning. However, interventions focused on exploring and
dealing with these students' experiences with violence may not be effective in
achieving this goal. Finally, it is suggested that further research into the
nature of the relationship between exposure to community violence, PTSD-like
symptoms, and observable outcome variables is urgently needed.
========================================

Title: Assessing the influence of violence and trauma on mental health in an
urban outpatient psychiatric clinic.
Author(s)/Editor(s): Ford, Briggett Coellette
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 60(2-A) Aug 1999, US: University Microfilms
International; 1999, 0549
Abstract/Review/Citation: Violence has become a major mental health and public
health problem in the United States. There already exists a known link between
violence trauma and mental health through the studies of combat and rape
victims. However, very little is known about the effect of violence and trauma
on the mental health of general psychiatric populations. The goal of this
study was to: (1) develop a better picture of mental health/mental illness in
African-American women, (2) examine the influence of exposure to violence and
trauma upon mental health, and (3) to assess the efficacy of using a
semi-structured diagnostic tool to determine the rate of Axis I disorders in
an urban African-American female sample. Data were collected by eight self.
administered questionnaires, in-depth clinical assessment using the Structured
Clinical Interview for DSM-IV and the Victimization Screening Form. The
fifty-five individuals interviewed in this study were between the ages of
35-55 years, unemployed, single, and had a high school education or
less. Sixty-four percent of the women met criteria for a current mood or
anxiety disorder. Thirty-three percent met criteria for a current psychotic
disorder. Fifty-one percent met criteria for PTSD. Fourteen women reported
having been exposed to at least three traumas during their lifetime. Seven
women reported being victims of childhood sexual assault, twelve were victims
of sexual assault, six were victims of physical assault, and eight women had significant others who were murdered. Hierarchal regression was used to
examine a model Consisting of diagnostic burden, exposure to violence and
trauma and mental health well-being. Findings suggest that diagnostic burden
and exposure to violence and trauma are predictors of poor mental health
well-being when present. Exposure to violence and trauma appears to have a
moderating effect on an individual's well-being. These findings further
suggest that the use of a screening and assessment tool for violence and
trauma exposure may have important clinical implications in providing
appropriate mental health services to African-American women.
========================================

Title: Neuropsychological findings in Vietnam veterans with combat-related
posttraumatic stress disorder.
Author(s)/Editor(s): Johnson, Beryl-Ann
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 60(2-B) Aug 1999, US: Univ. Microfilms International;
1999, 0832
Abstract/Review/Citation: An exploratory study was conducted to assess the
cognitive functioning of Vietnam veterans with combat-related post traumatic
stress disorder (PTSD). It was hypothesized that veterans with PTSD would
exhibit impaired memory and concentration abilities on neuropsychological
tests. Furthermore, veterans with a history of alcohol-related problems would
show greater cognitive deficits. Data was collected at two Veterans Affairs
Medical Centers in the Northeast. Twenty-four inpatient and outpatient,
Caucasian, African-American, and Hispanic Vietnam veterans with PTSD received
comprehensive neuropsychological and psychological assessments. Instruments
included seven WAIS-R subtests, the California Verbal Learning Test (CVLT),
WMS-R: Logical Memory and Visual Reproduction subtests, Grooved Pegboard,
Wisconsin Card Sorting Test (WCST), Paced Auditory Serial Addition Test
(PASAT), Stroop Neuropsychological Screening Test (SNST), Trail Making A-B,

Minnesota Multiphasic Personality Inventory-2 (MMPI-2), Beck
Depression Inventory (BDI), Severity of Dependence Scale (SDS), Combat
Exposure Scale (CES), Alcohol Use Disorders Inventory Test (AUDIT), and the
Mississippi Scale of Combat-Related Post Traumatic Stress Disorder. Veterans
with PTSD revealed abnormalities on the Stroop test implicating difficulty
with response inhibition. Also, the CVLT revealed a pattern of reduced
acquisition, poor retention, and numerous intrusive errors. Other measures of
cognitive functioning were within normal limits. Tests of psychopathology
revealed MMPI-2 scale elevations for depression, hypochondriasis, paranoia,
psychopathic deviate, psychasthenia, schizophrenia, and the PTSD scales.
Significant relationships were not detected between cognitive abilities and
psychopathology; nor were there significant differences between subjects with
alcohol-related problems and subjects without such problems. The pattern of
performance suggests that Vietnam combat veterans with PTSD suffer from
circumscribed cognitive deficits related to dysregulation of frontal
subcortical systems. Veterans demonstrated difficulty with organizing and
developing effective strategies to learn and remember new complex verbal
information. Subjects' difficulty with inhibiting a prepotent, overlearned
response further strengthens the implication of frontal regions in cognitive
difficulties.
========================================

Title: The prevalence of posttraumatic stress disorder among federal prison
inmates.
Author(s)/Editor(s): Guthrie, Robert Karl
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 60(6-B) Jan 1999, US: Univ. Microfilms International;
1999, 2943
Abstract/Review/Citation: Epidemiological studies concerning the prevalence of
posttraumatic stress disorder (PTSD) have identified lifetime rates for males
ranging from 0.5% to 6%. By contrast, studies of prison inmates have
identified lifetime prevalence rates for PTSD ranging from 2.3% to 13%. The
central hypothesis of this study stated that prevalence rates for incarcerated
males are higher than previously identified. In the study, 100 federal inmates
were assessed for PTSD using the Clinician-Administered PTSD Scale-DX
(CAPS-DX), the Posttraumatic Stress Diagnostic ScaleTM (PDSTM), and the Keane
Scale from the MMPI-2. Using the CAPS-DX as the official diagnostic
instrument, a lifetime prevalence rate of 30% and a current prevalence rate of
14% were identified. Both rates were significantly higher than previously
identified rates. Corrections psychologists were unaware of the presence of
all but one PTSD case identified in the study. The PDSTM was identified as an
effective screening instrument for use with federal inmates, and a previously
determined cut-off score of 24 on the Keane Scale was confirmed as useful with
this population. All three instruments, the CAPS-DX, PDSTM, and Keane Scale
agreed on nine of 14 diagnoses for current PTSD. The current research
confirmed previous research indicating that the number of potentially
traumatic events experienced by an individual is associated with increased
levels of PTSD symptomatology. Although it had been hypothesized that
African-Americans and Hispanics would have higher rates of PTSD than
Caucasians, just the opposite was found. Incarceration itself was identified
as a traumatic stressor that can precipitate PTSD symptomatology. However,
most of the identified PTSD cases were not the result of a discrete stressor,
but of multiple stressors. The study's efficacy was limited by the sample's
lack of representativeness of both the site and the federal inmate population
as a whole. This resulted from the unrepresentative racial composition of the
research site and the diminished participation of African-American inmates.
This diminish participation may have resulted, in part, from the racial
dissimilarity of the investigator. A study involving a greater number of
participants, using researchers of varying racial backgrounds, may help
confirm and expand upon the results of the current study.
========================================

