Comparison of successful, unsuccessful, and relapsed Vietnam veterans treated for posttraumatic stress disorder

Article Abstract:

Very little information is available about the overall effectiveness of psychotherapy as a treatment for posttraumatic stress disorder (PTSD). PTSD often results from exposure to extreme trauma, and is characterized by flashbacks, nightmares, and other anxiety-related symptoms. Treatment of anxiety-related symptoms is difficult, so many treatments focus on the secondary symptoms, including depression and guilt. The present study examined the differences between sufferers of PTSD who benefited from psychotherapeutic interventions and those who did not. In all, 45 Vietnam combat veterans participated. Subjects provided information about their battle experiences, sociodemographic data were collected, and a psychiatric inventories were completed. The subjects underwent a variety of therapeutic interventions including group therapy, desensitization, problem-solving and stress management, social skills training, vocational counseling, and recreational activities. Following the six-week treatment, the psychiatric assessments were repeated; patients were also reassessed 18 months after treatment. The patients were categorized into three groups: improved, relapsed, or unchanged. At 18-month follow-up, maintenance of improvement was investigated. Those in the improved group who maintained their improved status had lower initial intakes of alcohol than those in other groups, and their participation in treatment was greater. The pretreatment alcohol intake of the relapsed and unchanged groups was approximately four times that of the improved group. In addition, the relapsed and unchanged groups had increased alcohol intake at the time of follow-up compared with pre-treatment consumption levels; the improved group had reduced their alcohol intake. The group that improved also had lower scores on measures of psychopathology. It is suggested that treatment outcome predictors can be derived from the data for each group. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Usage, Psychotherapy

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Changes in plasma norepinephrine to combat-related stimuli among Vietnam veterans with posttraumatic stress disorder

Article Abstract:

There have been several reports that Vietnam veterans suffering from posttraumatic stress disorder (PTSD) experience physiological reactions of the peripheral sympathetic nervous system when they are exposed to stimuli reminiscent of combat. These responses include increased heart rate, increased blood pressure, and changes in skin conductance. Researchers have also found that the levels of certain neurotransmitters, such as norepinephrine, increase in the urine upon such as exposures, providing further evidence of increased sympathetic nervous system activity. This study sought to compare levels of norepinephrine in the blood of combat veterans with and without diagnosed PTSD. There were 21 subjects in all, 15 of whom had been diagnosed with PTSD. Heart rate was monitored and blood was drawn while subjects were exposed to an auditory stimulus of combat sounds. Blood analysis revealed that norepinephrine levels increased by about 30 percent in subjects with PTSD, while no change was observed among the veterans who did not suffer from PTSD. There was no difference in the prestimulus norepinephrine levels between the two groups; this finding is, perhaps, more interesting than the changes noted following auditory stimulation. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Physiological aspects, Noradrenaline, Norepinephrine

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