Page 54 - January Febuary 2016 Issue
P. 54
PTSD Among Military Personnel: A Review
The three sub scales measures, avoidance (the pressure). Blanchard et al. (1982) found that
tendency to avoid thoughts or reminders about the heart rate response could correctly classify
the incident), intrusion (dificulty in staying 95.5 percent of the combined sample of 11
asleep, dissociative-like re-experiencing of male Vietnam veterans suffering from PTSD
when experiencing true lash-back), and hyper and 11 non-veteran controls. Blanchard et al.
arousal (feeling irritated, angry, dificulty in (1982) and Malloy et al. (1983) found that this
getting sleep). In addition to the 3 subscale reactivity predicts the PTSD diagnosis while
scores, IES-R gives an overall impact of events using auditory and audiovisual cues. Pitman
score (sum of the 3 subscales) also. et al. (1987) also observed similar reactivity
using personal scripts of traumatic events that
PTSD scale for the SCL-90 derived by were then read to subjects. A 15-site clinical
Saunders et al. (1990) has 28-items that best trial conducted by the Department of Veterans
discriminated women with crime-related Affairs’ Cooperative Study Program later
PTSD from non-cases. Using the Diagnostic found that psycho-physiological assessment
Interview Scale (DIS) as criterion, this scale approach could be a useful diagnostic tool
obtained good sensitivity (.75) and high in discriminating cases of PTSD from
speciicity (.90). non-cases (Keane et al., 1988). Biological
alterations in central noradrenergic activity, the
The Penn Inventory (Hammarberg, 1992) was hypothalamic-pituitary-adrenocortical axis, the
developed and validated with both combat endogenous opioid system, and the sleep cycle
veterans and trauma-exposed non-veterans. have been associated with PTSD (Friedman,
This 26-item instrument has high internal 1991). Therefore a biological approach
consistency (alpha = .94), and test-retest can complement psychological diagnostic
reliability (.96). Sensitivity was found to be .90 techniques.
and speciicity was 1.0 among a sample of 83
veterans, and in a sample of disaster survivors Role of personality in the development of
sensitivity was 0.94 and speciicity of 1.0. PTSD
Other self-report measures of PTSD include, The contribution of predeployment personality
Modiied PTSD Scale (MPSS-SR) (Falsetti traits and exposure to traumatic events during
et al., 1993), Posttraumatic Stress Disorder deployment to the development of PTSD
Diagnostic Scale (PDS) (Foa, 1995), and symptoms was studied (Bramsen, Dirkzwager,
Davidson Trauma Scale (DTS) (1997). & Van Der Ploeg, 2000) among 572 male
veterans of UN Protection Force in former
III. Psycho-physiological assessment of Yugoslavia. Other than exposure to traumatic
PTSD events during deployment, personality traits
of negativism and psychopathology had the
Exposure to cues of a traumatic event highest unique contribution to the prediction of
provoked a systematic physiological response PTSD symptom severity.
across several measurement domains (e.g.,
heart rate, skin conductance, EMG, and blood Among a random sample of 1007 young
54
The three sub scales measures, avoidance (the pressure). Blanchard et al. (1982) found that
tendency to avoid thoughts or reminders about the heart rate response could correctly classify
the incident), intrusion (dificulty in staying 95.5 percent of the combined sample of 11
asleep, dissociative-like re-experiencing of male Vietnam veterans suffering from PTSD
when experiencing true lash-back), and hyper and 11 non-veteran controls. Blanchard et al.
arousal (feeling irritated, angry, dificulty in (1982) and Malloy et al. (1983) found that this
getting sleep). In addition to the 3 subscale reactivity predicts the PTSD diagnosis while
scores, IES-R gives an overall impact of events using auditory and audiovisual cues. Pitman
score (sum of the 3 subscales) also. et al. (1987) also observed similar reactivity
using personal scripts of traumatic events that
PTSD scale for the SCL-90 derived by were then read to subjects. A 15-site clinical
Saunders et al. (1990) has 28-items that best trial conducted by the Department of Veterans
discriminated women with crime-related Affairs’ Cooperative Study Program later
PTSD from non-cases. Using the Diagnostic found that psycho-physiological assessment
Interview Scale (DIS) as criterion, this scale approach could be a useful diagnostic tool
obtained good sensitivity (.75) and high in discriminating cases of PTSD from
speciicity (.90). non-cases (Keane et al., 1988). Biological
alterations in central noradrenergic activity, the
The Penn Inventory (Hammarberg, 1992) was hypothalamic-pituitary-adrenocortical axis, the
developed and validated with both combat endogenous opioid system, and the sleep cycle
veterans and trauma-exposed non-veterans. have been associated with PTSD (Friedman,
This 26-item instrument has high internal 1991). Therefore a biological approach
consistency (alpha = .94), and test-retest can complement psychological diagnostic
reliability (.96). Sensitivity was found to be .90 techniques.
and speciicity was 1.0 among a sample of 83
veterans, and in a sample of disaster survivors Role of personality in the development of
sensitivity was 0.94 and speciicity of 1.0. PTSD
Other self-report measures of PTSD include, The contribution of predeployment personality
Modiied PTSD Scale (MPSS-SR) (Falsetti traits and exposure to traumatic events during
et al., 1993), Posttraumatic Stress Disorder deployment to the development of PTSD
Diagnostic Scale (PDS) (Foa, 1995), and symptoms was studied (Bramsen, Dirkzwager,
Davidson Trauma Scale (DTS) (1997). & Van Der Ploeg, 2000) among 572 male
veterans of UN Protection Force in former
III. Psycho-physiological assessment of Yugoslavia. Other than exposure to traumatic
PTSD events during deployment, personality traits
of negativism and psychopathology had the
Exposure to cues of a traumatic event highest unique contribution to the prediction of
provoked a systematic physiological response PTSD symptom severity.
across several measurement domains (e.g.,
heart rate, skin conductance, EMG, and blood Among a random sample of 1007 young
54
