Behav. Sci.2015, 5(1), 59-69; doi:10.3390/bs5010059 - published 3 February 2015 Show/Hide Abstract
Abstract: The widely used posttraumatic stress disorder (PTSD) Checklist (PCL) has established reliability and validity, but it does not differentiate posttraumatic symptom frequency from intensity as elements of posttraumatic symptom severity. Thus, the PCL in its existing form may not provide a comprehensive appraisal of posttraumatic symptomatology. Because of this, we modified the PCL to create the PCL-I/F that measures both frequency and intensity of PTSD symptoms via brief self-report. To establish validity and internal consistency of the PCL-I/F, we conducted a pilot study comparing PCL-I/F scores to structured diagnostic interview for PTSD (the Clinician Administered PTSD Scale [CAPS]) in a male combat veteran sample of 92 participants. Statistically significant correlations between the PCL-I/F and the CAPS were found, suggesting initial validation of the PCL-I/F to screen and assess frequency and intensity of combat-related PTSD symptoms. Implications are discussed for screening and assessment of PTSD related to combat and non-combat trauma.
Behav. Sci.2015, 5(1), 43-58; doi:10.3390/bs5010043 - published 30 January 2015 Show/Hide Abstract
Abstract: Characterization of cognitive and behavioral complaints is explored in Post-traumatic stress disorder (PTSD) and mild traumatic brain injury (MTBI) samples according to the severity of PTSD, depression and general anxiety conditions. Self-reported questionnaires on cognitive and behavioral changes are administered to PTSD, MTBI, MTBI/PTSD and control groups. Confounding variables are controlled. All groups report more complaints since the traumatic event. PTSD and MTBI/PTSD groups report more anxiety symptoms, depression and complaints compared to the MTBI group. Relatives of the PTSD group confirm most of the behavioral changes reported. Results suggest the utility of self-reported questionnaires to personalize cognitive and behavioral interventions in PTSD and MTBI to cope with the impacts of the traumatic event.
Behav. Sci.2015, 5(1), 27-40; doi:10.3390/bs5010027 - published 23 December 2014 Show/Hide Abstract
Abstract: There is increasing awareness of the impact of post-traumatic stress disorder (PTSD) on physical health, particularly cardiovascular disease. We review the literature on the role of trauma in the development of cardiovascular risk factors and disease, aftermath of a cardiac event, and risk for recurrence in cardiac patients. We explore possible mechanisms to explain these relationships, as well as appropriate assessment and treatment strategies for this population. Our main conclusion is that screening and referral for appropriate treatments are important given the high prevalence rates of PTSD in cardiac populations and the associated impact on morbidity and mortality.
Behav. Sci.2015, 5(1), 1-26; doi:10.3390/bs5010001 - published 23 December 2014 Show/Hide Abstract
Abstract: This paper provides an attempt to conceive of music in terms of a sounding environment. Starting from a definition of music as a collection of vibrational events, it introduces the distinction between discrete-symbolic representations as against analog-continuous representations of the sounds. The former makes it possible to conceive of music in terms of a Humboldt system, the latter in terms of an experiential approach. Both approaches, further, are not opposed to each other, but are complementary to some extent. There is, however, a distinction to be drawn between the bottom-up approach to auditory processing of environmental sounds and music, which is continuous and proceeding in real time, as against the top-down approach, which is proceeding at a level of mental representation by applying discrete symbolic labels to vibrational events. The distinction is discussed against the background of phylogenetic and ontogenetic claims, with a major focus on the innate auditory capabilities of the fetus and neonate and the gradual evolution from mere sensory perception of sound to sense-making and musical meaning. The latter, finally, is elaborated on the basis of the operational concepts of affordance and functional tone, thus bringing together some older contributions from ecology and biosemiotics.
Behav. Sci.2014, 4(4), 511-527; doi:10.3390/bs4040511 - published 8 December 2014 Show/Hide Abstract
Abstract: Patients with posttraumatic stress disorder (PTSD) who fail to respond to established treatments are at risk for chronic disability and distress. Although treatment-resistant PTSD (TR-PTSD) is a common clinical problem, there is currently no standard method for evaluating previous treatment outcomes. Development of a tool that could quantify the degree of resistance to previously provided treatments would inform research in patients with PTSD. We conducted a systematic review of PTSD treatment trials to identify medication and psychotherapy interventions proven to be efficacious for PTSD. We then developed a semi-structured clinician interview called the Emory Treatment Resistance Interview for PTSD (E-TRIP). The E-TRIP includes clinician-administered questions to assess the adequacy and benefit derived from past treatment trials. For each adequately delivered treatment to which the patient failed to respond, a score is assigned depending on the strength of evidence supporting the treatment’s efficacy. The E-TRIP provides a comprehensive assessment of prior PTSD treatments that should prove valuable for researchers studying TR-PTSD and evaluating the efficacy of new treatments for patients with PTSD. The E-TRIP is not intended to guide treatment; rather, the tool quantifies the level of treatment resistance in patients with PTSD in order to standardize TR-PTSD in the research domain.