Longitudinal study of acute stress disorder, posttraumatic stress disorder and dissociation following myocardial infarction

Since dissociation has been recognized as a marker of posttraumatic processes, this study examines the chronological relations between dissociation and stress reactions (acute stress disorder, ASD, and posttraumatic stress disorder, PTSD) following myocardial infarction (MI). One hundred sixteen MI patients were examined twice: within 1 week of the trauma (time 1) and 7 months later (time 2). Sixty-seven matched controls were studied in a parallel interval. ASD was assessed at time 1, PTSD at time 2, and dissociative tendencies at both times. ASD and PTSD were moderately associated with levels of dissociation. In addition, while the MI patients did not differ from the controls in level of dissociation, both in time 1 and time 2, among the MI group, PTSD was associated with an increase in dissociation. These findings may reflect either the development of two comorbid entities, or a presentation of a dissociative subtype of PTSD.     

Recurrent trauma: Holocaust survivors cope with aging and cancer

BACKGROUND: The current study aims to determine whether elderly Holocaust survivors are affected differently from non-survivors by the adversity of aging and cancer. METHOD: Holocaust survivors and non-survivors suffering from cancer, were assessed tapping PTSD, psychiatric symptomatology, psychosocial adjustment to illness and coping with the aftermath of the Holocaust. RESULTS: Findings indicate a significant difference between survivors and non-survivors in post-traumatic symptoms and their intensity, survivors endorsing significantly more PTSD symptoms. Survivors were classified into 3 sub-groups, namely "Victims," "Fighters," and "Those who made it". "Victims" reported the highest percentage of persons who met PTSD, psychiatric symptomatology and difficulty coping with the problems of old age. CONCLUSIONS: The diversity of responses points to heterogeneity of long-term adaptation and adjustment among Holocaust survivors and similar response to subsequent adversity.     

Is the Holocaust Implicated in Posttraumatic Growth in Second‐Generation Holocaust Survivors? A Prospective Study

With the growing interest in posttraumatic growth (PTG), and the ongoing debate on the implications of transgenerational transmission of trauma, this longitudinal study examined PTG among Holocaust survivor offspring following their own exposure to trauma. Using self‐report questionnaires, we assessed PTG over time in middle aged (age: M = 53 years) Israeli male combat veterans of the 1973 Yom Kippur War whose parents were (n = 43) and were not (n = 156) second‐generation survivors of the Nazi Holocaust at 2 time points: 30 and 35 years following the war (in 2003 and 2008). Posttraumatic stress disorder symptoms and trauma exposure were also assessed in 1991. We hypothesized that second‐generation survivors would report more PTG than controls. However, repeated measures design revealed that the second‐generation veterans reported less PTG than veterans who were not second generation, which was evident in the PTG domains of relations to others, personal strength, and appreciation of life. Our findings suggest that transmission of trauma from one generation to the next is possibly implicated in the offspring's propensity for growth following subsequent trauma. Future research is warranted to examine the link between transmission of trauma and positive outcomes following trauma.     

Trajectories of attachment in older age: interpersonal trauma and its consequences

ABSTRACT

Previous studies suggest that attachment insecurities may increase after trauma exposure, an effect documented only at a group level. This study explores the heterogeneity of changes over time and examines the associations of the nature of the traumatic event (interpersonal and nonpersonal), and its consequences (posttraumatic stress disorder [PTSD] and loneliness) with attachment trajectories. Two groups of Israeli veterans participated: 164 former prisoners-of-war and 185 combat veterans. Attachment was assessed at four points (1991–2015). Risk factors were evaluated in 1991. Using latent growth mixture modeling, trajectories of attachment insecurities were explored. Three avoidance trajectories (stability, decrease, inverse u-shaped) and two anxiety trajectories (stability, decrease) were identified. The inverse u-shaped avoidance trajectory was associated with captivity, humiliation, loneliness, and PTSD, and stable avoidance was associated with loneliness. Stable anxiety was associated with captivity and loneliness. Attachment insecurities can change during aging and persist decades after a trauma. Trauma-related risk factors are related to more deleterious trajectories.     

A longitudinal study of cognition in asymptomatic and mildly symptomatic bipolar disorder patients

Bipolar disorder (BD) is characterized by cognitive deficits that impair patients' functioning and quality of life. Most of the earlier studies assessing changes in BD patients' cognitive functioning over time utilized a cross-sectional research design. The few longitudinal studies that were conducted tended to have methodological limitations such as very short follow-up periods, recruitment of acutely ill patients, and lack of assessment of practice effects. The current study aimed to assess changes over time in the cognitive functioning of typical BD outpatients. For this purpose, asymptomatic and mildly symptomatic BD outpatients were assessed at baseline and after two years (n=31). At baseline, the cognitive functioning of the BD patients was compared to that of gender- and age-matched healthy controls. Practice effects were estimated by re-assessing the controls one week after their first assessment. Compared to the controls, BD patients had deficits in psychomotor speed, sustained attention, and one domain of executive functioning (cognitive planning). No evidence was found of a decline in their cognitive functioning over the two year time interval. These findings support a developmental model of cognitive impairment in BD. Studies using longer follow-up periods and larger sample sizes, however, are needed before these conclusions can be stated confidently.     

Characteristic Expressions of Combat-related Posttraumatic Stress Disorder among Israeli Soldiers in the 1982 Lebanon War

Abstract

This study assessed the clinical picture of two groups of Israeli soldiers: front-line soldiers who had been treated for combat stress reaction during the 1982 Lebanon War (n = 382); and matched control front-line soldiers who did not sustain combat stress reaction (n = 334). Subjects were screened one year after the war for posttraumatic stress disorder (PTSD) and psychiatric symptomatology using the symptom checklist-90 (SCL-90). Results indicated that anxiety, depression, hostility, and obsessive-compulsive problems were the most salient features of PTSD among combat stress reaction casualties. The contribution of DSM-III criteria as well as their limitations in the diagnosis of PTSD are discussed.