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Bipolar Disorder and PTSD
Affect Regulation-Self Esteem-Expecting Best-Preparing for Worst
Bipolar Disorder and Trauma
Bipolar Disorder DSM-IV
Bipolar I Disorder
Bipolar II Disorder
Cingulate Gyrus and Trauma
Circadiam Rhythm and PTSD
Circadian Rhythm and REM Behavior Disorder
Circadian Rhythm and Sleepwalking
Circadian Rhythm and Trauma
Circadian Rhythm DSM-IV
Corpus Callosum and PTSD
Cortisol and Dissociation
Cortisol and Trauma
Dissociation and Affect Dysregulation
Fornix and Trauma
Hippocampus Trauma and PTSD
Hypothalamus and PTSD
Limbic System and Trauma
MRI and Trauma
Neocortex and Trauma
NeuroImaging and DID
NeuroImaging and Trauma
NMRI and PTSD
Prefrontal Lobe and Trauma
ADHD and PTSD
ADHD and EMDR
ADHD and Dissociation
ADHD and DID
ADHD and Trauma
Affect Regulation
Attachment and Relational Trauma II
Affect Development and Attachment
Affect Regulation: Mentalization and the Development of the Self
Attachment and Affect Development
AffectDysregulation and Dissociation
Affect Dysregulation and Disorders of the Self
Affect Regulation and Attachment
Affect Dysregulation and Disorders of the Self
Affect Regulation and Attachment I
Affect Regulation and Attachment II
Affect Dysregulation
Affect Regulation and PTSD
Affect Regulation and Binge Drinking
Affect Regulation in Married Styles
Affect Regulation and Trauma
Affect Regulation-Delayed memories of Childhood
Affect Regulation-Mentalization and Development of The Self
Affect Regulaqtion-Recurrent Abortiona in Bulimics
Affect Regulation-Social Context on Childrens Affect Regulation
Affect Regulation-the Development of Psychopathology
Amygdala and Fear
Amygdala and PTSD
Aspergers Disorder and Adolescence
Aspergers Disorder and Childhood
Aspergers Disorder and Development
Aspergers Disorder and Infancy
Aspergers Disorder DSM-IV
Basal Ganglia and PTSD
Basal Ganglia and Trauma
Bipolar Disorder and DID
Sleepwalking and Trauma
Sleepwalking and PTSD
Sleep Disorders and PTSD
Sleep Disorders and Trauma
Sleep Disorders DSM-IV-R
Circadian Rhythm DSMIV-R
Sleep Terror Disorder
Self-Mutilization and Trauma
Self-Mutilization and Resilience
Self-Mutilization and PTSD
Self-Mutilization and DID
Human Stress Continuum

Psychological

and Physiological

Trauma Research

 

 

Seize Your Journeys

 

_______________________

Traumatic stress is found in many competent, healthy, strong, good people.  No one can completely protect themselves from traumatic experiences.  Many people have long-lasting problems following exposure to trauma.  Up to 8% of persons will have PTSD at some time in their lives. People who react to traumas are not going crazy.  What is happening to them is part of a set of common symptoms and problems that are connected with being in a traumatic situation, and thus, is a normal reaction to abnormal events and experiences.  Having symptoms after a traumatic event is NOT a sign of personal weakness.  Given exposure to a trauma that is bad enough, probably all people would develop PTSD.

By understanding trauma symptoms better, a person can become less fearful of them and better able to manage them. By recognizing the effects of trauma and knowing more about symptoms, a person will be better able to decide about getting treatment.

_______________________

 

FUNCTIONAL NEUROANATOMY

In order to best understand this atlas it is important to have a sense of the functional neuroanatomy of the brain. Over the next several pages there is a brief summary of the 5 major brain systems that relate to behavior, along with the general location seen on SPECT of these areas.


 

The Deep Limbic System


side active view


underside surface view


underside active view

Functions

  • sets the emotional tone of the mind

  • filters external events through internal states (emotional coloring)

  • tags events as internally important

  • stores highly charged emotional memories

  • modulates motivation

  • controls appetite and sleep cycles

  • promotes bonding

  • directly processes the sense of smell

  • modulates libido

Problems

  • moodiness, irritability, clinical depression

  • increased negative thinking

  • perceive events in a negative way

  • decreased motivation

  • flood of negative emotions

  • appetite and sleep problems

  • decreased or increased sexual responsiveness

  • social isolation

The Basal Ganglia System


left side active view


underside active view

Functions

  • integrates feeling and movement

  • shifts and smoothes fine motor behavior

  • suppression of unwanted motor behaviors

  • sets the body's idle or anxiety level

  • enhances motivation

  • pleasure/ecstasy

Problems

  • anxiety, nervousness

  • panic attacks

  • physical sensations of anxiety

  • tendency to predict the worst

  • conflict avoidance

  • Gilles de la Tourette's Syndrome/tics

  • muscle tension, soreness

  • tremors

  • fine motor problems

  • headaches

  • low or excessive motivation

The Prefrontal Cortex


dorsal lateral prefrontal cortex
outside view


inferior orbital prefrontal cortex
outside view


side surface view
dorsal lateral prefrontal area


inferior orbital prefrontal area
inside view


underside surface view
inferior orbital prefrontal area


top-down surface view
dorsal lateral prefrontal area

Functions

  • attention span

  • perseverance

  • judgment

  • impulse control

  • organization

  • self-monitoring and supervision

  • problem solving

  • critical thinking

  • forward thinking

  • learning from experience

  • ability to feel and express emotions

  • influences the limbic system

  • empathy

Problems

  • short attention span

  • distractibility

  • lack of perseverance

  • impulse control problems

  • hyperactivity

  • chronic lateness, poor time management

  • disorganization

  • procrastination

  • unavailability of emotions

  • misperceptions

  • poor judgement

  • trouble learning from experience

  • short term memory problems

  • social and test anxiety

The Cingulate Gyrus


inside side view


side active view


active top-down view


active front-on view

  • allows shifting of attention

  • cognitive flexibility

  • adaptability

  • helps the mind move from idea to idea

  • gives the ability to see options

  • helps you go with the flow

  • cooperation

Problems

  • worrying

  • holds onto hurts from the past

  • stuck on thoughts (obsessions)

  • stuck on behaviors (compulsions)

  • oppositional behavior, argumentative

  • uncooperative, tendency to say no

  • addictive behaviors (alcohol or drug abuse, eating disorders, chronic pain)

  • cognitive inflexibility

  • obsessive compulsive disorder

  • OCD spectrum disorders

  • eating disorders, road rage

The Temporal Lobes


side view


side surface view


underside surface view


active side view

Functions

Dominant Side (usually the left)

  • understanding and processing language

  • intermediate term memory

  • long term memory

  • auditory learning

  • retrieval of words

  • complex memories

  • visual and auditory processing

  • emotional stability

Problems

Dominant Temporal Lobe

  • aggression, internally or externally driven

  • dark or violent thoughts

  • sensitivity to slights, mild paranoia

  • word finding problems

  • auditory processing problems

  • reading difficulties

  • emotional instability

Non-dominant Side (usually the right)

  • recognizing facial expression

  • decoding vocal intonation

  • rhythm

  • music

  • visual learning

  • difficulty recognizing facial expression

  • difficulty decoding vocal intonation

  • implicated in social skill struggles


Either/Both Temporal Lobe Problems

  • memory problems, amnesia

  • headaches or abdominal pain without a clear explanation

  • anxiety or fear for no particular reason

  • abnormal sensory perceptions, visual or auditory distortions

  • feelings of déjà vu or jamais vu

  • periods of spaciness or confusion

  • religious or moral preoccupation

  • hypergraphia, excessive writing

  • seizures

 

 

Secure Attachments as a Defense Against Trauma

 “All people mature and thrive in a social context that has profound effects on how they cope with life’s stresses.  Particularly early in life, the social context plays a critical role in fuffering an individual against stressful situations, and in building the psychological and biological capacities to deal with further stresses.  The primary function of parents can be thought of as helping children modulate their arousal by attuned and well-timed provision of playing, feeding, comforting, touching, looking, cleaning, and resting—in short, by teaching them skills that will gradually help them modulate their own arousal.  Secure attachment bonds serve as primary defenses against trauma-induced psychopathology in both children and adults (Finkelhor & Browne, 1984).  In children who have been exposed to severe stressors, the quality of the parental bond is probably the single most important determinant of long-term damage (McFarlane, 1988).”  van der Kolk, Bessel, Alexander C. McFarlane, and Lars Weisaeth, eds.  1996. Traumatic stress: The effects of overwhelming experience on mind, body, and society.  New York and London: Guilford Press. .p. 185

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Sleep Disorders

 

            “The sleep disorders are organized into four major sections according to presumed etiology.  Primary Sleep Disorders are those in which none of the etiologies listed below (i.e., another mental disorder, a general medical condition, or a substance) is responsible.  Primary Sleep Disorders are presumed to arise from endogenous abnormalities in sleep-wake generating or timing mechanisms, often complicated by conditioning factors.  Primary Sleep Disorders in turn are divided into Dyssomnias (characterized by abnormalities in the amount, quality, or timing of sleep) and Parasomnias (characterized by abnormal behavioral or physiological events occurring in association with sleep, specific sleep stages, or sleep-awake transitions).

            Sleep Disorder Related to Another Mental Disorder involves a prominent complaint of sleep disturbance that results from a diagnosable mental disorder (often a Mood Disorder or Anxiety Disorder) but that is sufficiently severe to warrant independent clinical attention.  Presumably, the pathophysiological mechanisms responsible for the mental disorder also affect sleep-awake regulation. 

            Sleep Disorder Due to a General Medical Condition involves a prominent complaint of sleep disturbance that results from the direct physiological effects of a general medical condition on the sleep-wake system.

            Substance-Induced Sleep Disorder involves prominent complaints of sleep disturbance that result from the concurrent use, or recent discontinuation of use, of a substance (including medications).

            That systematic assessment in individuals who present with prominent complaints of sleep disturbance includes an evaluation of the specific type of sleep complaint and a consideration of concurrent mental disorders, general medical conditions, and substance (including medication) use that may be responsible for the sleep disturbance.

            Five distinct sleep stages can be measured by polysomnography:  rapid eye movement (REM) sleep and four stages of non-rapid eye movement (NREM) sleep (stages 1, 2, 3, and 4).  Stage 1 NREM sleep is a transition from wakefulness to sleep and occupies about 5% of time spent asleep in healthy adults.  Stage 2 NREM sleep, which is characterized by specific EEG waveforms (sleep spindles and K complexes), occupies about 50% of time spent asleep.  Stages 3 and 4 NREM sleep (also known collectively as slow-wave sleep) are the deepest levels of sleep and occupy about 10%-20% of sleep time.  REM sleep, during which the majority of typical storylike dreams occur, occupies about 20%-25% of total sleep.

            These sleep stages have a characteristic temporal organization across the night.  NREM stages 3 and 4 tend to occur in the first one-third to one-half of the night and increase in duration in response to sleep deprivation.  REM sleep occurs cyclically throughout the night, alternating with NREM sleep about every 80-100 minutes.  REM sleep periods increase in duration toward the morning.  Human sleep also varies characteristically across the life span.  After relative stability with large amounts of slow-wave sleep in childhood and early adolescence, sleep continuity and depth deteriorate across the adult age range.  This deterioration is reflected by increased wakefulness and stage 1 sleep and decreased stages 3 and 4 sleep.  Because of this, age must be considered in the diagnosis of a Sleep Disorder in any individual.

            Polysomnography is the monitoring of multiple electrophysiological parameters during sleep and generally includes measurement of EEG activity, electroculographic activity, and electromyographic activity.  Additional polysomnographic measures may include oral or nasal airflow, respiratory effort, chest and abdominal wall movement, oxyhemoglobin saturation, or exhaled carbon dioxide concentration; these measures are used to monitor respiration during sleep and to detect the presence and severity of sleep apnea.  Measurement of peripheral electromyographic activity may be used to detect abnormal movements during sleep.  Most polysomnographic studies are conducted during the person’s usual sleeping hours—that is, at night.  However, daytime polysomnographic studies also are used to quantify daytime sleepiness.  The most common daytime procedure is the Multiple Sleep Latency Test (MSLT), in which the individual is instructed to lie down in a dark room and not resist falling asleep; this protocol is repeated fives times during the day.  Sleep latency (the amount of time required to fall asleep) is measured on each trial and is used as an index of physiological sleepiness.  The converse of the MSLT is also used:  In the Repeated Test of Sustained Wakefulness (RTSW), the individual is placed in a quiet, dimly lit room and instructed to remain awake; this protocol is repeated several times during the day.  Again, sleep latency is measured, but is it used here as an index of the individual’s ability to maintain wakefulness.

            Standard terminology for polysomnographic measures is used throughout the test in this section.  Sleep continuity refers to the overall balance of sleep and wakefulness during a night of sleep.  “Better” sleep continuity indicates consolidated sleep and wakefulness; “worse” sleep continuity indicates disrupted sleep with more wakefulness.  Specific sleep continuity measures include sleep latency—the amount of time required to fall asleep (expressed in minutes); intermittent wakefulness—the amount of awake time after initial sleep onset (expressed in minutes); and sleep efficiency—the ratio of actual time spent asleep to time spent in bed (expressed as a percentage, with higher numbers indicating better sleep continuity).  Sleep architecture refers to the amount and distribution of specific sleep stages.  Sleep architecture measures include absolute amount of REM sleep and each NREM sleep stage (in minutes), relative amount of REM seep and NREM sleep stages (expressed as a percentage of total sleep time), and latency between sleep onset and the first REM period (REM latency).

            The text for each of the Sleep Disorders contains a section describing its relationship to corresponding disorders in The International Classification of Sleep Disorders:  (ICSD) diagnostic and Coding Manual, published in 1990 by the American Sleep Disorders Association.

_________________

 

Substance Dependence

“Features

The essential feature of Substance Dependence is a cluster of cognitive, behavioral, and physiological symptoms indicating that the individual continues use of the substance despite significant substance-related problems.  There is a pattern of repeated self-administration that can result in tolerance, withdrawal, and compulsive drug-taking behavior.  A diagnosis of Substance Dependence can be applied to every class of substances except caffeine.  The symptoms of Dependence are similar across the various categories of substances, but for certain classes some symptoms are less salient, and in a few instances not all symptoms apply (e.g., withdrawal symptoms are not specified for Hallucinogenic Dependence).  Although not specifically listed as a criterion item, “craving” (a strong subjective drive to use the substance) is likely to be experienced by most (if not all) individuals with Substance Dependence.  Dependence is defined as a cluster of three or more of the symptoms listed below occurring at any time in the same 12-month-period.

Tolerance (Criterion 1) is the need for greatly increased amounts of the substance to achieve intoxication (or the desired effect) or a markedly diminished effect with continued use of the same amount of the substance.  The degree to which tolerance develops varies greatly across substances.  Furthermore, for a specific drug, varied degrees of tolerance may develop for its different central nervous system effects.  For example, for opioids, tolerance to respiratory depression and tolerance to analgesia develop at different rates.  Individuals with heavy use of opioids and stimulants can develop substantial (e.g., 10-f0ld) levels of tolerance, often to a dosage that would be lethal to a nonuser.  Alcohol tolerance can also be pronounced, but is usually less extreme than for amphetamine.  Many individuals who smoke cigarettes consume more than 20 cigarettes a day, an amount that would have produced symptoms of toxicity when they first started smoking.  Individuals with heavy use of cannabis or phencyclidine (PCP) are generally not aware of having developed tolerance (although it has been demonstrated in animal studies and in some individuals).  Tolerance may be difficult to determine by history alone when the substance used is illegal and perhaps mixed with various diluents or with other substances.  In such situations, laboratory tests may be helpful (e.g., high blood levels of the substance coupled with little evidence of intoxication suggest that tolerance is likely).  Tolerance must also be distinguished from individual variability in the initial sensitivity to the effects of particular substances.  For example, some first-time drinkers show very little evidence of intoxication with three or four drink, whereas others of similar weight and drinking histories had slurred speech and incoordination.

Withdrawal (Criterion 2a) is a maladaptive behavioral change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance.  After developing unpleasant withdrawal symptoms, the persons is likely to take the substance to relieve or to avoid those symptoms (Criterion 2b), typically using the substance throughout the day beginning soon after awakening.  Withdrawal symptoms, which are generally the opposite of the acute effects of the substance, vary greatly across the calluses of substances, and separate criteria sets for Withdrawal are provided for most of the classes.  Marked and generally easily measured physiological signs of withdrawal are common with alcohol, opioids, and sedatives, hypnotics, and anxiolytics.  Withdrawal signs and symptoms are often present, but may be less apparent, with stimulants such as amphetamines and cocaine, as well as with nicotine and cannabis.  No significant withdrawal is seen even after repeated use of hallucinogens.  Withdrawal from phencyclidine and related substances has not yet been described in humans (although it has been demonstrated in animals).  Neither tolerance nor withdrawal is necessary or sufficient for a diagnosis of Substance Dependence.  However, for most classes of substances, a past history of tolerance or withdrawals is associated with a more severe clinical course (i.e., an earlier onset of Dependence, higher levels of substance intake, and a greater number of substance-related problems).  Some individuals (e.g., those with Cannabis Dependence) show a pattern of compulsive use without obvious signs of tolerance or withdrawal.  Conversely, some general medical and postsurgical patients without Opioid Dependence may develop a tolerance to prescribed opioids and experience withdrawal symptoms without showing any signs of compulsive use.  The specifiers With Physiological Dependence and Without Physiological Dependence are provided to indicate the presence or absence of tolerance or withdrawal.

The following items describe the pattern of compulsive substance use that is characteristic of Dependence.  The individual may take the substance in larger amounts or over a longer period than was originally intended (e.g., continuing to drink until severely intoxicated despite having set a limit of only one drink) (Criterion 3).  The individual may express a persistent desire to cut down or regulate substance use.  Often, there have been many unsuccessful efforts to decrease or discontinue use (Criterion 4).  The individual may spend a great deal of time obtaining the substance, using the substance, or recovering from its effects (Criterion 5).  In some instances of Substance Dependence, virtually all of the person’s daily activities revolve around the substance.  Important social, occupational, ore recreational activities may be given up or reduced because of substance use (Criterion 6).  The individual may withdraw from family activities and hobbies in order to use the substance in private or to spend more time with substance-using friends.  Despite recognizing the contributing role of the substance to a psychological or physical problem (e.g., sever depressive symptoms or damage to organ systems), the person continues to use the substance (Criterion 7).  The key issue in evaluating this criterion is not eh existence of the problem, but rather the individual’s failure to abstain from using the substance despite having evidence of the difficulty it is causing.

 

Specifiers

            Tolerance and withdrawal may be associated with a higher risk for immediate general medical problems and a higher relapse rate.  Specifiers are provided to note their presence or absence:

With Physiological Dependence.  This specifier should be used when Substance Dependence is accompanied by evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).

Without Physiological Dependence.  This specifier should be used when there is no evidence of tolerance (Criterion 1) or withdrawal (Criterion 2).  In these individuals, Substance Dependence is characterized by a pattern of compulsive use (at least three items from Criteria 3-7).”

 

Diagnostic and Statistical Manual of Mental Disorders. 2000. 4th ed. Washington, D.C.: American Psychiatric Association. P. 193-195.

