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Childhood abuse and subsequent sexual assault among female inpatients
Cloitre M; Tardiff K; Marzuk PM; Leon AC; Portera L
The relationship between a history of childhood abuse and subsequent sexual assault was assessed among 409 consecutive female inpatient admissions. A total of 45% of the sample reported a history of some form of childhood abuse and 22% reported at least one adulthood sexual assault. A hierarchical logistic regression indicated that, after controlling for sociodemographic and diagnostic variables, women with a history of childhood abuse were 3.1 times more likely to have experienced an adult sexual assault compared to those without abuse. There was a higher prevalence of adult sexual assault among women reporting only physical abuse or physical and sexual abuse than those reporting only sexual abuse, indicating the significance of physical abuse as a potential risk factor for adult sexual assault
PMID: 8827650
ISSN: 0894-9867
CID: 37258
Social-vocational adjustment in unipolar mood disorders: results of the DSM-IV field trial
Evans S; Cloitre M; Kocsis JH; Keitner GI; Holzer CP; Gniwesch L
430 patients participating in the DSM-IV field trial receiving a DSM-III-R SCID-derived diagnosis of episodic major depression (n = 131), dysthymic disorder (n = 37) and double depression (n = 262) completed the social adjustment scale-self-report (Weissman and Bothwell, 1976). Patients with double depression demonstrated greater social morbidity than those suffering from episodic major depression or dysthymic disorder (P < 0.05). Significant predictors of high social morbidity in double depressives included severity of symptoms (P < 0.0001), followed by age of onset of first major depression (P < 0.04). Subscale analysis revealed that double depressives were significantly more impaired in work outside the home and in terms of their financial status (P < 0.05)
PMID: 8791176
ISSN: 0165-0327
CID: 37259
Memory performance among women with parental abuse histories: enhanced directed forgetting or directed remembering?
Cloitre M; Cancienne J; Brodsky B; Dulit R; Perry SW
Performance on a directed forgetting task was assessed in 24 individuals with borderline personality disorder and early life parental abuse, 24 borderline individuals with no history of abuse, and 24 healthy nonclinical controls under conditions of explicit and implicit memory. In the explicit memory condition, individuals with abuse histories showed greater differential recall of 'to-be-remembered' versus 'to-be-forgotten' material compared to the 2 comparison groups. Implicit memory performance was equivalent for all 3 groups. The enhanced selective memory in the abused group was the result of better recall for 'remember' and not poorer recall for 'forget' information, indicating that abused individuals have an enhanced ability to sustain attention to designated 'remember' information. Because most people with childhood abuse recall their abuse, enhanced remembering of designated events (e.g., information not associated with abuse) may be a coping strategy
PMID: 8723001
ISSN: 0021-843x
CID: 37260
Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder
Brodsky BS; Cloitre M; Dulit RA
OBJECTIVE: This study sought to document the prevalence of dissociative experiences in adult female inpatients with borderline personality disorder and to explore the relationship between dissociation, self-mutilation, and childhood abuse history. METHOD: A treatment history interview, the Dissociative Experiences Scale, the Sexual Experiences Questionnaire, and the Hamilton Depression Rating Scale were administered to 60 consecutively admitted female inpatients with borderline personality disorder as diagnosed by the Structured Clinical Interview for DSM-III-R Personality Disorders. RESULTS: Fifty percent of the subjects had a score of 15 or more on the Dissociative Experiences Scale, indicating pathological levels of dissociation. Fifty-two percent reported a history of self-mutilation, and 60% reported a history of childhood physical and/or sexual abuse. The subjects who dissociated were more likely than those who did not to self-mutilate and to report childhood abuse. They also had higher levels of current depressive symptoms and psychiatric treatment. Multiple regression analysis demonstrated that each of these variables predicted dissociation when each of the others was controlled for, and that self-mutilation was the most powerful predictor of dissociation. CONCLUSIONS: Female inpatients with borderline personality disorder who dissociate may represent a sizable subgroup of patients with the disorder who are at especially high risk for self-mutilation, childhood abuse, depression, and utilization of psychiatric treatment. The strong correlation between dissociation and self-mutilation independent of childhood abuse history should alert clinicians to address these symptoms first while exercising caution in attributing them to a history of abuse
