Philip A. Saigh

Loss as a determinant of PTSD in a cohort of adult survivors of the 1988 earthquake in Armenia: implications for policy

Objective: To study the relationship of post‐traumatic stress disorder (PTSD) to severity of the disaster experience.

The development of posttraumatic stress disorder following four different types of traumatization

The Childrens Posttraumatic Stress Disorder Inventory (CPTSDI) was used to identify 230 childhood posttraumatic stress disorder (PTSD) cases. Of these cases, 58 had been traumatized through direct experience, 128 through observation, 13 through verbal mediation, and 31 by combinations thereof. The 230 children and 35 controls completed the Revised Childrens Manifest Anxiety Scale (RCMAS) and the Childrens Depression Inventory (CDI). In addition, their conduct was rated on the Connors Teacher Rating Scale (CTRS) criteria. Each of the PTSD groups had significantly greater RCMAS, CDI, and CTRS scores than the non-clinical controls, but there were no differences between the four types of PTSD cases.

The Children's PTSD Inventory: development and reliability.

Information involving the development of the DSM-IV version of the Childrens PTSD Inventory is described. Independent ratings by highly experienced judges denote that the instrument encompassed the universe of definition that it was intended to measure (i.e., the DSM-IV criteria for PTSD). The instrument was administered to 82 traumatized and 22 nontraumatized youths at Bellevue Hospital. Moderate to high Cronbach alphas (.53–.89) were evident at the subtest level. An alpha of .95 was evident at the diagnostic level. In terms of inter-rater reliability, 98.1% agreement was evident at the diagnostic level. Inter-rater intraclass correlation coefficients (ICCs) ranged from .88 to .96 at the subtest level and .98 at the diagnostic level. Good to excellent kappas (.66–1.00) were reported for inter-rater reliability at the subtest level. An inter-rater reliability kappa of .96 was evident at the diagnostic level. In terms of test-retest reliability, 97.6% agreement was evident at the diagnostic level. Good to excellent test-retest kappas (.66–1.00) and ICCs (.66–.94) were observed. A test-retest kappa of .91 and an ICC of .88 was observed at the diagnostic level.

The validity of the DSM-III posttraumatic stress disorder classification as applied to children.

Tested three groups of children: The first group (n = 231) presented with posttraumatic stress disorder (PTSD), the second group (n = 32) presented with simple phobia (i.e., test phobia), and the third group (n = 35) was made up of nonclinical controls. The subjects marked the Revised Childrens Manifest Anxiety Scale (RCMAS), Childrens Depression Inventory (CDI) and their conduct was rated against the Conners Teacher Rating Scale (CTRS) criteria. A MANOVA evinced significant group and gender differences. No significant interaction effects were noted. Univariate F tests and Bonferroni posttests revealed that the PTSD cases evinced markedly higher RCMAS, CDI, and CTRS scores than their phobic and nonphobic peers. Analogously, the RCMAS and CDI scores of the phobia cases were appreciably greater than the control groups. On the other hand, the CTRS scores of the test phobia and control groups were not significantly different.

An analysis of the internalizing and externalizing behaviors of traumatized urban youth with and without PTSD

To test the differential validity of the posttraumatic stress disorder (PTSD) classification, 3 groups of youths (PTSD, traumatized PTSD negatives, and controls) were examined. Youth with major comorbid disorders were excluded. On the basis of an analysis of parent-derived Child Behavior Checklist (CBCL) ratings, significant variations in CBCL scores were associated with PTSD but not with exposure to exceptional stress in the absence of PTSD. The results also indicated that traumatic exposure without the development of PTSD was not associated with higher estimates of psychopathology.

In vitro flooding in the treatment of a 6-yr-old boy's posttraumatic stress disorder

Abstract In vitro flooding was used to treat a 6-yr-old boys war-related posttraumatic stress disorder. Traumatic scenes were identified and stimulus response imagery cues were presented according to a multiple-baseline regimen. The results revealed that the boys affective, behavioral and cognitive parameters were positively influenced by the treatment.

The history and prevalence of posttraumatic stress disorder with special reference to children and adolescents

Abstract This article reviews the history and prevalence of PTSD with special reference to children and adolescents. Historical examples as well as an account of the way that this form of psychiatric morbidity has been represented in various models of classification are presented. Information about the prevalence of PTSD among youth who were exposed to war-related stressors, criminal and/or deliberate victimization, and accidents or disasters is also provided. Recommendations for future epidemiological research involving traumatized youth are also made.

Psychological Services in Schools: A Summary of International Perspectives.

Abstract School psychological services in 26 countries are summarized. An understanding of school psychological services is enhanced by knowing the conditions that affect the acceptance of psychology and support for public education in the various countries. The article also discusses the nature of services, the points of delivery, and the number of school psychologists. Three major problems inhibiting the growth and development of school psychology are discussed along with possible solutions to these and other questions.

A Comparative Analysis of the Affective and Behavioral Symptomology of Traumatized and Nontraumatized Children

Abstract The selected sample (N=80) consisted of three groups of Lebanese children (x age=7.6 years). The first group (n=22) presented with chronic posttraumatic stress disorder (PTSD), the second (n=25) group presented with simple phobia (i.e., test phobia), and the third group (n=33) consisted of nonclinical controls. The subjects marked the Revised Childrens Manifest Anxiety Scale (RCMAS), and the Childrens Depression Inventory (CDI), and their conduct was rated according to the Conners Teacher Rating Scale (CTRS) criteria by their teachers. A MANOVA was performed on the group data and a significant main effect was observed. MANOVAs were also performed to test for Gender and Gender X Group effects and no significant variations were apparent. Univariate F tests and Scheffe comparisons revealed that the RCMAS, CDI, and CTRS scores of the PTSD cases significantly exceeded the scores of the test phobia and control groups. Although the CDI scores of the phobia group were significantly greater than the CDI scores of the controls, no significant differences were apparent between the RCMAS and CTRS scores of the two groups.

Structured clinical interviews and the inferential process

Abstract This article reviews the history of psychiatric nosology and the use of interview data as a vehicle for formulating clinical inferences. Attention is focused on the qualities of structured interviews as well as procedures for constructing these indices and methods for establishing their psychometric properties. Practical and theoretical limitations relating to formal systems of classification and structured clinical interviews are reviewed and future directions are considered.