Tore C. Stiles

Acute treatment of whiplash neck sprain injuries : A randomized trial of treatment during the first 14 days after a car accident

Study Design. A single‐blinded, randomized treatment study with a follow‐up period of 6 months. Objective. To study the long‐term consequences of whiplash neck sprain injuries in patients treated with two different regimes during the first 14 days after the car accident. Patients in the first group were encouraged to act as usual, i.e., continue to engage in their normal, pre‐injury activities; that group was compared with another group of patients who were given time off from work and who were immobilized using a soft neck collar. The end point of the comparison was the evaluation of subjective symptoms 6 months after the accident. Summary of Background Data. Few randomized treatment studies have been performed to evaluate the clinical outcome for patients with neck sprain. Method. Patients who participated in the study were recruited from the Emergency Clinic at the University Hospital in Trondheim, Norway. The study group included 201 patients (47% of the study group) with neck sprain that resulted from a car accident. Neck and shoulder movements and subjective symptoms, which were assessed using several different measurements, were assessed during the follow‐up period. Results. There was a significant reduction of symptoms from the time of intake to 24 weeks after the treatment period in both groups. There was a significantly better outcome for the act‐as‐usual group in terms of subjective symptoms, including pain localization, pain during daily activities, neck stiffness, memory, and concentration, and in terms of visual analog scale measurements of neck pain and headache. Conclusions. The outcome was better for patients who were encouraged to continue engaging in their normal, pre‐injury activities as usual than for patients who took sick leave from work and who were immobilized during the first 14 days after the neck sprain injury.

Comparative Effects of Short-Term Psychodynamic Psychotherapy: A Meta-Analysis.

In a review of 19 clinically relevant comparative outcome studies published 1978-1988, short-term psychodynamic psychotherapy (STPP) was evaluated as to overall effects, differential effects, and moderating effects vis-à-vis no-treatment controls (NT) and alternative psychotherapies (AP), respectively. Overall, STPP was superior to NT at posttreatment, inferior to AP at posttreatment, and even more so at 1-year follow-up. STPP was inferior to AP in treating depression and, in particular, to cognitive-behavioral therapy for major depression. STPP was equally successful with mixed neurotics. As research quality increased, STPP grew less superior to NT. Furthermore, STPP decreased its overall superiority over NT and increased its overall inferiority to AT on a series of clinically relevant variables. Improvement in research quality from 1978 to 1988 was noted. Evidence, although limited, supported the view that STPP approaches do seem to differ along a few major dimensions.

Memory functioning in patients with primary fibromyalgia and major depression and healthy controls

Memory functioning was assessed in 25 primary fibromyalgia (FM) patients by comparing them with 22 major depressed patients and 18 healthy controls. A broad range of short- and long-term memory tasks were included. Both major depressed and FM patients were significantly impaired on long-term memory tasks requiring effortful processing, compared to healthy controls. When the depressive status of the fibromyalgia patients was accounted for, only the subsample with a lifetime major depressive disorder showed memory impairment as compared with the healthy controls.

A New Scale for Adolescent Resilience: Grasping the Central Protective Resources Behind Healthy Development

Abstract In this study, the Resilience Scale for Adolescents (READJ was developed with confirmatory factor analysis and cross-validated factor model. The results show that the READ has sound psychometric qualities and that it measures all the central aspects of the psychological construct of resiliency.

Resilience as a Predictor of Depressive Symptoms: A Correlational Study with Young Adolescents:

This correlational study explored the Resilience Scale for Adolescents (READ)1 as a predictor for developing depressive symptoms controlling for known risk factors. A young adolescent sample (N = 387) completed the READ, the Short Mood and Feeling Questionnaire (SMFQ), Social Phobia Anxiety Index for Children (SPAI-C), and the occurrence of Stressful Life Events (SLE). In addition, a subsample of their parents (N = 240) completed a parental version of READ (READ-P). The results indicated that the READ assesses important protective factors that are associated with fewer depressive symptoms among young adolescents even when controlling for known risk factors. All five READ-factors were predictors of depressive symptoms, while the READ-P showed no predictive value. There were no significant interaction effects between READ and SLE. There were, however, significant main-effects supporting a compensatory model of protective factors. The findings suggest that the READ is a significant predictor of mental health and a useful tool for further research examining differences in stress tolerance among young adolescents.