PMID: 8526247
ISSN: 0002-953x
CID: 37261
Memory bias does not generalize across anxiety disorders
Cloitre M; Cancienne J; Heimberg RG; Holt CS; Liebowitz M
Individuals with social phobia were compared with normal controls on their memory for socially-related threat words in contrast to positive and neutral words. A memory paradigm used in a previous study of panic disorder patients [Cloitre, M. & Liebowitz, M. R. (1991) Cognitive Therapy and Research, 15, 609-619] was applied to test the generalizability of findings of threat-biased memory in a semantic memory task (free recall) and a perceptual memory task (high-speed recognition) to social phobics. No evidence of threat-related memory bias among social phobics was obtained. Since both the social phobic and control groups showed better memory for affectively valenced (threat and positive) compared to neutral information, it is unlikely that the absence of threat-biased memory among social phobics was the result of insensitive measurement
PMID: 7726806
ISSN: 0005-7967
CID: 37262
Psychodynamic perspectives
Chapter by: Cloitre, Marylene; Shear, M. Katherine
in: Social phobia: Clinical and research perspectives by Stein, Murray B. [Eds]
Washington, DC : American Psychiatric Press, 1995
pp. 163-187
ISBN: 0880486538
CID: 3088
Emotion-focused treatment for panic disorder: A brief, dynamically informed therapy
Chapter by: Shear, M. Katherine; Cloitre, Marylene; Heckelman, Leora
in: Dynamic therapies for psychiatric disorders : axis I by Barber, Jacques P.; Crits-Christoph, Paul. [Eds]
New York : BasicBooks, 1995
pp. 267-293
ISBN: 0465017428
CID: 3089
Cognitive behavioral treatment compared with nonprescriptive treatment of panic disorder
Shear MK; Pilkonis PA; Cloitre M; Leon AC
BACKGROUND: The efficacy of cognitive behavioral treatment for panic disorder has been established in controlled studies. However, little is known about the efficacy of other psychological treatments. We report the results of a study comparing cognitive behavioral treatment with a focused nonprescriptive treatment for panic. METHODS: Three sessions of panic-related information were provided in each treatment, followed by 12 sessions of either nonprescriptive, reflective listening (non-prescriptive treatment) or a treatment package that included breathing retraining, muscle relaxation, cognitive reframing, and exposure to interoceptive and agoraphobic stimuli (cognitive behavioral treatment). RESULTS: Posttreatment and 6-month follow-up assessments revealed a good response to both treatments. We observed a high rate of panic remission and significant improvement in associated symptoms in subjects in each treatment group. CONCLUSION: These findings raise questions about the specificity of cognitive behavioral treatment
PMID: 8179463
ISSN: 0003-990x
CID: 37263
Does mood-congruence or causal search govern recall bias? A test of life event recall
Raphael KG; Cloitre M
Recall bias has been hypothesized to occur as a function of mood congruence or causal-search related mechanisms. This study tested whether either mechanism related to recall of stressful life events over a year. Respondents consisted of 136 cases suffering from chronic facial pain and 131 acquaintance controls. After reporting life events for 1 year at monthly intervals, respondents attempted to recall these same events at year-end. Mood and likelihood of engaging in causal search were also ascertained at year-end. Results showed no effect of mood congruence or causal search on recall of event occurrence. However, mood did influence subjective appraisal of those events that were recalled. In addition, a significant mood-related memory deficit was detected. Findings indicate that mood-related memory deficit may reduce effect sizes artifactually. Furthermore, when assessing effects of recall bias, recall of event occurrence must be considered separately from subjective appraisal of event characteristics
PMID: 7730881
ISSN: 0895-4356
CID: 37264
Implicit and explicit memory for catastrophic associations to bodily sensation words in panic disorder
Cloitre, Marylene; Shear, M. Katherine; Cancienne, James; Zeitlin, Sharon B
Investigated explicit (cued recall) and implicit (word completion) memory bias for catastrophic associations among 24 individuals with panic disorder (PD), 24 clinician controls, and 24 normal controls. Compared to both control groups, the PD group showed biased explicit and implicit memory for catastrophic associations to bodily sensation words (e.g., palpitation-coronary) compared to positive (e.g., smiles-elation) and neutral (e.g., groceries-coupons) word pairs of equal relatedness. Results support cognitive formulations of panic disorder which suggest that individuals with PD have biased memory for catastrophic associations and that these biases can occur in both conscious (explicit) and nonconscious (implicit) memory processes.
PSYCH:1994-37593-001
ISSN: 0147-5916
CID: 38073