Title: The use of the Rorschach in the assessment of PTSD among child victims of
sexual abuse: A validity study. (Posttraumatic Stress Disorder).
Author(s)/Editor(s): Heaton, Mari Katharine
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 60(6-B) Jan 1999, US: Univ. Microfilms International;
1999, 3001
Abstract/Review/Citation: The purpose of this study was to create a
Post-Traumatic Stress Disorder (PTSD) Rorschach Constellation that would
provide information useful in the assessment of PTSD in sexually abused
children and adolescents. It was hypothesized that the constellation would be
able to correctly discriminate subjects with PTSD from those subjects not
having PTSD. The sample consisted of 56 subjects who were selected from
archival data. Subjects, both male and female, were between the ages of 6 and
16 years of age when tested and were either Caucasian or African American.
Each subject was determined to have experienced some form of sexual abuse.
Each subject had been given the Rorschach which was administered and scored
using Exner's Comprehensive System. Utilizing pre-determined PTSD and Non-PTSD
groups, the PTSD Rorschach Constellation was not found to be able to correctly
classify subjects into the appropriate groups. Results from the validation of
the Constellation were not statistically significant. While the findings from
this study did not support the Rorschach Constellation's ability to provide
useful information in the assessment of PTSD, confounding variables likely
contributed to the Constellation's inability to discriminate those sexually
abused children with PTSD from those without the disorder.
========================================

Title: Evaluating stress:  A book of resources, Vol. 2.
Author(s)/Editor(s): Zalaquett, Carlos P.; Wood, Richard John
Source/Citation: Lanham, MD, US: Scarecrow Press, Inc; 1998, (xvii, 378)
Abstract/Review/Citation: This volume brings together 17 different instruments
for the evaluation of stress or stress-related factors. A book outline is
provided to help the reader easily find the location of each instrument, with
the page numbers of its description, research, benefits, administration,
scoring, application, case examples, and references in the main text. The
outline of this volume shows that the instruments reflect cultural diversity
and societal changes.  This volume, like the first one, is intended for
practitioners at all levels of practice and education in the social sciences.
The 2 volumes together present a broader number of instruments used in the
field and capture the breadth, depth, and complexity of stress instruments.
The instruments evaluating stress and the case examples provided in most of
the chapters show the diverse possibilities for evaluating stress in
individuals, groups, and organizations.
Notes/Comments:  Introduction Outline of the book Acronyms An Acculturative Stress Scale for International Students: A practical approach to stress management Daya S. Sandhu and Badiolah R. Asrabadi African-American Women's Stress Scale (AWSS) Darielle Watts-Jones The Coping Resources Inventory for Stress: A comprehensive measure of resources for stress-coping Kenneth B. Matheny and William L. Curlette The Daily Life Stressors Scale Christopher A. Kearney and Bonnie L. Horne The Derogatis Affects Balance Scale: A measure of affective balance and disregulation Leonard R. Derogatis
and Amy B. Palmer The Global Inventory of Stress (GIS): A comprehensive
approach to stress assessment Charles L. Sheridan and Sally A. Radmacher The
Hilson Career Satisfaction/Stress Index Robin Inwald, William Traynor and
Vicki Favuzza The Inventory of Positive Psychological Attitudes: Measuring
attitudes that buffer stress and facilitate primary prevention using
constructs responsive to diverse cultural world views Jared D. Kass The
Multidimensional Scale of Perceived Social Support (MSPSS) Gregory D. Zimet
The Perinatal Posttraumatic Stress Disorder (PTSD) Questionnaire (PPQ) Michael
T. Hynan The Personal Style Inventory: A measure of stress resiliency Charles
L. Sheridan and Sally A. Radmacher The School Refusal Assessment Scale
Christopher A. Kearney and Cheryl A. Tillotson The Self-Reliance Inventory: An
approach to interdependence and secure school attachments J. Lee Whittington,
Janice R. W. Joplin, Debra L. Nelson, Jonathan D. Quick and James Campbell
Quick The Stress Response Scale: A measure of children's behavioral adjustment
Louis A. Chandler The Stress Response Scale for Adolescents Gerald R. Adams
Student-Life Stress Inventory Bernadette M. Gadzella The Ways of Religious
Coping Scale Pamela Davis Martin, Sheryl L. Catz, Edwin Boudreaux and Phillip
J. Brantley Names index Subject index About the authors description &
research & benefits & administration & scoring & application  & case examples

of 17 instruments for evaluating stress or stress-related factors
========================================

Title: Provocation of a posttraumatic flashback by cholecystokinin tetrapeptide?
Author(s)/Editor(s): Kellner, Michael; Levengood, Robert; Yehuda, Rachel; Wiedemann, Klaus
Source/Citation: American Journal of Psychiatry; Vol 155(9) Sep 1998, US:
American Psychiatric Assn; 1998, 1299
Abstract/Review/Citation: Reports observation of a posttraumatic stress disorder
(PTSD) patient to receive an intravenous bolus of 50 mg of the potent
panicogen cholecystokinin tetrapeptide (CCK-4) in a double-blind,
placebo-controlled randomized trial. The S, a 35-yr-old African American male,
had been suffering from chronic PTSD with repetitive flashbacks for 4 yrs
after being shot in the stomach point-blank. After placebo injection, no
significant symptoms emerged. After CCK-4 injection, the S developed a
full-blown panic attack with nausea and abdominal symptoms. Furthermore, the S
reported (1) having seen himself, as in a video, back in the posttrauma
emergency room; (2) having smelled blood; and (3) having felt a drainage in
his stomach for about 45 sec, beginning approximately 1 min after CCK-4
injection. The flashback occurring during CCK-4 induced panic attack could
have been a drug effect mediated  by the activation of brainstem CCK
receptors. On the other hand, the abdominal symptoms produced by CCK-4 and the
contingent memories of trauma could have acted as conditioned stimuli to
trigger the flashback.
========================================

Title: The relationship between community crime level and the manifestation of
anxiety in a referred sample of children.
Author(s)/Editor(s): Kubiak, Clare Heather Simmons
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 58(7-A) Jan 1998, US: University Microfilms
International; 1998, 2546
Abstract/Review/Citation: Recent research has found an association between
exposure to chronic community violence and symptoms of post-traumatic stress
disorder (PTSD) in children. The assessment of PTSD and other anxiety
disorders can be problematic due to the low degree of agreement typically
found among parent, teacher, and childrens' ratings of anxiety. The current
study examined the relationship between community crime level and the
manifestation of anxiety in a sample of 298 children, ages 6 to 17 years,
referred for psychoeducational evaluation due to behavioral problems.
 ependent measures included the Revised Children's Manifest Anxiety Scale
(RCMAS) (Reynolds & Richmond, 1985); the Child Behavior Checklist (CBCL)
(Achenbach & Edelbrock, 1983); and the Teacher Report Form (TRF)
(Achenbach & Edelbrock, 1986). Other demographic variables of interest
were collected from psychoeducational records. Higher levels of community
crime, and larger family size were associated with lower self-report ratings
of anxiety. African-American females, of younger ages, residing in higher
crime areas with single, lower educated parents received higher ratings of
externalizing behaviors by teachers. Parent and teacher agreement was higher
for externalizing, as compared to internalizing behaviors. Higher levels of
community crime significantly influenced ratings of internalizing behaviors
among African-Americans who reported lower levels of anxiety than their
parents and teachers. Gender and age level did not influence cross-informant
agreement. Although the findings of this nonexperimental study should be
interpreted cautiously, the results imply that similar children residing in
high crime areas may deny anxiety symptomatology, and tend to display
increases in externalizing behaviors. This may promote adaptation to a
psychologically challenging environment. The results also suggest that
information should be obtained from multiple informants, and interpreted
within the context of childrens' environments, when using ratings scales to
measure anxiety in children.
========================================

