Faculty Bibliography

OBJECTIVE: Although posttraumatic stress disorder (PTSD) is a highly prevalent and often chronic condition, the relationship between PTSD and functioning and quality of life remains incompletely understood. METHOD: The authors undertook an archival analysis of data from the National Vietnam Veterans Readjustment Study. The study subjects consisted of the nationally representative sample of male Vietnam veterans who participated in the National Vietnam Veterans Readjustment Study. The authors estimated PTSD at the time of the interview with the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder. They examined the following outcomes: diminished well-being, physical limitations, bed day in the past 2 weeks, compromised physical health status, currently not working, and perpetration of violence. Logistic models were used to determine the association between PTSD and outcome; adjustment was made for demographic characteristics and comorbid psychiatric and other medical conditions. RESULTS: The risks of poorer outcome were significantly higher in subjects with PTSD than in subjects without PTSD in five of the six domains. For the outcome domains of physical limitations, not working, compromised physical health, and diminished well-being, these significantly higher risks persisted even in the most conservative logistic models that removed the shared effects of comorbid psychiatric and other medical disorders. CONCLUSIONS: The suffering associated with combat related-PTSD extends beyond the signs and symptoms of the disorder to broader areas of functional and social morbidity. The significantly higher risk of impaired functioning and diminished quality of life uniquely attributable to PTSD suggests that PTSD may well be the core problem in this group of difficult to treat and multiply afflicted patients

OBJECTIVE: This investigation assessed whether current post-traumatic stress disorder (PTSD) was associated with impaired functioning in a nationally representative sample of female Vietnam veterans. METHODS: Logistic models were used to determine the association between PTSD and outcome while adjusting for demographic characteristics and medical and psychiatric co-morbidities. RESULTS: PTSD was associated with significantly elevated odds of poorer functioning in five of the six outcome domains; only the association between perpetration of violence in the past year and PTSD did not achieve statistical significance. After adjusting for demographics and medical and psychiatric co-morbidities, PTSD remained associated with significantly elevated odds of bed days, poorer physical health, and currently not working. CONCLUSIONS: Among female Vietnam veterans PTSD is associated with a broad profile of functional impairment. The significantly increased odds of impaired functioning and diminished quality of life suggest that PTSD may be the core problem of the set of problems afflicting female Vietnam veterans

This study examined the relationship of dissociation at the time of trauma, as assessed by the Peritraumatic Dissociation Experiences Questionnaire, Rater Version (PDEQ-RV; C.R. Marmar, D.S. Weiss, & T.J. Metzler, in press), and posttraumatic stress symptoms in a group of 77 female Vietnam theater veterans. PDEQ-RV ratings were found to be associated strongly with posttraumatic stress symptomatology, as measured by the Impact of Event Scale (M.J. Horowitz, N. Wilner, & W. Alvarez, 1979), and also positively associated with level of stress exposure and general dissociative tendencies, measured by the Dissociative Experiences Scale. The PDEQ-RV was unassociated with general psychiatric symptomatology, as assessed by the clinical scales of the Minnesota Multiphasic Personality Inventory-2 (J.N. Butcher, W.G. Dahlstrom, J.R. Graham, A. Tellegen, & B. Kaemmer, 1989). The PDEQ-RV was predictive of posttraumatic stress symptoms beyond the contributions of level of stress exposure and general dissociative tendencies. The findings provide further support for the reliability and validity of the PDEQ-RV as a measure of peritraumatic dissociation

BACKGROUND: Interpersonal problems may negatively affect crews on long-duration space missions. These problems stem from crewmember tension and its displacement to the outside monitoring personnel and from disruptions in crew cohesion and unclear leadership roles. HYPOTHESES: We hypothesized that crew tension and dysphoria would transiently increase following stressful events and be greater in the second half of a mission; that cohesion would be less during the second half of a mission; that tension and dysphoria would be displaced to the outside monitoring personnel; and that high levels of leader support and control would produce high levels of cohesion. METHODS: We tested these hypotheses during a 135-d Mir space station simulation study in Moscow. At weekly intervals, the three crewmembers completed items from two group climate questionnaires, a mood questionnaire, and a log of stressful events. RESULTS: Contrary to expectations, there was significantly (p < 0.05) more total mood disturbance and tension during the first 9 wks than during the subsequent 10 wks of the simulation. Although levels of cohesion remained the same over time, cohesion scores dropped at a significantly greater rate during the last third of the seclusion. There was evidence for the displacement of tension and dysphoria to the outside monitoring personnel. There were significant correlations in the predicted direction between leader support and control and crew cohesion, as well as evidence of status leveling in the mission commander. CONCLUSIONS: Crewmember tension, cohesion, and leadership are important issues affecting people working in secluded environments, and they need to be studied further in space