Social sharing of Gulf War experiences: association with trauma-related psychological symptoms

It commonly is believed that talking with family and friends (social sharing) about stressful or traumatic experiences can be therapeutic with regard to stress-related psychological symptoms. Two years after serving in the Gulf War, 58 National Guard Reservists completed the Mississippi Posttraumatic Stress Disorder Scale (PTSD), the Brief Symptom Inventory, and a measure of social sharing that asked how much they had talked to family and friends about their experiences in the Gulf during the 2-year period since returning from the war. Subjects had a broad range of Mississippi PTSD scores. Six subjects met Mississippi criteria for PTSD. Degree of talking to family and friends about Gulf War experiences did not account for a significant portion of the variance in the prediction of PTSD symptoms but did significantly contribute to prediction of scores for interpersonal sensitivity, depression, and psychoticism. Thus, degree of talking with family and friends was not found to be related to PTSD symptoms, although it may have influenced some symptoms of general psychopathology, such as depression, that are not specific to PTSD.     

Case management service provision and client change

The present study examines the relationship between case management service provision to the chronically mentally ill and consequent client change. Subjects were clients who had been in the Mississippi case management system for at least six months. It was predicted that the services, of linkage/referral and advocacy would account for the most change in the number of problems and severity of problems on the part of the client. However, less than three precent of the variance in overall client change was explained by all five services combined. Results are discussed in light of certain constraints within the system.This research was supported by a contract from the Mississippi Department of Mental Health to the Center for Applied Research and Evaluation, University of Mississippi, University, MS 38677. Dr. Dan Landis was the principal investigator. This paper is partially based on a thesis submitted by the first author, under the direction of the second, to the Graduate School of Mississippi State University in partial fulfillment of the requirements for a Master of Science degree. Comments and reprint requests should be addressed to Dr. Landis at the above address.     

Simple devices for the physically disabled

A report is given on a number of devices for the disabled that have been developed in the Biomedical Engineering Department at the Mississippi Methodist Rehabilitation Center. The primary criteria used in selection of devices to be included use simplicity, ease of fabrication and low cost.     

Prospective study of posttraumatic stress disorder symptoms and coronary heart disease in the Normative Aging Study

CONTEXT: Various correlates of posttraumatic stress disorder (PTSD), such as high levels of sympathetic activation and hypothalamic-pituitary-adrenal axis dysregulation, have been linked to arterial damage and coronary heart disease (CHD) risk. While psychological disturbance is frequently found among patients with cardiac disease, whether psychological problems precede or occur as a result of having a potentially fatal disease is not clear. To our knowledge, no prospective studies to date have evaluated whether PTSD is associated with increased risk of CHD. OBJECTIVE: To test the hypothesis that high levels of PTSD symptoms may increase CHD risk, using 2 different measures of PTSD. DESIGN: Prospective cohort study. SETTING: Community-dwelling men from the Greater Boston, Mass, area who served in the military. PARTICIPANTS: Data are from the Veterans Affairs Normative Aging Study. Men who completed either the Mississippi Scale for Combat-Related PTSD in 1990 (n = 1002) or the Keane PTSD scale in 1986 (n = 944) were included in the study. MAIN OUTCOME MEASURE: Incident CHD occurring during follow-up through May 2001. RESULTS: Levels of PTSD symptoms in this cohort were low to moderate. Men with preexisting CHD at baseline were excluded, and PTSD was measured with the Mississippi Scale for Combat-Related PTSD. For each SD increase in symptom level, men had age-adjusted relative risks of 1.26 (95% confidence interval, 1.05-1.51) for nonfatal myocardial infarction and fatal CHD combined and 1.21 (95% confidence interval, 1.05-1.41) for all of the CHD outcomes combined (nonfatal myocardial infarction, fatal CHD, and angina). Findings were replicated using the Keane PTSD scale and somewhat strengthened after controlling for levels of depressive symptoms. CONCLUSIONS: To our knowledge, this is the first study to demonstrate a prospective association between PTSD symptoms and CHD even after controlling for depressive symptoms. These results suggest that a higher level of PTSD symptoms may increase the risk of incident CHD in older men.     