 

 

 

_______________________

 

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

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Major Depressive Disorder

“Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

“Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 

Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

 

________________

Major Depressive Disorder

 “Diagnostic Features

The essential feature of Major Depressive Disorder is a clinical course that is characterized by one or more Major Depressive Episodes without a history of Manic, Mixed, or Hypomanic Episodes (Criteria A and C).  Episodes of Substance-Induced Mood Disorder (due to the direct physiological effects of a drug of abuse, a medication, or toxin exposure) or of Mood Disorder Due to a General Medical Condition do not count toward a diagnosis of Major Depressive Disorder.  In addition, the episodes must not be better accounted for by Schizoaffective Disorder and are not superimposed on Schizophrenia, Schizophreniform Disorder, Delusional Disorder, or Psychotic Disorder Not Otherwise Specified (Criterion B).

            The fourth digit in the diagnostic code for Major Depressive Disorder indicates whether it is a Single Episode (used only for first episodes) or Recurrent.  It is sometimes difficult to distinguish between a single episode with waxing and waning symptoms and two separate episodes.  For purposes of this manual, an episode is considered to have ended when the full criteria for eh Major Depressive Episode have not been met for at least 2 consecutive months.  During this 2-month period, there is either complete resolution of symptoms or the presence of depressive symptoms that no longer meet the full criteria for a Major Depressive Episode (In Partial Remission).

            The fifth digit in the diagnostic code for Major Depressive Disorder indicates the current state of the disturbance.  If the criteria for a Major Depressive Disorder are met, the severity of the episode is notes as Mild, Moderate, Severe Without Psychotic Features, or Severe With Psychotic Features.  If the criteria for a Major Depressive Episode are not currently met, the fifth digit is used to indicate whether the disorder is In Partial Remission or In Full Remission.

            If Manic, Mixed, or Hypomanic Episodes develop in the course of Major Depressive Disorder, the diagnosis is changed to a Bipolar Disorder.  However, if manic or hypomanic symptoms occur as a direct effect of antidepressant treatment, use of other medications, substance use, or toxin exposure, the diagnosis of Major Depressive Disorder remains appropriate and an addition diagnosis of Substance-induced Mood Disorder, With Manic features (or With Mixed Features), should be noted.  Similarly, if manic or hypomanic symptoms occur as a direct effect of a general medical condition, the diagnosis of Major Depressive Disorder remains appropriate and an additional diagnosis of Mood Disorder Due to a General Medical Condition, With Manic Features (or With Mixed Features), should be noted.” p. 369

 “Course

Major Depressive Disorder may begin at any age, with an average age at onset in the mid-20s.  Epidemiological data suggest that the age at onset is decreasing for those born more recently.  The course of Major Depressive Disorder, Recurrent, is variable.  Some people have isolated episodes that are separated by many years without any depressive symptoms, whereas others have clusters of episodes, and still others have increasingly frequent episodes as they grow older.  Some evidence suggests that the periods of remission generally last longer early in the course of the disorder.  The number of prior episodes predicts the likelihood of developing a subsequent Major Depressive Episode.  At least 60% of individuals with Major Depresssive Disorder, Single Episode, can be expected to have a second episode.  Individuals who have had tow episodes have a 70% chance of having a third, and individuals who have had three episodes have a 90% chance  of having a fourth.  About 5%-10% of individuals with Major Depressive Disorder, single Episode, subsequently develop a Manic Episode (i.e., develop Bipolar I Disorder).

            Major Depressive Episodes may end completely (in about two-thirds of cases), or only partially or not at all (in about one-third of cases).  For individuals who have only partial remission, there is a greater likelihood of developing additional episodes and of continuing the pattern of partial interepisode recovery.  The longitudinal course specifiers With Full Interepisode Recovery and Without Full Interepisode Recovery may therefore have prognostic value.  A number of individuals have pre-existing Dysthymic Disorder prior to the onset of Major Depressive Disorder, single Episode.  Some evidence suggests that these individuals are more likely to have additional Major Depressive Episodes, have poorer interepisode recovery, and may require additional acute-phase treatment and a longer period of continuing treatment to attain and maintain a more thorough and longer-lasting euthymic state.

            Follow-up naturalistic studies suggested that 1 year after the diagnosis of a major Depressive Episode, 40% of individuals still have symptoms that are sufficiently severe to meet criteria for a full Major Depressive Episode, roughly 20% continue to have some symptoms that no longer meet full criteria for a Major Depressive Episode (i.e., major Depressive Disorder, In Partial Remission), and 40% have no Mood Disorder.  The severity of the initial Major Depressive Episode appears to predict persistence.  Chronic general medical conditions are also a risk factor for more persistent episodes.

            Episodes of Major Depressive Disorder often follow a severe psychosocial stressor, such as the death of a loved one or divorce.  Studies suggest that psychosocial events 9stressors) may play a more significant role in the precipitation of the first or second episodes of Major Depressive Disorder and may play less of a role in the onset of subsequent episodes.  Chronic general medical conditions and Substance Dependence (particularly Alcohol or Cocaine Dependence) may contribute to the onset or exacerbation of Major Depressive Disorder.

            It is difficult to predict whether the first episode of a Major Depressive Disorder in a young person will ultimately evolve into a Bipolar Disorder.  Some data suggest that the acute onset of severe depression, especially with psychotic features and psychomotor retardation, in a young person without prepubertal psychopathology is more likely to predict a bipolar disorder.  A family history of Bipolar Disorder may also be suggestive of subsequent development of Bipolar Disorder.” p. 372-373

 Diagnostic and statistical manual of mental disorders. 2000. 4th ed.  Washington, D.C.: American Psychiatric Association.

________________

DID-PTSD-EMDR

Dissociative Identity Disorder (DID)

"The essential feature of Dissociative identity Disorder is the presence of two or more distinct identities or personality states (Criterion A) that recurrently take control of behavior (Criterion B).  There is an inability to recall important personal information, the extent of which is too great to be explained by ordinary forgetfulness (Criterion C).  The disturbance is not due tot eh direct physiological effects of a substance or a general medical condition (Condition D.).  In children, the symptoms cannot be attributed to imaginary playmates or other fantasy play.

Dissociative Identity Disorder reflects a failure to integrate various aspects of identity, memory, and consciousness.  Each personality state may be experienced as if it has a distinct personal history, self-image, and identity, including a separate name.  Usually there is a primary identity that carries the individual's given name and is passive, dependent, guilty, and depressed.  The alternate identities frequently have different names and characteristics that contrast with the primary identity (e.g., are hostile, controlling, and self-destructive).  Particular identities may emerge in specific circumstances and may differ in reported age and gender, vocabulary, general knowledge, or predominant affect.  Alternate identities are experienced as taking control in sequence, ore at the expense of the other, and may deny knowledge of one another, be critical of one another, or appear to be in open conflict.  Occasionally, one or more powerful identities allocate time to the others.  Aggressive or hostile identities may at times interrupt activities or place the others in uncomfortable situations.

Individuals with this disorder experience frequent gaps in memory for personal history, both remote and recent.  The amnesia is frequently asymmetrical.  The more passive identities tend to have more constricted memories, whereas the more hostile, controlling, or "protector" identities have more complete memories.  An identity that is not in control may nonetheless gain access to consciousness by producing auditory or visual hallucinations (e.g., a voice giving instructions).  Evidence of amnesia may be uncovered by reports from others who have witnessed behavior that is disavowed by the individual or by the individual's own discoveries (e.g., finding items of clothing at home that the individual cannot remember having bought).  There may be loss of memory not only for recurrent periods of time, but also an overall loss of biographical memory for some extended period of childhood, adolescence, or even adulthood.  Transitions among identities are often triggered by psychosocial stress.  The time required to switch from one identity to another is usually a matter of seconds, but, less frequently, may b gradual.  Behavior that may be frequently associated with identity switches include rapid blinking, facial changes, changes in voice or demeanor, or disruption in the individual's train of thoughts.  The number of identities reported ranges from 2 to more than 100.  Half of reported cases include the individuals with 10 or fewer identities."

Diagnostic and Statistical Manual of Mental Disorders. 2000.  4th ed. Washington, D.C.: American Psychiatric Association.

PTSD, DID, and EMDR

Posttraumatic Stress Disorder

"The essential feature of Posttraumatic Stress Disorder us the development of characteristic symptoms following exposure to an extreme traumatic stressor involving direct personal experience of an event that involves actual or threatened death or serious injury, or other threat to one's physical integrity; or witnessing an event that involves death, injury, or a threat to the physical integrity of another person; or learning about unexpected or violent death, serious harm, or threat of death or injury experienced by a family member or other close associate (Criteria A1).  The person's response to the event must involve intense fear, helplessness, or horror (or in children, the response must involve disorganized or agitated behavior) (Criterion A2).  The characteristic symptoms resulting from the exposure to the extreme trauma include persistent reexperiencing of the traumatic event (Criterion E), and the disturbance must cause clinically significant distress or impairment in social, occupational, or other important areas of functioning (Criterion F).

Traumatic events that are experienced directly include, but are not limited to, military combat, violent personal assault (sexual assault, physical attack, robbery, mugging), being kidnapped, being taken hostage, terrorist attack, torture, incarceration as a prisoner of war or in a concentration camp, natural or manmade disasters, severe automobile accidents, or being diagnosed with a life-threatening illness.  For children, sexually traumatic events may include developmentally inappropriate sexual experiences without threatened or actual violence or injury.  Witnessed events include, but are not limited to, observing the serious injury or unnatural death of another person due to violent assault, accident, war, or disaster or unexpectedly witnessing a dead body or body parts.  Events experienced by others that are learned about include, but are not limited to, violent personal assault, serious accident, or serious injury experienced y a family member or a close friend; learning about the sudden, unexpected death of a family member or a close friend; or learning that one's child has a life threatening disease.  The disorder may be especially sever or long lasting when the stressor is of human design (e.g., torture, rape). the likelihood of developing this disorder may increase as the intensity of and physical proximity to the stressor increase.

The traumatic event can be reexperienced in various ways.  Commonly the person has recurrent and intrusive recollections of the event (Criterion B1) or recurrent distressing dreams during which the event can be replayed or otherwise represented (Criterion B2). In rare instances, the person experiences dissociative states that last from a few seconds to several hours, or even days, during which components of the event are relived and the person behaves as though experiencing the event at that moment (Criterion B3).  These episodes, often referred to as "flashbacks," are typically brief but can be associated with prolonged distress and heightened arousal.  Intense psychological distress (Criterion B4) or physiological reactivity (Criterion B5) often occurs when the person is exposed to triggering events that resemble or symbolize an aspect of the traumatic event (e.g., anniversaries of the traumatic event; cold, snowy weather or uniformed guards for survivors of death camps in cold climates; hot, humid weather for combat veterans of the South Pacific; entering any elevator for an woman who was reaped in an elevator).

Stimuli associated with the trauma are persistently avoided.  The person commonly makes deliberate efforts to avoid thoughts, feelings, or conversations about the traumatic event (Criterion C1) and to avoid activities, situations, or people who around recollections of it (Criterion C2).  This avoidance of reminders may include amnesia for an important aspect of the traumatic event (Criterion C3).  Diminished responsiveness to the external work, referred to as "psychic numbing" or "emotional anesthesia," usually begins soon after the traumatic event.  The individual may complain of having markedly diminished interest or participation in previously enjoyed activities (Criterion C4), of feeling detached or estranged from other people (Criterion C5), or of having markedly reduced ability to feel emotions (especially those associated with intimacy, tenderness and sexuality) (Criterion C6).  The individual may have a sense of a foreshortened future (e.g., not expecting to have a career, marriage, children, or a normal life span) (Criterion C7).

The individual has persistent symptoms of anxiety or increased arousal that were not present before the trauma.  these symptoms may include difficulty falling or staying asleep that may be to recurrent nightmares during which the traumatic event is relived (Criterion D1), hypervigilance (Criterion D4), and exaggerated startle response (Criterion D5).  Some individuals report irritability or outburst of anger (Criterion D2) or difficulty concentrating or completing tasks (Criterion D3)."

 

EMDR

Eye Movement Desensitization and Reprocessing

"Eye Movement Desensitization and Reprocessing (EMDR)1 integrates elements of many effective psychotherapies in structured protocols that are designed to maximize treatment effects. These include psychodynamic, cognitive behavioral, interpersonal, experiential, and body-centered therapies2. EMDR is an information processing therapy and uses an eight phase approach.

During EMDR1 the client attends to past and present experiences in brief sequential doses while simultaneously focusing on an external stimulus. Then the client is instructed to let new material become the focus of the next set of dual attention. This sequence of dual attention and personal association is repeated many times in the session.

Eight Phases of Treatment

The first phase is a history taking session during which the therapist assesses the client's readiness for EMDR and develops a treatment plan. Client and therapist identify possible targets for EMDR processing. These include recent distressing events, current situations that elicit emotional disturbance, related historical incidents, and the development of specific skills and behaviors that will be needed by the client in future situations.

During the second phase of treatment, the therapist ensures that the client has adequate methods of handling emotional distress and good coping skills, and that the client is in a relatively stable state. If further stabilization is required, or if additional skills are needed, therapy focuses on providing these. The client is then able to use stress reducing techniques whenever necessary, during or between sessions. However, one goal is not to need these techniques once therapy is complete.

In phase three through six, a target is identified and processed using EMDR procedures. These involve the client identifying the most vivid visual image related to the memory (if available), a negative belief about self, related emotions and body sensations. The client also identifies a preferred positive belief. The validity of the positive belief is rated, as is the intensity of the negative emotions.

After this, the client is instructed to focus on the image, negative thought, and body sensations while simultaneously moving his/her eyes back and forth following the therapist's fingers as they move across his/her field of vision for 20-30 seconds or more, depending upon the need of the client. Athough eye movements are the most commonly used external stimulus, therapists often use auditory tones, tapping, or other types of tactile stimulation. The kind of dual attention and the length of each set is customized to the need of the client. The client is instructed to just notice whatever happens. After this, the clinician instructs the client to let his/her mind go blank and to notice whatever thought, feeling, image, memory, or sensation comes to mind. Depending upon the client's report the clinician will facilitate the next focus of attention. In most cases a client-directed association process is encouraged. This is repeated numerous times throughout the session. If the client becomes distressed or has difficulty with the process, the therapist follows established procedures to help the client resume processing. When the client reports no distress related to the targeted memory, the clinician asks him/her to think of the preferred positive belief that was identified at the beginning of the session, or a better one if it has emerged, and to focus on the incident, while simultaneously engaging in the eye movements. After several sets, clients generally report increased confidence in this positive belief. The therapist checks with the client regarding body sensations. If there are negative sensations, these are processed as above. If there are positive sensations, they are further enhanced.

In phase seven, closure, the therapist asks the client to keep a journal during the week to document any related material that may arise and reminds the client of the self-calming activities that were mastered in phase two.

The next session begins with phase eight, re-evaluation of the previous work, and of progress since the previous session. EMDR treatment ensures processing of all related historical events, current incidents that elicit distress, and future scenarios that will require different responses. The overall goal is produce the most comprehensive and profound treatment effects in the shortest period of time, while simultaneously maintaining a stable client within a balanced system.

After EMDR processing, clients generally report that the emotional distress related to the memory has been eliminated, or greatly decreased, and that they have gained important cognitive insights. Importantly, these emotional and cognitive changes usually result in spontaneous behavioral and personal change, which are further enhanced with standard EMDR procedures." www.emdr.com

 1Shapiro, F. (2001). Eye Movement Desensitization and Reprocessing: Basic Principles, Protocols and Procedures (2nd ed.). New York: Guilford Press.

2Shapiro, F. (2002). EMDR as an Integrative Psychotherapy Approach: Experts of Diverse Orientations Explore the Paradigm Prism. Washington, DC: American Psychological Association Books.

 

 

 

 

NeuroBiology of Trauma

 

Bipolar Disorder and PTSD
Title: The Off-Label Use of Clozapine in Adolescents with Bipolar
Disorder, Intermittent Explosive Disorder, or Posttraumatic Stress
Disorder.
Author(s): Kant, Ravi, Head Injury Clinic, Pittsburgh, PA, US

Chalansani, Ranjit, Special Studies Center, Mayview State Hospital,
Pittsburgh, PA, US

Chengappa, K. N. Roy, Western Psychiatric Institute and Clinic,
University of Pittsburgh Health System, Pittsburgh, PA, US,
chengappakn@msx.upmc.edu

Dieringer, Mary F., Barnesville Hospital, Barnesville, OH, US

Chengappa, K. N. Roy, Special Studies Center, Mayview State Hospital,
Western Psychiatric Institute and Clinic, University of Pittsburgh
Medical Center, 3811 O'Hara Street, Pittsburgh, PA, US,
chengappakn@msx.upmc.edu
Source: Journal of Child & Adolescent Psychopharmacology, Vol 14(1), Spr
2004. pp. 57-63.