Title: Culture-centeredness training as an intervention for chronic
racism-related posttraumatic stress disorder symptoms in African-American
adolescents.
Author(s)/Editor(s): Olatunji, Cirecie Ann
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 58(12-A) Jun 1998, US: University Microfilms
International; 1998, 4570
Abstract/Review/Citation: The relationship between post-traumatic stress
disorder symptomology and evidence of African self-consciousness was explored
in this experimental study of 14 African-American male and female adolescents.
The participants, ranging in age from 13-15 years, were all in attendance at
an experimental middle school for students with severe behavioral and
attitudinal problems. Participants were administered the African
Self-Consciousness Scale (ASCS) and the Child Post-Traumatic Stress Disorder
Reaction Index (CPTSD-RI) as pre- and post-test instruments. The experimental
group received the CCMA Cultural Awareness Training Module workshops while the
control group received life skills workshops. Using a mixed-method design, a
correlation between African self-consciousness and post-treatment
post-traumatic stress disorder symptomology was found, but not in the
predictive direction. Neither gender nor participant group was found to have a
significant effect on the subjects' cultural identity awareness or
post-traumatic stress disorder symptomology. While the experimental component
of the study suggests replication with a larger sample size, the case study
conclusions seem to support the role of developmental frameworks in mediating
the effects of psychological distress among adolescents, particularly
African-American adolescents as put forth by Calabrese and Underwood (1994)
and Shakoor and Chalmers (1991). That is, the success of African-American
adolescents in resolving the developmental crisis of moving into early
adulthood may be influenced by culturally-bound attitudes of group identity.
========================================

Title: The impact of exposure to community violence on children and adolescents.
Author(s)/Editor(s): Scott, Marilyn Cole
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 59(2-B) Aug 1998, US: Univ. Microfilms International;
1998, 0887
Abstract/Review/Citation: The crisis of violence in our urban cities has
expanded to more than the victims. A previously unrecognized group of victims
are children and adolescents who witness or are victimized by community
violence. It is assumed that African-American youth who experience violence
are not traumatized or impacted with psychological distress symptomatology.
Based upon the above assumption, a study was conducted that examined the
relationship between violence exposure, psychological symptoms, and parental
support among a group of high school students. The study consisted of 100
students in an alternative public high school in Chicago. Fifty males and
fifty females were used in the sample. The students selected for the study
reported exposure to violence in their respected communities. Three
instruments were used as measurement tools in the study: The Survey of
Children's Exposure to Community Violence, abbreviated version (Richter,
1993), Trauma Symptom Checklist for Children (TSCC), and the Life Stressors
and Social Resources Inventory-Youth-Form (LISRES-Y). A correlational research
design which included Pearson Correlation Coefficient, ANOVA, MANOVA, ANCOVA,
descriptive statistics, and frequency counts were utilized to investigate the
findings and the four major hypotheses. The hypotheses tested were as follows:
(a) that exposure to violence will not have a positive and significant
association with PTSD symptoms or other psychological distress symptoms, (b)
that adolescents who are exposed to chronic violence will not exhibit symptoms
when parental support is available, (c) females will not exhibit more PTSD
symptoms than males as a result of chronic violence, and (d) males will not
experience higher levels of victimization and witnessing of violence than
females. The results revealed that increased exposure to cumulative violence
is associated with depression. The results indicated that there were gender
differences associated with the psychological distress symptoms of depression
and post-traumatic Stress Disorder. Females exhibited more symptoms than their
male counterparts. Also, it was found that males experienced far more
victimization and witnessed more violence than females. Future studies
indicate that more empirical research is needed across diverse populations.
========================================

Title: Does PTSD transcend cultural barriers? A study from the Khmer Adolescent
refugee project.
Author(s)/Editor(s): Sack, William H.; Seeley, John R.; Clarke, Gregory N.
Source/Citation: Journal of the American Academy of Child & Adolescent
Psychiatry; Vol 36(1) Jan 1997, US: Williams & Wilkins Co.; 1997, 49-54
Abstract/Review/Citation: Sought to determine whether the factor structure of
the posttraumatic stress disorder (PTSD) syndrome in Cambodian refugee youth
resembles earlier reported factor studies in Caucasian samples. 194 Khmer
refugees (aged 13-25 yrs) who reported prior significant trauma (most of it
massive war trauma as children) were administered the PTSD module of the
Diagnostic Interview for Children and Adolescents, as part of an
epidemiological study on the effects of war on this group of refugees. Four
factors were found: arousal, avoidance, intrusion, and numbing. A confirmatory
factor analysis using data from the parents of this sample yielded a good fit
for the 4-factor solution based on the youth data. The factor solution
resembled those found in earlier studies on traumatized Caucasian and
African-American adults. These results lend further credibility to the
veracity of this diagnosis with refugee samples. PTSD as a result of prior war
trauma appears to surmount the barriers of culture and language.
========================================

Title: Posttraumatic symptomatology in children and adolescents after an
industrial fire.
Author(s)/Editor(s): March, John S.; Amaya-Jackson, Lisa; Terry, Robert;

Costanzo, Philip
Source/Citation: Journal of the American Academy of Child & Adolescent
Psychiatry; Vol 36(8) Aug 1997, US: Williams & Wilkins Co.; 1997,
1080-1088
Abstract/Review/Citation: Evaluated the extent and nature of posttraumatic
symptomatology (PTS) in children and adolescents (aged 10-16 yrs) 9 mo after
an industrial fire at a processing plant in their community caused extensive
loss of life. Using a PTS self-report measure and self- and teacher-reports of
comorbid symptoms, 1,019 4th- to 9th-grade students in the community were
surveyed. Three factors comprising PTS were identified: reexperiencing,
avoidance, and hyperarousal. Reexperiencing and avoidance were positively
correlated. 9.7% of Ss met criteria for PTS; 11.9% of Ss met criteria for
posttraumatic stress disorder (PTSD) using Mental Disorders-III-Revised
(DSM-III-R) criteria. Degree of exposure was the most powerful predictor of
PTS. Race (African-American) and gender (female) posed significant risk
factors for PTS. Self-reported internalizing symptoms and teacher-reported
externalizing symptoms were positively predicted by intercurrent PTS, and
independently of PTS, by degree of exposure. Lack of self-attributed personal
efficacy predicted PTS but did not moderate the effects of race or gender on
PTS risk.
========================================

