Stephen C. Messer

Association of Posttraumatic Stress Disorder With Somatic Symptoms, Health Care Visits, and Absenteeism Among Iraq War Veterans

OBJECTIVE Studies of soldiers from prior wars conducted many years after combat have shown associations between combat-related posttraumatic stress disorder (PTSD) and physical health problems. The current Iraq war has posed a considerable PTSD risk, but the association with physical health has not been well studied. METHOD The authors studied 2,863 soldiers using standardized self-administered screening instruments 1 year after their return from combat duty in Iraq. RESULTS Among all participants, 16.6% met screening criteria for PTSD. PTSD was significantly associated with lower ratings of general health, more sick call visits, more missed workdays, more physical symptoms, and high somatic symptom severity. These results remained significant after control for being wounded or injured. CONCLUSIONS The high prevalence of PTSD and its strong association with physical health problems among Iraq war veterans have important implications for delivery of medical services. The medical burden of PTSD includes physical health problems; combat veterans with serious somatic concerns should be evaluated for PTSD.

A multicomponent behavioral treatment for social phobia: social effectiveness therapy.

The development of a new, comprehensive and multicomponent treatment for social phobia is described. Initial results of a pilot study with the new treatment also are reported. The treatment was found to be effective with severe (generalized) social phobics, most of whom had co-occurring Axis I and/or II conditions. In addition to significant change on a host of outcome variables, a normative-based endstate functioning index was used to determine treatment efficacy. The results are discussed with respect to the implementation of the treatment and in terms of the need for a comprehensive approach to treating social phobia.

Social Support Networks among Families of Children with Craniofacial Anomalies

Investigated the social support available to families of children born with craniofacial anomalies and the perceived degree of satisfaction derived from these relationships. Thirty-six children (1 month to 5 years old) born with craniofacial deformities (FD) were matched by age and sex to 36 children with no significant physical or behavioral problems. The Social Support Questionnaire-Revised, the Revised Denver Developmental Screening Test, and a semistructured interview were administered. Results indicated that parents of FD children reported less available social support and were significantly less satisfied with their support. Parents of children who had more severe physical impairments and were rated as less attractive reported having less available and less satisfying social support. In particular, the social competence of the child was the most important predictor of parental social support. This result is interesting as the parents of FD children appeared to underreport the presence of behavioral-psychological problems in their children.

Myofunctional and dentofacial relationships in second grade children.

One hundred and thirty-three second graders in rural public school were assessed on a number of dental, skeletal, and oral muscle function measures. Correlational analyses were conducted in order to determine whether specific myofunctional variables were associated with dentofacial development. Significant relationships were observed between open mouth posture and a narrow maxillary arch and long facial height. Labial and lingual rest and swallow patterns were also related to poor coordination of lip and tongue movements.

Latchkey children: a pilot study investigating behavior and academic achievement

The effects of latchkey status on the normal development of children are poorly addressed in the literature. After formulating an operational definition, the prevalence, academic performance, and behavior characteristics of latchkey children were investigated in a rural area. Few differences were found to distinguish latchkey from nonlatchkey children.

Hypoglycemia and psychopathology: A methodological review

Abstract In this article, the authors review the available medical and psychological literature relating hypoglycemia and psychopathology. Issues surrounding the proper assessment of hypoglycemia are discussed. The research suggests that many persons carrying the popular diagnosis of hypoglycemia do not meet stringent diagnostic criteria. However, these inaccurately diagnosed individuals often exhibit psychiatric symptomatology, particularly somatization and depression. Also, many persons exhibiting low blood glucose levels do not report symptoms. The evidence supports a relationship between low and/or rapidly declining blood glucose levels and transient cognitive, affective, and somatic symptoms. The limited evidence does not support a relationship between hypoglycemia and panic disorder, major depression, aggression, or somatizing personality features. Implications for the clinician are discussed.

Former Latchkey Children: Personality and Academic Correlates

The purpose of this study was to examine the prevalence and correlates (demographic, personality, and academic) of former latchkey status (children unsupervised by an adult after school during their elementary or middle school years) in a college student sample (N = 188). A clear operational definition of latchkey status was provided. Students were surveyed and administered a personality questionnaire, and their academic aptitude test scores were verified through university records. Twenty-five percent of the male and 14% of the female participants were identified as former latchkey children, resulting in an 18% latchkey prevalence rate. The mean age of onset of latchkey status was 8.7 years for the male and 10.0 years for the female subjects. Having been a latchkey child was positively associated with being male and Caucasian, coming from a one-parent family, and having had a mother who worked outside the home. Multivariate analyses of the personality and academic measures revealed no significant between-group differences.

Clinical Behavior Therapy with Children

The extent of childhood behavioral and psychological problems in need of services is enormous. At least 12% (about 7.5 million) of children under age 18 suffer from one or more psychological disorders (Gould, Wunsch-Hitzig, & Dohrenwend, 1981). Of these 7.5 million, nearly half are considered severely impaired by their condition (Office of Technology Assessment, 1986). Evidence also suggests that some of these childhood problems persist into late adolescence and possibly adulthood (e. g., Kazdin, 1989; Kovacs et al., 1984). Moreover the economic costs of the direct treatment of the behavior problems of children (under age 14) are estimated at a conservative

Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care

1.5 billion (Rice, Kelman, & Dunmeyer, in progress, cited in Institute of Medicine, 1989). Clearly, child behavior problems represent a significant social problem in search of potential solutions.