The Experts below are selected from a list of 306 Experts worldwide ranked by ideXlab platform
Brett T Litz - One of the best experts on this subject based on the ideXlab platform.
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An epidemiological evaluation of trauma types in a cohort of deployed service members.
Psychological Trauma: Theory Research Practice and Policy, 2019Co-Authors: Candice Presseau, Brett T Litz, Katherine A Dondanville, Nora K. Kline, Nourhan M. Elsayed, Douglas Maurer, Kevin Kelly, Jim Mintz, Stacey Young-mccaughan, Alan L. PetersonAbstract:OBJECTIVE: Using Stein et al.'s (2012) categorization scheme for typing Criterion A events (i.e., Life Threat to Self, Life Threat to Other, Aftermath of Violence, Traumatic Loss, Moral Injury by Self, and Moral Injury by Other) and extending Litz et al.'s (2018) prior work, we investigated the prevalence of trauma types, prevalence of posttraumatic stress disorder within each trauma type, and associations between trauma types and behavioral and mental health outcomes for an epidemiological sample of service members. METHOD: Criterion A events coded by independent raters (kappas = .85-1.00) were used to determine prevalence rates and to conduct two path models examining all trauma types in relation to mental health outcomes. RESULTS: Consistent with prior research, we found events containing Life Threat to Self (51.1%) and Life Threat to Other (30.8%) to be most prevalent, and a majority of events (62.9%) were coded with one trauma type. Although least prevalent, Aftermath of Violence (12.0%) and Moral Injury by Self (4.8%) were most frequently and strongly associated with worse mental health outcomes. Path models predicted a very small amount of variance in continuous outcomes, thus limiting the interpretation of findings. CONCLUSION: More epidemiological research is needed to understand the role of trauma type in relation to mental health among nontreatment-seeking service members. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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distinct trauma types in military service members seeking treatment for posttraumatic stress disorder
Journal of Traumatic Stress, 2018Co-Authors: Brett T Litz, Ateka A Contractor, Charla Rhodes, Katherine A Dondanville, Alexander H Jordan, Patricia A Resick, Stacey YoungmccaughanAbstract:: We examined the frequency of trauma types reported in a cohort of service members seeking treatment for posttraumatic stress disorder (PTSD) and compared symptom profiles between types. In this observational study, 999 service members (9.2% women; Mage = 32.91 years; 55.6% White) were evaluated using a standardized assessment procedure to determine eligibility for clinical trials. Participants were evaluated for DSM-IV-TR-defined PTSD using the PTSD Symptom Scale-Interview; all participants reported a Criterion A event. Independent evaluators rated descriptions of Criterion A events as belonging to trauma types at a high degree of reliability, κ = 0.80. Aggregated non-Life-Threat primary trauma types were more frequently endorsed than aggregated Life-Threat types, 95% CI [17.10%, 29.20%]. Participants who endorsed moral injury-self traumas had a higher level of reexperiencing (d = 0.39), guilt (hindsight bias, d = 1.06; wrongdoing, d = 0.93), and self-blame (d = 0.58) symptoms, relative to those who reported Life Threat-self. Participants who experienced traumatic loss had greater reexperiencing (d = 0.39), avoidance (d = 0.22), guilt (responsibility, d = 0.39), and greater peri- and posttraumatic sadness (d = 0.84 and d = 0.70, respectively) symptoms, relative to those who endorsed Life Threat-self. Relative to Life Threat-self, moral injury-others was associated with greater peri- (d = 0.36) and posttraumatic (d = 0.33) betrayal/humiliation symptoms, and endorsement of aftermath of violence was associated with greater peri- (d = 0.84) and posttraumatic sadness (d = 0.57) symptoms. War zone traumas were heterogeneous, and non-Life-Threat traumas were associated with distinct symptoms and problems.
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A Scheme for Categorizing Traumatic Military Events
Behavior Modification, 2012Co-Authors: Nathan R. Stein, Patricia A Resick, Mary Alice Mills, Kimberly Arditte, Crystal Mendoza, Adam M. Borah, Brett T LitzAbstract:A common assumption among clinicians and researchers is that war trauma primarily involves fear-based reactions to Life-Threatening situations. However, the authors believe that there are multiple types of trauma in the military context, each with unique perievent and postevent response patterns. To test this hypothesis, they reviewed structured clinical interviews of 122 active duty service members and assigned the reported index (principal, most currently distressing) events to one or more of the following categories: Life Threat to Self, Life Threat to Others, Aftermath of Violence, Traumatic Loss, Moral Injury by Self, and Moral Injury by Others. They found high interrater reliability for the coding scheme and support for the construct validity of the categorizations. In addition, they discovered that certain categories were related to psychiatric symptoms (e.g., reexperiencing of the traumatic event, guilt, anger) and negative thoughts about the world. Their study provides tentative support for use o...