Title: Assessment of intellectual resources in Gulf War veterans: Relationship
to PTSD.
Author(s)/Editor(s): Vasterling, Jennifer J.; Brailey, Kevin; Constans, Joseph I.; Borges, Alicia; et al
Source/Citation: Assessment; Vol 4(1) Mar 1997, US: Psychological Assessment
Resources Inc; 1997, 51-59
Abstract/Review/Citation: Recent research has indicated that individual
difference factors may alter vulnerability to trauma-related distress; one
such factor is intellectual sophistication. To examine the effects of this
factor to the development of posttraumatic stress disorder (PTSD)
symptomatology, intellectual functioning in 2 subsets of African-American and
Hispanic Persian Gulf War veterans (18 PTSD-diagnosed and 23
psychopathology-free veterans [PFVs] [mean age 35.17 yrs]), were compared with
the use of Wechsler Adult Intelligence ScaleRevised (WAISR). Results showed
that PTSD-diagnosed veterans performed poorly than the PFVs on WAIS-R verbal
subtests, including those tasks thought to reflect premorbid functioning. The
2 groups did not differ on visuospatial tasks or on a task of attention.
Findings suggest that greater intellectual resources, particularly verbal
skills, may buffer the development of stress-related psychopathology following
trauma exposure.
========================================

Title: An intergenerational model of posttraumatic stress disorder in the
African American community: An analysis of the autobiographies of Olaudah
Equiano, Harriet A. Jacobs, Zora Neale Hurston, and Langston Hughes.
Author(s)/Editor(s): Bolling, Carolyn Rae
Source/Citation: Dissertation Abstracts International Section A: Humanities
& Social Sciences; Vol 58(3-A) Sep 1997, US: University Microfilms
International; 1997, 0867
Abstract/Review/Citation: This study presents an Intergenerational Model of
Posttraumatic Stress Disorder (PTSD) in the African American community by
reading the proposed Intergenerational PTSD Model against four
autobiographical works produced by African descended authors. The basic
premise of the study is that African psyches have been traumatized by exposure
to and encounters with catastrophic threats and extreme levels of stress in
the context of American oppression. The study basically focuses on the issue
of trauma and how traumatic experiences have affected the African psyche. The
Intergenerational Model of PTSD suggests that African Americans as a
collective group are suffering from a psychological disorder similar to but
not completely within the confines of PTSD. This study argues that generation
after generation of extreme psychosocial stressors have created a type of
psychohistorical or intergenerational PTSD in the African American collective
psyche. In this model PTSD is not a disorder of a single individual caused by
a single event. Intergenerational PTSD is a disorder that plagues a group of
people over the course of history. This study contends that African Americans
are suffering from generation upon generation of PTSD. The first generation of
PTSD would have occurred when the first generation of Africans were enslaved
in the Americas and every generation of African Americans since that time has
suffered its own unique PTSD. This model sees the original untraumatized
African at the center of a circle with layer upon layer, generation after
generation of PTSD encircling him or her. Therefore, contemporary generations
of African Americans would be encircled by at least twenty generations of
PTSD. There are three primary components in the Intergenerational PTSD Model.
The autobiographies of Olaudah Equiano, Harriet Jacobs, Zora Neale Hurston,
and Langston Hughes will be examined based on these components.
========================================

Title: The impact of violence exposure in latency age African-American children.
Author(s)/Editor(s): Lockhart, Keli Drew
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 58(5-B) Nov 1997, US: Univ. Microfilms International;
1997, 2687
Abstract/Review/Citation: Forty-eight African American boys and girls, ages nine
and ten, from an urban setting of the Bay Area in California, were studied to
determine if exposure to community violence had a negative effect on their
self-esteem, resulted in symptoms of posttraumatic stress disorder (PTSD) or
hindered their ability to define a future for themselves (future orientation)
Research questions also addressed whether there was an effect by type of
violence exposure; direct, indirect or combined (direct and indirect) and
gender on the self-esteem, development of PTSD symptoms or future orientation
in the target population. No participants fit into the category of direct
victim; those who experienced direct personal physical harm as a result of a
violent act. Forty-four percent (n = 21) of study participants fell into the
indirect category of violence exposure and fifty-six percent (n = 27) into the
combined category. Forty-six percent (n = 22) of the participants were female
and fifty-four percent (n = 26), male. Five measures were orally and
individually administered in the study: the Hopelessness Scale for Children,
My Future Scale, Survey of Children's Exposure to Community Violence, Child
Post-traumatic Stress Reaction Index, and Piers-Harris Children's Self-Concept
Scale-Revised. A debriefing process was incorporated because of the serious
nature of the topic and potential stress to the participants. Pearson
product-moment correlations revealed a significant relationship between
exposure to violence and self-esteem and exposure to violence and symptoms of
PTSD, but not on exposure to violence and future orientation. There were also
no significant differences in study variables based on type of violence
exposure (indirect or combined) or gender as determined by analysis of
variance. The results provided strong evidence that exposure to violence
lowers self-esteem in children and results in moderate to severe symptoms of
 osttraumatic stress disorder. Qualitative measures indicated a diminished
sense of the future with exposure to violence with children reporting specific
fears about their future. The impact of violence exposure on children is
clearly significant and requires early interventions to decrease the negative
impact on children who are unable to leave their 'warzones.'
========================================

Title: Traumatic stress and health status in HIV-infected women.
Author(s)/Editor(s): Kimerling, Rachel
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 58(6-B) Dec 1997, US: Univ Microfilms International;
1997, 3318
Abstract/Review/Citation: A sample of low socioeconomic status African American
HIV-infected women were assessed for reports of traumatic life events as
specified in the Diagnostic and Statistical Manual IV criteria for Post
Traumatic Stress Disorder (PTSD). Symptoms of PTSD were also assessed in women
who reported traumatic events. Exposure to trauma and symptoms of PTSD were
examined as longitudinal predictors of health status. Self-reported physical
symptoms, AIDS-defining conditions, and CD4 and CD8 t-cell subpopulations were
examined as health status indicators. These variables were assessed twice,
with an interval of 12-14 months between assessments. Hypotheses were that
exposure to trauma and symptoms of PTSD would each contribute some unique
variance in the prediction of health status, and that increased stressor
exposure and PTSD symptoms would be associated with increases in self-reported
physical symptoms and AIDS-defining conditions, and decreases in CD4 and CD8
t-cell subpopulations. Results of the study revealed high prevalence of death
of one's child, being mugged or attacked, physical assault, and completed
rape. These events were associated with increased reports of physical
symptoms, increased diagnoses of AIDS-defining conditions, and increased
decline in CD4 t-cells and CD8 t-cells. Symptoms of PTSD mediated the
relationship between traumatic events and self-reported physical symptoms, and
moderated the relationship between traumatic events and CD8 t-cell decline.
========================================