Journal URL: http://www.liebertpub.com/CAP/default1.asp
Publisher: US: Mary Ann Liebert Publishers

Publisher URL: http://www.liebertpub.com/
ISSN: 1044-5463 (Print)
Digital Object Identifier: 10.1089/104454604773840490
Language: English
Abstract: This report describes the use of clozapine in
adolescents with diagnoses of bipolar disorder, intermittent explosive
disorder (IED), and posttraumatic stress disorder (PTSD). A chart review
of 39 adolescents treated with clozapine at two residential facilities
was undertaken. The cohort included 26 females and 13 males with a mean
age of 14 years. Clozapine was titrated slowly, and the mean daily dose
was 102 mg. The diagnoses included bipolar disorder (n = 7), IED (n =
9), and PTSD (n = 19). There were significant reductions in polypharmacy
once the clozapine dosage was stabilized. Once the clozapine dosage was
stabilized, only 24% of the subjects required concomitant mood
stabilizers, and only 21% of the subjects required concomitant
antidepressants. Eight subjects discontinued clozapine due to
agranulocytosis (n = 1), neutropenia (n = 2), excessive weight gain (n =
2), or not requiring it long term (n = 1), and data were unavailable in
2 subjects. Significant weight gain was noted in 20 subjects. Clozapine,
in relatively modest doses, appears to have clinical benefits for
adolescent with bipolar disorder, IED, and PTSD. There is no labeled
indication for clozapine use in these disorders. Clozapine is also
associated with serious side effects in subsets of individuals.
(PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects: *Bipolar Disorder; *Clozapine; *Drug Therapy; *Explosive
Disorder; *Posttraumatic Stress Disorder; Adolescent Psychotherapy; Drug
Dosages; Side Effects (Drug)
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)

Male (30)

Female (40)

Inpatient (50)
Location: US
Age Group: Adolescence (13-17 yrs) (200)
Tests & Measures: Wechsler Adult Intelligence Scale
Form/Content Type: Empirical Study (0800)

Longitudinal Study (0850)

Retrospective Study (0852)

Journal Article (2400)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20040531
Accession Number: 2004-14085-010
Number of Citations in Source: 11

Persistent link to this record:
http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=psyh&an
=2004-14085-010

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2004-14085-010">The Off-Label Use of Clozapine in Adolescents
with Bipolar Disorder, Intermittent Explosive Disorder, or Posttraumatic
Stress Disorder.</A>

Database: PsycINFO
_____

Record: 2

Title: Psychological Trauma and the Borderline Personality.
Series Title: Personality-guided psychology
Author(s): Everly, George S. Jr., Loyola College, MD, US

Lating, Jeffrey M., Loyola College, MD, US
Source: Personality-guided therapy for posttraumatic stress
disorder. Everly, George S. Jr.; Lating, Jeffrey M.; pp. 197-208.
Washington, DC, US: American Psychological Association, 2004. xiii, 267
pp.
ISBN: 1-59147-044-7 (hardcover)
Language: English
Key Concepts: posttraumatic stress disorder; psychological trauma;
borderline personalty disorder; PTSD
Abstract: (from the chapter) The purpose of this brief review was
to examine the association between trauma, posttraumatic stress
disorder, and the occurrence of bipolar disorder. (PsycINFO Database
Record (c) 2003 APA, all rights reserved)
Subjects: *Borderline Personality Disorder; *Emotional Trauma;
*Posttraumatic Stress Disorder
Classification: Psychological Disorders (3210)
Population: Human (10)
Form/Content Type: Literature Review (1300)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 20030908
Accession Number: 2003-88019-012

Persistent link to this record:
http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=psyh&an
=2003-88019-012

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2003-88019-012">Psychological Trauma and the Borderline
Personality.</A>

Database: PsycINFO
_____

Record: 3

Title: Transtorno de estresse pos-traumatico e transtorno de humor
bipolar.
Translated Title: Posttraumatic stress disorder and bipolar mood
disorder.
Author(s): Vieira, Rodrigo Machado, Programa de Transtorno de Humor
Bipolar do Hospital de Clinicas de Porto Alegre-UFRGS, Porto Alegre,
Brazil, rvieira@usp.br

Gauer, Gabriel J. C., Departamento de Psiquiatria e Medicina Legal e do
Programa de Mestrado em Ciencias Criminais da PUCRS, Brazil
Address: Vieira, Rodrigo Machado, Centro de Pesquisas,
Laboratorio de Psiquiatria Experimental, Rua Ramiro Barcellos, 2350, RS,
90035-003, Porto Alegre, Brazil, rvieira@usp.br
Source: Revista Brasileira de Psiquiatria, Vol 25(Suppl1), Jun 2003. pp.
55-61.
Publisher: Brazil: Associacao Brasileira de Psiquiatria

ISSN: 1516-4446 (Print)
Language: Portuguese
Key Concepts: posttraumatic stress disorder; bipolar mood disorder;
comorbidity; intrusive memories; traumatic memories; behavioral
sensitivity; psychotic patients; epidemiology; etiology; pharmocological
treatment
Abstract: Bipolar disorder (BD) is not only an endogenous
condition. Severe negative life events have been shown to influence the
development of the first episode and lifetime course of BD.
Posttraumatic stress disorder (PTSD) is a severe and incapacitating
mental condition that affects a significant proportion of the general
population at some time in their lives. The concomitant presence of BD
and PTSD has been shown to be more frequent than previously suggested
and psychotic patients with trauma histories have a tendency to present
more severe symptoms and are more prone to present substance use
disorders. Trauma-related intrusive memories and nightmares of PTSD have
been associated with mood changes. Also, kindling and behavioral
sensitization have been proposed to explain the etiology and course of
both disorders. Pharmacological approaches for this comorbidity are
still based on empirical or not controlled approaches. In this article,
we critically review the current literature regarding this comorbid
condition, and highlight some aspects related to epidemiology, etiology,
course and pharmacological treatment of both disorders. Overall, our
review emphasizes the importance of systematically evaluating trauma
histories in patients with BD. (PsycINFO Database Record (c) 2003 APA,
all rights reserved)(journal abstract)
Subjects: *Bipolar Disorder; *Epidemiology; *Etiology;
*Posttraumatic Stress Disorder; Drug Therapy; Dual Diagnosis; Emotional
States; Patients; Stress
Classification: Neuroses & Anxiety Disorders (3215)

Clinical Psychopharmacology (3340)
Population: Human (10)
Form/Content Type: Journal Article (2400)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date: 20031215
Accession Number: 2003-99555-012
Number of Citations in Source: 79

Persistent link to this record:
http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=psyh&an
=2003-99555-012

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2003-99555-012">Transtorno de estresse pos-traumatico e
transtorno de humor bipolar.</A>

Database: PsycINFO
_____

Record: 4

Title: Psychosocial stressors as predisposing factors to affective
illness and PTSD: Potential neurobiological mechanisms and theoretical
implications.
Author(s): Post, Robert M., National Inst of Mental Health,
Biological Psychiatry Branch, Rockville, MD, US

Leverich, Gabriele S., National Inst of Mental Health, Biological
Psychiatry Branch, Rockville, MD, US

Weiss, Susan R. B., National Inst of Mental Health, Biological
Psychiatry Branch, Rockville, MD, US

Zhang, Li-Xin, National Inst of Mental Health, Biological Psychiatry
Branch, Rockville, MD, US

Xing, Guoqiang, National Inst of Mental Health, Dept of Psychiatry
Uniformed Services, Rockville, MD, US

Li, He, National Inst of Mental Health, Biological Psychiatry Branch,
Rockville, MD, US

Smith, Mark, National Inst of Mental Health, Experimental Station,
DuPont Pharmaceutical, Rockville, MD, US
Source: Neurodevelopmental mechanisms in psychopathology. Cicchetti,
Dante (Ed); Walker, Elaine (Ed); pp. 491-525. New York, NY, US:
Cambridge University Press, 2003. xii, 558 pp.
ISBN: 0-521-80225-3 (hardcover)

0-521-00262-1 (paperback)
Language: English
Key Concepts: affective illness; neurobiological mechanisms;
psychosocial stressors; stressful experiences; bipolar illness; brain
structure
Abstract: (from the chapter) Discusses the predisposing factors
and related hypotheses of affective disorders, and reviews the
literature regarding the role of psychosocial stressors in initial and
later episodes of affective illness. Several topics are covered
including the following: sensitization in the affective disorders;
neurobiological mechanisms for long-lasting behavioral and biochemical
vulnerabilities following early life stressors; impact of early
stressful experiences in bipolar affective disorder; clinical approaches
to bipolar illness and its prevention; and affective illness and brain
structure. (PsycINFO Database Record (c) 2004 APA, all rights reserved)
Subjects: *Affective Disorders; *Neurobiology; *Predisposition;
*Psychosocial Factors; *Stress; Bipolar Disorder; Early Experience;
Neural Development; Posttraumatic Stress Disorder
Classification: Affective Disorders (3211)

Developmental Psychology (2800)
Population: Human (10)
Form/Content Type: Literature Review (1300)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 20031014
Correction Date: 20040223
Accession Number: 2003-88062-020
Number of Citations in Source: 143

Persistent link to this record:
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=2003-88062-020

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2003-88062-020">Psychosocial stressors as predisposing factors to
affective illness and PTSD: Potential neurobiological mechanisms and
theoretical implications.</A>

Database: PsycINFO
_____

Record: 5

Title: Prevalence and patterns of Post-Traumatic Stress Disorder among
persons with severe mental illness.
Author(s): Albert, David Brian, Northwestern U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 63(4-B), Oct 2002. pp. 2048.
Publisher: US: Univ Microfilms International

ISSN: 0419-4217 (Print)
Order Number: AAI3050481
Language: English
Key Concepts: prevalence; PTSD; severe mental illness
Abstract: 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. (PsycINFO Database Record
(c) 2003 APA, all rights reserved)
Subjects: *Mental Disorders; *Posttraumatic Stress Disorder
Classification: Health & Mental Health Treatment & Prevention (3300)
Population: Human (10)
Location: US
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date: 20030303
Accession Number: 2002-95020-210

Persistent link to this record:
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=2002-95020-210

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-95020-210">Prevalence and patterns of Post-Traumatic Stress
Disorder among persons with severe mental illness.</A>

Database: PsycINFO
_____

Record: 6

Title: Use of general medical services by VA patients with psychiatric
disorders.
Author(s): Cradock-O'Leary, Julie, Dept of Veterans Affairs (VA)
Desert Pacific Mental Illness Research, Education, & Clinical Ctr
(MIRECC), Los Angeles, CA, US

Young, Alexander S., Dept of Veterans Affairs (VA) Desert Pacific Mental
Illness Research, Education, & Clinical Ctr (MIRECC), Los Angeles, CA,
US

Yano, Elizabeth M., VA Health Services Research & Development Ctr of
Excellence for the Study of Healthcare Provider Behavior, Los Angeles,
CA, US

Wang, Mingming, VA Health Services Research & Development Ctr of
Excellence for the Study of Healthcare Provider Behavior, Los Angeles,
CA, US

Lee, Martin L., VA Health Services Research & Development Ctr of
Excellence for the Study of Healthcare Provider Behavior, Los Angeles,
CA, US
Address: Young, Alexander S., West Los Angeles Healthcare Ctr,
11301 Wilshire Blvd (210A), Los Angeles, CA, US
Source: Psychiatric Services, Vol 53(7), Jul 2002. pp. 874-878.

Journal URL: http://psychservices.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 1075-2730 (Print)
Digital Object Identifier: 10.1176/appi.ps.53.7.874
Language: English
Key Concepts: general medical services use; VA medical centers;
psychiatric disorder; demographics; medical characteristics; psychiatric
characteristics
Abstract: Further developed understanding of the demographic,
medical, and psychiatric characteristics of patients with psychiatric
disorders to inform efforts to improve the medical care of these
persons. Using Department of Veterans Affairs (VA) databases, the
authors examined use of medical services by 175,653 patients. Factors
affecting receipt of any medical care and the number of medical visits
were assessed. Results show that patients with psychiatric diagnoses had
fewer medical visits than other VA patients; the largest differences
were seen for patients with severe mental illnesses. Patients who were
younger and male had few visits. Patients with diabetes or hypertension
who had been diagnosed as having schizophrenia, bipolar disorder, or an
anxiety disorder had substantially fewer visits than those who did not
have these psychiatric diagnoses. Patients older than 50 yrs were less
likely to have any medical care if they had a diagnosis of a substance
use, depressive, bipolar, or anxiety disorder or posttraumatic stress
disorder (PTSD). It is concluded that use of medical care varies by
psychiatric diagnosis. Young adults with schizophrenia and PTSD and
adults of all ages with bipolar disorder have an especially high risk of
not receiving general medial services. (PsycINFO Database Record (c)
2003 APA, all rights reserved)
Subjects: *Client Characteristics; *Comorbidity; *Health Care
Utilization; *Medical Patients; *Mental Disorders; Demographic
Characteristics; Symptoms
Classification: Health & Mental Health Services (3370)
Population: Human (10)

Male (30)

Female (40)
Location: US
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20020821
Accession Number: 2002-15195-010
Number of Citations in Source: 19

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=2002-15195-010

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-15195-010">Use of general medical services by VA patients
with psychiatric disorders.</A>

Database: PsycINFO
_____

Record: 7

Title: The comorbidity of bipolar and anxiety disorders: Prevalence,
psychobiology, and treatment issues.
Author(s): Freeman, Marlene P., U Cincinnati Coll of Medicine, Dept
of Psychiatry, Cincinnati, OH, US, marlenef@email.arizona.edu

Freeman, Scott A., U Cincinnati Coll of Medicine, Dept of Psychiatry,
Cincinnati, OH, US

McElroy, Susan L., U Cincinnati Coll of Medicine, Dept of Psychiatry,
Cincinnati, OH, US
Address: Freeman, Marlene P., U Cincinatti Coll of Medicine,
Biological Psychiatry Program, Dept of Psychiatry, PO Box 670559, 231
Bethesda Ave, Cincinnati, OH, US, marlenef@email.arizona.edu
Source: Journal of Affective Disorders, Vol 68(1), Feb 2002. pp. 1-23.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/6/0/7/7/
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0165-0327 (Print)
Digital Object Identifier: 10.1016/S0165-0327(00)00299-8
Language: English
Key Concepts: anxiety & bipolar disorders; panic disorder; obsessive
compulsive disorder; comorbidity; psychopharmacological treatment;
epidemiology; PTSD; social phobia
Abstract: Reviews the epidemiological and clinical studies that
have assessed the overlap of bipolar and anxiety disorders, with focus
on panic disorder and obsessive-compulsive disorder (OCD), and to a
lesser extent, social phobia and post-traumatic stress disorder. A
growing number of studies have found that bipolar disorder significantly
co-occurs with anxiety disorders at rates higher than those in the
general population. Clinical studies have also demonstrated high
comorbidity between bipolar disorder and panic disorder, OCD, social
phobia, and post-traumatic stress disorder. Psychobiological mechanisms
that may account for these high comorbidity rates likely involve a
complicated interplay among various neurotransmitter systems,
particularly norepinephrine, dopamine, gamma-aminobutyric acid, and
serotonin. The second-messenger system constituent, inositol, may also
be involved. Adequate mood stabilization should be achieved before
antidepressants are used to treat residual anxiety symptoms so as to
minimize antidepressant-induced mania or cycling. Moreover, preliminary
data suggesting that certain antimanic agents may have anxiolytic
properties, and that some anxiolytics may not induce mania indicate that
these agents may be particularly useful for anxious bipolar patients.
(PsycINFO Database Record (c) 2003 APA, all rights reserved)(journal
abstract)
Subjects: *Anxiety Disorders; *Bipolar Disorder; *Comorbidity;
*Obsessive Compulsive Disorder; *Panic Disorder; Drug Therapy;
Epidemiology; Posttraumatic Stress Disorder; Social Phobia
Classification: Psychological Disorders (3210)
Form/Content Type: Literature Review (1300)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20020424
Accession Number: 2002-02637-001
Number of Citations in Source: 228

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=2002-02637-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-02637-001">The comorbidity of bipolar and anxiety disorders:
Prevalence, psychobiology, and treatment issues.</A>

Database: PsycINFO
_____

Record: 8

Title: Trauma exposure and posttraumatic stress disorder in psychosis:
Findings from a first-admission cohort.
Author(s): Neria, Yuval, State U of New York at Stony Brook, Dept
of Psychiatry & Behavioral Science, US, NY126@columbia.edu

Bromet, Evelyn J.

Sievers, Sylvia

Lavelle, Janet

Fochtmann, Laura J.
Address: Neria, Yuval, Mailman School of Public Health, Columbia
University, 100 Haven Avenue, Tower 3-19E, New York, NY, US,
NY126@columbia.edu
Source: Journal of Consulting & Clinical Psychology, Vol 70(1), Feb
2002. pp. 246-251.

Journal URL: http://www.apa.org/journals/ccp.html
Publisher: US: American Psychological Assn

Publisher URL: http://www.apa.org
ISSN: 0022-006X (Print)
Digital Object Identifier: 10.1037//0022-006X.70.1.246
Language: English
Key Concepts: trauma exposure; posttraumatic stress disorder;
psychiatric admission; psychosis; females & drug abuse; psychotic
disorders
Abstract: This study examined the lifetime prevalence of trauma
exposure and posttraumatic stress disorder (PTSD) and their demographic,
diagnostic, and trauma-related correlates in a clinical cohort of 426
patients with a first psychiatric admission for psychosis. The
prevalence of trauma exposure was 68.5%. Female gender and substance
abuse were risk factors for trauma exposure. The prevalence of PTSD was
14.3% in the full sample and 26.5% in those with trauma exposure. PTSD
was less prevalent in patients with bipolar disorder and schizophrenia
and was twice as common in women. Other significant risk factors were
younger age and trauma exposure that was repeated and ongoing or that
involved childhood victimization. The findings highlight the importance
of systematically ascertaining trauma histories in patients with
psychotic disorders. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)(journal abstract)
Subjects: *Human Females; *Mental Disorders; *Posttraumatic Stress
Disorder; *Psychosis
Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)

Male (30)

Female (40)
Location: US
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)

Followup Study (0840)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date: 20020220
Accession Number: 2002-10464-023
Number of Citations in Source: 23

Persistent link to this record:
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=2002-10464-023

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-10464-023">Trauma exposure and posttraumatic stress disorder
in psychosis: Findings from a first-admission cohort.</A>

Database: PsycINFO
_____

Record: 9

Title: Under the influence of unconscious process; Countertransference
in the treatment of PTSD and substance abuse in women.
Author(s): Cramer, Margaret A., Harvard Medical School, Cambridge,
US
Address: Cramer, Margaret A., 40 Beacon St., Melrose, MA, US
Source: American Journal of Psychotherapy, Vol 56(2), 2002. pp. 194-210.

Journal URL: http://www.ajp.org
Publisher: US: Assn for the Advancement of Psychotherapy

ISSN: 0002-9564 (Print)
Language: English
Key Concepts: substance abuse; schizoaffective disorder; borderline
personality; childhood abuse; dissociative disorder; traumatic
childhood; therapeutic supervision; PTSD; countertransference;
treatment; suicidal
Abstract: Present 3 clinical vignettes of countertransference in
the treatment of PTSD and substance abuse in women. The patients
suffered from schizoaffective disorder, bipolar disorder, borderline
personality disorder, atypical psychotic disorder, PTSD, and
dissociative disorder. They were characterized as suicidal, with
traumatic childhood experiences of physical, sexual, and emotional
abuse. These women represent a growing number of patients with substance
abuse that present special challenges in treatment for both patient and
therapist. This paper explores the treatment dilemmas in work with this
population as mutually constructed, unconscious cocreations of both
therapist and patient. The author discusses the paradoxical nature of
these experiences. The centrality of the treatment alliance and the
management of countertransference affects will be emphasized. The
benefit of process supervision in the treatment will be examined.
(PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Countertransference; *Drug Abuse; *Mental Disorders;
*Psychoanalysis; *Psychotherapeutic Processes; Attempted Suicide;
Borderline Personality Disorder; Child Abuse; Dissociative Disorders;
Physical Abuse; Posttraumatic Stress Disorder; Schizoaffective Disorder;
Sexual Abuse
Classification: Psychoanalytic Therapy (3315)
Population: Human (10)

Female (40)
Age Group: Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Middle Age (40-64 yrs) (360)
Form/Content Type: Empirical Study (0800)

Case Study (non-clinical) (2300)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date: 20021106
Accession Number: 2002-06189-004
Number of Citations in Source: 14

Persistent link to this record:
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=2002-06189-004

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-06189-004">Under the influence of unconscious process;
Countertransference in the treatment of PTSD and substance abuse in
women.</A>

Database: PsycINFO
_____

Record: 10

Title: Disociativni komponenty v etiopatogenezi deprese, moznosti
jejich sledovani a terapeutickeho ovlivneni.
Translated Title: Dissociative components in etiopathogenesis of
depression, possibilities of monitoring and therapeutic influence.
Author(s): Bob, P., Psychiatricka klinika 1, Praha, Czech Republic

Zvolsky, P.

Paclt, I.

Pav, M.

Pavlat, J.

Vyhnankova, Z.

Uhrova, T.

Zukov, I.
Source: Ceska a Slovenska Psychiatrie, Vol 98(2), 2002. pp. 81-85.

