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Author Schechter, D.S.; Coots, T.; Zeanah, C.H.; Davies, M.; Coates, S.W.; Trabka, K.A.; Marshall, R.D.; Liebowitz, M.R.; Myers, M.M. file  url
Title Maternal mental representations of the child in an inner-city clinical sample: violence-related posttraumatic stress and reflective functioning Type Journal Article
Year 2005 Publication Attachment & Human Development Abbreviated Journal Attach Hum Dev  
Volume 7 Issue 3 Pages 313-331  
Keywords Adolescent; Adult; Analysis of Variance; Child Abuse/prevention & control/psychology; Child of Impaired Parents/psychology; Child, Preschool; Female; Humans; Infant; Logistic Models; *Mental Processes; Middle Aged; *Mother-Child Relations; Parenting/*psychology; Poverty Areas; Risk Factors; *Social Perception; Stress Disorders, Post-Traumatic/*psychology; United States; Violence/*psychology  
Abstract Parental mental representations of the child have been described in the clinical literature as potentially useful risk-indicators for the intergenerational transmission of violent trauma. This study explored factors associated with the quality and content of maternal mental representations of her child and relationship with her child within an inner-city sample of referred, traumatized mothers. Specifically, it examined factors that have been hypothesized to support versus interfere with maternal self- and mutual-regulation of affect: posttraumatic stress disorder (PTSD) and maternal reflective functioning (RF). More severe PTSD, irrespective of level of RF, was significantly associated with the distorted classification of non-balanced mental representations on the Working Model of the Child Interview (WMCI) within this traumatized sample. Higher Levels of RF, irrespective of PTSD severity, were significantly associated with the balanced classification of maternal mental representations on the WMCI. Level of maternal reflective functioning and severity of PTSD were not significantly correlated in this sample. Clinical implications are discussed.  
Call Number Serial 2171  
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Author Ursano, R.J.; Colpe, L.J.; Heeringa, S.G.; Kessler, R.C.; Schoenbaum, M.; Stein, M.B. file  url
Title The Army study to assess risk and resilience in servicemembers (Army STARRS) Type Journal Article
Year 2014 Publication Psychiatry Abbreviated Journal Psychiatry  
Volume 77 Issue 2 Pages 107-119  
Keywords Anxiety Disorders/psychology; Case-Control Studies; Depressive Disorder/*psychology; Humans; Military Personnel/*psychology/statistics & numerical data; Prospective Studies; *Resilience, Psychological; Retrospective Studies; Risk Assessment/*methods; Stress Disorders, Post-Traumatic/*psychology; Suicide/prevention & control/*psychology/statistics & numerical data; Suicide, Attempted/prevention & control/*psychology/statistics & numerical data; Surveys and Questionnaires; United States  
Abstract IMPORTANCE/OBJECTIVE: Although the suicide rate in the U.S. Army has traditionally been below age-gender matched civilian rates, it has climbed steadily since the beginning of the Iraq and Afghanistan conflicts and since 2008 has exceeded the demographically matched civilian rate. The Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) is a multicomponent epidemiological and neurobiological study designed to generate actionable evidence-based recommendations to reduce Army suicides and increase knowledge about risk and resilience factors for suicidality and its psychopathological correlates. This paper presents an overview of the Army STARRS component study designs and of recent findings. DESIGN/SETTING/PARTICIPANTS/INTERVENTION: Army STARRS includes six main component studies: (1) the Historical Administrative Data Study (HADS) of Army and Department of Defense (DoD) administrative data systems (including records of suicidal behaviors) for all soldiers on active duty 2004-2009 aimed at finding administrative record predictors of suicides; (2) retrospective case-control studies of fatal and nonfatal suicidal behaviors (each planned to have n = 150 cases and n = 300 controls); (3) a study of new soldiers (n = 50,765 completed surveys) assessed just before beginning basic combat training (BCT) with self-administered questionnaires (SAQ), neurocognitive tests, and blood samples; (4) a cross-sectional study of approximately 35,000 (completed SAQs) soldiers representative of all other (i.e., exclusive of BCT) active duty soldiers; (5) a pre-post deployment study (with blood samples) of soldiers in brigade combat teams about to deploy to Afghanistan (n = 9,421 completed baseline surveys), with sub-samples assessed again one, three, and nine months after returning from deployment; and (6) a pilot study to follow-up SAQ respondents transitioning to civilian life. Army/DoD administrative data are being linked prospectively to the large-scale survey samples to examine predictors of subsequent suicidality and related mental health outcomes. MAIN OUTCOME MEASURES: Measures (self-report and administratively recorded) of suicidal behaviors and their psychopathological correlates. RESULTS: Component study cooperation rates are comparatively high. Sample biases are relatively small. Inefficiencies introduced