Title: Warriors as peacekeepers: Features of the Somalia experience and PTSD.
Author(s)/Editor(s): Litz, Brett T.; King, Lynda A.; King, Daniel W.; Orsillo, Susan M.; Friedman, Matthew J.
Source/Citation: Journal of Consulting & Clinical Psychology; Vol 65(6) Dec
1997, US: American Psychological Assn; 1997, 1001-1010
Abstract/Review/Citation: There has been scant empirical study of the
psychological consequences of contemporary peacekeeping missions. This study
examined relationships among 4 variables characterizing this type of operation
(traditional combat events, negative aspects of peacekeeping, pressure to
uphold restraint, and positive aspects of peacekeeping) and symptoms of
posttraumatic stress disorder (PTSD). Participants were 3,310 male and female
soldiers who served in the 1992-1994 Somalia mission. Structural equation
modeling procedures were applied to data from subsamples of non-African
Americans and African Americans. For both groups, traditional combat and
negative aspects of peacekeeping were associated with PTSD, frustration with
restraint, and positive aspects of peacekeeping; however, restraint was not
related to PTSD. Discrepancies between the groups involved relationships among
the restraint, positive aspects, and PTSD variables. Recommendations are
offered to foster inquiry into this new research. 
========================================

Title: Pancreatitis associated with serotonin-dopamine antagonists.
Author(s)/Editor(s): Nishawala, Melissa A.; Callaghan, Marian; Malatack, J. Jeffrey; Moughan, Beth; Ambrosini, Paul J.; Price, Bernadette; Elia, Josephine
Source/Citation: Journal of Child & Adolescent Psychopharmacology; Vol 7(3)
1997, US: Mary Ann Liebert Inc Publishers; 1997, 211-213
Abstract/Review/Citation: Presents a case report of a 16-yr-old African-American
female who developed nearly fatal pancreatitus following olanzipine and
divalproex treatment for major psychotic depression and severe posttraumatic
stress disorder (PTSD). Three weeks following the start of olanzipine
treatment, the S was admitted to a pediatric hospital with abdominal pain and
bilious emesis. A biochemistry profile profile showed results consistent with
the diagnosis of acute pancreatitus with associated renal failure. Within
hours of admission, the S became critically ill with hemodynamic instability,
acute renal failure, and respiratory failure. Subsequent findings were
consistent with hepatitus secondary to pancreatitus. The author notes this is
the 7th case of pancreatitus associated with the use of serotonin-dopamine
antagonists, and the 2nd in a young patient. It is argued that the speed at
which serotonin-dopamine antagonist use has entered the arena of child and
adolescent treatment is a cause for concern. Vigilance in monitoring adverse
reactions is necessary, particularly if this medication is used in combination
with other drugs, especially valproate.
========================================

Title: Psychiatric symptomatology and psychological functioning in HIV-infected
mothers.
Author(s)/Editor(s): Mellins, Claude Ann; Ehrardt, Anke A.; Grant, Wanda F.
Source/Citation: AIDS & Behavior: Special Issue:  ; Vol 1(4) Dec 1997,
Netherlands: Kluwer Academic Publishers; 1997, 233-245
Abstract/Review/Citation: The present study examined psychiatric and
psychological functioning in HIV-infected mothers (mean age 31 yrs old) with
young children. Reflecting the epidemiology of HIV disease in women, the
majority were African American and Latina, socioeconomically disadvantaged
single parents with histories of substance use. Women were recruited from
primary care HIV clinics. They were administered a structured psychiatric
interview (SCID-R-Nonpatient form), as well as a psychological symptom
questionnaire (Demoralization Scale). Prevalence rates of lifetime psychiatric
diagnoses (88%), particularly lifetime histories of major depression (58%) and
posttraumatic stress disorder (PTSD) (38%), were considerably higher than in
other comparable samples in the literature. History of substance use was
associated with history of PTSD and the number of traumas experienced was
associated with psychiatric and psychological functioning.
========================================

Title: Effects of chronic violence on inner city junior high school-aged
children.
Author(s)/Editor(s): Coles, Harold A.
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 56(9-B) Mar 1996, US: Univ. Microfilms International;
1996, 5153
Abstract/Review/Citation: Until recently, there has been very little research
dealing with the effects of chronic exposure to violence on children. Many
inner city children live in an environment, that is, by definition--stressful.
When children experience trauma in their daily lives and it goes unrecognized,
what are the possible ramifications? One of the goals of this study was to go
beyond documenting frequency accounts of different types of chronic traumatic
experience. This study investigated the relationship between chronic exposure
to violence and stress reaction. The sample consisted of 4 classes totaling
100 sixth grade mainstream students (51 males and 49 females) attending a
junior high school in Brooklyn, New York (80 African-American, 7
Latin-American, and 13 other). The junior high school was one of 5 in a very
high crime area of the city. The questionnaire designed for this study
consisted of Background information, a Violence Screening Form, the Child Post
Traumatic Stress Reaction Index (CPTS), Checklist of Child Distress Symptoms
(CCDS), Kazdin Hopelessness Scale (KHS), and a Life Events scale of the last
six months (LSM). The students completed the questionnaire during the morning
part of their school day in June 1993. Correlations were obtained between
exposure to violence (type and target) and resulting stress reactions. The
relationship between social support buffering the effects of exposure to
violence and stress reactions were also investigated. According to the CPTS
 scoring, most of the children experienced some level of symptoms associated
with PTSD. Males and females showed similar reactions to exposure to violence
across four of the five categories. The first hypothesis was supported with a
positive correlation found between the exposure to violence type and target on
two measures of PTSD related symptoms. A positive relationship was found
between exposure to violence and stress reaction. The second hypothesis of the
greater the degree of social support, the lower the PTSD related symptoms.
========================================

