Miles Y. Muraoka

Eye movement desensitization and reprocessing (EDMR) treatment for combat-related posttraumatic stress disorder

Despite the clinical and social impact of posttraumatic stress disorder (PTSD), there are few controlled studies investigating its treatment. In this investigation, the effectiveness of two psychotherapeutic interventions for PTSD were compared using a randomized controlled outcome group design. Thirty five combat veterans diagnosed with combat-related PTSD were treated with either (a) 12 sessions of eye movement desensitization and reprocessing, EMDR (n = 10), (b) 12 sessions of biofeedback-assisted relaxation (n = 13), or (c) routine clinical care, serving as a control (n = 12). Compared with the other conditions, significant treatment effects in the EMDR condition were obtained at posttreatment on a number of self-report, psychometric, and standardized interview measures. Relative to the other treatment group, these effects were generally maintained at 3-month follow-up. Psychophysiological measures reflected an apparent habituation effect from pretreatment to posttreatment but were not differentially affected by treatment condition.

Anger, impulsivity, and anger control in combat-related posttraumatic stress disorder.

Empirical evidence of a relationship between combat-related PTSD and increased anger is lacking. In this study, 24 veterans of the Vietnam War with posttraumatic stress disorder (PTSD) scored significantly higher on an Anger factor comprising multiple measures of anger than did comparison groups of 23 well-adjusted Vietnam combat veterans and 12 noncombat Vietnam-era veterans with psychiatric diagnoses. In contrast, the 3 groups did not differ significantly on orthogonal factors, one of which comprised cognitive impulsivity measures and the other of which reflected motor impulsivity. Changes in heart rate in response to provocation loaded positively on the Anger factor and negatively on the 2 Impulsivity factors. Concurrent depression and trait anxiety did not have an effect on level of anger in individuals with PTSD. These empirical findings support and extend the clinical evidence regarding PTSD and anger.

Specific anti-aggressive effects of fluprazine hydrochloride.

Two experiments were performed with adult male rats of the Long-Evans strain to determine the specificity of fluprizine hydrochloride in decreasing offensive attack. Both 4 and 8 mg/kg doses (IP) significantly reduced offense by resident males selected for high or medium levels of aggression when tested with intruders 30 min postinjection. No reliable differences in other social or nonsocial behaviors were observed. Drug treatment resulted in an overall reduction in offensive behavior of more than 70% in both groups. Actual biting and wounding of intruders by treated subjects was decreased by as much as 98%. A second experiment assessed the drugs influence on defense in the “shockelicited aggression” paradigm. While duration of boxing to multiple intermittent shocks was significantly suppressed by drug administration (4 and 8 mg/kg), the same doses had no effect on postshock duration of boxing, or sonic and ultrasonic vocalizations following several high intensity (1.5 mA) shocks. These findings are consistent with other research on this and related phenylpiperazine compounds, indicating that its action is specific in reducing offense with minimal influence on social or defensive behavior.

Copulation increases offensive attack in male rats

Twenty-four adult male rats with previous sexual experience were tested for aggression against intruders after one of four treatments (n = 6 per treatment): exposure to inaccessible estrous females; exposure to anestrous females; no female exposure, or copulation to ejaculation. Although both exposure to inaccessible estrous females and copulation significantly decreased latency to attack only copulation produced significant elevation of intensity and duration of attack. Results are discussed in reference to the role of aggression in maintaining priority of access to females, and as a means of assuring paternity of offspring by dominant males.

Head injury and combat-related posttraumatic stress disorder.

Given the association of injury and posttraumatic stress disorder (PTSD), we examined whether head injury might be associated with increased frequency and severity of PTSD. Using a mail survey, we queried 143 male combat veterans with and without PTSD, who had previously participated in PTSD research in our laboratory, about their history of head injury. Respondents with a PTSD diagnosis were significantly more likely to report a history of head injury than those without. Patients with a history of head injury also reported more severe symptoms of PTSD compared with PTSD patients without head injury. The association of head injury and PTSD was not due to greater combat exposure in the head-injured group. Head injury is associated with a greater likelihood of developing combat-related PTSD and with more severe PTSD symptoms. This retrospective study did not address mechanisms that could account for this finding. The results indicate head injury should be systematically assessed by both nonpsychiatric and psychiatric physicians concerned with the psychological sequelae of exposure to victimizing experiences.