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Israeli civilians under heavy bombardment: prediction of the severity of post-traumatic symptoms.
Prehospital and Disaster Medicine, 2009Co-Authors: Eli Somer, Shira Maguen, Aviva Zrihan-weitzman, Tiffany Fuse, Holly Parker, Ben Dickstein, Brett T LitzAbstract:CONTEXT: The military conflict that occurred between Lebanon and Israel in July and August of 2006 was characterized by the heavy bombardment of specific geographic regions in Israel, resulting in considerable civilian casualties and property damage. OBJECTIVE: Israeli civilians directly and indirectly exposed to bombardment were compared on exposure to the recent bombardment, trauma history, perceived Life Threat and peri-traumatic dissociation during the recent bombardment, and current post-traumatic stress disorder (PTSD) symptom severity. DESIGN, SETTING, AND PARTICIPANTS: Following the conflict, data were collected by telephone from 317 Israeli residents randomly selected from two towns that were subject to differing levels of exposure to the bombardment. INTERVENTION(S): None MAIN OUTCOME MEASURE(S): Exposure to trauma during the Second Lebanon War, prior trauma exposure, PTSD symptom severity, perceived Life Threat, and peri-traumatic dissociation. RESULTS: The residents directly affected by the bombardment (Kiryat Shmona; KS) endorsed more trauma exposure, (p Language: en
Todd C Buckley - One of the best experts on this subject based on the ideXlab platform.
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the impact of severity of physical injury and perception of Life Threat in the development of post traumatic stress disorder in motor vehicle accident victims
Behaviour Research and Therapy, 1995Co-Authors: Edward B Blanchard, Edward J Hickling, Neil Mitnick, Ann E Taylor, Warren R Loos, Todd C BuckleyAbstract:For 98 victims of recent (1 to 4 months post-accident) motor vehicle accidents who sought medical attention as a result of the accident, we obtained data on the extent of physical injury using blind ratings with the Abbreviated Injury Scale (AIS), as well as victims reports of their perceptions of how much danger they perceived at the time of the accident and the degree of Life Threat (fear of dying) they perceived. AIS scores significantly predicted (P < 0.01) development of post-traumatic stress disorder (PTSD) (r point biserial = 0.302) and development of post-traumatic stress symptoms (PTSS) (r = 0.311) as did perception of Life Threat (r point biserial = 0.294 for PTSD and r = 0.229 for PTSS). A multiple regression equation combining AIS and Life Threat accounted for 12.2% of variance in PTSS scores.
Cristina Becchimanzi - One of the best experts on this subject based on the ideXlab platform.
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biweekly rituximab cyclophosphamide vincristine non pegylated liposome encapsulated doxorubicin and prednisone r comp 14 in elderly patients with poor risk diffuse large b cell lymphoma and moderate to high Life Threat impact cardiopathy
British Journal of Haematology, 2011Co-Authors: Gaetano Corazzelli, Ferdinando Frigeri, Manuela Arcamone, Anna Lucania, Gaetana Capobianco, Maria Rosariavilla, Emanuela Morelli, Alfonso Amore, Antonietta Caronna, Cristina BecchimanziAbstract:This Phase II study assessed feasibility and efficacy of a biweekly R-COMP-14 regimen (rituximab, cyclophosphamide, non-pegylated liposome-encapsulated doxorubicin, vincristine and prednisone) in untreated elderly patients with poor-risk diffuse large B-cell lymphoma (DLBCL) and moderate to high ‘Life Threat’ impact NIA/NCI cardiac comorbidity. A total of 208 courses were delivered, with close cardiac monitoring, to 41 patients (median age: 73 years, range: 62–82; 37% >75 years) at a median interval of 15·6 (range, 13–29) days; 67% completed all six scheduled courses. Response rate was 73%, with 68% complete responses (CR); 4-year disease-free survival (DFS) and time to treatment failure (TTF) were 72% and 49%, respectively. Failures were due to early death (n = 3), therapy discontinuations (no-response n = 2; toxicity n = 6), relapse (n = 6) and death in CR (n = 3). Incidence of cardiac grade 3–5 adverse events was 7/41 (17%; 95% confidence interval: 8–31%). Time to progression and overall survival at 4-years were 77% and 67%, respectively. The Age-adjusted Charlson Comorbidity Index (aaCCI) correlated with failures (P = 0·007) with patients scoring ≤7 having a longer TTF (66% vs. 29%; P = 0·009). R-COMP-14 is feasible and ensures a substantial DFS to poor-risk DLBCL patients who would have been denied anthracycline-based treatment due to cardiac morbidity. The aaCCI predicted both treatment discontinuation rate and TTF.