Title: Ethnocultural aspects of posttraumatic stress disorder:  Issues,
research, and clinical applications.
Author(s)/Editor(s): Marsella, Anthony J.; Friedman, Matthew J.; Gerrity, Ellen T.; Scurfield, Raymond M.
Source/Citation: Washington, DC, US: American Psychological Association; 1996,
(xxii, 576)
Abstract/Review/Citation: The purpose of this volume is to explore and examine
the role of ethnocultural aspects of posttraumatic stress disorder (PTSD)
through a . . . discussion of current theory, research and practice on the
topic. [The book explores] both universal and culture-specific reactions to
trauma, and [discusses] implications for research, treatment, and prevention.
The multidisciplinary perspective of the book will appeal to a broad audience
of psychologists, psychiatrists, anthropologists, epidemiologists,
sociologists, and social workers.
Notes/Comments:  Contributors Preface Acknowledgments Introduction [by] Anthony J. Marsella, Matthew J. Friedman, Ellen T. Gerrity and Raymond M. Scurfield Part I: Foundations Posttraumatic stress disorder: An overview of the concept  Matthew J. Friedman and Anthony J. Marsella The epidemiology of PTSD: A comprehensive review of the international literature  Giovanni de Girolamo and Alexander C. McFarlane The treatment of PTSD and related stress disorders: Current research and clinical knowledge  Ellen T. Gerrity and Susan D. Solomon Part II: Ethnocultural research on PTSD:
Conceptual and methodological issues Ethnocultural aspects of PTSD: An
overview of issues and research directions  Anthony J. Marsella, Matthew J.
Friedman, and E. Huland Spain Confusion of the senses: Implications of
ethnocultural variations in somatoform and dissociative disorders for PTSD 
Laurence J. Kirmayer Culture, emotion, and PTSD  Janis H. Jenkins Ethnocultural considerations in the assessment of PTSD  Terence M. Keane,
Danny G. Kaloupek and Frank W. Weathers Part III: PTSD among specific
ethnocultural groups PTSD among African Americans  Irving M. Allen Cumulative
trauma and PTSD in American Indian communities  Robert W. Robin, Barbara
Chester and David Goldman Wounded spirits, ailing hearts: PTSD and related
disorders among American Indians  Spero Manson, Janette Beals, Theresa O'Nell,
Joan Piasecki, Donald Bechtold, Ellen Keane and Monica Jones Traumatization
stress among Asians and Asian Americans  Francis R. Abueg and Kevin M. Chun
PTSD and related stress disorders among Hispanics  Richard L. Hough, Glorisa
J. Canino, Francis R. Abueg and Fred D. Gusman Part IV: Ethnocultural aspects
of PTSD among specific victim populations Cross-national and ethnocultural
issues in disaster research  Bonnie L. Green Women of color and traumatic
stress in "domestic captivity": Gender and race as disempowering
statuses  Maria P. Root Ethnocultural aspects of PTSD and related disorders
among children and adolescents  Vincenzo F. DiNicola Ethnocultural
considerations in understanding PTSD and related disorders among military
veterans  William Schlenger and John Fairbank Part V: Ethnocultural
considerations in therapy and mental health services for PTSD A multicultural
developmental approach for treating trauma  Fred D. Gusman, Judith Stewart,
Bruce Hiley Young, Sherry J. Riney, Francis R. Abueg and Dudley David Blake
Ethnocultural considerations in the treatment of PTSD: Therapy and service
delivery  Juris G. Draguns Ethnocultural variations in service use among
veterans suffering from PTSD  Robert Rosenheck and Alan Fontana
Ethnopsychopharmacology and the treatment of PTSD  Keh-Ming Lin, Russell E.
Poland, Dora Anderson and Ira M. Lesser Part VI: Conclusion Ethnocultural
aspects of PTSD: Some closing thoughts Anthony J. Marsella, Matthew J.
Friedman, Ellen T. Gerrity and Raymond M. Scurfield Author index Subject index
About the editors ethnocultural aspects of PTSD, implications for research
& treatment & prevention, conference presentation
========================================

Title: PTSD among African Americans.
Author(s)/Editor(s): Allen, Irving M.
Source/Citation: Ethnocultural aspects of posttraumatic stress disorder: 
Issues, research, and clinical applications., Washington, DC, US: American
Psychological Association; 1996, (xxii, 576), 209-238
Source editor(s): Marsella, Anthony J. (Ed)
Abstract/Review/Citation: review and interpret some research, especially on
Vietnam War veterans, that demonstrates a positive relationship between
African American status and the development of posttraumatic stress disorder
(PTSD) / 3 studies of civilian populations that have implications for African
Americans will also be discussed / discuss recent studies that document a
huge increase in urban violence during the 1980s and the concomitant
disturbing increase in obvious PTSD-related symptomatology in young people who
are either witnesses or victims of this violence epidemic / review work that
shows the disturbing incidence of domestic violence towards African American
women / a context for understanding the epidemic of violence will be provided
by an extensive discussion of the current status of African Americans that
will cite health, unemployment, crime, and other data that document grim
current life circumstances for the majority of African Americans /
psychological theory, using the concept of projective identification, will be
presented as a means of understanding the development and persistence of
destructive, abusive, and racially discriminating behavior towards African
Americans / the consequences of projective identification will also be applied
to the processes of clinical diagnosis and treatment
========================================

Title: Ethnocultural variations in service use among veterans suffering from PTSD.
Author(s)/Editor(s): Rosenheck, Robert; Fontana, Alan
Source/Citation: Ethnocultural aspects of posttraumatic stress disorder: 
Issues, research, and clinical applications., Washington, DC, US: American
Psychological Association; 1996, (xxii, 576), 483-504
Source editor(s): Marsella, Anthony J. (Ed)
Abstract/Review/Citation: provide a thorough discussion of [the authors'] data
on ethnocultural elements of service use for [posttraumatic stress disorder
(PTSD)] in VA [US Department of Veterans Affairs] clinics, with a special
focus on African American, Hispanic, and Euro-American populations /
explores differences among ethnocultural minority groups in 5 related domains:
(a) sociodemographic status and baseline clinical presentation, (b)
self-identified service needs, (c) past service use, (d) prospectively
examined use of team services during the year after first contact with the
program, and (e) clinical improvement as assessed by team clinicians at the
time of the last clinical contact / hoped to determine whether there were
differences among minority groups in clinical problems and self-identified
needs, in receipt of services, and in benefit from services / [veterans]
received a formal assessment using a structured interview instrument, the War
Stress Interview, Part 1.
========================================

Title: Vietnam wives:  Facing the challenges of life with veterans suffering
post-traumatic stress (2nd ed.).
Author(s)/Editor(s): Matsakis, Aphrodite
Source/Citation: Lutherville, MD, US: The Sidran Press; 1996, (440)
Abstract/Review/Citation: In "Vietnam Wives," Dr. Matsakis revisits
the plight of the secondary victims of the war: the wives and children of
veterans with posttraumatic stress disorder (PTSD). The book explores the many
changes encountered by traumatized veterans and their families as they face
the difficult developmental stage of mid-life: retirement, the "empty
nest syndrome," becoming grandparents, and, in many cases, separation and
divorce. Matsakis deftly leads readers through the process of finding better
ways to cope with new challenges and old. She explains PTSD, its causes,
symptoms, and the devastating long-term effects, including domestic violence,
substance abuse, and suicidal feelings.
========================================

Title: Assessment of psychological distress in Persian Gulf troops: Ethnicity
and gender comparisons.
Author(s)/Editor(s): Sutker, Patricia B.; Davis, John Mark; Uddo, Madeline; Ditta, Shelly R.
Source/Citation: Journal of Personality Assessment; Vol 64(3) Jun 1995, US:
Lawrence Erlbaum Associates; 1995, 415-427
Abstract/Review/Citation: Used data collected from 912 military personnel (63%
white, 28% African American, 8% Hispanic, 14% women) mobilized by Operation
Desert Storm to examine whether ethnic minority status and female gender would
be associated with higher levels of psychological distress. Ss were divided
into 653 war-zone-deployed and 259 stateside-duty personnel. Ss completed a
battery of tests that included the Shipley Institute of Living Scale, the
Wechsler Adult Intelligence Scale--Revised (WAIS--R), and the Mental
Disorders-III-Revised (DSM-III-R). The experience of war-zone duty was
associated with higher levels of post-military duty psychological distress,
specifically symptoms of depression, anxiety, and physical discomfort, that
was found for Ss who remained stateside, regardless of gender and ethnicity
characteristics. Minority, particularly male minority, troops tended to report
more psychological distress and PTSD symptoms. Women did not report greater
symptoms of psychological symptoms.
========================================