Vocational integration services in community mental health: Professionals' perceptions of training needs

Vocational integration in mental health is part of a national initiative to make quality, community-based work a possibility for persons with psychiatric disabilities. While effective delivery of these services requires trained staff, preparing professionals to provide relevant vocationally oriented services is complex and challenging. This study examines perceived priority training needs in vocational integration services from the perspectives of professionals in mental health, rehabilitation, and education organizations in Mississippi. Findings suggest that vocational integration activities are perceived differently across organizations and across occupational specialties. Implications for staff development in community support and psychosocial rehabilitation programs are discussed.Susan D.M. Kelley, Ph.D., CRC, was Public Academic Linkage Visiting Professor in Psychosocial Rehabilitation at Mississippi State University at the time this study was completed. Win Belgard, ACSW, is Coordinator of Case Management Services for the Mississippi Department of Mental Health. Dana L. Cooper, Ph.D., received her doctoral degree at MSU and is currently Assistant Professor, Department of Counseling & Human Services, St. Mary's University, San Antonio, TX.     

The Mississippi Stroke Education Consortium: a state-based template to promote stroke awareness, prevention and emergency treatment

The Mississippi Stroke Education Consortium (MSEC) is a state-based volunteer advocacy group founded in 1994 consisting of specific policy-setting organizations dedicated to decreasing the impact of stroke on Mississippi's inhabitants through a continuous educational process targeting both laypersons and healthcare professionals.     

The Mississippi years (1969-1974)

The 4 years that Michel Hersen spent at the University of Mississippi Medical Center (1970-1974) are described in this article from the viewpoint of his place in the history of the development of behavior analysis and therapy. The Department of Psychiatry at the University of Mississippi Medical Center became a leader in enhancing the role of psychologists as clinician researchers within psychiatry and applying basic findings from psychology to the bedside. A vigorous research program involving psychology residents and postdoctoral students, and psychology and psychiatry faculty emerged from this integration of science and practice. Many of the faculty members, including Michel Hersen, became leaders in the field of behavior therapy. Much of what was groundbreaking at the time is now commonplace within many medical schools.     

The development of the Self-Rating Inventory for Posttraumatic Stress Disorder

In this study a newly developed Self-rating Inventory for Posttraumatic Stress Disorder (PTSD) is presented. The instrument consists of 47 items, reflecting DSM-III-R criteria, associated features and items corresponding to the disorder of extreme stress not otherwise specified. All items are phrased in a trauma-independent way and are measured on an intensity scale. The instrument was validated on 76 subjects with war-related trauma and 59 psychiatric outpatients, one third of whom were traumatized. Test-retest for the scale was 0.90. The coefficient alpha appeared to be 0.96 for the 47-items scale and 0.92 for the 22 DSM-III-R subscale. The scale correlated significantly with the Clinician Administered PTSD Scale, the Mississippi Scale for Combat-related PTSD, the MMPI PTSD subscale and the Impact of Event Scale. The overall efficiency of the Self-rating Inventory for PTSD was comparable to the overall efficiency of the Mississippi Scale and superior to the MMPI PTSD subscale. Factor analysis on the 22 DSM-III-R items showed 4 factors, representing numbing, intrusion, avoidance and sleeping problems. It is concluded that the Self-rating Inventory for PTSD is a powerful instrument for diagnosing PTSD in survey research. The instrument appears to be capable of differentiating not only between PTSD and non-PTSD subjects but also between traumatized non-PTSD subjects and non-traumatized psychiatric patients.     

Cooperative stroke management project by a peer-review organization.

To improve the care of patients in Mississippi through increased adherence to nationally accepted ischemic stroke management guidelines, patterns for ischemic stroke services were determined from hospital chart review. Hospital-specific education and data feedback were performed to encourage international systems improvements. The Mississippi Foundation for Medical Care, Inc, reviewed records of Medicare beneficiaries discharged with the principal diagnosis of acute ischemic stroke from four hospitals over a 1-year period. Records were analyzed for compliance with stroke management guidelines. Hospital-specific and aggregate data were presented to the staffs of each hospital and the hospitals were encouraged to develop internal quality improvement projects. The Foundation reviewed 427 records of acute stroke patients, of whom 375 (87.8%) had ischemic stroke. Among the 427 stroke patients, there were 76 (17.8%) in-hospital deaths. Notable variances from the ischemic stroke management guidelines included those for emergent hypertension management, deep vein thrombosis prophylaxis, evaluation for cause of ischemic stroke, and use of antithrombotic therapy on discharge of ischemic stroke patients. Thus, the management of acute stroke patients in these four regional hospitals in Mississippi often differed from nationally accepted guidelines. We hope to improve the care of stroke patients by using the expertise of academic stroke physicians and hospital-specific analyses that are personally meaningful but not personally threatening to treating physicians.     

Report Training nonphysicians to work with the chronically mentally ill: A survey of one rural state

Portions of this paper were presented at the 1985 annual meeting of the Mississippi Psychological Association.     