Journal URL: http://www.clsjep.cz/nts/casop/psychiatrie/psychiatrie.asp
Publisher: Czech Republic: Czech Medical Society JEv Purkyne

Publisher URL: http://www.clsjep.cz/en
ISSN: 1212-0383 (Print)
Language: Czech
Key Concepts: psychic dissociation; dissociative disorders; recurrent
depression; bipolar depression; etiopathogenesis; somatoform
dissociation
Abstract: Dissociation in its historical definition by P. Janet
represents splitting the stream of consciousness in response to a
traumatic event or in hypnosis. Dissociation is traditionally considered
an important etiopathogenetic factor of mental diseases, explaining some
psychopathological phenomena. It has been used as an explanation for the
group of dissociative disorders and its influence in other psychiatric
disorders such as depression and posttraumatic stress disorder (PTSD)
has been proven. In this study, researchers tested 22 patients with
recurrent or bipolar depression for psychic dissociation; dissociation
measured by means of the DES score was more than twice as high as in the
normal population. Median BDI-11 represented major depression.
Somatoform dissociation measured by means of SDQ-20 was near the lower
limit for dissociative disorders. The correlation between DES and BDI-11
was not close but the correlation between DES and SDQ-20 was very close
(representing psychic and somatoform dissociation, respectively.) Three
patients from the group (13.6%) probably had criteria for dissociative
disorders; this corresponds with findings showing that 15% of all
psychiatric patients have dissociative disorders. Treatment implications
are discussed. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Bipolar Disorder; *Dissociation; *Dissociative
Disorders; *Etiology; *Major Depression
Classification: Affective Disorders (3211)
Population: Human (10)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date: 20020828
Accession Number: 2002-12650-002
Number of Citations in Source: 48

Persistent link to this record:
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=2002-12650-002

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-12650-002">Disociativni komponenty v etiopatogenezi deprese,
moznosti jejich sledovani a terapeutickeho ovlivneni.</A>

Database: PsycINFO
_____

Record: 11

Title: On the epidemiology of posttraumatic stress disorder: Period
prevalence rates and acute service utilization rates among Massachusetts
Medicaid program enrollees: 1993--1996,.
Author(s): Macy, Robert Donnelly, Union Inst And U., US
Source: Dissertation Abstracts International: Section B: The Sciences &
Engineering, Vol 63(6-B), Jan 2002. pp. 3014.
Publisher: US: Univ Microfilms International

ISSN: 0419-4217 (Print)
Order Number: AAI3057835
Language: English
Key Concepts: PTSD; prevalence rates; acute service utilization rates;
Medicaid
Abstract: Period prevalence rates of DSM III-R posttraumatic
stress disorder (PTSD) were studied in the statewide Massachusetts
Medicaid Mental Health and Substance Abuse Program. Among 85,000
enrolled Medicaid recipients seeking treatment, 55,931 received one of
the five study diagnoses that included PTSD, Panic Disorder, Multiple
Personality Disorder, Major Depression, and Bipolar Disorder.
Interactions between period prevalence rates by study diagnoses, gender,
multiple age and public assistance AID categories, and acute service
utilization rates were investigated. Major Depression (n = 21,842)
ranked highest with an overall period prevalence rate of 390.5 per 1,000
(CI: 386.5-394.6). PTSD (n = 19,775) ranked second highest with an
overall period prevalence rate of 353.6 per 1000 (CI: 346.6-357.5). PTSD
exhibited its highest period prevalence rate, 609.5 per 1,000 (CI:
601.0-618.0), for the study population in the youngest age group (5 to
12 years). Age-specific PTSD period prevalence rates for both the
youngest age group and the aggregate of the two youngest age groups (5
to 18 years) far exceed rates in both the other study diagnoses, and in
all of the published rates for comparable child treatment seeking
populations. PTSD ranked highest for utilization of acute inpatient days
and for length of stay and ranked highest in overall cost for acute
service utilization. The highest PTSD period prevalence rates were
positively associated with the AID category of refugee, orphans and
children under 21 in need of medical assistance. This study may provide
a unique first look at age-specific PTSD period prevalence rates for
non-disaster youth populations, and certainly argues for further
investigation among community treatment seeking samples into the
positive associations between age, trauma exposure and the early
development of PTSD. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Epidemiology; *Health Care Utilization; *Medicaid;
*Posttraumatic Stress Disorder
Classification: Health & Mental Health Treatment & Prevention (3300)
Population: Human (10)
Location: US
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Dissertation Abstract (350); Print

Format(s) Available: Print
Release Date: 20030728
Accession Number: 2002-95024-242

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=2002-95024-242

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-95024-242">On the epidemiology of posttraumatic stress
disorder: Period prevalence rates and acute service utilization rates
among Massachusetts Medicaid program enrollees: 1993--1996,.</A>

Database: PsycINFO
_____

Record: 12

Title: A twin study of genetic and environmental influences on
suicidability in men.
Author(s): Fu, Qiang, Washington U, Dept of Psychiatry, Missouri
Alcoholism Research Ctr, St Louis, MO, US

Heath, A. C.

Bucholz, K. K.

Nelson, E. C.

Glowinski, A. L.

Goldberg, J.

Lyons, M. J.

Tsuang, M. T.

Jacob, T.

True, M. R.

Eisen, S. A.
Address: Fu, Qiang, Washington U School of Medicine, Dept of
Psychiatry, Missouri Alcoholism Research Ctr, 40N Kingshighway Blvd.,
Suite 2, St Louis, MO, US
Source: Psychological Medicine, Vol 32(1), Jan 2002. pp. 11-24.

Journal URL: http://uk.cambridge.org/journals/psm/
Publisher: US: Cambridge Univ Press

Publisher URL: http://www.cup.org
ISSN: 0033-2917 (Print)
Language: English
Key Concepts: genetic influences; environmental influences; suicidal
ideation; suicide attempt; male twin pairs
Abstract: Examined genetic influences on suicidality (i.e.,
suicidal ideation and/or suicide attempt). Sociodemographics, combat
exposure, lifetime major depression, bipolar disorder, childhood conduct
disorder, adult antisocial personality disorder, panic disorder,
posttraumatic stress disorder (PTSD), drug dependence, alcohol
dependence and lifetime suicidal ideation and attempt were assessed in
3,372 male twin pairs from the Vietnam Era Twin Registry who were
assessed in 1987 and 1992. Additive genetic, shared environmental and
non-shared environmental effects on suicidality were estimated using
structural equation modelling. The prevalence of suicidal ideation and
suicide attempt were 16.1% and 2.4% respectively. Co-twin's suicidality,
being White, unemployment, being other than married, medium combat
exposure and psychiatric disorders were predictors for suicidal
ideation. Co-twin's suicidality, unemployment, marital disruption, low
education attainment and psychiatric disorders were predictors for
suicide attempt. Model-fitting suggested that suicidal ideation was
influenced by additive genetic (36%) and non-shared environmental (64%)
effects, while suicide attempt was affected by additive genetic (17%),
shared environmental (19%) and non-shared environmental (64%) effects.
(PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Attempted Suicide; *Environment; *Genetics; *Human
Males; *Suicidal Ideation; Twins
Classification: Behavior Disorders & Antisocial Behavior (3230)
Population: Human (10)

Male (30)
Age Group: Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20020529
Accession Number: 2002-02914-002
Number of Citations in Source: 77

Persistent link to this record:
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=2002-02914-002

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-02914-002">A twin study of genetic and environmental
influences on suicidability in men.</A>

Database: PsycINFO
_____

Record: 13

Title: An overview of coexisting conditions for women with AD/HD.
Author(s): Nadeau, Kathleen G., Chesapeake Ctr for Attention &
Learning Disorders, Silver Spring, MD, US

Quinn, Patricia O.
Source: Understanding women with AD/HD. Nadeau, Kathleen G. (Ed); Quinn,
Patricia O. (Ed); pp. 152-176. Silver Spring, MD, US: Advantage Books,
2002. vii, 465 pp.
ISBN: 0-96609366-4-6 (paperback)
Language: English
Key Concepts: comorbidity; ADHD; women; depression; bipolar mood
disorder; anxiety disorders; PTSD; addiction; eating disorders; sleeping
problems; learning disabilities.
Abstract: (from the chapter) Notes that a broad range of
conditions commonly coexist with attention deficit hyperactivity
disorder (ADHD) in women. This chapter outlines the following comorbid
conditions: depression, bipolar mood disorder, anxiety disorders,
posttraumatic stress disorder (PTSD), addiction, eating disorders,
sleeping problems, and learning disabilities. (PsycINFO Database Record
(c) 2003 APA, all rights reserved)
Subjects: *Attention Deficit Disorder with Hyperactivity;
*Comorbidity; *Human Females; Addiction; Anxiety Disorders; Bipolar
Disorder; Eating Disorders; Learning Disabilities; Major Depression;
Posttraumatic Stress Disorder; Sleep Disorders
Classification: Developmental Disorders & Autism (3250)
Population: Human (10)

Female (40)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 20020731
Accession Number: 2002-12830-009
Number of Citations in Source: 61

Persistent link to this record:
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=2002-12830-009

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-12830-009">An overview of coexisting conditions for women
with AD/HD.</A>

Database: PsycINFO
_____

Record: 14

Title: Developmental vulnerabilities to the onset and course of bipolar
disorder.
Author(s): Post, Robert M., National Inst of Mental Health,
Biological Psychiatry Branch, Bethesda, MD, US

Leverich, Gabriele S.

Xing, Guoqiang

Weiss, Susan R. B.
Source: Development & Psychopathology, Vol 13(3), Sum 2001. Special
issue: Stress and development: Biological and psychological
consequences. pp. 581-598.

Journal URL: http://uk.cambridge.org/journals/dpp/
Publisher: US: Cambridge Univ Press

Publisher URL: http://www.cup.org
ISSN: 0954-5794 (Print)
Digital Object Identifier: 10.1017/S0954579401003091
Language: English
Key Concepts: early stressful experiences; precipitants; developmental
vulnerabilities; neurobiological mechanisms; bipolar disorder
Abstract: Different types of psychosocial stressors have long been
recognized as potential precipitants of both unipolar and bipolar
affective episodes and the causative agents in posttraumatic stress
disorder (PTSD). New data have revealed some of the neurobiological
mechanisms that could convey the long-term behavioral and biochemical
consequences of early stressors. Maternal deprivation stress in the
neonatal rodent can be associated with lifelong anxiety-like behaviors,
increases in stress hormones and peptides, and proneness to drug and
alcohol administration, in association with decrements in neurotrophic
factors and signal transduction enzymes necessary for learning and
memory. Patients with bipolar illness who have a history of early
extreme adversity, vs those without, show an earlier onset of illness,
faster cycling frequencies, increased suicidality, more Axis I and Axis
II comorbidities, and more time ill in more than 2 yrs of prospective
follow-up. To the extent that the more severe course of bipolar illness
characteristics are directly and causally related to these early
stressful experiences, early recognition and treatment of high-risk
children could be crucial in helping to prevent or ameliorate the
long-term adverse consequences of these stressors. (PsycINFO Database
Record (c) 2003 APA, all rights reserved)
Subjects: *Bipolar Disorder; *Early Experience; *Neurobiology;
*Stress; *Susceptibility (Disorders); Human Development; Onset
(Disorders)
Classification: Affective Disorders (3211)
Population: Human (10)
Age Group: Childhood (birth-12 yrs) (100)

Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)
Form/Content Type: Literature Review (1300)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20010912
Accession Number: 2001-18325-008
Number of Citations in Source: 111

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=2001-18325-008

Cut and Paste: <A
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syh&an=2001-18325-008">Developmental vulnerabilities to the onset and
course of bipolar disorder.</A>

Database: PsycINFO
_____

Record: 15

Title: Teaching group process to mentally ill adult clients: Effect on
client ratings of self-esteem and psychological well-being.
Author(s): Barr, Kyran, Nichols Coll, Dudley, MA, US

Emer, Denise

Keller, Peggy
Source: Journal for Specialists in Group Work, Vol 26(1), Mar 2001. pp.
48-65.
Publisher: US: Sage Publications

Publisher URL: http://www.sagepub.com
ISSN: 0193-3922 (Print)
Language: English
Key Concepts: group therapy, self-esteem development & psychological
well-being, patients with schizoaffective or major depressive or bipolar
disorder or schizophrenia or PTSD
Abstract: Mentally ill clients spend a considerable amount of time
in groups. Understanding the dynamics of group process could provide
clients with a greater sense of mastery over their own recovery. This
study compared the development of self-esteem and psychological
well-being in 10 clients who participated in an experimental course on
group process with 10 control Ss who did not participate in such a
group. Ss' diagnoses included schizoaffective disorder, major
depression, bipolar disorder, posttraumatic stress disorder, and
schizophrenia. Results suggest that clients who were taught group
process showed greater increases along these variables than did those
who did not participate in the course. Implications for the importance
of helping clients understand the process of group therapy are
discussed. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Group Psychotherapy; *Mental Disorders; *Self Esteem;
*Well Being; Bipolar Disorder; Major Depression; Posttraumatic Stress
Disorder; Schizoaffective Disorder; Schizophrenia
Classification: Group & Family Therapy (3313)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20010411
Accession Number: 2001-14608-004
Number of Citations in Source: 35

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=2001-14608-004

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2001-14608-004">Teaching group process to mentally ill adult
clients: Effect on client ratings of self-esteem and psychological
well-being.</A>

Database: PsycINFO
_____

Record: 16

Title: Family treatment of schizophrenia and bipolar disorder.
Author(s): Mueser, Kim T., Dartmouth Medical School, Dept of
Psychiatry, Hanover, NH, US
Source: Family therapy and mental health: Innovations in theory and
practice. MacFarlane, Malcolm M. (Ed); pp. 57-81. Binghamton, NY, US:
Haworth Clinical Practice Press, 2001. xxviii, 410 pp.
ISBN: 0-7890-0880-7 (hardcover)

0-7890-1589-7 (paperback)
Language: English
Key Concepts: family therapy; schizophrenia; bipolar disorder; family
intervention model; behavioral family therapy
Abstract: (from the chapter) Describes one family intervention
model for schizophrenia and bipolar disorder, behavioral family therapy
(BFT). BFT is the most extensively studied model of family intervention
for severe mental illness, with multiple studies on both schizophrenia
and bipolar disorder. BFT is also the only family intervention model
that has been systematically examined in individuals with bipolar
disorder; the other models have been evaluated only for schizophrenia.
Several manuals for the BFT model exist, including I. R. Falloon et al
(1984) for schizophrenia, D. J. Miklowitz and M. J. Goldstein (1997) for
bipolar disorder, and K. T. Mueser and S. M. Glynn (1999) for the range
of severe mental illnesses, including schizophrenia, schizoaffective
disorder, bipolar disorder, major depression, obsessive-compulsive
disorder, and posttraumatic stress disorder (PTSD). A case example is
given of a man, Dave, who was enrolled in an outpatient treatment
program that combined low-dose antipsychotic medication with BFT.
Throughout the course of treatment, Dave steadily improved. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Behavior Therapy; *Bipolar Disorder; *Family Therapy;
*Schizophrenia; Models
Classification: Group & Family Therapy (3313)
Population: Human (10)

Outpatient (60)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 20020605
Accession Number: 2002-01051-002
Number of Citations in Source: 52

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=2002-01051-002

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syh&an=2002-01051-002">Family treatment of schizophrenia and bipolar
disorder.</A>

Database: PsycINFO
_____

Record: 17

Title: Reminiscence and its relationship to attachment and personality
in geropsychiatric patients.
Author(s): Molinari, Victor, Veterans Affairs Medical Ctr,
Psychology, Houston, TX, US

Cully, Jeffrey A.

Kendjelic, Edward M.

Kunik, Mark E.
Source: International Journal of Aging & Human Development, Vol 52(3),
2001. pp. 173-184.

Journal URL: http://baywood.com/search/PreviewJournal.asp?qsRecord=5
Publisher: US: Baywood Publishing

Publisher URL: http://baywood.com
ISSN: 0091-4150 (Print)

1541-3535 (Electronic)
Language: English
Key Concepts: reminiscence functions; attachment style; personality
factors; geropsychiatric patients
Abstract: Examined the relationships between reminiscence,
attachment styles and personality factors in 40 60-85 yr old patients
attending a geropsychiatric outpatient clinic. Diagnoses included
depression, anxiety, delusional disorder, bipolar disorder,
posttraumatic stress disorder (PTSD), schizophrenia, adjustment disorder
and insomnia. The patients completed the Reminiscence Functions Scale,
NEO--FFI, and the Relationship Questionnaire. Results show that,
compared with insecurely attached older patients, securely attached
older patients scored higher on the teach/inform reminiscence function.
Consistent with prior research, there were relationships between the
extraversion personality factor and conversation reminiscence; and
between the openness personality factor and both identity and
problem-solving reminiscence functions. (PsycINFO Database Record (c)
2003 APA, all rights reserved)
Subjects: *Attachment Behavior; *Geriatric Patients; *Personality
Correlates; *Psychiatric Patients; *Reminiscence
Classification: Psychological Disorders (3210)
Population: Human (10)

Outpatient (60)
Age Group: Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)

Aged (65 yrs & older) (380)

Very Old (85 yrs & older) (390)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20010801
Accession Number: 2001-01086-001
Number of Citations in Source: 29

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=2001-01086-001

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2001-01086-001">Reminiscence and its relationship to attachment
and personality in geropsychiatric patients.</A>

Database: PsycINFO
_____

Record: 18

Title: Assessment and treatment of addictive sexual disorders:
Relevance for chemical dependency relapse.
Author(s): Schneider, Jennifer P., Arizona Community Physicians,
Tucson, AZ, US, jennifer@jenniferschneider.com

Irons, Richard R., Professional Resource Ctr, Tucson, AZ, US
Address: Schneider, Jennifer P., Arizona Community Physicians,
1500 N. Wilmot, B-250, Tucson, AZ, US, jennifer@jenniferschneider.com
Source: Substance Use & Misuse, Vol 36(13), 2001. Special issue: Do
treatments and other interventions work?. pp. 1795-1820.
Publisher: US: Marcell Dekker

Publisher URL: http://www.dekker.com
ISSN: 1082-6084 (Print)
Digital Object Identifier: 10.1081/JA-100108428
Language: English
Key Concepts: addictive sexual disorders; chemical dependency;
relapse; fantasy sex; seductive role sex; anonymous sex; sexual
excesses; paraphilias; impulse control disorders; bipolar; PTSD;
recovery
Abstract: Discusses the differential diagnosis of addictive sexual
disorders, and their assessment, treatment, and interaction with
chemical dependency. Addictive sexual disorders often coexist with
chemical dependency and are a frequently unrecognized cause of chemical
dependency relapse. The range of fantasies, urges, and behaviors that
can be considered addictive sexual disorders includes: (1) fantasy sex;
(2) seductive role sex; and (3) anonymous sex. Sexual improprieties and
excesses that are considered addictive can usually be classified as
paraphilia, impulse control disorder, or sexual disorder. The
progression of untreated sexual addiction comprises: (1) the initiation
phase, in which sex becomes the drug of choice; and (2) the
establishment phase, in which there is repetition of an addictive cycle.
Many chemical dependency treatment centers in the US provide clients, at
entry, with checklists designed to uncover coexisting compulsive sexual
behaviors. Several diagnoses can be manifested as an addictive sexual
disorder, including paraphilias, bipolar affective disorder, and
posttraumatic stress disorder (PTSD). Recovery from sexual addiction is
in some ways more analogous to recovery from eating disorders than to
recovery from substance use disorders. (PsycINFO Database Record (c)
2003 APA, all rights reserved)
Subjects: *Comorbidity; *Drug Addiction; *Recovery (Disorders);
*Relapse (Disorders); *Sexual Addiction; Bipolar Disorder; Impulse
Control Disorders; Paraphilias; Seduction; Sexual Fantasy
Classification: Behavior Disorders & Antisocial Behavior (3230)
Population: Human (10)

Male (30)

Female (40)
Age Group: Adulthood (18 yrs & older) (300)

Young Adulthood (18-29 yrs) (320)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20020327
Accession Number: 2002-00129-003
Number of Citations in Source: 42

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=2002-00129-003

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2002-00129-003">Assessment and treatment of addictive sexual
disorders: Relevance for chemical dependency relapse.</A>

Database: PsycINFO
_____

Record: 19

Title: Empirically supported cognitive therapies: Current and future
applications.
Author(s): Lyddon, William J., (Ed), U Southern Mississippi, Dept
of Psychology, Hattiesburg, MS, US

Jones, John V. Jr., (Ed)
Source: New York, NY, US: Springer Publishing Co, 2001. xiii, 258 pp.
Publisher URL: http://www.springerpub.com
ISBN: 0-8261-2299-X (hardcover)
Language: English
Key Concepts: cognitive therapies; depression; bipolar disorder;
obsessive compulsive disorder; PTSD; anger management; antisocial
behavior; children; adolescents
Abstract: (from the cover) Empirically validated cognitive
techniques for depression, bipolar I disorder, obsessive compulsive
disorder, posttraumatic stress disorder (PTSD), and other common
clinical disorders, including anger management and antisocial behavior
in children and adolescents are presented. Case examples are integral to
each discussion. Encompassing recent trends, current limitations, and
new directions and developments, this text offers a fundamental
knowledge base for students and practitioners alike. (PsycINFO Database
Record (c) 2004 APA, all rights reserved)
Subjects: *Cognitive Therapy; *Mental Disorders;
*Psychotherapeutic Techniques; Adolescent Psychotherapy; Anger Control;
Antisocial Behavior; Bipolar Disorder; Child Psychotherapy; Major
Depression; Obsessive Compulsive Disorder; Posttraumatic Stress Disorder

Classification: Cognitive Therapy (3311)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Edited Book (140); Print
Release Date: 20010919
Correction Date: 20040126
Accession Number: 2001-18468-000

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2001-18468-000">Empirically supported cognitive therapies:
Current and future applications.</A>

Database: PsycINFO
_____

Record: 20

Title: The role of psychotherapy in public psychiatry today.
Author(s): Goin, Marcia Kraft, U Southern California, School of
Medicine, Los Angeles, CA, US
Source: Psychiatric Services, Vol 51(11), Nov 2000. pp. 1379-1381.

