Editor-in-Chief: John A. Talbott, MD
ISSN: 0022-3018
Online ISSN: 1539-736X
Frequency: 12 issues / year
Ranking: Psychiatry 51/120
Impact Factor: 1.688

ORIGINAL ARTICLES

Pharmacotherapies for Posttraumatic Stress Disorder: A Meta-Analysis
Wenjie Gu, MS, Chao Wang, MS, Xiaoyan Zhang, PhD, Zhen Wang, PhD, Zuofeng Li, PhD

In this systematic meta-analysis, the dropout and response rates of various pharmacotherapy and placebo treatments reported by randomized clinical trials were compared. A total of 34 reports that described the acceptability and efficacy of PTSD pharmacotherapies were retrieved and analyzed. Of them, 30 trials examined the dropout rate as an index of acceptability and revealed the superiority of the PTSD pharmacotherapy to placebos. The response rate was determined in 20 trials as an index of efficacy, showing that the PTSD pharmacotherapies were superior to the placebos.

Improving Treatment Engagement for Returning Operation Enduring Freedom and Operation Iraqi Freedom Veterans With Posttraumatic Stress Disorder, Depression, and Suicidal Ideation
Autumn M. Gallegos, PhD, Nicholas A. Streltzov, BA, Tracy Stecker, PhD

This report examined the effectiveness of a brief phone-based cognitive-behavioral intervention on treatment seeking among suicidal and nonsuicidal Operation Enduring Freedom and Operation Iraqi Freedom veterans who screened positive for PTSD. We found that suicidal participants, regardless of condition, were twice as likely to attend treatment as nonsuicidal participants. Participants assigned to the control condition who did not indicate suicidality at baseline were less likely to attend treatment at both the 1- and 6-month follow-up interviews. Qualitative findings of the suicidal participants indicated PTSD and depressive symptoms, low social support, and infrequent positive coping mechanisms. Our finding indicates the effectiveness of an intervention to motivate veterans with PTSD to initiate and remain in treatment.

Relationships Between Latent Factors of Posttraumatic Stress Disorder and Posttraumatic Growth
Mojisola F. Tiamiyu, PhD, Yiqun Gan, PhD, Dani Kwiatkowski, BA, Kayla C. Foreman, BA, Aaron Dietrich, BA, Kirstin Elliott, BA, Jon D. Elhai, PhD

In the present study, we examined PTSD symptoms and posttraumatic growth (PTG) responses among a nonclinical sample of 202 participants. Canonical correlation analysis evidenced a strong relationship between PTSD and PTG subscales. Path analysis results demonstrated that PTSD's re-experiencing subscale was related to PTG's appreciation for life subscale. Posttraumatic stress disorder's avoidance was related to PTG's personal strength subscale. We also tested curvilinear relationships between PTSD and PTG subscales. Results and implications are discussed in the context of the constructs of PTSD and PTG.

Defense Mechanisms in Adolescence as Predictors of Adult Personality Disorders
Thea Strandholm, Lic.A. (Psych.), Olli Kiviruusu, MSoc.Sc, Linnea Karlsson, MD, PhD, Jouko Miettunen, PhD, Mauri Marttunen, MD, PhD

Our study examines whether defense styles and separate defenses in depressed adolescent outpatients predict adult personality disorders (PDs). We obtained data from consecutive adolescent outpatients who participated in the Adolescent Depression Study at baseline and at the 8-year follow-up (N = 140). Defense styles were divided into mature, neurotic, image-distorting, and immature and a secondary set of analyses were made with separate defenses as predictors of a PD diagnosis. Neurotic, image-distorting, and immature defense styles in adolescence were associated with adulthood PDs. Neurotic defense style associated with cluster B diagnosis and image-distorting defense style associated with cluster A diagnosis. Separate defenses of displacement, isolation, and reaction formation were independent predictors of adult PD diagnosis even after adjusting for PD diagnosis in adolescence.

Personality Disorder in Adult Attention-Deficit/Hyperactivity Disorder: Attrition and Change During Long-term Treatment
Thomas E. Gift, MD, Frederick W. Reimherr, MD, Barrie K. Marchant, MS, Tammy A. Steans, MS, Paul H. Wender, MD

To assess the impact of personality disorders (PDs) or personality traits on retention rates in ADHD trials and whether treating ADHD affects the expression of PD, data were analyzed from 2 methylphenidate trials. Major findings were that subjects with cluster A, cluster B, passive-aggressive, or more than 1 PD showed more attrition. Subjects dropping out also had more schizoid and narcissistic traits. Attention-deficit/hyperactivity disorder symptoms (p < 0.001) and all personality traits (range, p = 0.03 to p = 0.001) improved, but there was almost no correlation between changes on these 2 measures. Conversely, of 11 Wisconsin Personality Disorders Inventory IV items that improved most, 8 resembled ADHD or oppositional defiant disorder symptoms.

Adult Attention Deficit Hyperactivity Disorder Symptoms, Perceived Stress, and Well-Being: The Role of Early Maladaptive Schemata
Mónika Miklósi, MA, Orsolya Máté, MA, Klára Somogyi, MA, Marianna Szabó, PhD

In a sample of 204 nonclinical adults, we conducted a serial multiple mediator analysis, which supported the proposed model. More severe ADHD symptoms were associated with higher levels of perceived stress both directly and indirectly through stronger maladaptive schemata, which, in turn, were related to lower levels of emotional well-being. Results suggest that identifying and modifying maladaptive schemata may be an important addition to psychotherapy for adult ADHD patients.