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Biweekly rituximab, cyclophosphamide, vincristine, non‐pegylated liposome‐encapsulated doxorubicin and prednisone (R‐COMP‐14) in elderly patients with poor‐risk diffuse large B‐cell lymphoma and moderate to high ‘Life Threat’ impact cardiopathy
British Journal of Haematology, 2011Co-Authors: Gaetano Corazzelli, Ferdinando Frigeri, Manuela Arcamone, Gaetana Capobianco, Maria Rosariavilla, Emanuela Morelli, Alfonso Amore, Antonietta Caronna, A. Lucania, Cristina BecchimanziAbstract:This Phase II study assessed feasibility and efficacy of a biweekly R-COMP-14 regimen (rituximab, cyclophosphamide, non-pegylated liposome-encapsulated doxorubicin, vincristine and prednisone) in untreated elderly patients with poor-risk diffuse large B-cell lymphoma (DLBCL) and moderate to high ‘Life Threat’ impact NIA/NCI cardiac comorbidity. A total of 208 courses were delivered, with close cardiac monitoring, to 41 patients (median age: 73 years, range: 62–82; 37% >75 years) at a median interval of 15·6 (range, 13–29) days; 67% completed all six scheduled courses. Response rate was 73%, with 68% complete responses (CR); 4-year disease-free survival (DFS) and time to treatment failure (TTF) were 72% and 49%, respectively. Failures were due to early death (n = 3), therapy discontinuations (no-response n = 2; toxicity n = 6), relapse (n = 6) and death in CR (n = 3). Incidence of cardiac grade 3–5 adverse events was 7/41 (17%; 95% confidence interval: 8–31%). Time to progression and overall survival at 4-years were 77% and 67%, respectively. The Age-adjusted Charlson Comorbidity Index (aaCCI) correlated with failures (P = 0·007) with patients scoring ≤7 having a longer TTF (66% vs. 29%; P = 0·009). R-COMP-14 is feasible and ensures a substantial DFS to poor-risk DLBCL patients who would have been denied anthracycline-based treatment due to cardiac morbidity. The aaCCI predicted both treatment discontinuation rate and TTF.
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a phase ii study of r comp14 in elderly patients with high risk diffuse large b cell lymphoma dlbcl and moderate to high Life Threat impact cardiopathy
Journal of Clinical Oncology, 2011Co-Authors: Gaetano Corazzelli, Ferdinando Frigeri, Manuela Arcamone, Anna Lucania, Gaetana Capobianco, M R Villa, Filippo Russo, Stefania Crisci, Gianpaolo Marcacci, Cristina BecchimanziAbstract:8058 Background: R-CHOP14 delivery in pts with poor IPI score and/or EBV+ and cardiac morbidity, may be hampered by acute, early and late cardiac toxicity from dose-dense doxorubicin. Non-pegylated liposome-encapsulated doxorubicin (NPLD) is accounted as equivalent to free doxorubicin with less cardiac adverse events (CAE). Methods: Untreated pts (median age 73 y, r 62-82) with IPI 3-5 DLBCL and moderate-high ‘Life Threat’ impact cardiac comorbidity [lymphoma-validated NIA/NCI index (Janssen-Heijnen 2005)], entered a phase II study of 6 biweekly courses of R-COMP14 (R-CHOP with doxo replaced by 50 mg/m2 of NPLD; Myocet). Therapy was given as inpatients with close cardiac monitoring. A CrCl >30 ml/min and left ventricular ejection fraction (LVEF) ≥0.45 were required. Age-adjusted Charlson Comorbidity Index (aaCCI) was used to weight comorbidity. Results: 41 pts were enrolled and 208 courses delivered at a median interval of 15.6 days (r 13-29); 67% of pts received all 6 courses. ORR was 73 %, with 68% CRs ...
Anne E Kazak - One of the best experts on this subject based on the ideXlab platform.