Journal URL: http://psychservices.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 1075-2730 (Print)
Digital Object Identifier: 10.1176/appi.ps.51.11.1379
Language: English
Key Concepts: role of individual & supportive psychotherapy in public
psychiatry clinic, 41-yr-old woman with bipolar disorder & 54-yr-old man
with schizophrenia
Abstract: Briefly examines the role of psychotherapy in current
public psychiatry by examining 2 clinical case reports: Jane, a
41-yr-old single mother who has bipolar disorder and was a previous
substance abuser, and Sam, a 54-yr-old man with schizophrenia. The role
of psychotherapy is discussed in relation to their conditions, as well
as diagnoses such as panic disorder, dysthymia, posttraumatic stress
disorder (PTSD), and major depression. The author feels that it is
important to provide psychotherapy with individualized interventions,
which involves knowing the biopsychosocial aspects of the patient's
mental illness. Some knowledge of the patient's history, including the
genetic and constitutional elements and the developmental history, as
well as the current social and cultural stresses would permit
psychiatrists to offer patient-specific psychotherapeutic interventions.
In supportive psychotherapy, interpretations of the links between past
and present provide explanations and give meaning to current behavior.
The author believes that many factors contribute to a clinician's
developing a skilled supportive psychotherapy stance--understanding
transference and countertransference, being psychodynamically informed,
understanding cognitive development, and having a knowledge of learning
theory. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Bipolar Disorder; *Psychiatry; *Psychotherapy;
*Schizophrenia; Clinicians; Individual Psychotherapy; Public Health
Services; Supportive Psychotherapy; Therapist Role
Classification: Psychotherapy & Psychotherapeutic Counseling (3310)
Population: Human (10)

Male (30)

Female (40)

Outpatient (60)
Age Group: Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)
Form/Content Type: Empirical Study (0800)

Clinical Case Report (0820)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 20001129
Accession Number: 2000-12273-006

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syh&an=2000-12273-006">The role of psychotherapy in public psychiatry
today.</A>

Database: PsycINFO
_____

Record: 21

Title: Estimulacion magnetica transcraneal: Aportacion a la Psiquiatria
y al estudio de la relacion cerebro-conducta.
Translated Title: Transcranial magnetic stimulation: Contributions
to psychiatry and to the study of the brain-behavior relationship.
Author(s): Bartres-Faz, David, U Barcelona, Dept Psiquiatria y
Psicogiologia Clinica, Barcelona, Spain

Tormos, J. M.

Junque, C.

Pascual-Leone, A.
Source: Actas Espanolas de Psiquiatria, Vol 28(2), Mar-Apr 2000. pp.
130-136.
Publisher: Spain: Editorial Garsi SA

ISSN: 1139-9287 (Print)
Language: Spanish
Key Concepts: use & efficacy of transcranial magnetic stimulation,
patients with depression or mania or obsessive-compulsive disorder or
PTSD or schizophrenia
Abstract: Describes the use and therapeutic effects of
transcranial magnetic stimulation, a noninvasive imaging technique that
modulates cortical excitability. Potential therapeutic effects on
depression, mania, obsessive-compulsive disorder, posttraumatic stress
disorder (PTSD), and schizophrenia are described. Use of the technique
with other neuroimaging methods for the study of cognitive functions is
also considered. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Brain Stimulation; *Magnetism; *Mental Disorders;
*Treatment; Bipolar Disorder; Major Depression; Obsessive Compulsive
Disorder; Posttraumatic Stress Disorder; Schizophrenia
Classification: Health Psychology & Medicine (3360)
Population: Human (10)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print
Release Date: 20010425
Accession Number: 2000-16200-008
Number of Citations in Source: 55

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2000-16200-008">Estimulacion magnetica transcraneal: Aportacion a
la Psiquiatria y al estudio de la relacion cerebro-conducta.</A>

Database: PsycINFO
_____

Record: 22

Title: "The Rorschach test in clinical diagnosis": A critical review,
with a backward look at Garfield (1947).
Author(s): Wood, James M., U Texas, Dept of Psychology, El Paso,
TX, US

Lilienfeld, Scott O.

Garb, Howard N.

Nezworski, M. Teresa
Source: Journal of Clinical Psychology, Vol 56(3), Mar 2000. pp.
395-430.

Journal URL: http://www.interscience.wiley.com/jpages/0021-9762/
Publisher: US: John Wiley & Sons

Publisher URL: http://www.wiley.com
ISSN: 0021-9762 (Print)

1097-4679 (Electronic)
Digital Object Identifier:
10.1002/(SICI)1097-4679(200003)56:3<395::AID-JCLP15>3.3.CO;2-F
Language: English
Key Concepts: use of Rorschach test in clinical diagnoses, consecutive
psychiatric cases with either schizophrenia or psychoneurosis,
commentary
Abstract: The present article comments on the reprinted study by
S. L. Garfield (see record 2000-15184-014) regarding the use of the
Rorschach test in clinical diagnoses. The article then reviews research
on the Rorschach and psychiatric diagnoses. Despite a few positive
findings, the Rorschach has demonstrated little validity as a diagnostic
tool. Deviant verbalizations and bad form on the Rorschach, and indices
based on these variables, are related to Schizophrenia and perhaps to
Bipolar Disorder and Schizotypal Personality Disorder. Patients with
Borderline Personality Disorder also seem to give an above-average
number of deviant verbalizations. Otherwise the Rorschach has not shown
a well-demonstrated relationship to these disorders or to Major
Depressive Disorder, Posttraumatic Stress Disorder (PTSD), anxiety
disorders other than PTSD, Dissociative Identity Disorder, Dependent,
Narcissistic, or Antisocial Personality Disorders, Conduct Disorder, or
psychopathy. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Neurosis; *Psychodiagnosis; *Rorschach Test;
*Schizophrenia; Psychiatric Patients
Classification: Clinical Psychological Testing (2224)

Psychological Disorders (3210)
Population: Human (10)

Inpatient (50)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Comment (0500)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 20000501
Accession Number: 2000-15184-014

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syh&an=2000-15184-014">"The Rorschach test in clinical diagnosis": A
critical review, with a backward look at Garfield (1947).</A>

Database: PsycINFO
_____

Record: 23

Title: Psychiatric morbidity and comorbidity following accidental
man-made traumatic events: Incidence and risk factors.
Author(s): Maes, Michael, U Hosp of Maastricht, Dept of Psychiatry
& Neurology, Maastricht, Netherlands

Mylle, Jacques

Delmeire, Laure

Altamura, Carlo
Source: European Archives of Psychiatry & Clinical Neuroscience, Vol
250(3), 2000. pp. 156-162.

Journal URL:
http://link.springer.de/link/service/journals/00406/index.htm
Publisher: Germany: Springer Verlag

Publisher URL: http://www.springer.de
ISSN: 0940-1334 (Print)

1433-8491 (Electronic)
Digital Object Identifier: 10.1007/s004060050008
Language: English
Key Concepts: PTSD & incidence & risk factors of major depression &
bipolar disorder & psychoactive substance abuse & psychotic & anxiety
disorder following accidental trauma, victims of fire or vehicle
accidents
Abstract: The aims of this study were to examine the incidence and
risk factors of major depression, bipolar disorder, psychoactive
substance abuse, psychotic, and anxiety disorders in relation to
posttraumatic stress disorder (PTSD) in a study group exposed to 2
different traumatic events, i.e. 128 fire and 55 motor vehicle accident
victims. Data have been collected 7-9 mo after the traumatic event. The
diagnosis of axis-I diagnoses, other than PTSD, was made according to
Diagnostic and Statistical Manual of Mental Disorders-III-Revised
(DSM-III-R) criteria using the Structured Interview according to
DSM-III-R. The incidence of new-onset major depression was 13.4%,
generalized anxiety disorder 12.6%, agoraphobia 10.2%, and psychoactive
substance use disorders 6%. Simple phobia, panic disorder, and obsessive
compulsive disorder had much lower incidence. 51 percent of the victims
with PTSD had 1 or more additional axis-I diagnoses, major depression
(26.2%), agoraphobia (21.0%), and generalized anxiety disorder (24.6%)
being the most common. Physical injury was the single best predictor for
major depression. The best predictors for the development of new-onset
anxiety disorders, other than PTSD, were: type and horror of trauma, the
extent of physical injury, the loss of control during the traumatic
event, contextual stimuli, younger age, and female sex. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Emotional Responses; *Emotional Trauma; *Epidemiology;
Acute Psychosis; Anxiety Disorders; Bipolar Disorder; Comorbidity;
Disasters; Drug Abuse; Major Depression; Motor Traffic Accidents; Onset
(Disorders); Posttraumatic Stress Disorder; Survivors
Classification: Psychological & Physical Disorders (3200)
Population: Human (10)

Male (30)

Female (40)
Location: Belgium
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 20000816
Correction Date: 20031124
Accession Number: 2000-08872-008

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2000-08872-008">Psychiatric morbidity and comorbidity following
accidental man-made traumatic events: Incidence and risk factors.</A>

Database: PsycINFO
_____

Record: 24

Title: Clinical uses and differences among the selective serotonin
reuptake inhibitors.
Author(s): Raap, Jonathon W., U Hospitals & Clinics, Dept of
Pharmacy Services, Salt Lake City, UT, US

Beckwith, M. Christina

Reimherr, Frederick W.
Source: Journal of Pharmaceutical Care in Pain & Symptom Control, Vol
8(3), 2000. pp. 23-38.

Journal URL: http://www.haworthpressinc.com/store/product.asp?sku=J088
Publisher: US: Haworth Press

Publisher URL: http://www.haworthpressinc.com
ISSN: 1056-4950 (Print)
Language: English
Key Concepts: role of differences in pharmacokinetic profiles & side
effect & doses & indication & cost in selection of selective serotonin
reuptake inhibitors
Abstract: Discusses the role of differences in pharmacokinetic
profiles, side effects, relative doses, FDA-approved indications, and
cost in the selection of particular selective serotonin reuptake
inhibitors (SSRIs). It is stated that since SSRIs inhibit neuronal
serotonin reuptake and have minimal effects on sites affected by other
antidepressants, SSRIs have a different pharmacodynamic and tolerability
profile from other antidepressants. SSRIs are effective in treating many
disorders, including major depression, obsessive-compulsive disorder,
panic attacks, bulimia, alcoholism, bipolar disorder, posttraumatic
stress disorder (PTSD), premenstrual dysphoric disorder, and perhaps
migraine headaches. Common adverse reactions of SSRIs include CNS
activation, insomnia, sedation, and gastrointestinal upset. Altered
sleep patterns and sexual dysfunction due to SSRIs may adversely impact
patients' quality of life. Potentially serious drug interactions may
occur when SSRIs are given concomitantly with other agents. SSRIs
provide clinicians with an effective alternative to older
antidepressants. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Costs and Cost Analysis; *Drug Dosages; *Drug Therapy;
*Serotonin Reuptake Inhibitors; *Side Effects (Drug)
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)
Publication Type: Peer Reviewed Journal (270); Print

Format(s) Available: Print; Electronic
Release Date: 20010214
Accession Number: 2000-00975-001

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=2000-00975-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2000-00975-001">Clinical uses and differences among the selective
serotonin reuptake inhibitors.</A>

Database: PsycINFO
_____

Record: 25

Title: Drug treatment of pathological aggression.
Author(s): Fava, Maurizio, Harvard Medical School, Boston, MA, US
Source: Science, treatment, and prevention of antisocial behaviors:
Application to the criminal justice system. Fishbein, Diana H. (Ed); pp.
20-1-20-27. Kingston, NJ, US: Civic Research Institute, 2000. xiii,
27-25 pp.
ISBN: 1-887554-12-2 (hardcover)
Language: English
Key Concepts: drug treatment & psychopharmacology of pathological
aggression, patients exhibiting antisocial behavior
Abstract: (from the chapter) Explores drug treatment for
pathological aggression. Neurochemical studies in humans have supported
the modulating role in pathologic aggression of several systems of
neurotransmitters, in particular serotonin. Assessment instruments
include clinician-rated instruments and self-report measures. Drug
treatments studies in pathological aggression include agents indicated
in the treatment of a specific neuropsychiatric condition associated
with anger or aggression, or other drugs with possible antiaggressive
properties but not otherwise specified to the population treated.
Pathological aggression can result from dementia, Huntington's disease,
brain injury and organic brain syndrome, seizure disorder, and mentally
retarded and handicapped patients. Children and adolescents with
aggressive conduct disorder or attention deficit disorder may utilize
psychostimulants, lithium and neuroleptic medications, anticonvulsants,
or other agents. Other factors that can promote pathological aggression
include autism, schizophrenia and other psychoses, psychoactive
substance intoxification or withdrawal, unipolar depression, bipolar
disorder, posttraumatic stress disorder (PTSD), premenstrual dysphoric
disorder, and personality disorders. (PsycINFO Database Record (c) 2003
APA, all rights reserved)
Subjects: *Aggressive Behavior; *Antisocial Behavior; *Drug
Therapy; *Psychopharmacology
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 20000705
Accession Number: 2000-08319-019
Number of Citations in Source: 187

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Cut and Paste: <A
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syh&an=2000-08319-019">Drug treatment of pathological aggression.</A>

Database: PsycINFO
_____

Record: 26

Title: Psychopathology in adulthood (2nd ed.).
Author(s): Hersen, Michel, (Ed), Pacific U, School of Professional
Psychology, Forest Grove, OR, US

Bellack, Alan S., (Ed)
Source: Needham Heights, MA, US: Allyn & Bacon, 2000. xiii, 481 pp.
ISBN: 0-205-20027-3 (hardcover)
Language: English
Key Concepts: psychopathology; models; major disorders; epidemiology;
etiology; disease course; complications; treatment implications; adults
Abstract: (from the cover) Psychopathology in Adulthood
acknowledges that the study of psychopathology in the late 1990s has
become considerably more complex. The Second Edition asserts that the
psychopathologist of the 21st century must have broad scope and be fully
conversant with the various descriptions that contribute to a
comprehensive understanding of this vast topic. Readers are presented
with the latest developments in the field along with recent advances in
Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) and
related research carried out since 1993.

This work is divided into 2 major sections: (1) general issues and
models and (2) major disorders. Coverage includes schizophrenia, anxiety
disorders, posttraumatic stress disorder (PTSD), obsessive-compulsive
disorder, bipolar disorder, personality disorders, substance abuse, and
sexual dysfunction and deviation. Each chapter presents a description of
the disorder, epidemiology, etiology, course and complications,
treatment implications, and a case description. The book acknowledges
the current complexity of studying psychopathology in light of recent
discoveries in genetics, improved diagnostic procedures, use of
structured interview techniques, and technological advances. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Mental Disorders; *Models; *Psychopathology; Disease
Course; Epidemiology; Etiology; Treatment
Classification: Psychological & Physical Disorders (3200)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Edited Book (140); Print
Release Date: 20011010
Correction Date: 20031124
Accession Number: 2001-18643-000

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syh&an=2001-18643-000">Psychopathology in adulthood (2nd ed.).</A>

Database: PsycINFO
_____

Record: 27

Title: Reliability of reports of violent victimization and
posttraumatic stress disorder among men and women with serious mental
illness.
Author(s): Goodman, Lisa A., Boston Coll, School of Education,
Counseling Psychology Program, Boston, MA, US

Thompson, Kim M.

Weinfurt, Kevin

Corl, Susan

Acker, Pat

Mueser, Kim T.

Rosenberg, Stanley D.
Source: Journal of Traumatic Stress, Vol 12(4), Oct 1999. pp. 587-599.

Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: Netherlands: Kluwer Academic Publishers

Publisher URL: http://www.wkap.nl
ISSN: 0894-9867 (Print)
Language: English
Key Concepts: reliability & temporal consistency of childhood sexual
abuse & adult sexual & physical abuse self reports & current symptoms of
PTSD, adults with serious mental illness:
Abstract: Although violent victimization is highly prevalent among
men and women with serious mental illness (SMI, e.g., schizophrenia,
bipolar disorder), future research in this area may be impeded by
controversy concerning the ability of individuals with SMI to report
traumatic events reliably. This article presents the results of a study
exploring the temporal consistency of reports of childhood sexual abuse,
adult sexual abuse, and adult physical abuse, as well as current
symptoms of posttraumatic stress disorder (PTSD) among 50 people with
SMI (29 women whose mean age was 42.1 yrs and 21 men with a mean age of
37.6). Results show that trauma history and PTSD assessments can, for
the most part, yield reliable information essential to further research
in this area. The study also demonstrates the importance of using a
variety of statistical methods to assess the reliability of self-reports
of trauma history. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Child Abuse; *Early Memories; *Mental Disorders;
*Posttraumatic Stress Disorder; *Self Report; Physical Abuse; Sexual
Abuse; Victimization
Classification: Psychological Disorders (3210)
Population: Human (10)

Male (30)

Female (40)

Outpatient (60)
Location: US
Age Group: Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 20000401
Accession Number: 2000-13266-004

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=2000-13266-004

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=2000-13266-004">Reliability of reports of violent victimization
and posttraumatic stress disorder among men and women with serious
mental illness.</A>

Database: PsycINFO
_____

Record: 28

Title: Categorizing fear: The role of trauma in a clinical formulation.