The Relationship Between Psychological Buffers, Hopelessness, and Suicidal Ideation Identification of Protective Factors

In this study we examined the role of psychological buffers (life satisfaction, self-esteem, perception of family cohesion, and perception of social support) in the development of hopelessness and suicidal ideation. The participants were 314 university students, 71 males and 243 females, who were asked to complete a battery of instruments measuring the psychological buffers mentioned above. The results of a set of hierarchical multiple regression analyses suggested that life satisfaction and self-esteem are independent predictors of lower levels of hopelessness, while perception of social support seems to be the major predictor of lower levels of suicidal ideation independent of depression and hopelessness severity. Thus, hopelessness seems to be minimized by the level of life satisfaction and level of self-esteem exhibited by the individuals, while the key factor to the mitigation of suicidal ideas seems to be perception of social support.

The relationship between resilience and levels of anxiety, depression, and obsessive-compulsive symptoms in adolescents.

OBJECTIVE Mental health problems affect approximately 20% of adolescents. Traditionally, the principal focus has been on vulnerability and risk factors and less on protective factors. The study, therefore, explores the relation between frequent psychiatric symptoms and resilience factors among older adolescents. METHOD The Resilience Scale for Adolescents (READ) was completed by 307 Norwegian high school students (M = 16.4 years) along with the Depression Anxiety Stress Scales, and the Obsessive-Compulsive Inventory-Revised. RESULTS Higher resilience scores predicted lower scores on levels of depression, anxiety, stress and obsessive-compulsive symptoms after controlling for age and gender. CONCLUSION This study provides further evidence that it may be fruitful for clinicians and researchers to attend to resilience factors in relation to psychological symptoms among older adolescents.

MR imaging and radiography of patients with cervical hyperextension-flexion injuries after car accidents.

Fifty-two patients underwent MR imaging and conventional radiography of the neck within 4 days after a hyperextension-flexion injury. The patients also had follow-up investigations during the first 2 years. The images did not reveal any serious lesions in any of them. Based on the main MR and radiographical findings the patients were divided into 4 groups; no findings, posture abnormalities, spondylosis and disc pathology (from MR images) or reduced intervertebral space (from the radiographs). The outcomes of the different groups were compared with reference to neck stiffness, neck pain and headache during a 2-year follow-up period. The patient groups did not correspond completely when diagnosed from MR imaging and radiography. However, patients with pre-existing spondylosis had more symptoms when examined by both modalities. Based on the radiographs, the group with posture abnormalities had significant fewer symptoms than the other groups.

A repetition–prediction study of European parasuicide populations: a summary of the first report from Part II of the WHO/EURO Multicentre Study on Parasuicide in co‐operation with the EC Concerted Action on Attempted Suicide

One of the aims of the European Study on Parasuicide, which was initiated by the Regional Office for the European Region of the World Health Organization in the mid‐1980s, was to try to identify social and personal characteristics that are predictive of future suicidal behaviour. A follow‐up interview study (the Repetition‐Prediction Study) was designed, and to date 1145 first‐wave interviews have been conducted at nine research centres, representing seven European countries. The present paper provides an abridged version of the first report from the study. The design and the instrument used (The European Parasuicide Study Interview Schedules, EPSIS I and II) are described. Some basic characteristics of the samples from the various centres, such as sex, age, method of suicide attempt, and history of previous attempts, are presented and compared. The male/female sex ratio ranged from 0.41 to 0.85; the mean age range for men was 33–45 years and that for women was 29–45 years. At all of the centres, self‐poisoning was the most frequently employed method. On average, more than 50% of all respondents had attempted suicide at least once previously. The representativeness of the samples is discussed. There were differences between the centres in several respects, and also in some cases the representativeness of the different samples varied. Results obtained from analyses based on pooled data should therefore be treated with caution.

Personality profile among symptomatic and recovered patients with neck sprain injury, measured by MCMI-I acutely and 6 months after car accidents

The relationships between personality and psychiatric symptoms and long-lasting physical symptoms were assessed in 88 neck sprain patients injured in car accidents. The Millon Clinical Multiaxial Inventory (MCMI-I) was completed at time of occurrence (intake) and 6 months after the injury. The neck sprain patients were divided into three subgroups according to symptoms 6 months after the accident. In addition, the total neck sprain group was compared with three other subject groups. The results indicated that the three neck sprain subgroups did not differ on the MCMI-I neither at intake nor 6 months later. The total neck sprain patients group was significantly different from patients with major depression on all scales of the MCMI-I, but not significantly different compared to patients with localized musculoskeletal pain. Compared to a group of health personnel, there were only a few significant differences. The study does not support the view that premorbid personality traits can predict outcome for neck sprain patients.