into parameter estimates by using nonresponse adjustment weights and time-space clustering are small. Initial findings show that the suicide death rate, which rose over 2004-2009, increased for those deployed, those never deployed, and those previously deployed. Analyses of administrative records show that those deployed or previously deployed were at greater suicide risk. Receiving a waiver to enter the Army was not associated with increased risk. However, being demoted in the past two years was associated with increased risk. Time in current deployment, length of time since return from most recent deployment, total number of deployments, and time interval between most recent deployments (known as dwell time) were not associated with suicide risk. Initial analyses of survey data show that 13.9% of currently active non-deployed regular Army soldiers considered suicide at some point in their lifetime, while 5.3% had made a suicide plan, and 2.4% had attempted suicide. Importantly, 47-60% of these outcomes first occurred prior to enlistment. Prior mental disorders, in particular major depression and intermittent explosive disorder, were the strongest predictors of these self-reported suicidal behaviors. Most onsets of plans-attempts among ideators (58.3-63.3%) occurred within the year of onset of ideation. About 25.1% of non-deployed U.S. Army personnel met 30-day criteria for a DSM-IV anxiety, mood, disruptive behavior, or substance disorder (15.0% an internalizing disorder; 18.4% an externalizing disorder) and 11.1% for multiple disorders. Importantly, three-fourths of these disorders had pre-enlistment onsets. CONCLUSIONS: Integration across component studies creates strengths going well beyond those in conventional applications of the same individual study designs. These design features create a strong methodological foundation from which Army STARRS can pursue its substantive research goals. The early findings reported here illustrate the importance of the study and its approach as a model of studying rare events particularly of national security concern. Continuing analyses of the data will inform suicide prevention for the U.S. Army.  
Call Number Serial 1308  
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Author Bryant, R.A. file  url
Title Early predictors of posttraumatic stress disorder Type Journal Article
Year 2003 Publication Biological Psychiatry Abbreviated Journal Biol Psychiatry  
Volume 53 Issue 9 Pages 789-795  
Keywords Humans; Risk Factors; Stress Disorders, Post-Traumatic/*psychology; Time Factors  
Abstract The benefits of providing early intervention for people recently exposed to trauma have highlighted the need to develop means to identify people who will develop chronic posttraumatic stress disorder (PTSD). This review provides an overview of prospective studies that have indexed the acute reactions to trauma that are predictive of chronic posttraumatic stress disorder. Ten studies of the predictive power of the acute stress disorder diagnosis indicate that this diagnosis does not have adequate predictive power. There is no convergence across studies on any constellation of acute symptoms that predict posttraumatic stress disorder. A review of biological and cognitive mechanisms occurring in the acute posttraumatic phase suggests that these factors may provide more accurate means of predicting chronic posttraumatic stress disorder. Recommendations for future research to facilitate identification of key markers of acutely traumatized people who will develop posttraumatic stress disorder are discussed.  
Call Number Serial 1162  
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Author Parrott, D.J.; Drobes, D.J.; Saladin, M.E.; Coffey, S.F.; Dansky, B.S. file  url
Title Perpetration of partner violence: effects of cocaine and alcohol dependence and posttraumatic stress disorder Type Journal Article
Year 2003 Publication Addictive Behaviors Abbreviated Journal Addict Behav  
Volume 28 Issue 9 Pages 1587-1602  
Keywords Adult; Alcoholism/psychology; Cocaine-Related Disorders/psychology; Diagnosis, Dual (Psychiatry); Female; Humans; Interview, Psychological; Male; Middle Aged; Risk Factors; Sex Distribution; Spouse Abuse/*psychology; Stress Disorders, Post-Traumatic/*psychology; Substance-Related Disorders/*psychology  
Abstract The present study examined the effects of substance dependence and posttraumatic stress disorder (PTSD) on perpetration of partner violence. Participants were 72 men and 124 women diagnosed with and/or without PTSD and cocaine or alcohol dependence. Participants were interviewed with the Structured Clinical Interview for the DSM-IV (SCID-IV) and completed the Conflict Tactics Scale-2 (CTS-2). Analyses indicated that participants with comorbid cocaine dependence and PTSD reported the highest frequency of partner violence relative to all other groups. Main effects were also detected for drug dependence and PTSD. Results suggest that substance dependence and PTSD alone are associated with increased violence in couples, and most importantly, the presence of PTSD serves to further potentiate the perpetration of partner violence among cocaine-dependent individuals.  
Call Number Serial 226  
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