The Effects of Stigma on Recovery Attitudes in People With Anorexia Nervosa in Intensive Treatment
Gina Dimitropoulos, MSW, PhD, Leslie McCallum, MA, PhD, Marlena Colasanto, BAH, MA, Victoria E. Freeman, BAH, MSW, Tahany Gadalla, MSc, PhD

Using a cross-sectional design, 36 female participants with anorexia nervosa (AN) completed questionnaires during the first week of intensive inpatient treatment. Better attitude towards recovery was positively correlated with higher self-esteem and self-efficacy and negatively correlated with greater internalized stigma and perceptions of others devaluing families of individuals with AN. Together, these factors accounted for 63% of the variance in recovery attitudes. Findings demonstrate the adverse effects perceived stigma towards families, self-stigma, and self-esteem have on recovery attitudes in individuals with AN. Clinical interventions are needed to challenge internalized stigma and bolster self-esteem.

Anxiety Sensitivity Among First-Time Fathers Moderates the Relationship Between Exposure to Stress During Birth and Posttraumatic Stress Symptoms
Gadi Zerach, PhD, Ortal Magal, MA

This longitudinal study examined PTSD and anxiety symptoms among men attending the birth of their first offspring. Furthermore, we examined the moderating role of anxiety sensitivity (AS) and intolerance of uncertainty in the association between exposure to stress during birth and PTSD and anxiety symptoms. Participants were Israeli men (n = 171) who were assessed with self-report questionnaires during the third trimester of pregnancy (T1) and approximately a month following birth (T2). Results show that the rates of postnatal PTSD and anxiety symptoms were relatively low. Subjective exposure to stress during birth and AS predicted PTSD in T2, above and beyond other negative life events and PTSD in T1. AS moderated the relations between subjective exposure to stress during birth and PTSD symptoms. Pregnancy and childbirth professionals may benefit from the insight that men with high levels of AS might experience childbirth as a highly stressful situation with possible posttraumatic stress symptoms.

Emotional Freedom Techniques for Anxiety: A Systematic Review With Meta-analysis
Morgan Clond, PhD

Randomized controlled trials were assessed for quality using the criteria developed by the American Psychological Association's Division 12 Task Force on Empirically Validated Treatments. As of December 2015, 14 studies (n = 658) met inclusion criteria. The pre-post effect size for the Emotional Freedom Technique (EFT) treatment group was 1.23, whereas the effect size for combined controls was 0.41. Emotional freedom technique treatment demonstrated a significant decrease in anxiety scores, even when accounting for the effect size of control treatment. However, there were too few data available comparing EFT to standard-of-care treatments such as cognitive behavioral therapy, and further research is needed.

Agoraphobia Related to Unassertiveness in Panic Disorder
Michelle Nigri Levitan, PhD, Pedro Simoes, PhD, Aline G. Sardinha, PhD, Antonio E. Nardi, PhD

Forty-six symptomatic patients with panic disorder (PD) and 46 college students responded to assessment scales regarding assertiveness and clinical data. Seventy-five percent of the patients had a secondary diagnosis of agoraphobia. We found that the PD group was characterized as nonassertive and slightly less assertive than control subjects. Furthermore, the deficit in the level of assertiveness correlated with the severity of the PD. The diagnosis of agoraphobia was correlated with unassertiveness (p < 0.05). Agoraphobia predisposes individuals to dependency and insecurity about their ability to overcome anxiogenic situations. These data demonstrate the importance of managing assertiveness in patients with PD accompanied by agoraphobia.

 

BRIEF REPORT

Mental Illness Stigma Intervention in African Americans: Examining Two Delivery Methods
Ebony S. Vinson, PhD, Tahirah Abdullah, PhD, Tamara L. Brown, PhD

This study sought to examine the effects of 2 intervention delivery methods in reducing reported stigma. African Americans (n = 158) were nonrandomly assigned to an inperson contact or video condition and administered a survey immediately before, after, and 2 weeks following the stigma intervention. The in vivo contact condition consisted of an African American man discussing his experiences with mental illness and psychotherapy. The session was recorded, and the recording was used for the video condition. There were no significant effects based on delivery method; however, there was a significant effect for time on stigma and helpseeking attitude measures. Further research is needed to determine the overall effectiveness of the intervention.

 

BOOK REVIEWS

Sexualities: Contemporary Analytic Perspectives. Alessandra Lemma, Paul E. Lynch, Eds (2015) New York, NY: Routledge. 244 pp.
Reviewed by Dr. Michelle T. Joy.

Minority and Cross-Cultural Aspects of Neuropsychological Assessment: Enduring and Emerging Trends, Second Edition. F. Richard Ferraro, Ed. (2015) London, England and New York, NY: Taylor & Francis. 538 pp.
Reviewed by Dr. Edmond Pi.

Thinking in Numbers: On Life, Love, Meaning, and Math. Daniel Tammet (2012) New York, NY: Little, Brown and Company. 288 pp.
Reviewed by Dr. Dominic Cicchetti.

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Dr. Talbott and Lippincott Williams & Wilkins
wish to thank the
University of Maryland School of Medicine
Department of Psychiatry
for their support of
The Journal of Nervous and Mental Disease 

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