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Peritraumatic and trait dissociation differentiate police officers with resilient versus symptomatic trajectories of posttraumatic stress symptoms
Galatzer-Levy IR; Madan A; Neylan TC; Henn-Haase C; Marmar CR
Research has consistently demonstrated that stress reactions to potentially traumatic events do not represent a unified phenomenon. Instead, individuals tend to cluster into prototypical response patterns over time including chronic symptoms, recovery, and resilience. We examined heterogeneity in a posttraumatic stress disorder (PTSD) symptom course in a sample of 178 active-duty police officers following exposure to a life-threatening event using latent growth mixture modeling (LGMM). This analysis revealed 3 discrete PTSD symptom trajectories: resilient (88%), distressed-improving (10%), and distressed-worsening (2%). We further examined whether trait and peritraumatic dissociation distinguished these symptom trajectories. Findings indicate that trait and peritraumatic dissociation differentiated the resilient from the distressed-improving trajectory (trait, p < .05; peritraumatic, p < .001), but only peritraumatic dissociation differentiated the resilient from the distressed-worsening trajectory (p < .001). It is essential to explore heterogeneity in symptom course and its predictors among active-duty police officers, a repeatedly exposed group. These findings suggest that police officers may be a highly resilient group overall. Furthermore, though there is abundant evidence that dissociation has a positive linear relationship with PTSD symptoms, this study demonstrates that degree of dissociation can distinguish between resilient and symptomatic groups of individuals
PMCID:3974926
PMID: 21898602
ISSN: 1573-6598
CID: 140504
The impact of killing and injuring others on mental health symptoms among police officers
Komarovskaya, Irina; Maguen, Shira; McCaslin, Shannon E; Metzler, Thomas J; Madan, Anita; Brown, Adam D; Galatzer-Levy, Isaac R; Henn-Haase, Clare; Marmar, Charles R
This study examined the relationship between killing or seriously injuring someone in the line of duty and mental health symptoms in a sample of police officers (N = 400) who were first assessed during academy training and at five additional time points over three years. We found that nearly 10% of police officers reported having to kill or seriously injure someone in the line of duty in the first three years of police service. After controlling for demographics and exposure to life threat, killing or seriously injuring someone in the line of duty was significantly associated with PTSD symptoms (p < .01) and marginally associated with depression symptoms (p = .06). These results highlight the potential mental health impact of killing or seriously injuring someone in the line of duty. Greater attention to mental health services following these types of exposures can serve as a preventative measure for police officers who have been negatively impacted
PMCID:3974970
PMID: 21658717
ISSN: 1879-1379
CID: 137879
What we don't expect when expecting: evidence for heterogeneity in subjective well-being in response to parenthood
Galatzer-Levy, Isaac R; Mazursky, Heather; Mancini, Anthony D; Bonanno, George A
A recent article in New York Magazine echoed what psychological studies of parenthood have consistently demonstrated since the 1970s: "Most people assume that having children will make them happier. Yet a wide variety of academic research shows that parents are not happier than their childless peers, and in many cases are less so" (Senior, 2010). There is consistent evidence that, as opposed to other life events that cause transient disruptions in life satisfaction, becoming a parent appears to cause harm to individual subjective well-being (Twenge, Campbell, & Foster, 2003), and that this harm is sustained over time (Clark, Diener, Georgellis, & Lucas, 2008). The current investigation was predicated on the concern that these findings may be the result of the methodology used to examine them. As the experience of parenthood does not represent a unified phenomenon, we employed a methodological approach that allows for the exploration of heterogeneity as well as its predictors. By modeling heterogeneous trajectories within a prospective design from 4 years prior to 4 years after the birth of a parent's first child, we find that the majority of individuals (84.2%) demonstrate no long-term effects on life satisfaction in response to childbirth. Only a small percentage demonstrate the sustained declines (7.2%), and a significant cohort, previously unobserved in the literature, demonstrate dramatic and sustained improvements in response to parenthood (4.3%), providing compelling evidence for heterogeneity in life satisfaction among parents. Key demographic covariates that distinguish between trajectories of response are also explored.
PMID: 21553960
ISSN: 0893-3200
CID: 226472
August Aichhorn: a different vision of psychoanalysis, children, and society [Historical Article]
Galatzer-Levy, Isaac R; Galatzer-Levy, Robert M
Though August Aichhorn, in name, remains a significant figure in the history of psychoanalysis, his ideas have been all but abandoned in the modern clinical conception of the treatment of children and adolescents who act out. The current treatment of children and adolescents, so disturbed that their behavior demands treatment outside of their home environment, is currently rudderless and highly dependent on broad societal counter-transferential reactions to disturbed youth. We argue that not only does Aichhorn hold a distinguished position in the history of the treatment of youngsters, but that his ideas about the meaning of severely disruptive behavior as well as the techniques which align with those theories remain relevant and, if utilized, would improve the treatment of severely disturbed youth.
PMID: 18524091
ISSN: 0079-7308
CID: 226482
The revolution in psychiatric diagnosis: problems at the foundations [Historical Article]
Galatzer-Levy, Isaac R; Galatzer-Levy, Robert M
The third edition of the American Psychiatric Association's Diagnostic and Statistical Manual (DSM-III; 1974) not only revolutionized psychiatric diagnosis, it transformed and dominated American psychiatry. The nosology of psychiatry had been conceptually confusing, difficult to apply, and bound to widely questioned theories. Psychiatry and clinical psychology had been struggling with their scientific status. DSM attempted to solve psychiatry's problems by making psychiatry more like its authors' perception of general medicine. It tried to avoid theory, especially psychoanalytic theories, by discussing only observable manifestations of disorders. But DSM is actually highly theory-bound. It implicitly and powerfully includes an exclusively "medical" model of psychological disturbance, while excluding other psychiatric ideas. Its authors tried to meet what they saw as "scientific standards." To a surprising extent, DSM reflects its creators' personal distaste for psychoanalysis. The result is that DSM rests on a narrow philosophical perspective. The consequences of its adoption are widespread: it has profoundly affected drug development and other therapeutic studies, psychiatric education, attitudes toward patients, the public perception of psychiatry, and administrative and legal decisions. This article explores how DSM's most problematic features arise from its history in psychiatric controversies of the 1960s and its underlying positivistic philosophy.
PMID: 17468537
ISSN: 0031-5982
CID: 226492