Robert J. Gerardi

Psychological morbidity associated with motor vehicle accidents

Fifty victims of recent motor vehicle accidents (MVAs), who had sought medical attention after their accidents, were assessed for possible psychological morbidity as a result of the accident. Forty age, gender-matched controls were also assessed with the same instruments. Forty-six percent of the MVA victims met the criteria for current post-traumatic stress disorders (PTSD) as a result of the accident while 20% showed a sub-syndromal version (the reexperiencing symptom cluster plus either the avoidance/numbing cluster or the over-arousal cluster) of PTSD. Although all MVA victims showed some form of driving reluctance, only 1 S met the criteria for driving phobia. Those MVA victims who met the criteria for PTSD or sub-syndromal PTSD were significantly more likely to have experienced previous trauma, other than a serious MVA, and were more likely (P = 0.008) to have previously met the criteria for PTSD as a result of that trauma. Forty-eight percent of MVA victims who met the criteria for current PTSD also met the criteria for current major depression. Significantly more current MVA-PTSDs had suffered previous major depressive episodes.

A psychophysiological study of Post Traumatic Stress Disorder in Vietnam veterans

Comparisons were made between a group of male Vietnam veterans suffering from Post-Traumatic Stress Disorder (PTSD) (n=11) and an age and sex matched group of nonveteran controls (n=11) on their psychophysiological responding (heart rate (HR), blood pressure (BP), forehead EMG, skin resistance level, and peripheral temperature) to mental arithmetic and an audiotape of combat sounds played at gradually increasing volume levels. The two groups responded differently to the combat sounds in terms of HR, systolic BP, and forehead EMG. The HR response could correctly classify 95.5% of the combined sample. Implications of these findings for the basis of PTSD are discussed.

Ability of Vietnam Veterans to dissimulate a pscchophysiological assessment for post-traumatic stress disorder

Psychophysiological assessment procedures have begun to play an important adjunctive role in the diagnosis of post-traumatic stress disorder (PTSD). The present study sought to examine the ability of Vietnam veterans with and without PTSD to fake the psychophysiological assessment. The study replicated previous findings in demonstrating that PTSD veterans respond to combat stimuli with significantly greater increases in psychophysiology than veterans without the disorder. When subjects were instructed to alter their psychophysiological responses to the combat stimuli, subjects with PTSD were unable to do so. However, subjects without PTSD were able to increase certain psychophysiological responses to appear more like the PTSD veterans. Despite the ability of some non-PTSD veterans to control these responses, PTSD and non-PTSD subjects were still discriminated at a high rate. This study also found relatively good short-term test-retest reliability for heart rate and skin conductance in subjects given no instructions to fake.

The psychophysiology of motor vehicle accident related posttraumatic stress disorder

Fifty victims of recent motor vehicle accidents (MVAs) and 40 non-MVA controls participated in a psychophysiological assessment in which heart rate (HR), systolic and diastolic blood pressures, forehead EMG and electrodermal activity were measured during mental arithmetic, idiosyncratic audiotaped descriptions of the victims own MVA, and a standard videotape of MVAs. The MVA victims were subdivided into 23 with full posttraumatic stress disorder (PTSD), 10 with sub-syndromal PTSD, and 17 without PTSD. HR response to the idiosyncratic audiotape reliably ( p

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: I. Short-term and long-term outcome *

Eighty-seven patients whose blood pressures (BPs) were controlled on a regimen of at least two antihypertensive medications were randomly assigned to either thermal biofeedback or progressive relaxation to see if patients could be withdrawn from the second-stage antihypertensive medication while BPs remained under control. Results on this clinical end point significantly favored thermal biofeedback both in the short-term (1-month posttreatment) and in the long-term (1-year posttreatment) with 35% of those patients who were initially assigned to thermal biofeedback and completed treatment remaining off the second-stage medication for over 12 months.

The utility of the Anxiety Disorders Interview Schedule (ADIS) in the diagnosis of Post-Traumatic Stress Disorder (PTSD) in Vietnam veterans

Abstract The ability of a novice interviewer utilizing the ADIS to make diagnoses of PTSD in Vietnam veterans with combat experience was tested in a sample of 43 cases. Agreement between ADIS diagnosis and a criterion diagnosis was found in 93.0% of cases (κ = 0.857), suggesting that the diagnostic category can be reliably identified and demonstrating the utility of the ADIS for ascertaining this diagnosis.

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: II. Effects on cardiovascular reactivity.

In the course of conducting a controlled comparison of progressive muscle relaxation and thermal biofeedback as possible substitutes for second-stage (sympatholytic) antihypertensive medications, we measured reactivity (heart rate, systolic blood pressure, and diastolic blood pressure) to three different stressors (mental arithmetic, cold pressor, and negative mental imagery) before and after treatment and drug withdrawal. Neither treatment was consistently effective in reducing reactivity across a variety of stressors. Relaxation led to more reductions in some aspect of reactivity than did biofeedback. The modest level of reductions in reactivity were seen more for mental arithmetic and systolic blood pressure.

Psychological dimensions of ‘office hypertension’

Abstract The present study examined the psychological and psychophysiological dimensions of ‘office hypertension’. Forty hypertensive Ss were classified as Office Responders (n = 13), Nonresponders (n = 17) or Home Responders (n = 10) based on the observed discrepancies between home and office measures of BP. Psychological tests consisted of the SCL-90, Beck Depression Inventory, Spielberger Self-Analysis Questionnaire, State-Trait Anxiety Inventory, Buss-Durkee Hostility Inventory, Social Readjustment Rating Scale and Jenkins Activity Survey. Psychophysiological assessment consisted of constant monitoring and recording of BP during Baseline, Mental Arithmetic, Cold Pressor and Stressful Imagery conditions. Contrary to expectations, on psychological tests Office Responders did not differ from Nonresponders on measures of anxiety. However, Nonresponders were significantly higher than Office Responders on measures of anger and hostility, characteristics ascribed to the hypertensive personality. On psychophysiological assessment, Office Responders showed significantly greater increases in systolic BP than Nonresponders during a Mental Arithmetic task; however, the groups did not differ during a Cold-pressor task.

Preliminary results from a controlled evaluation of thermal biofeedback as a treatment for essential hypertension

In a controlled trial, thermal biofeedback (n=20) and abbreviated progressive relaxation (n=22) were compared in the treatment of mild to moderate hypertensive patients whose blood pressures (BP) were initially controlled on two medications. For the clinical end point of maintaining control of BP on a single drug after treatment, biofeedback was superior to relaxation training (at 3 months, 47% success for biofeedback versus 23% for relaxation). This same result tended to be true for patient-measured home BPs. BPs from laboratory psychophysiological testing showed no consistent advantage for one treatment over the other.

A controlled comparison of thermal biofeedback and relaxation training in the treatment of essential hypertension: IV: Prediction of short-term clinical outcome*

Seventy-seven hypertensive patients, whose blood pressure [BP] on entry into the study was controlled on a regimen of two drugs (diuretic plus sympatholytic), participated in either progressive muscle relaxation or thermal biofeedback prior to attempting to discontinue the second stage drug. Although a discriminant function, containing 9 predictors, correctly classified 78% of short-term (6 weeks) successes and failures, no variables from standard psychological tests, several biochemical assays (plasma nor-epinephrine), or baseline home BPs entered the final equation. Overall, the value of prediction from the variables studied seems weak.