Title: Sibling death in adolescence: The relationship of coping responses to
adjustment, stressor type, and age.
Author(s)/Editor(s): Aupperle, Douglas Ronald
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 56(2-B) Aug 1995, US: Univ. Microfilms International;
1995, 1098
Abstract/Review/Citation: This study attempted to identify how adolescents cope
with traumatic sibling death. Participants were 10 male and 10 female young
people from the Chicago metropolitan area. Their average age was 16.20 years,
and all had lost a sibling to either suicide (n = 9) or an automobile accident
(n = 11). They were 60% white, 30% African-American, 5% Latino, and 5% Native
American. Interviews occurred 8 to 34 months after the deaths of the siblings
(M = 14.3 months). Participants completed the Ways of Coping Questionnaire
(WCQ) for both the sibling death and a minor stressor. They also completed the
Family Environment Scale (FES), Children's Depression Inventory (CDI),
Posttraumatic Reaction Index (PRI), and the grief recovery section of the
Grief Inventory (GI). Adolescents reported less use of planful problem-solving
and greater use of escape-avoidance and positive reappraisal when coping with
traumatic sibling death than when coping with minor stressors. Appraised
control of the stressor was less for sibling death than for minor stressors.
In addition, the number of coping behaviors used with sibling death was
greater than with minor stressors. With regard to traumatic sibling death, the
use of escape-avoidance to cope decreased as adolescents' age increased. With
regard to minor stressors, the use of distancing to cope decreased and the use
of planful problem-solving to cope increased as adolescents' age increased.
Higher use of escape-avoidance to cope with sibling death correlated with
higher severity of depression, severity of posttraumatic stress disorder
(PTSD), intrusiveness/numbing/avoidance symptoms of PTSD, and fear/anxiety
symptoms of PTSD. Higher use of confrontive coping correlated with higher PTSD
severity, intrusiveness/numbing/avoidance symptoms, and fear anxiety symptoms
but not depression. Higher seeking of social support correlated with higher
PTSD severity and fear/anxiety symptoms only. Higher accepting responsibility
correlated with higher PTSD severity.
========================================

Title: Impact of community violence on African-American children and adolescents
in a high violent crime neighborhood.
Author(s)/Editor(s): Cunningham, Phillippe Belton
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 56(6-B) Dec 1995, US: Univ. Microfilms International;
1995, 3440
Abstract/Review/Citation: This project examined psychosocial functioning
associated with exposure to a chronic stressor, namely, community violence
among randomly selected 8 to 17 year-old African-American children and
adolescents residing in a relatively high violent-crime neighborhood. A
structured psychiatric interview, the Diagnostic Interview for Children and
Adolescents-Revised, and self-report measures including Sexual Abuse Fear
Evaluation, Horowitz Impact of Events Scale, and Children's Depression
Inventory were administered. Consistent with previous findings, the results
indicate that inner-city African-American children are exposed to a
considerable amount of community violence. As predicted, high levels of
exposure to community violence was significantly associated with various
measures of psychological distress, particularly with externalizing
symptomatology. Additionally, regression analyses revealed that exposure to
community violence added significant variance above and beyond that
contributed by pertinent demographic characteristics. Partial support was
found for the hypotheses that number and quality of social supports as well as
self-perceived competence (self-esteem) across various domains moderated the
relationship between exposure to community violence and psychological
distress. Discussion of the relatively low levels of PTSD, fear, and
depression are discussed in terms of sample characteristics and cross-cultural
relevance of current diagnostic nosology, as well as, instruments measuring
psychological distress. Findings are also discussed within the context of the
Conservation of Resources Model of stress.
========================================

Title: Psychological testing as a diagnostic and therapeutic tool in the
treatment of traumatized Latin American and African refugees.
Author(s)/Editor(s): Nieves-Grafals, Sara
Source/Citation: Cultural Diversity & Mental Health; Vol 1(1) 1995, US:
Educational Publishing Foundation; 1995, 19-27
Abstract/Review/Citation: The use of psychological assessment, an underutilized
tool, in connection with posttraumatic stress disorder (PTSD) is presented.
Identification of PTSD in refugees from Latin America and Africa is usually
difficult because it is compounded by the trauma of migration. Issues
regarding diagnosis and treatment are discussed, and case examples (adult
Hispanic male and 40-yr-old African female) are provided to illustrate
specific clinical concerns. Disclosure of historical information to the
clinician and validation of a history of trauma are addressed through the
testing process and projective data patterns.
========================================

Title: Violence among inner city high school students and post-traumatic stress
disorder.
Author(s)/Editor(s): Jenkins, Esther J.; Bell, Carl C.
Source/Citation: Anxiety disorders in African Americans., New York, NY, US:
Springer Publishing Co, Inc; 1994, (xviii, 246), 76-88
Source editor(s): Friedman, Steven (Ed)
Abstract/Review/Citation: [discuss] relationships between exposure to community
and family violence and psychological distress [and posttraumatic stress
disorder (PTSD)] / examined variables related to violence exposure in a sample
of high school students in a high violence area [in] Chicago / this adolescent
group is of particular interest because their trauma reactions may include
negative behaviors (i.e., delinquency, violence, and drug use) that are quite
destructive for the individual and the community and may feed into and
perpetuate the cycle of violence / the sample consisted of 203 African
American students / correlations were made [for boys and girls] between the
distress symptoms, frequency of the high-risk behaviors in the last 6 mo, and
the 4 types of violence exposure (severity of violent act witnessed, personal
victimization, victimization of friends, and victimization of family members)
========================================

Title: Post-traumatic stress disorder in women recovering from substance abuse.
Author(s)/Editor(s): Fullilove, Mindy Thompson; Fullilove, Robert E. III
Source/Citation: Anxiety disorders in African Americans., New York, NY, US:
Springer Publishing Co, Inc; 1994, (xviii, 246), 89-101
Source editor(s): Friedman, Steven (Ed)
Abstract/Review/Citation: in order to assess the extent to which women in drug
treatment had experienced trauma [and violence] and had developed
posttraumatic stress disorder (PTSD), . . . surveyed [20-53 yr old] women in a
drug treatment program / the sample was predominantly African American /
[examined] the factors that might be associated with the diagnosis of PTSD in
this patient population
========================================