Geographic distribution of motor neuron disease and correlation with possible etiologic factors

Average annual age-adjusted motor neuron disease (MND) mortality rates were mapped for the first time at the county level in the continental United States. Although the great majority of the rates did not differ significantly from the US average, the highest mortality rates were generally found west of the Mississippi and the lowest rates east of the Mississippi. MND mortality was associated with rural farming and socioeconomic status but not with urbanization, physician-population ratios, lead or mercury exposure, or mortality rates of five kinds of cancer.     

Gender differences in psychological effect of the August 1999 earthquake in Turkey

Disasters traumatically expose normal populations to severe threats to life, deaths of relatives and massive environmental destruction. Epidemiological studies found that women would be more vulnerable to disaster than men. In this study, we examined gender differences in short-term psychological effect of the 1999 earthquake in Turkey on adult survivors. A total of 184 subjects (79 males and 105 females) who used a psychiatric service were interviewed within 6-10 weeks after the earthquake. All subjects were assessed using a modified version of the Mississippi Scale for Posttraumatic Stress Disorder, the Beck Depression Inventory, the Beck Hopelessness Scale, and four subscales (depression, anxiety, hostility and somatization) of the Symptom Check List (SCL-90-R). Women had higher mean total Mississippi Scale scores than men (84.29 vs. 78.72; P<0.05). Women scored higher on the Beck Depression Inventory and the Beck Hopelessness Scale than men (respectively 16.3 vs. 10.4; P<0.001 and 7.5 vs. 6.0; P<0.05). Women had significantly higher depression (1.40 vs. 0.94; P<0.001), anxiety (1.46 vs. 1.12; P<0.05) and somatization (1.31 vs. 0.84; P<0.001) subscale scores of the SCL-90-R than men. These findings indicate that women may experience more severe psychological reactions than men after a disastrous earthquake.     

Adverse race-related events as a risk factor for posttraumatic stress disorder in Asian American Vietnam veterans

Few studies have explored the relationship between exposure to adverse race-related events and posttraumatic stress disorder (PTSD). This study examined whether adverse race-related events can give rise to symptoms that meet the criteria for a PTSD diagnosis as specified in the DSM-IV. Three hundred Asian American Vietnam veterans were administered a Mississippi Scale and a questionnaire that assessed exposure to adverse race-related events in the military and associated PTSD symptoms. A subsample was administered the Clinician-Administered PTSD Scale. A majority of the participants (77%) reported exposure to adverse race-related events. Depending on the number of events to which they were exposed, between 13% and 36% reported symptoms consistent with meeting full criteria for PTSD. Mississippi Scale scores increased significantly as a function of frequency of exposure to adverse race-related events. These results converge with the Clinician-Administered PTSD Scale findings to demonstrate that adverse race-related events can be traumatic and associated with PTSD. These findings support the construct and convergent validity of race-related PTSD.     

New trends in cannabis potency in USA and Europe during the last decade (2008–2017)

European Archives of Psychiatry and Clinical Neuroscience - Through the potency monitoring program at the University of Mississippi supported by National Institute on Drug Abuse (NIDA), a total of...     

Dropouts and terminators from a community mental health center: Their use of other psyciatric services

Differences in patterns of utilization of psychiatric services were studied in 178 adult outpatients who either had dropped out of, or had terminated from treatment with the consent of their therapists. The Monroe County Psychiatric Case Register was employed to determine the use of psychiatric services by these patients within a period of two years before and two years after their admission to a community mental health center (CMHC). Dropping out of treatment was associated with a pattern of utilization of multiple psychiatric facilities. Of those individuals who made contact with a psychiatric facility both prior to and subsequent to their admission to the CMHC, the dropout group made, on the average, approximately twice as many contacts per person as the terminator group.Mr. Carpenter is a clinical psychology graduate student at the University of Southern Mississippi. Dr. Del Gaudio was, until his untimely death in August 1978, an Assistant Professor of Psychiatry (Psychology); and Dr. Morrow is an Assistant Professor of Psychiatry (Psychology and Oncology) at the University of Rochester School of Medicine and Dentistry. All reprint requests should be directed to Paul J. Carpenter, P.O. Box 8482, University of Southern Mississippi, Hattiesburg, MS 39401.     

California encephalitis virus causes subacute encephalomyelitis in an adult

A 24-year-old man from rural Mississippi had a case of California encephalitis (CE) that evolved as a subacute encephalomyelitis. The incidence of CE in adults is low, especially in the southeastern United States, and to our knowledge the clinical profile of symptomatic disease in adults has not been established. The characteristics of CE and St Louis encephalitis, the usual cause of arboviral illness affecting adults in the Southeast, differ.     

