Combat trauma Johnson, James D
2010., 2010, 2010-09-16
eBook
In this book, Johnson relates the stories of fifteen of his combat brothers to share with the world what their terror of four decades ago has done to them and how it affects them to this day. With ...candor and vivid detail, they reveal how their combat trauma symptoms still infect their thoughts, feelings, and behaviors on a daily basis.
Substantial empirical evidence has indicated impairment in the cognitive functioning of patients with obsessive-compulsive disorder (OCD) despite inconsistencies. Although several confounding factors ...have been investigated to explain the conflicting results, the findings remain mixed. This study aimed to investigate cognitive dysfunction in patients with OCD using a meta-analytic approach.
The PubMed database was searched between 1980 and October 2012, and reference lists of review papers were examined. A total of 221 studies were identified, of which 88 studies met inclusion criteria. Neuropsychological performance and demographic and clinical variables were extracted from each study.
Patients with OCD were significantly impaired in tasks that measured visuospatial memory, executive function, verbal memory and verbal fluency, whereas auditory attention was preserved in these individuals. The largest effect size was found in the ability to recall complex visual stimuli. Overall effect estimates were in the small to medium ranges for executive function, verbal memory and verbal fluency. The effects of potentially confounding factors including educational level, symptom severity, medication status and co-morbid disorders were not significant.
Patients with OCD appear to have wide-ranging cognitive deficits, although their impairment is not so large in general. The different test forms and methods of testing may have influenced the performance of patients with OCD, indicating the need to select carefully the test forms and methods of testing used in future research. The effects of various confounding variables on cognitive functioning need to be investigated further and to be controlled before a definite conclusion can be made.
This book presents a comprehensive overview of traumatic stress. Chapters address such topics as biomarkers in traumatic stress, the role of microglia activation, proliferation, and ...neuro-inflammation in the genesis of mental disorders and pain, the role of anger in the genesis and maintenance of hypertension, the role of anger and imagery in the maintenance of stress-related disorders, the role of oxidative stress in the etiology and maintenance of cardiovascular diseases, the mental health impacts of the COVID-19 pandemic, and much more.
Many millions of people are affected by the trauma of war. Psychologists have a good understanding of how experiences of war impact on memory, but the significance of external environmental ...influences is often disregarded. Memory, War and Trauma focuses on our understanding of the psychosocial impact of war in its broadest sense. Nigel C. Hunt argues that, in order to understand war trauma, it is critical to develop an understanding not only of the individual perspective but also of how societal and cultural factors impact on the outcome of an individual's experience. This is a compelling book which helps to demonstrate why some people suffer from post-traumatic stress while other people don't, and how narrative understanding is important to the healing process. Its multidisciplinary perspective will enable a deeper understanding of both individual traumatic stress and the structures of memory.
Since October 2001, approximately 1.64 million U.S. troops have been deployed for Operations Enduring Freedom and Iraqi Freedom (OEF/OIF) in Afghanistan and Iraq. Early evidence suggests that the ...psychological toll of these deployments many involving prolonged exposure to combat-related stress over multiple rotations--may be disproportionately high compared with the physical injuries of combat. In the face of mounting public concern over post-deployment health care issues confronting OEF/OIF veterans, several task forces, independent review groups, and a Presidential Commission have been convened to examine the care of the war wounded and make recommendations. Concerns have been most recently centered on two combat-related injuries in particular: post-traumatic stress disorder and traumatic brain injury. With the increasing incidence of suicide and suicide attempts among returning veterans, concern about depression is also on the rise. The study discussed in this monograph focuses on post-traumatic stress disorder, major depression, and traumatic brain injury, not only because of current high-level policy interest but also because, unlike the physical wounds of war, these conditions are often invisible to the eye, remaining invisible to other servicemembers, family members, and society in general. All three conditions affect mood, thoughts, and behavior; yet these wounds often go unrecognized and unacknowledged. The effect of traumatic brain injury is still poorly understood, leaving a large gap in knowledge related to how extensive the problem is or how to address it. RAND conducted a comprehensive study of the post-deployment health-related needs associated with these three conditions among OEF/OIF veterans, the health care system in place to meet those needs, gaps in the care system, and the costs associated with these conditions and with providing quality health care to all those in need. This monograph presents the results of our study, which should be of interest to mental health treatment providers; health policymakers, particularly those charged with caring for our nation's veterans; and U.S. service men and women, their families, and the concerned public. All the research products from this study are available at http://veterans.rand.org. Data collection for this study began in April 2007 and concluded in January 2008. Specific activities included a critical review of the extant literature on the prevalence of post-traumatic stress disorder, major depression, and traumatic brain injury and their short- and long-term consequences; a population-based survey of servicemembers and veterans who served in Afghanistan or Iraq to assess health status and symptoms, as well as utilization of and barriers to care; a review of existing programs to treat servicemembers and veterans with the three conditions; focus groups with military servicemembers and their spouses; and the development of a microsimulation model to forecast the economic costs of these conditions over time. Among our recommendations is that effective treatments documented in the scientific literature, evidence-based care--are available for PTSD and major depression. Delivery of such care to all veterans with PTSD or major depression would pay for itself within two years, or even save money, by improving productivity and reducing medical and mortality costs. Such care may also be a cost-effective way to retain a ready and healthy military force for the future. However, to ensure that this care is delivered requires system-level changes across the Department of Defense, the Department of Veterans Affairs, and the U.S. health care system.
Structured for easy evaluation of learning outcomes and replete with useful Web sites and suggested reading, this book is an invaluable resource for clinicians seeking to understand the myriad ...factors that may influence a person's reaction to trauma.
L'auteur cherche dans une nouvelle étude sur l'hystérie ce qui est susceptible d'être dégagé par rapport au modèle classique de la névrose. C'est à partir de l'expérience clinique que l'émergence de ...la projection conduit à penser sa place et sa fonction singulières au sein d'un fonctionnement psychique par ailleurs soutenu par le refoulement et le conflit interne. Les maux du corps si caractéristiques des symptômes hystériques relèvent alors d'un déplacement du même ordre lorsque les mots viennent à manquer. Dans certaines situations, la projection vient renverser cette tendance dominante par l'externalisation des mouvements pulsionnels et des fantasmes qui s'y attachent.
Cognitive behaviour therapy (CBT) is an effective treatment for obsessive-compulsive disorder (OCD) but access to CBT is limited. Internet-based CBT (ICBT) with therapist support is potentially a ...more accessible treatment. There are no randomized controlled trials testing ICBT for OCD. The aim of this study was to investigate the efficacy of ICBT for OCD in a randomized controlled trial.
Participants (n=101) diagnosed with OCD were randomized to either 10 weeks of ICBT or to an attention control condition, consisting of online supportive therapy. The primary outcome measure was the Yale-Brown Obsessive Compulsive Scale (YBOCS) administered by blinded assessors.
Both treatments lead to significant improvements in OCD symptoms, but ICBT resulted in larger improvements than the control condition on the YBOCS, with a significant between-group effect size (Cohen's d) of 1.12 (95% CI 0.69-1.53) at post-treatment. The proportion of participants showing clinically significant improvement was 60% (95% CI 46-72) in the ICBT group compared to 6% (95% CI 1-17) in the control condition. The results were sustained at follow-up.
ICBT is an efficacious treatment for OCD that could substantially increase access to CBT for OCD patients. Replication studies are warranted.
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