Title: Comparability of two administration formats of the Keane Posttraumatic
Stress Disorder Scale.
Author(s)/Editor(s): Lyons, Judith A.; Scotti, Joseph R.
Source/Citation: Psychological Assessment; Vol 6(3) Sep 1994, US: American
Psychological Assn.; 1994, 209-211
Abstract/Review/Citation: Evaluated the utility of administering the 49 items of
the Keane MMPI posttraumatic stress disorder (PTSD) scale (T. M. Keane et al) as an instrument separate from the full MMPI. Scores obtained through a separate administration of the PTSD scale were significantly positively correlated with scores obtained through a standard administration of the MMPI. This finding held for both White (n = 114) and African-American (n = 61) Ss. Within each ethnic group, mean scores were virtually identical across administration formats. Overall, 94.3% of the
veterans were similarly classified on both administrations of the PTSD scale
when the recommended cutoff score of 30 was applied. The clinical and research
uses of the PTSD scale as a separate instrument are discussed.
========================================

Title: Integrating African and Western healing practices in South Africa.
Author(s)/Editor(s): Straker, Gillian
Source/Citation: American Journal of Psychotherapy; Vol 48(3) Sum 1994, US: Assn
for the Advancement of Psychotherapy; 1994, 455-467
Abstract/Review/Citation: Outlines a therapeutic encounter with 3 adolescent
daughters of a murdered tribal chief who were suffering from symptoms
characteristic of posttraumatic stress disorder (PTSD). The author shows how a
dream shared by the 3 sisters can be interpreted from within both African and
Western frameworks. Both frameworks acknowledge these symptoms as a function
of (1) breached stimulus boundaries, (2) existing survivor guilt, and (3)
frozen mourning. Many factors considered to be part of Western psychotherapy
(e.g., catharsis after reliving the trauma, insightful reordering of
perceptions, and fostering hope while reconnecting with the past) can be
promoted while viewing the dream as a communication from ancestral spirits
concerning duties to be fulfilled, as opposed to a manifestation of
intrapsychic conflict.
========================================

Title: The effects of community violence on inner city school-age children.
Author(s)/Editor(s): Mercer, Diana Faye
Source/Citation: Dissertation Abstracts International: Section B: The Sciences
& Engineering; Vol 54(7-B) 1994, US: Univ. Microfilms International; 1994, 3859
========================================

Title: The prevalence and consequences of exposure to violence among
African-American youth.
Author(s)/Editor(s): Fitzpatrick, Kevin M.; Boldizar, Janet P.
Source/Citation: Journal of the American Academy of Child & Adolescent
Psychiatry; Vol 32(2) Mar 1993, US: Williams & Wilkins Co.; 1993, 424-430
Abstract/Review/Citation: Examined the relationship between chronic exposure to
community violence and posttraumatic stress disorder (PTSD) symptoms in 102
male and 119 female low-income African-American youth (aged 7-18 yrs). Males
were more likely than females to be victims of and witness to violent acts;
there were no other significant sociodemographic differences in degree of
exposure to violence. PTSD symptom reporting was moderately high for this
sample; 54 Ss met all 3 diagnostic criteria considered. Regression analyses
reveal that being victimized and witnessing violence were significantly
related to reporting of PTSD symptoms. These symptoms were more extreme among
victimized females and among victimized Ss who had no primary males (i.e.,
fathers, brothers) living with them in the household.
========================================

Title: Anxiety disorders in African-American and White children.
Author(s)/Editor(s): Last, Cynthia G.; Perrin, Sean
Source/Citation: Journal of Abnormal Child Psychology; Vol 21(2) Apr 1993, US:
Kluwer Academic/Plenum Publishers; 1993, 153-164
Abstract/Review/Citation: Compared 30 African-American and 39 White children
(all aged 5-17 yrs), with anxiety disorder and were seeking treatment, on
sociodemographic background variables, clinical characteristics, and lifetime
rates of specific anxiety disorders. The groups were more similar than
different; however, they differed on variables (trend only), including rates
of school refusal, severity of primary anxiety disorder, lifetime prevalence
of posttraumatic stress disorder (PTSD), and total scores on the Fear Survey
Schedule for Children--Revised (FSSC--R). White Ss were more likely to present
with school refusal and higher severity ratings, while African-American Ss
were more likely to have a history of PTSD and score higher on the FSSC--R.
========================================

Title: An examination of post traumatic stress disorder in Urban African
American children.
Author(s)/Editor(s): Kooperkamp, Elizabeth Blanche
Source/Citation: Dissertation Abstracts International; Vol 53(10-B) Apr 1993,
US: Univ. Microfilms International; 1993, 5447
========================================

Title: Post-traumatic stress disorder in African-American Vietnam veterans: An
ethnographic case study.
Author(s)/Editor(s): Satterfield, Terry L.
Source/Citation: Dissertation Abstracts International; Vol 51(3-A) Sep 1990, US:
Univ. Microfilms International; 1990, 746
========================================

Title: The dynamics of posttraumatic stress disorder in South African political
ex-detainees.
Author(s)/Editor(s): Solomons, Kevin
Source/Citation: American Journal of Psychotherapy; Vol 43(2) Apr 1989, US: Assn
for the Advancement of Psychotherapy; 1989, 208-217
Abstract/Review/Citation: Describes defense mechanisms observed in Black South
Africans who were former political detainees and who presented with
posttraumatic stress disorder (PTSD). It is argued that when extreme external
threats lead persons to anticipate their own destructions, under circumstances
that preclude any possibility to alter the situation, a regressive libidinal
shift occurs from the world of objects back into the self-preserving
narcissistic core. These threats give rise to the liberation of free-floating
narcissistic anxiety, and 3 defense mechanisms are mobilized to bind this
anxiety: repetition-compulsion, denial, and conversion-somatization. When these defenses fail to defuse the intensity of this anxiety, they transform it
into the symptoms that characterize PTSD.

========================================
 

Title: Interpersonal violence and posttraumatic symptomatology: The effects of

ethnicity, gender, and exposure to violent events.

Author(s)/Editor(s): McGruder-Johnson, Anita K.; Davidson, Emily S.; Gleaves, David H.; Stock, Wendy; Finch, John F.

Source/Citation: Journal of Interpersonal Violence; Vol 15(2) Feb 2000, US: Sage

Publications Inc; 2000, 205-221

Abstract/Review/Citation: A sample of 222 African American, Mexican American, or

European American undergraduate students completed questionnaires assessing

lifetime exposure to interpersonal violence and current levels of

psychological distress. The frequency of interpersonal violence was high:

 39.2% of the students reported direct exposure to at least 1 violent,

nonsexual life event and 43.7% reported at least 1 violent sexual experience.

14 percent of the participants had lifetime diagnoses of posttraumatic stress

disorder (PTSD), with the highest reported rate occurring for the African

Americans, who also reported more violent sexual and nonsexual experiences and

higher levels of psychological distress. Women reported more direct sexual

experiences whereas men reported more nonsexual violent events. Covariance

analyses suggested that degree of exposure to violence explained most, but not

all of the ethnic and gender differences found in terms of posttraumatic

symptomatology. Thus, exposure to life-threatening events, rather than ethnic

or gender group per se was most directly related to psychological distress.

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