Author(s): Burton, John K., Columbia U, Coll of Physicians &
Surgeons, Dept of Psychiatry, New York, NY, US

Marshall, Randall D.
Source: American Journal of Psychiatry, Vol 156(5), May 1999. pp.
761-766.

Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 0002-953X (Print)
Language: English
Key Concepts: trauma & fear categorization in clinical formulation of
diagnosis & treatment, female 39 yr old meeting criteria for several
disorders, case report
Abstract: Illustrates, in a case report, the difficulties that can
accompany the evaluation and treatment of an individual with a history
of severe psychological trauma, who meets criteria for several
disorders, and presents problems in multiple domains of functioning. The
social, family and psychiatric history of a 39-yr old female is
presented, followed by evaluation information. Problems in treatment are
highlighted including split psychotherapy and pharmacotherapy treatments
following initial diagnoses of bipolar disorder and borderline
personality disorder. The patients' affective lability and trauma and
abuse history are focused upon in relation to a subsequent diagnostic
formulation of PTSD, chronic; dissociative disorder; major depressive
disorder, recurrent, and personality disorder. (PsycINFO Database Record
(c) 2003 APA, all rights reserved)
Subjects: *Emotional Trauma; *Fear; *Psychodiagnosis; *Treatment
Classification: Psychological Disorders (3210)
Population: Human (10)

Female (40)
Location: US
Age Group: Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)
Form/Content Type: Empirical Study (0800)

Clinical Case Report (0820)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19990701
Accession Number: 1999-13809-013

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=1999-13809-013

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1999-13809-013">Categorizing fear: The role of trauma in a
clinical formulation.</A>

Database: PsycINFO
_____

Record: 29

Title: Brain imaging correlates.
Author(s): Krishnan, K. Ranga, Duke U, Medical Ctr, Dept of
Psychiatry, Durham, NC, US
Source: Journal of Clinical Psychiatry Monograph Series, Vol 17(2), Apr
1999. pp. 36-39.
Publisher: US: Physicians Postgraduate Press

Publisher URL: http://www.psychiatrist.com
ISSN: 0742-1915 (Print)
Language: English
Key Concepts: brain imaging data on neuroanatomical circuitry related
to aggression symptom prevalence in psychiatric disorders
Abstract: The aggression complex of symptoms is important to
understand, because it is present in a variety of psychiatric disorders,
including posttraumatic stress disorder (PTSD), bipolar disorder,
depression, dementia, schizophrenia, and attention deficit hyperactivity
disorder (ADHD). This paper discusses the neuroanatomical circuitry
potentially implicated in aggression (probably similar in many ways to
any other affective regulation), and examines data from a rhesus monkey
study and a human study with single photon emission computed tomography
(SPECT) to follow the direction of current research. (PsycINFO Database
Record (c) 2003 APA, all rights reserved)
Subjects: *Aggressive Behavior; *Mental Disorders; *Neuroanatomy;
*Tomography
Classification: Psychological Disorders (3210)
Population: Human (10)
Form/Content Type: Conference Proceedings/Symposia (0600)
Conference: "Phenomenology and Treatment of Aggression Across
Psychiatric Illnesses", Aug, 1998, Chicago, IL, US
Publication Type: Journal (250); Print
Release Date: 19990801
Accession Number: 1999-05506-010

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=1999-05506-010

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1999-05506-010">Brain imaging correlates.</A>

Database: PsycINFO
_____

Record: 30

Title: Antecedents and complications of trauma in boys with ADHD:
Findings from a longitudinal study.
Author(s): Wozniak, Janet, Massachusetts General Hosp, Pediatric
Psychopharmacology Unit, Boston, MA, US

Crawford, Margaret Harding

Biederman, Joseph

Faraone, Stephen V.

Spencer, Thomas J.

Taylor, Andrea

Blier, Heather K.
Source: Journal of the American Academy of Child & Adolescent
Psychiatry, Vol 38(1), Jan 1999. pp. 48-56.

Journal URL: http://www.jaacap.com/
Publisher: US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com
ISSN: 0890-8567 (Print)
Language: English
Key Concepts: ADHD & increased risk for trauma or PTSD or
trauma-associated psychopathology, 6-17 yr old males
Abstract: Examined the relationship between trauma and
attention-deficit hyperactivity disorder (ADHD) and evaluated whether
ADHD increases the risk for trauma, the risk for posttraumatic stress
disorder (PTSD), or the risk for trauma-associated psychopathology. Data
from a longitudinal sample of 260 male children and adolescents (aged
6-17 yrs) with and without ADHD were examined. All were evaluated
comprehensively with assessments in multiple domains of functioning
including systematic assessments of trauma and PTSD. Comparisons were
made between traumatized and nontraumatized youths with and without
ADHD. No meaningful differences were detected in comparisons between
ADHD and control children, either in the rate of trauma exposure or in
the development of PTSD. Although trauma was associated with the
development of major depression, this effect was independent of ADHD
status. In contrast, bipolar disorder at baseline assessment was a
significant risk factor for subsequent trauma exposure. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Attention Deficit Disorder; *Emotional Trauma;
*Posttraumatic Stress Disorder; *Psychopathology; *Risk Analysis; Human
Males; Hyperkinesis
Classification: Developmental Disorders & Autism (3250)
Population: Human (10)

Male (30)
Age Group: Childhood (birth-12 yrs) (100)

School Age (6-12 yrs) (180)

Adolescence (13-17 yrs) (200)
Form/Content Type: Empirical Study (0800)

Longitudinal Study (0850)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19990301
Accession Number: 1999-00128-017

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=1999-00128-017

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1999-00128-017">Antecedents and complications of trauma in boys
with ADHD: Findings from a longitudinal study.</A>

Database: PsycINFO
_____

Record: 31

Title: Trauma and posttraumatic stress disorder in severe mental
illness.
Author(s): Mueser, Kim T., New Hampshire--Dartmouth Psychiatric
Research Ctr, Concord, NH, US

Goodman, Lisa B.

Trumbetta, Susan L.

Rosenberg, Stanley D.

Osher, Fred C.

Vidaver, Robert

Auciello, Patricia

Foy, David W.
Source: Journal of Consulting & Clinical Psychology, Vol 66(3), Jun
1998. pp. 493-499.

Journal URL: http://www.apa.org/journals/ccp.html
Publisher: US: American Psychological Assn

Publisher URL: http://www.apa.org
ISSN: 0022-006X (Print)
Digital Object Identifier: 10.1037//0022-006X.66.3.493
Language: English
Key Concepts: lifetime prevalence of traumatic events & current PTSD,
patients with severe mental illness receiving public mental health
services
Abstract: This research assessed the lifetime prevalence of
traumatic events and current posttraumatic stress disorder (PTSD) in 275
patients with severe mental illness (e.g., schizophrenia and bipolar
disorder) receiving public mental health services in Concord and
Manchester, New Hampshire and Baltimore, Maryland. Lifetime exposure to
traumatic events was high, with 98% of the sample reporting exposure to
at least 1 traumatic event. The rate of PTSD in our sample was 43%, but
only 3 of 119 patients with PTSD (2%) had this diagnosis in their
charts. PTSD was predicted most strongly by the number of different
types of trauma, followed by childhood sexual abuse. The findings
suggest that PTSD is a common comorbid disorder in severe mental illness
that is frequently overlooked in mental health settings. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)(journal abstract)
Subjects: *Emotional Trauma; *Epidemiology; *Mental Disorders;
*Posttraumatic Stress Disorder; Mental Health Services
Classification: Psychological Disorders (3210)
Population: Human (10)

Male (30)

Female (40)

Inpatient (50)

Outpatient (60)
Location: US
Age Group: Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)

Middle Age (40-64 yrs) (360)
Form/Content Type: Conference Proceedings/Symposia (0600)

Empirical Study (0800)
Conference: Trauma and Illness: An International Research
Conference, Jul, 1996, Durham, NH, US
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19980701
Accession Number: 1998-02631-005

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=1998-02631-005

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1998-02631-005">Trauma and posttraumatic stress disorder in
severe mental illness.</A>

Database: PsycINFO
_____

Record: 32

Title: Plasma dopamine beta-hydroxylase activity in psychotic and
non-psychotic post-traumatic stress disorder.
Author(s): Hamner, Mark B., Ralph H. Johnson Veterans Affairs
Medical Ctr, Mental Health Services, Charleston, SC, US

Gold, Paul B.
Source: Psychiatry Research, Vol 77(3), Feb 1998. pp. 175-181.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/2/2/7/7/3/
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0165-1781 (Print)
Digital Object Identifier: 10.1016/S0165-1781(98)00002-X
Language: English
Key Concepts: plasma dopamine beta-hydroxylase activity, 41-60 yr old
male PTSD patients with vs without psychosis
Abstract: Altered dopamine beta-hydroxylase (DBH) activity has
been reported in mood disorders. Plasma DBH is reduced in major
depression with psychosis and elevated in bipolar disorder with
psychosis compared with their respective non-psychotic diagnostic
groups. The authors therefore evaluated DBH activity in posttraumatic
stress disorder (PTSD) patients with and without psychotic features and
compared these groups with age- and gender-matched control Ss. 19 male
Vietnam combat veterans (aged 41-60 yrs) with PTSD (including patients
with and without psychotic features) had plasma DBH enzyme activity
assayed photometrically. DBH was significantly higher in patients with
PTSD with psychotic features than in patients without psychotic features
and was also higher than that in normal control Ss. It is concluded that
plasma DBH activity may differentiate psychotic and non-psychotic
subtypes of PTSD. The observed changes are opposite to those seen in
psychotic depression but comparable to psychotic bipolar disorder. Since
DBH is a genetic marker, this may reflect individual vulnerabilities to
develop psychosis in the context of trauma. (PsycINFO Database Record
(c) 2003 APA, all rights reserved)
Subjects: *Blood Plasma; *Dopamine; *Hydroxylases; *Posttraumatic
Stress Disorder; *Psychosis; Human Males
Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)

Male (30)
Age Group: Adulthood (18 yrs & older) (300)

Middle Age (40-64 yrs) (360)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19980601
Accession Number: 1998-02123-005

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=1998-02123-005

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1998-02123-005">Plasma dopamine beta-hydroxylase activity in
psychotic and non-psychotic post-traumatic stress disorder.</A>

Database: PsycINFO
_____

Record: 33

Title: Validity of substance use self-reports in dually diagnosed
outpatients.
Author(s): Weiss, Roger D., McLean Hosp, Belmont, MA, US

Najavits, Lisa M.

Greenfield, Shelly F.

Soto, Jose A.

Shaw, Sarah R.

Wyner, Dana
Source: American Journal of Psychiatry, Vol 155(1), Jan 1998. pp.
127-128.

Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 0002-953X (Print)
Language: English
Key Concepts: validity of self-reports of substance abuse, outpatients
dually diagnosed with substance use & bipolar disorder or PTSD
Abstract: Assessed the validity of self-reports of substance use
among outpatients dually diagnosed with substance use disorder and
either bipolar disorder or posttraumatic stress disorder (PTSD).
Self-reports of substance use were compared with supervised urine
samples collected on the same day for 55 outpatients. Self-reports were
highly valid. Only 4.7% of cases involved Ss not reporting substance use
detected by urine screens. Self-reports of substance use may be highly
valid in nonpsychotic, dually diagnosed outpatients under certain
conditions, i.e., when patients are in treatment, when urine samples are
collected with patients' prior knowledge, when patients are well-known
to staff, and when honest self-reporting is encouraged. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Bipolar Disorder; *Drug Abuse; *Posttraumatic Stress
Disorder; *Self Report; *Statistical Validity; Dual Diagnosis;
Outpatients
Classification: Psychological Disorders (3210)
Population: Human (10)

Male (30)

Female (40)

Outpatient (60)
Location: US
Age Group: Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19980401
Accession Number: 1997-38496-019

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=1997-38496-019

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1997-38496-019">Validity of substance use self-reports in dually
diagnosed outpatients.</A>

Database: PsycINFO
_____

Record: 34

Translated Title: Psychological peculiarities of posttraumatic
stress states in veterans of the war in Afghanistan.
Author(s): Zelenova, Marina E., Russian Academy of Sciences, Inst
of Psychology, Moscow, Russia

Lazebnaya, Elena O.

Tarabrina, Nadezhda V.
Source: Psikhologicheskiy Zhurnal, Vol 18(2), Mar-Apr 1997. pp. 34-49.
Publisher: Russia: Nauka Publishing House

ISSN: 0205-9592 (Print)
Language: Russian
Key Concepts: psychological consequences of PTSD, male veterans of war
in Afghanistan, Russia
Abstract: Studied the psychological consequences of the
war-related posttraumatic stress experience of veterans of the war in
Afghanistan. Human Ss: 65 normal male Russian adults (mean age 32.3 yrs)
(veterans of the war in Afghanistan). 18 male Russian adults (mean age
31.1 yrs) (posttraumatic stress disorder, manifested or accompanied by
depression, bipolar disorder, phobias, panic disorder, generalized
anxiety, hypochondria, past or present alcoholism, and drug abuse)
(veterans of the war in Afghanistan). Ss were administered a
psychodiagnostic interview, and the level of their war-related trauma
was assessed. Demographic data, the frequency of manifestation of
posttraumatic stress disorder (PTSD) symptoms and dissociative states,
and drug use during the war were compared for the 2 groups. Tests used:
The Structured Clinical Interview for Diagnostic and Statistical Manual
of Mental Disorders-III-Revised (DSM-III-R) Non-Patient Version and the
Legacies Combat Exposure Scale (A. Egendorf et al, 1981). (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Military Veterans; *Posttraumatic Stress Disorder; *War

Classification: Neuroses & Anxiety Disorders (3215)

Military Psychology (3800)
Population: Human (10)

Male (30)
Location: Afghanistan; Russia
Age Group: Adulthood (18 yrs & older) (300)

Thirties (30-39 yrs) (340)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19980601
Correction Date: 20031124
Accession Number: 1997-06609-001

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=1997-06609-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1997-06609-001">Psychological peculiarities of posttraumatic
stress states in veterans of the war in Afghanistan.</A>

Database: PsycINFO
_____

Record: 35

Title: Current and lifetime psychiatric disorders among veterans with
war zone-related posttraumatic stress disorder.
Author(s): Orsillo, Susan M., Oklahoma State U, Dept of Psychology,
Stillwater, OK, US

Weathers, Frank W.

Litz, Brett T.

Steinberg, Howard R.

Huska, Jennifer A.

Keane, Terence M.
Source: Journal of Nervous & Mental Disease, Vol 184(5), May 1996. pp.
307-313.

Journal URL: http://www.jonmd.com/
Publisher: US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com
ISSN: 0022-3018 (Print)
Digital Object Identifier: 10.1097/00005053-199605000-00007
Language: English
Key Concepts: war zone related PTSD, DSM-III-R axis I and axis II
psychological disorders, male Vietnam veterans
Abstract: Examined the relationship between war zone related
posttraumatic stress disorder (PTSD) and other psychological disorders
among 311 male Vietnam theater veterans assessed at a national center
for PTSD, 197 of which met diagnostic criteria for PTSD. The
Clinician-Administered PTSD Scale and the Structured Clinical Interview
for Diagnostic and Statistical Manual of Mental Disorders-III-Revised
(DSM-III-R) were used to derive current and lifetime diagnoses of PTSD,
other axis I disorders, and 2 axis II disorders (borderline and
antisocial personality disorder). Ss also completed self-report measures
of PTSD and general psychopathology. Compared to Ss without PTSD, Ss
with PTSD had significantly higher rates of current major depression,
bipolar disorder, panic disorder, and social phobia, as well as
significantly higher rates of lifetime major depression, panic disorder,
social phobia, and obsessive-compulsive disorder. In addition, Ss with
PTSD scored significantly higher on all self-report measures of PTSD and
general psychopathology. (PsycINFO Database Record (c) 2003 APA, all
rights reserved)
Subjects: *Combat Experience; *Mental Disorders; *Military
Veterans; *Posttraumatic Stress Disorder; Human Males
Classification: Neuroses & Anxiety Disorders (3215)

Military Psychology (3800)
Population: Human (10)

Male (30)
Location: US
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19960101
Correction Date: 20031124
Accession Number: 1996-00445-007

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=1996-00445-007

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1996-00445-007">Current and lifetime psychiatric disorders among
veterans with war zone-related posttraumatic stress disorder.</A>

Database: PsycINFO
_____

Record: 36

Title: Open trial of fluvoxamine treatment for combat-related
posttraumatic stress disorder.
Author(s): Marmar, Charles R., Langley Porter Psychiatric Inst, San
Francisco, CA, US

Schoenfeld, Frank

Weiss, Daniel S.

Metzler, Thomas
Source: Journal of Clinical Psychiatry, Vol 57(Suppl 8), 1996. pp.
66-72.
Publisher: US: Physicians Postgraduate Press

Publisher URL: http://www.psychiatrist.com
ISSN: 0160-6689 (Print)
Language: English
Key Concepts: fluvoxamine, symptoms, 45-57 yr old Vietnam combat
veterans with PTSD
Abstract: Conducted a 10-wk open-label trial of fluvoxamine for 10
male Vietnam combat veterans (aged 45-57 yrs) with chronic posttraumatic
stress disorder (PTSD). Ss were excluded if they met full current
criteria for panic disorder or agoraphobia, and lifetime criteria for
psychosis, bipolar disorder, or organic mental syndrome. The modal dose
range of fluvoxamine at stabilization was 100-250 mg. Repeated
multivariate analysis of variance (MANOVA) was performed to determine
change over time. Results show fluvoxamine was well tolerated; side
effects were observed primarily early in treatment with headache,
insomnia, sedation, and gastrointestinal distress being most frequent.
Fluvoxamine was effective for treating the core intrusion, avoidance,
and arousal symptoms of PTSD. Large treatment effects were seen by 4-6
wks, and maintained at 10 wks. The magnitude of change was greater than
has been previously reported for antidepressant treatment of male
Vietnam combat veterans with PTSD. (PsycINFO Database Record (c) 2003
APA, all rights reserved)
Subjects: *Combat Experience; *Drug Therapy; *Fluvoxamine;
*Posttraumatic Stress Disorder; Human Males; Military Veterans
Classification: Military Psychology (3800)

Clinical Psychopharmacology (3340)
Population: Human (10)

Male (30)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19960101
Accession Number: 1996-06776-011

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Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1996-06776-011">Open trial of fluvoxamine treatment for
combat-related posttraumatic stress disorder.</A>

Database: PsycINFO
_____

Record: 37

Title: A clinical approach to the pharmacotherapy of aggression in
children and adolescents.
Series Title: Annals of the New York Academy of Sciences; Vol. 794.
Author(s): Connor, Daniel F., U Massachusetts, Medical Ctr,
Pediatric Psychopharmacology, Worcester, MA, US

Steingard, Ronald J.
Source: Understanding aggressive behavior in children. Ferris, Craig F.
(Ed); Grisso, Thomas (Ed); pp. 290-307. New York, NY, US: New York
Academy of Sciences, 1996. v, 426 pp.
ISBN: 1-57331-012-3 (hardcover)

1-57331-013-1 (paperback)
Language: English
Key Concepts: diagnostic-based approach to pharmacologic treatment,
children & adolescents with aggressive behavior, literature review
Abstract: (from the chapter) reviews the literature on
psychopharmacologic interventions for excessive aggression in 10
psychiatric diagnoses [i.e., attention deficit hyperactivity disorder
(ADHD), conduct disorder, psychotic disorders, traumatic brain injury,
seizure disorder, mental retardation, pervasive developmental disorders,
depression, bipolar disorder, and posttraumatic stress disorder (PTSD)]
associated with aggressive behavior in children and adolescents /
suggestions are made with the hope of better clarifying which
psychiatrically referred child or adolescent with aggression might be
helped by psychopharmacologic intervention

suggests the use of a diagnostic-based approach to the pharmacology of
aggression (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Aggressive Behavior; *Drug Therapy; *Literature Review;
*Psychodiagnosis
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)
Age Group: Childhood (birth-12 yrs) (100)

Adolescence (13-17 yrs) (200)
Form/Content Type: Literature Review (1300)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 19970601
Accession Number: 1996-98826-024

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=1996-98826-024

Cut and Paste: <A
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syh&an=1996-98826-024">A clinical approach to the pharmacotherapy of
aggression in children and adolescents.</A>

Database: PsycINFO
_____

Record: 38

Title: Chronology of comorbid and principal syndromes in first-episode
psychosis.
Author(s): Strakowski, Stephen M., U Cincinnati Coll of Medicine,
Dept of Psychiatry, Biological Psychiatry Program, OH, US

Keck, Paul E.