Exploratory factor analysis of two measures of posttraumatic stress disorder (PTSD) symptoms in a non-clinical sample of college students

This study investigated the psychometric structure of two widely utilized measures of posttraumatic symptoms in a primarily Caucasian non-clinical sample. Given the prevalence of trauma exposure in non-referred samples, measurement of resulting symptoms is a critical issue. Exploratory factor analysis was utilized to assess and compare the factor structure of the Impact of Event Scale [IES; Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of Event Scale: a measure of subjective stress. Psychosomatic Medicine, 41, 209-218] and the Mississippi Scale for Posttraumatic Stress Disorder, Civilian version [MIS-Civ; Vreven, D. L., Gudanowski, D. M., King, L. A., & King, D. W. (1995). The Civilian Version of the Mississippi PTSD Scale-a psychometric evaluation. Journal of Traumatic Stress, 8, 91-109] in a sample of college students reporting exposure to potentially traumatic events. The psychometric structure of the IES was largely consistent with the two-factor structure widely reported in the literature, while the structure of the MIS-Civ varied considerably in this sample. Notably, non-clinical samples tended to report fewer social and occupational dysfunction than clinical samples predominantly utilized in PTSD research. Implications for use of these instruments in screening samples are discussed.     

Gender differences in psychological effect of the August 1999 earthquake in Turkey

Disasters traumatically expose normal populations to severe threats to life, deaths of relatives and massive environmental destruction. Epidemiological studies found that women would be more vulnerable to disaster than men. In this study, we examined gender differences in short-term psychological effect of the 1999 earthquake in Turkey on adult survivors. A total of 184 subjects (79 males and 105 females) who used a psychiatric service were interviewed within 6–10?weeks after the earthquake. All subjects were assessed using a modified version of the Mississippi Scale for Posttraumatic Stress Disorder, the Beck Depression Inventory, the Beck Hopelessness Scale, and four subscales (depression, anxiety, hostility and somatization) of the Symptom Check List (SCL-90-R). Women had higher mean total Mississippi Scale scores than men (84.29 vs. 78.72; P<0.05). Women scored higher on the Beck Depression Inventory and the Beck Hopelessness Scale than men (respectively 16.3 vs. 10.4; P<0.001 and 7.5 vs. 6.0; P<0.05). Women had significantly higher depression (1.40 vs. 0.94; P<0.001), anxiety (1.46 vs. 1.12; P<0.05) and somatization (1.31 vs. 0.84; P<0.001) subscale scores of the SCL-90-R than men. These findings indicate that women may experience more severe psychological reactions than men after a disastrous earthquake.     

Comparative study of trauma-related phenomena in subjects with pseudoseizures and subjects with epilepsy

OBJECTIVE: The purpose of this study was to examine potential differences in measures of trauma-related phenomena between subjects with pseudoseizures and subjects with intractable epilepsy. METHOD: Thirty-one adult subjects with pseudoseizures and 32 subjects with intractable epilepsy (confirmed by video-EEG) were recruited from the epilepsy unit of a tertiary care hospital. Each participant completed the Impact of Event Scale, the Davidson Trauma Scale, the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (PTSD), the Dissociative Experience Scale, and the Pittsburgh Sleep Quality Index, as well as demographic, seizure history, and family functioning measures. RESULTS: Subjects with pseudoseizures had significantly higher mean scores on the Davidson Trauma Scale, Mississippi Scale for Combat-Related PTSD, Impact of Event Scale, and Pittsburgh Sleep Quality Index than subjects with epilepsy. In addition, a significantly higher percentage of subjects with pseudoseizures had scores above the clinical cutoff level of 30 on the Dissociative Experience Scale. CONCLUSIONS: Subjects with pseudoseizures exhibited trauma-related profiles that differed significantly from those of epileptic comparison subjects and closely resembled those of individuals with a history of traumatic experiences. Interventions aimed at trauma-related issues may be beneficial for patients with pseudoseizures.     

Risperidone in the treatment of delirium: results from a prospective open-label trial

BACKGROUND: Effective treatment is necessary to reverse delirium and prevent potentially serious consequences. METHOD: Patients were identified for screening by initial chart review of all consecutive admissions to the general medical or surgical wards at the Department of Veterans Affairs hospital and the University of Mississippi Medical Center in Jackson, Mississippi, between November 2000 and April 2002. Medically ill patients with delirium defined by DSM-IV criteria and a Delirium Rating Scale (DRS) score of >or= 13 were given risperidone, 0.5 mg, twice daily, with additional doses permitted on day 1 for target symptoms. Total day 1 dosage was given daily until the DRS score was 相似文献