Compelled attention: the effects of viewing trauma-related stimuli on concurrent task performance in posttraumatic stress disorder.

We examined the ability of Vietnam veterans with PTSD to focus attention on a primary digit detection task while concurrently viewing neutral or Vietnam-related picture and word distractors. Controlling for combat exposure, military service, and psychopathology, veterans with PTSD took longer to detect the target when Vietnam-related pictures were distractors. There were no reaction time differences when word stimuli were distractors. The latency effect was specific to trials with trauma-related pictures and did not spread to neutral trials interleaved within a mixed block of trauma and neutral pictures. Individuals with PTSD recalled proportionally more Vietnam-related words than other groups, implying differential attention to Vietnam-related words. Attending to trauma-related pictures interferes with performance of a concurrent task by individuals with PTSD.

Impact of assertive and accusatory communication of distress and anger: A verbal component analysis

Forty undergraduate women were asked to imagine discussing an important problem in their relationship with a personally close partner and to rate likely emotional and behavioral reactions to four kinds of statements: 1) assertive communication of distress, 2) assertive communication of anger, 3) accusatory communication of distress, and 4) accusatory communication of anger. Accusatory “you” statements were rated as more aversive and evoked more negative emotional and behavioral response inclinations than did assertive “I” messages. Statements including “anger” words evoked more negative emotional and behavioral response inclinations than statements including “distress” words. Findings were related to research on cue-controlled aggression and the work of Staats, which predicts ways that verbal labels (language) exert control over emotions and behavior.

Health attitudes and behaviors: comparison of Japanese and Americans of Japanese and European Ancestry.

Adults living in Japan (N = 357) and the US (N = 223) completed semi-structured interviews assessing health-related attitudes and practices. The US respondents were of Japanese (N = 106) and European (N = 117) ancestry. Results indicated considerable similarity between the two US groups and significant differences between the Japanese and American respondents. The Japanese respondents placed less priority on health, had less belief in the efficacy of health screening tests, lower levels of internal health locus of control (HLOC), and higher levels of chance and powerful-others HLOC. While Japanese and Americans had similar overall levels of healthy behaviors, the Japanese were less likely to have obtained health screening tests (especially gynecologic exams). The findings have implications for adapting health promotion programs in the context of Japanese and American cultures.

Cultural Aspects of Cancer Prevention and Control

Publisher Summary This chapter discusses cultural aspects of cancer prevention and control. Cancer is one of the most serious health threats in the United States. Currently, cancer has become increasingly prevalent and it is the second leading cause of death. This chapter focuses on cultures impact on individuals during their cancer experience. In this chapter, the concept of culture includes the central areas thought to define a cultural group, encompassing shared common beliefs, ideas, experiences, knowledge, attitudes, and behaviors, as all of these elements pertain to variations in cancer experiences. The chapter also discusses patterns of cancer in different ethnic groups; ethnic and cultural differences in knowledge, attitudes, and behaviors about cancer; cancer prevention, screening, and early detection; reactions to a diagnosis of cancer; and living with cancer. It emphasizes on the largest ethnic subgroups in the United States (African Americans, Native Americans, Asians and Pacific Islanders, and Hispanics) and comparisons are made with the majority population (White). The chapter concludes that 1500 Americans die of cancer each day stands as a stark reminder of the need for research, as well as its tremendous potential to make a positive difference.

The Honolulu posttraumatic stress disorder stimulus set

We present word and picture stimuli constituting a validated stimulus set appropriate for cognitive investigations of posttraumatic stress disorder (PTSD). Combat related and neutral words and pictures were rated by Vietnam veterans with PTSD and by three comparison groups along four dimensions: unpleasantness, Vietnam relevance, stressfulness, and memorability. There were distinctive patterns of responses by the PTSD group which efficiently discriminated the individuals in this group from those in the control groups. These stimuli have the potential to be developed as a diagnostic instrument.