McElroy, Susan L.

Lonczak, Heather S.

et al.
Source: Comprehensive Psychiatry, Vol 36(2), Mar-Apr 1995. pp. 106-112.

Journal URL:
http://www.harcourthealth.com/scripts/om.dll/serve?action=searchDB&searc
hDBfor=home&id=comp
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0010-440X (Print)
Language: English
Key Concepts: rates of antecedent comorbid syndromes, 12 yr olds &
older with 1st episode psychosis
Abstract: Examined the rates of antecedent comorbid syndromes in
71 inpatients and outpatients (aged >=12 yrs) with 1st-episode
psychoses. Ss had no history of previous hospitalization, and symptoms
did not result entirely from substance abuse or medical illness.
Diagnoses were made according to the Structured Clinical Interview for
Diagnostic and Statistical Manual of Mental Disorders-III-Revised
(DSM-III-R)--Patient Version. Ss included 39 with bipolar disorder, 18
with schizophrenia spectrum disorders, and 14 with psychotic depression.
Comorbidity was present in 69% of Ss, and 49% had multiple comorbid
diagnoses. Comorbidity was antecedent in 82% of Ss with concurrent
syndromes. Ss with psychotic depression had the highest rates of
comorbidity, in particular alcohol abuse and antecedent posttraumatic
stress disorder (PTSD). Antecedent comorbidities may represent risk
factors or prodromal syndromes for the psychotic disorder. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Comorbidity; *Onset (Disorders); *Psychosis
Classification: Schizophrenia & Psychotic States (3213)
Population: Human (10)
Age Group: Childhood (birth-12 yrs) (100)

School Age (6-12 yrs) (180)

Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19951001
Correction Date: 20031124
Accession Number: 1995-37092-001

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=1995-37092-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1995-37092-001">Chronology of comorbid and principal syndromes in
first-episode psychosis.</A>

Database: PsycINFO
_____

Record: 39

Title: Evaluation and treatment of mood and anxiety disorders in
opioid-dependent patients.
Author(s): Nunes, Edward V., Columbia U, New York State Psychiatric
Inst, Depression Evaluation Services, US

Donovan, Stephen J.

Brady, Ronald

Quitkin, Frederic M.
Source: Journal of Psychoactive Drugs, Vol 26(2), Apr-Jun 1994. pp.
147-153.
Publisher: US: Haight-Ashbury Publications

Publisher URL: http://www.hafci.org
ISSN: 0279-1072 (Print)
Language: English
Key Concepts: diagnosis & clinical independence & prevalence &
treatment of mood & anxiety disorders, opioid dependent patients
Abstract: Reviews the current knowledge of diagnosis, clinical
presentation, and prevalence of mood and anxiety disorders common among
opioid-dependent patients. Mood and anxiety disorders cause considerable
morbidity if left untreated, particularly for opioid-dependent
individuals, for whom diagnosis is difficult and rehabilitation easily
compromised. Major depression, bipolar disorder, panic disorder with
agoraphobia, social phobia, and posttraumatic stress disorder (PTSD) in
this population are discussed. The authors present guidelines for
clinicians to help them distinguish the patient with an independent mood
or anxiety disorder from the more common anxious or depressed addict who
is withdrawing, intoxicated, or reacting to a life crisis. Suggestions
are made for identification of features of a patient's history that
distinguish truly independent disorders. Treatment for depressive and
anxiety disorders is discussed. (PsycINFO Database Record (c) 2003 APA,
all rights reserved)
Subjects: *Affective Disorders; *Anxiety Disorders; *Drug
Dependency; *Opiates; *Psychodiagnosis; Drug Rehabilitation
Classification: Substance Abuse & Addiction (3233)

Drug & Alcohol Rehabilitation (3383)
Population: Human (10)
Conference Notes: Theme Issue: Treatment of opioid dependence:
Current issues and future prospects.
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19950201
Accession Number: 1995-05898-001

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=1995-05898-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1995-05898-001">Evaluation and treatment of mood and anxiety
disorders in opioid-dependent patients.</A>

Database: PsycINFO
_____

Record: 40

Title: Concomitant use of valproate and carbamazepine in bipolar and
schizoaffective disorders.
Author(s): Tohen, Mauricio, McLean Hosp, Bipolar & Psychotic
Disorders Program, Belmont, MA, US

Castillo, Jose

Pope, Harrison G.

Herbstein, Jessica
Source: Journal of Clinical Psychopharmacology, Vol 14(1), Feb 1994. pp.
67-70.

Journal URL: http://www.psychopharmacology.com/
Publisher: US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com
ISSN: 0271-0749 (Print)
Language: English
Key Concepts: carbamazepine & valproate, patients with bipolar vs
schizoaffective disorder vs major depression & PTSD
Abstract: Identified, from pharmacy records, 17 consecutive
patients who were treated with carbamazepine and valproate
simultaneously. 12 patients were diagnosed with bipolar disorder, manic
or mixed type; 4 patients received a diagnosis of schizoaffective
disorder, manic type; and 1 had major depression and posttraumatic
stress disorder (PTSD). All 12 bipolar patients had a moderate to marked
response to the combination drug treatment, whereas all 4
schizoaffective patients failed to respond. Only 2 patients had minor
side effects. The authors conclude that the combination of valproate and
carbamazepine is usually well tolerated and that it can be effective in
bipolar patients who have previously failed to respond to anticonvulsant
monotherapy. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Bipolar Disorder; *Carbamazepine; *Drug Therapy;
*Schizoaffective Disorder; *Valproic Acid; Major Depression;
Posttraumatic Stress Disorder
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19940701
Accession Number: 1994-26757-001

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=1994-26757-001

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1994-26757-001">Concomitant use of valproate and carbamazepine in
bipolar and schizoaffective disorders.</A>

Database: PsycINFO
_____

Record: 41

Title: Differential diagnosis and psychopharmacology of dual disorders.

Author(s): Decker, Kathleen P., Harborview Medical Ctr, Dept of
Psychiatry, Seattle, WA, US

Ries, Richard K.
Source: Psychiatric Clinics of North America, Vol 16(4), Dec 1993. pp.
703-718.

Journal URL:
http://www.harcourthealth.com/scripts/om.dll/serve?action=searchDB&searc
hDBfor=home&id=cpsy
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0193-953X (Print)
Language: English
Key Concepts: interaction & differential diagnosis of substance abuse
& other psychiatric disorders & substance effects on psychotropic
medication use, dual diagnosis patients
Abstract: Discusses the interactions of substance use disorders
(SUDs) with other psychiatric disorders and of different substances of
abuse with common therapeutic psychiatric medications. SUDs in people
with unipolar depression are common, with alcohol most often the
substance of abuse, as in the cases of a 25-yr-old man admitted
following a suicide attempt via an overdose of medications and alcohol
and of a 34-yr-old woman admitted for active suicidal ideation and a
past history of cocaine, alcohol, and marijuana use. The existence of
psychosis and SUD is shown in the cases of a 35-yr-old schizophrenic man
with an alcohol problem and a 22-yr-old woman with a history of
polysubstance abuse and a current problem of cocaine-induced psychosis.
A 53-yr-old woman had bipolar disorder complicated by the use of
caffeine and ephedrine. Discussion includes anxiety disorders in
alcoholics, dissociative disorders and posttraumatic stress disorder
(PTSD), and substance effects of psychotropic medication use. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Differential Diagnosis; *Drug Abuse; *Drug Therapy;
*Dual Diagnosis; *Mental Disorders; Alcohol Abuse; Drug Interactions;
Drugs
Classification: Psychological & Physical Disorders (3200)

Drug & Alcohol Rehabilitation (3383)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19940601
Accession Number: 1994-21396-001

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syh&an=1994-21396-001">Differential diagnosis and psychopharmacology of
dual disorders.</A>

Database: PsycINFO
_____

Record: 42

Title: Elevated PLA-sub-2 activity in schizophrenics and other
psychiatric patients.
Author(s): Noponen, Mikla, Veterans Affairs Medical Ctr, New York,
NY, US

Sanfilipo, Michael

Samanich, Karen

Ryer, Helena

et al.
Source: Biological Psychiatry, Vol 34(9), Nov 1993. pp. 641-649.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0006-3223 (Print)
Language: English
Key Concepts: phospholipase A2 activity, schizophrenic & other
psychiatric patients
Abstract: Measured serum phospholipase A-sub-2 (PLA-sub-2)
activity in 39 schizophrenics (mean age 44.8 yrs), 26 psychiatric
controls (mean age 47.2 yrs), and 26 normal controls (mean age 38.3 yrs)
using a radioenzymatic assay with phosphatidylcholine as precursor.
Serum PLA-sub-2 activity was significantly higher in schizophrenics and
psychiatric (including substance abusing) controls than in normal
controls. Enzyme activity did not differ between schizophrenic patients
and psychiatric controls. 51% of schizophrenics and 46% of psychiatric
controls had PLA-sub-2 values above the highest value for normal
controls. In the psychiatric control group, higher than normal PLA-sub-2
activities were observed in all diagnostic categories, including major
depression, bipolar disorder, posttraumatic stress disorder (PTSD), and
substance abuse. (PsycINFO Database Record (c) 2003 APA, all rights
reserved)
Subjects: *Enzymes; *Phosphatides; *Psychiatric Patients;
*Schizophrenia
Classification: Psychological Disorders (3210)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19940601
Accession Number: 1994-21480-001

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=1994-21480-001

Cut and Paste: <A
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syh&an=1994-21480-001">Elevated PLA-sub-2 activity in schizophrenics and
other psychiatric patients.</A>

Database: PsycINFO
_____

Record: 43

Title: Glucocorticoid receptor number and cortisol excretion in mood,
anxiety, and psychotic disorders.
Author(s): Yehuda, Rachel, Veterans Affairs Medical Ctr, Bronx, NY,
US

Boisoneau, David

Mason, John W.

Giller, Earl L.
Source: Biological Psychiatry, Vol 34(1-2), Jul 1993. pp. 18-25.

Journal URL:
http://www.elsevier.com/inca/publications/store/5/0/5/7/5/0/
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0006-3223 (Print)
Language: English
Key Concepts: lymphocyte glucocorticoid receptors & 24 hr urinary
cortisol excretion, 24-46 yr olds with major depressive vs panic
disorder vs bipolar mania vs PTSD vs schizophrenia
Abstract: Measured cytosolic lymphocyte glucocorticoid receptor
(GCR) and 24-hr urinary cortisol excretion in 40 adult patients with
major depressive disorder (MDD), bipolar mania, posttraumatic stress
disorder (PTSD), panic disorder, and schizophrenia. Ss with MDD had the
smallest and Ss with PTSD had the largest mean number of GCRs per cell
compared with Ss in the other groups. Bipolar manic and panic Ss did not
differ from each other in regard to number of lymphocyte GCRs, but did
have significantly more GCRs per cell than did schizophrenic Ss. Mean
24-hr urinary cortisol excretion was significantly higher in Ss with MDD
and bipolar mania than in those in the other diagnostic groups.
Lymphocyte GCR number and cortisol excretion tended to be inversely
related when the entire sample was considered as a whole, but this
effect did not reach significance. (PsycINFO Database Record (c) 2003
APA, all rights reserved)
Subjects: *Glucocorticoids; *Hydrocortisone; *Mental Disorders;
Bipolar Disorder; Lymphocytes; Major Depression; Panic Disorder;
Posttraumatic Stress Disorder; Schizophrenia; Urine
Classification: Psychological Disorders (3210)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19940101
Accession Number: 1994-01820-001

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=1994-01820-001

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syh&an=1994-01820-001">Glucocorticoid receptor number and cortisol
excretion in mood, anxiety, and psychotic disorders.</A>

Database: PsycINFO
_____

Record: 44

Title: Human brain fluoxetine concentrations.
Author(s): Karson, Craig N., Dept of Veterans Affairs Medical Ctr,
Dept of Psychiatry, North Little Rock Div, US

Newton, Joseph E.

Livingston, Richard

Jolly, John B.

et al.
Source: Journal of Neuropsychiatry & Clinical Neurosciences, Vol 5(3),
Sum 1993. pp. 322-329.

Journal URL: http://neuro.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 0895-0172 (Print)
Language: English
Key Concepts: fluoxetine dose & duration, brain fluoxetine
pharmacokinetics, 13-73 yr olds with psychiatric disorders
Abstract: Examined issues of long-term brain pharmacokinetics of
fluoxetine in 22 patients (aged 13-73 yrs) with various psychiatric
disorders, including bipolar disorder, major depression, dysthymia, and
posttraumatic stress disorder (PTSD). Ss received fixed doses of 20 or
40 mg/day. Brain concentration appeared to depend on duration of
treatment and dose, ranged up to approximately 11 mug/ml, and reached a
plateau between 6 and 8 mo of treatment. Results indicate that humans
apparently concentrate fluoxetine and norfluoxetine in the brain
relative to plasma at about 20:1. Furthermore, results demonstrate that
magnetic resonance spectroscopy of fluorine-19 can measure brain
concentrations of fluoxetine/norfluoxetine in vivo. (PsycINFO Database
Record (c) 2003 APA, all rights reserved)
Subjects: *Brain; *Drug Therapy; *Fluoxetine; *Mental Disorders;
Drug Dosages; Treatment Duration
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)
Age Group: Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)

Aged (65 yrs & older) (380)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19940101
Accession Number: 1994-02851-001

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Cut and Paste: <A
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syh&an=1994-02851-001">Human brain fluoxetine concentrations.</A>

Database: PsycINFO
_____

Record: 45

Title: Treatment of psychiatric disorders in children and adolescents.
Author(s): Klein, Rachel G., Columbia U, New York State Psychiatric
Inst, US

Slomkowski, Cheryl
Source: Psychopharmacology Bulletin, Vol 29(4), 1993. pp. 525-535.
Publisher: US: Psychopharmacology Bulletin

ISSN: 0048-5764 (Print)
Language: English
Key Concepts: psychotherapy & drug interventions, children &
adolescents with serious mental illness
Abstract: Reviews treatments of serious mental illness in children
and adolescents. Major child and adolescent disorders are summarized,
together with treatments. Depressive and bipolar disorders, anxiety
disorders, hyperactivity, conduct disorders, autism, Tourette's
disorder, and posttraumatic stress disorder (PTSD) in children and
adolescents are discussed. It is noted that most of the 9 million
children with mental disorders go untreated, but an array of therapeutic
interventions exists which can bring meaningful relief. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Drug Therapy; *Mental Disorders; *Psychotherapy
Classification: Health & Mental Health Treatment & Prevention (3300)
Population: Human (10)
Age Group: Childhood (birth-12 yrs) (100)

Adolescence (13-17 yrs) (200)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19941201
Accession Number: 1994-46039-001

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syh&an=1994-46039-001">Treatment of psychiatric disorders in children
and adolescents.</A>

Database: PsycINFO
_____

Record: 46

Title: Pharmacotherapy.
Series Title: Wiley series on personality processes
Author(s): Campbell, Magda, New York U, Medical Ctr, Dept of
Psychiatry, New York, NY, US

Godfrey, Katherine A.

Magee, Harry J.
Source: Handbook of clinical child psychology (2nd ed.). Walker,
Clarence Eugene (Ed); Roberts, Michael C. (Ed); pp. 873-898. Oxford,
England: John Wiley & Sons, 1992. xx, 1145 pp.
ISBN: 0-471-50361-4 (hardcover)
Language: English
Key Concepts: reviews research in the use of pharmacotherapy for
various psychiatric disorders of children
Abstract: Reviews research on the use of pharmacotherapy for
various psychiatric disorders of children.

(from the chapter) mental retardation (MR) and psychiatric disorders /
autism / attention deficit hyperactivity disorder / conduct disorder /
Tourette's disorder / obsessive-compulsive disorder (OCD) /
schizophrenia / psychopharmacology of anxiety disorders [school phobia,
panic disorder, situational anxiety, post-traumatic stress disorder
(PTSD), overanxious disorder] / pharmacotherapy of depression / bipolar
disorder / eating disorders [bulimia, anorexia nervosa] (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Drug Therapy; *Mental Disorders; Anxiety Disorders;
Attention Deficit Disorder; Autism; Bipolar Disorder; Conduct Disorder;
Eating Disorders; Gilles de la Tourette Disorder; Hyperkinesis; Major
Depression; Mental Retardation; Obsessive Compulsive Disorder;
Schizophrenia
Classification: Clinical Psychopharmacology (3340)
Population: Human (10)
Age Group: Childhood (birth-12 yrs) (100)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 19930201
Accession Number: 1992-98073-047

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syh&an=1992-98073-047">Pharmacotherapy.</A>

Database: PsycINFO
_____

Record: 47

Title: Prevalence of somatic and psychiatric disorders among former
prisoners of war.
Author(s): Eberly, Raina E., Dept of Veterans Affairs Medical Ctr,
Minneapolis, MN, US

Engdahl, Brian E.
Source: Hospital & Community Psychiatry, Vol 42(8), Aug 1991. pp.
807-813.

Journal URL: http://psychservices.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 0022-1597 (Print)
Language: English
Key Concepts: prevalence of depressive disorders & other somatic &
psychiatric disorders, former prisoners of war from WWII & Korean War
Abstract: Analyzed medical and psychiatric examination data for
426 American former prisoners of war (POWs) from World War II and the
Korean War. Detailed psychiatric diagnostic criteria were used to assess
the POWs' mental health. Compared with general population groups, POWs
had moderately elevated lifetime prevalence rates of depressive
disorders and greatly elevated rates of posttraumatic stress disorder
(PTSD), although their rates of hypertension, diabetes, myocardial
infarction, bipolar disorder, schizophrenia, and alchoholism were not
elevated. POWs who lost more than 35% of their body weight during
captivity had higher rates of anxiety disorder, depressive disorders,
PTSD, and schizophrenia, compared with other POWs. (PsycINFO Database
Record (c) 2003 APA, all rights reserved)
Subjects: *Disorders; *Mental Disorders; *Prisoners of War;
Military Veterans
Classification: Psychological & Physical Disorders (3200)

Military Psychology (3800)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)

Aged (65 yrs & older) (380)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19920101
Accession Number: 1992-01537-001

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syh&an=1992-01537-001">Prevalence of somatic and psychiatric disorders
among former prisoners of war.</A>

Database: PsycINFO
_____

Record: 48

Title: Affective disorders, DST, and treatment in PTSD patients:
Clinical observations.
Author(s): Olivera, Arturo A., Western Reserve Psychiatric Hosp,
Northfield, OH, US

Fero, David
Source: Journal of Traumatic Stress, Vol 3(3), Jul 1990. pp. 407-414.

Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: Netherlands: Kluwer Academic Publishers

Publisher URL: http://www.wkap.nl
ISSN: 0894-9867 (Print)
Language: English
Key Concepts: usefulness of DST & occurrence of major affective
disorders, combat veterans & other inpatients with PTSD
Abstract: Examined the occurrence of major affective disorders
(MADs) in 109 chronic posttraumatic stress disorder (PTSD) patients and
the usefulness of the dexamethasone suppression test (DST) in supporting
clinical diagnosis in an exclusively clinical setting. 65 Ss had current
MADs. Of these 65, 56 had major depression, and 9 had bipolar disorder.
Nonsuppression of the DST occurred only in Ss with concurrent MAD; the
incidence of nonsuppression was 32.3%. Treatment effectively attained
clinical improvement (i.e., resolution of depression, panic, anxiety,
sleep disorders, tolerance, isolation) and conversion of nonsuppressor
to suppressor state in these cases. The DST, cortisol suppression index,
and inhibition of cortisol production index were useful to support the
clinical diagnosis of MADs in PTSD patients. (PsycINFO Database Record
(c) 2003 APA, all rights reserved)
Subjects: *Affective Disorders; *Dexamethasone Suppression Test;
*Posttraumatic Stress Disorder; Combat Experience; Military Veterans;
Psychiatric Patients
Classification: Neuroses & Anxiety Disorders (3215)

Military Psychology (3800)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19910101
Accession Number: 1991-01451-001

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=1991-01451-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1991-01451-001">Affective disorders, DST, and treatment in PTSD
patients: Clinical observations.</A>

Database: PsycINFO
_____

Record: 49

Title: Serum testosterone levels in post-traumatic stress disorder
inpatients.
Author(s): Mason, John W., Yale U School of Medicine, Veterans
Administration Medical Ctr, West Haven, CT, US

Giller, Earl L.

Kosten, Thomas R.

Wahby, Victor S.
Source: Journal of Traumatic Stress, Vol 3(3), Jul 1990. pp. 449-457.

Journal URL: http://www.wkap.nl/journalhome.htm/0894-9867
Publisher: Netherlands: Kluwer Academic Publishers

Publisher URL: http://www.wkap.nl
ISSN: 0894-9867 (Print)
Language: English
Key Concepts: serum testosterone levels, male 24-64 yr olds with PTSD
vs major depression vs manic bipolar disorder vs paranoid schizophrenia
Abstract: Measured serum testosterone levels at 2-wk intervals in
34 male inpatients (aged 20-64 yrs) with posttraumatic stress disorder
(PTSD), endogenous major depressive disorder (MDD), paranoid
schizophrenia (PS), or manic bipolar disorder (BD) and 24 matched,
normal controls. Mean levels were significantly higher in PTSD, PS, and
control Ss. The same group differences were significant in the 1st
sample, while the last sample values were significantly higher in the
PTSD and PS groups. In spite of considerable depressive symptomatology,
PTSD patients do not show the relatively low testosterone levels seen in
MDD patients and instead align more closely with schizophrenic patients
with regard to the pituitary-gonadal system. Chronic basal testosterone
levels in PTSD patients may be elevated in comparison with normal
controls. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Bipolar Disorder; *Major Depression; *Paranoid
Schizophrenia; *Posttraumatic Stress Disorder; *Testosterone; Blood
Serum
Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19910101
Accession Number: 1991-01433-001

Persistent link to this record:
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=1991-01433-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1991-01433-001">Serum testosterone levels in post-traumatic
stress disorder inpatients.</A>

Database: PsycINFO
_____

Record: 50

Title: Psychodynamic psychotherapy for the depressive syndrome.
Author(s): Cameron, Paul M., Ottawa General Hosp, Dept of
Psychiatry, ON, Canada
Source: Psychiatric Journal of the University of Ottawa, Vol 14(2), Jun
1989. pp. 397-402.

Journal URL:
http://www.cma.ca/cma/common/displayPage.do?pageId=/staticContent/HTML/N
0/l2/jpn/index.htm
Publisher: Canada: Canadian Medical Assn

Publisher URL: http://www.cma.ca
ISSN: 1180-4882 (Print)
Language: English
Key Concepts: intrapsychic & interpersonal & family dynamics, social
support issues in psychotherapy, adolescents & adults & elderly with
depressive syndromes, literature review, conference presentation
Abstract: Contrasts historical approaches of psychotherapy for
depression with current psychotherapeutic strategies. Current strategies
are focused, structured, time-limited, observable, testable,
researchable, and data-based. The following depressive syndromes are
reviewed in terms of the literature that demonstrates the effectiveness
of psychotheray: major depressive disorder; bipolar depressive disorder;
depression associated with medical illness such as cancer, myocardial
infarction, and stroke; resistant depression; posttraumatic stress
disorder (PTSD), grief reactions; and depression during adolescence,
mid-life, and old age. A conceptual model favoring tripartite focus of
intervention is recommended. The model focuses on intrapsychic,
interpersonal, and family dynamics, and social supports. (PsycINFO
Database Record (c) 2003 APA, all rights reserved)
Subjects: *Literature Review; *Major Depression; *Psychotherapy;
Bipolar Disorder; Disorders; Family Relations; Grief; Posttraumatic
Stress Disorder; Social Support Networks
Classification: Psychotherapy & Psychotherapeutic Counseling (3310)
Population: Human (10)
Age Group: Adolescence (13-17 yrs) (200)

Adulthood (18 yrs & older) (300)

Aged (65 yrs & older) (380)
Form/Content Type: Conference Proceedings/Symposia (0600)

Literature Review (1300)
Conference Notes: Canadian Consensus Symposium on Depression
(1988, Ottawa, Canada).
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19900101
Accession Number: 1990-02094-001

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syh&an=1990-02094-001">Psychodynamic psychotherapy for the depressive
syndrome.</A>

Database: PsycINFO
_____

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Record: 1

Title: Elevation of urinary norepinephrine/cortisol ratio in
posttraumatic stress disorder.
Author(s): Mason, John W., West Haven Veterans Administration
Medical Ctr, Psychoendocrine Lab, CT, US

Giller, Earl L.

Kosten, Thomas R.

Harkness, Laurie
Source: Journal of Nervous & Mental Disease, Vol 176(8), Aug 1988. pp.
498-502.

Journal URL: http://www.jonmd.com/
Publisher: US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com
ISSN: 0022-3018 (Print)
Language: English
Key Concepts: urinary norepinephrine to cortisol ratio, differential
diagnosis, male inpatients with PTSD vs endogenous depression vs bipolar
disorder vs paranoid vs undifferentiated schizophrenia
Abstract: J. W. Mason et al (see record 1986-19959-001) and T. R.
Kosten et al (see record 1988-20262-001) have previously reported the unusual combination of low urinary free cortisol levels with high urinary norepinephrine excretion in posttraumatic stress disorder (PTSD) patients in comparison with 4 other patient groups: major depressive disorder, endogenous type; bipolar I, manic; paranoid schizophrenia; undifferentiated schizophrenia. Cortisol levels alone did not distinguish PTSD from paranoid schizophrenia patients, and norepinephrine levels alone did not distinguish PTSD from bipolar I, manic, patients. Using data from 44 male inpatients with a diagnosis of PTSD, combining the values for the 2 systems in a norepinephrine/cortisol ratio was found to provide a measure that significantly distinguishes PTSD from all the other patient groups throughout the hospitalization period. (PsycINFO Database Record (c)
2003 APA, all rights reserved)
Subjects: *Differential Diagnosis; *Hydrocortisone;
*Norepinephrine; *Posttraumatic Stress Disorder; *Urine; Bipolar
Disorder; Endogenous Depression; Paranoid Schizophrenia; Schizophrenia
Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19890201
Accession Number: 1989-05278-001

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=1989-05278-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1989-05278-001">Elevation of urinary norepinephrine/cortisol
ratio in posttraumatic stress disorder.</A>

Database: PsycINFO
_____

Record: 2

Title: Dissociation and hypnotizability in posttraumatic stress
disorder.
Author(s): Spiegel, David, Stanford U School of Medicine, CA, US

Hunt, Thurman

Dondershine, Harvey E.
Source: American Journal of Psychiatry, Vol 145(3), Mar 1988. pp.
301-305.

Journal URL: http://ajp.psychiatryonline.org/
Publisher: US: American Psychiatric Assn

Publisher URL: http://www.psych.org
ISSN: 0002-953X (Print)
Language: English
Key Concepts: hypnotizability & dissociation, Vietnam veteran patients
with PTSD vs other mental disorders
Abstract: Used the Hypnotic Induction Profile to compare the
hypnotizability of 65 Vietnam veteran patients with posttraumatic stress disorder (PTSD) to that of 83 normal controls and 115 patients divided into 4 diagnostic groups. The Ss with PTSD had significantly higher hypnotizability scores than the 23 Ss with diagnoses of schizophrenia; the 56 Ss with major depression, bipolar disorder (depressed state), or dysthymic disorder; the 18 Ss with generalized anxiety disorder; and the controls. This finding supports the hypothesis that dissociative phenomena are mobilized as defenses both during and after traumatic experiences. The literature suggests that spontaneous dissociation, imagery, and hypnotizability are important components of PTSD symptoms.
(PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Dissociative Disorders; *Hypnotic Susceptibility;
*Posttraumatic Stress Disorder; Military Veterans
Classification: Neuroses & Anxiety Disorders (3215)

Military Psychology (3800)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19880701
Accession Number: 1988-20334-001

Persistent link to this record:
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=1988-20334-001

Cut and Paste: <A
href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1988-20334-001">Dissociation and hypnotizability in posttraumatic
stress disorder.</A>

Database: PsycINFO
_____

Record: 3

Title: Sustained urinary norepinephrine and epinephrine elevation in
post-traumatic stress disorder.
Author(s): Kosten, Thomas R., Veteran Administration Medical Ctr,
West Haven, CT, US

Mason, John W.

Giller, Earl L.

Ostroff, Robert B.

et al.
Source: Psychoneuroendocrinology, Vol 12(1), 1987. pp. 13-20.

Journal URL: http://www.elsevier.com/inca/publications/store/4/7/3/
Publisher: United Kingdom: Elsevier Science

Publisher URL: http://www.elsevier.com
ISSN: 0306-4530 (Print)
Language: English
Key Concepts: urinary norepinephrine & epinephrine levels,
hospitalized males with PTSD vs major vs manic depression vs paranoid vs
undifferentiated schizophrenia
Abstract: Measured urinary norepinephrine (NE) and epinephrine
(EP) levels at 2-wk intervals during hospitalization of 9 males with posttraumatic stress disorder (PTSD); 8 with major depressive disorder (MDD); 8 with bipolar I, manic (BP); 12 with paranoid schizophrenia (PS); and 7 with undifferentiated schizophrenia (US). The mean NE level during hospitalization was significantly higher in PTSD than in BP, MDD, and US groups. The NE elevations in the PTSD group were sustained throughout hospitalization. This supports prior studies indicating increased sympathetic nervous system activity in PTSD. The mean EP level during hospitalization was also significantly higher in PTSD than in MDD, PS, and US but not BP groups. It appears likely that the main underlying mechanisms for elevations of both hormones are psychological.
(PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Epinephrine; *Norepinephrine; *Posttraumatic Stress
Disorder; Bipolar Disorder; Major Depression; Paranoid Schizophrenia;
Schizophrenia; Urine
Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19880701
Accession Number: 1988-20262-001

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=1988-20262-001

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1988-20262-001">Sustained urinary norepinephrine and epinephrine
elevation in post-traumatic stress disorder.</A>

Database: PsycINFO
_____

Record: 4

Title: Bipolar disorder in post-traumatic stress disorder: A difficult
diagnosis: Case reports.
Author(s): Lucking, Robert G., Battle Creek VA Medical Ctr, Mental
Health Clinic, MI
Source: Military Medicine, Vol 151(5), May 1986. pp. 282-284.
Publisher: US: Assn of Military Surgeons of the US

Publisher URL: http://www.amsus.org/
ISSN: 0026-4075 (Print)
Language: English
Key Concepts: diagnosis & treatment of coexisting bipolar disorder in
posttraumatic stress disorder, 33-39 yr old males, case reports
Abstract: Presents the cases of 3 33-39 yr old males with the
primary diagnosis of posttraumatic stress disorder (PTSD) and an unrecognized coexisting diagnosis of bipolar disorder. Treatment with lithium carbonate decreased the intensity of their symptoms and improved everyday functioning. The literature regarding the coexistence of PTSD and other psychiatric diagnoses suggests an underdiagnosis and undertreatment of the coexisting diagnosis. Bipolar disorder may exist in PTSD patients who show little improvement over time and have a significant impairment in daily life activities. (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Bipolar Disorder; *Differential Diagnosis;
*Posttraumatic Stress Disorder; *Psychodiagnosis; Case Report; Treatment

Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)

Clinical Case Report (0820)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19871101
Accession Number: 1987-31444-001

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=1987-31444-001

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1987-31444-001">Bipolar disorder in post-traumatic stress
disorder: A difficult diagnosis: Case reports.</A>

Database: PsycINFO
_____

Record: 5

Title: Urinary free-cortisol levels in posttraumatic stress disorder
patients.
Author(s): Mason, John W, VA Medical Ctr, West Haven, CT

et al.
Source: Journal of Nervous & Mental Disease, Vol 174(3), Mar 1986. pp.
145-149.

Journal URL: http://www.jonmd.com/
Publisher: US: Lippincott Williams & Wilkins

Publisher URL: http://www.lww.com
ISSN: 0022-3018 (Print)
Language: English
Key Concepts: urinary free cortisol levels, patients with
posttraumatic stress disorder vs major depressive disorder vs bipolar I
manic vs paranoid vs undifferentiated schizophrenia
Abstract: Measured the urinary free-cortisol levels of 44 patients
with either posttraumatic stress disorder (PTSD); major depressive disorder; bipolar I, manic; paranoid schizophrenia; and undifferentiated schizophrenia by radioimmunoassay at 2-wk intervals during hospitalization. Results indicate that the mean cortisol level was significantly lower in PTSD than in major depressive disorder; bipolar I, manic; and undifferentiated schizophrenia, but that it was similar to that in paranoid schizophrenia. Findings suggest a possible role of defensive organization as a basis for the low, constricted cortisol levels in PTSD and paranoid schizophrenic patients. (30 ref) (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Hydrocortisone; *Posttraumatic Stress Disorder; Bipolar
Disorder; Depression (Emotion); Paranoid Schizophrenia; Schizophrenia
Classification: Neuroses & Anxiety Disorders (3215)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19860801
Accession Number: 1986-19959-001

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=1986-19959-001

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1986-19959-001">Urinary free-cortisol levels in posttraumatic
stress disorder patients.</A>

Database: PsycINFO
_____

Record: 6

Title: Psychopathology and social disruption in refugees.
Series Title: The series in clinical and community psychology
Author(s): Lin, Keh-Ming, U California, Medical Ctr, Dept of
Psychiatry, Los Angeles, CA, US
Source: Refugee mental health in resettlement countries. Williams,
Carolyn L. (Ed); Westermeyer, Joseph (Ed); pp. 61-73. Washington, DC,
US: Hemisphere Publishing Corp, 1986. xv, 267 pp.
ISBN: 0-89116-455-6 (hardcover)
Language: English
Key Concepts: sources of stress emotional & behavioral & psychiatric
disturbances, refugees
Abstract: (from the chapter) various sources of stress in the
refugee's life will be examined / discussion of the common emotional and behavioral manifestation of distress in refugees / the prevalence and nature of major psychiatric syndromes among the refugee populations will be reviewed in light of the Diagnostic and Statistical Manual, 3rd edition . . . diagnostic system

sources of stress / loss and grief / social isolation / status inconsistency / impact of traumatic experiences / "culture shock" and adjustment to new lifestyles / acculturation stress / accelerated modernization / minority status

common emotional and behavioral manifestations of distress in refugees / depression and anxiety / somatic preoccupation and complaints / marital conflicts / intergenerational conflicts / substance abuse / sociopathic behavior

psychiatric syndromes in refugees / anxiety and depressive disorders / posttraumatic stress disorder (PTSD) / conversion and dissociative disorders / brief reactive psychosis / paranoid psychosis / organic brain syndromes / bipolar disorder and schizophrenia (PsycINFO Database Record (c) 2003 APA, all rights reserved)
Subjects: *Mental Disorders; *Refugees; *Stress; Affective
Disorders; Behavior Problems; Stress Reactions
Classification: Psychological & Physical Disorders (3200)
Population: Human (10)
Intended Audience: Psychology: Professional & Research (PS)
Publication Type: Chapter (160); Print
Release Date: 19870101
Accession Number: 1986-98789-004

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=1986-98789-004

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1986-98789-004">Psychopathology and social disruption in
refugees.</A>

Database: PsycINFO
_____

Record: 7

Title: Low dose lithium carbonate in the treatment of post traumatic
stress disorder: Brief communication.
Author(s): Kitchner, Irving, VA Medical Ctr, Mental Hygiene Clinic,
Philadelphia, PA

Greenstein, Robert
Source: Military Medicine, Vol 150(7), Jul 1985. pp. 378-381.
Publisher: US: Assn of Military Surgeons of the US

Publisher URL: http://www.amsus.org/
ISSN: 0026-4075 (Print)
Language: English
Key Concepts: case history & treatment with low doses of lithium
carbonate, 31-42 yr old male Vietnam veterans with posttraumatic stress
disorder
Abstract: Presents the case histories of 4 males (aged
approximately 31-42 yrs) who suffered from posttraumatic stress disorders (PTSD) as a result of their experiences in the Vietnam War.
Results from treatment with low doses (300-600 mg/day) of lithium carbonate indicate that treatment was effective in reducing inappropriate anger, irritability, anxiety, and insomnia. The clinical observation of mood swings beyond the normal range but milder than those associated with bipolar disorder suggest the presence of a subthreshold mood disorder in these PTSD Ss. (8 ref) (PsycINFO Database Record (c)
2003 APA, all rights reserved)
Subjects: *Drug Dosages; *Drug Therapy; *Lithium Carbonate;
*Military Veterans; *Posttraumatic Stress Disorder; Case Report
Classification: Clinical Psychopharmacology (3340)

Military Psychology (3800)
Population: Human (10)
Age Group: Adulthood (18 yrs & older) (300)
Form/Content Type: Empirical Study (0800)

Clinical Case Report (0820)
Publication Type: Peer Reviewed Journal (270); Print
Release Date: 19860701
Accession Number: 1986-18072-001

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=1986-18072-001

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href="http://search.epnet.com/direct.asp?AuthType=cookie,ip,url,uid&db=p
syh&an=1986-18072-001">Low dose lithium carbonate in the treatment of
post traumatic stress disorder: Brief communication.</A>

Database: PsycINFO
_____

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