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commentary Life Threat risk and resilience in pediatric medical traumatic stress
Journal of Pediatric Psychology, 2007Co-Authors: Branlyn E Werba, Anne E KazakAbstract:Since the initial descriptive studies in the 1980s, the medical traumatic stress field has grown substantially, with an estimated 8-fold increase in papers about children and their families from 2000 to 2007 compared to the 1990s (Kazak, Schneider & Kassam-Adams, in press). Pediatric conditions can be traumatic experiences across family members and a traumatic stress framework can help explain short- and long-term responses to illnesses and injuries. Traumatic stress is compelling, in part, because it maps on to a competency based framework for understanding the trajectory of adjustment, from acute stress through potential long-term effects. The two reports in this issue related to cancer (Jurbergs, Long, Ticono, & Phipps, 2007) and burns (Landolt, Buehlmann, Maag, & Schiestl, 2007) are largely consistent with the existing literature and help to advance our understanding of posttraumatic stress symptoms (PTSS) in pediatrics. In this commentary, we link these papers to three concepts key to PTSS—Life Threat, risk, and resiliency. Both papers highlight the importance of considering what circumstances place children and families at risk for developing PTSS (e.g., history of traumatic experiences and recurrent) or are associated with resiliency (e.g., maternal presence when the injury is occurring) and potentially growth enhancing aspects of traumatic events. Although Jurbergs et al. (2007) present some data that is somewhat discrepant from others (including some from our laboratory), we offer comments in terms of how we may understand variability across studies. In both investigations, the perception of Life Threat appears to be a key element that contributes to PTSS across developmental stage and type of medical condition. That is, for young children with burns, maternal presence at the time of the trauma may minimize the potential for children to perceive their burn as Life-Threatening (they may feel safer with their parents). This is consistent with evidence that separation anxiety may help explain traumatic stress responses for young children with burns (Stoddard et al., 2006). For parents of children with cancer, relapse could introduce or reintroduce child Life-Threat. Although relapse has not been studied as a discrete event, their finding is consistent with other evidence that parental perceptions of Life-Threat are related to PTSS (Kazak et al., 2001). Thus, a child’s severe burn or cancer diagnosis may be examples of actual or Threatened harm to self or others, but yet not necessarily include the subjective experience of LifeThreat that is important for not only the diagnosis of posttraumatic stress disorder (PTSD), but the development of PTSS. It is important to understand circumstances that may place children and parents at greater risk for developing PTSS after potentially traumatic events (PTE; Kazak et al., 2006) that occur as part of pediatric illness and injury. Jurbergs and colleagues (2007) highlight that increased exposure to traumatic events may result in greater PTSS. In parents of children who had relapsed, this traumatization was associated with substantively more PTSS, compared to parents of children with cancer who had not relapsed. The framing of relapse as a ‘‘second hit’’ for parents after the initial ‘‘first hit’’ of child cancer diagnosis seems useful. Indeed, parents may have more extensive trauma histories; cancer could realistically be the third, fourth, or fifth ‘‘hit.’’ Alternatively, if parents believe that their child’s chances of cure were high during initial treatment, relapse could mark the first time they perceive their child’s Life as truly Threatened. Both articles highlight resiliency in families of children. Acute short-term stress responses are ‘‘normal’’ and understandable in the face of potentially traumatic events. Landolt and colleagues (2007) show that interpersonal circumstances at the time can be associated with PTSS for
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Posttraumatic Stress Symptoms and Stressful Life Events Predict the Long-term Adjustment of Survivors of Childhood Cancer and Their Mothers
Journal of Clinical Psychology in Medical Settings, 2000Co-Authors: Lamia P. Barakat, Anne E Kazak, Kathleen Meeske, Paul R. Gallagher, Margaret StuberAbstract:Objectives: To examine prospectively the impact of posttraumatic stress symptoms (PTSS) in response to childhood cancer and treatment on general adjustment while accounting for the role of other stressful Life events and appraisal of Life Threat and treatment intensity. Methods: As part of a larger study assessing PTSS, 56 childhood cancer survivors, aged 8 to 18, and 65 mothers completed self-report measures of PTSS and appraisal of the intensity and Life Threat associated with cancer treatment at time 1 and self-report measures of stressful Life events and general adjustment at time 2 (approximately 18 months after time 1). Results: For child survivors and their mothers, posttraumatic stress at time 1 significantly predicted general adjustment at time 2, over and above the significant contribution of Lifetime stressful events. The Life events variable did not function as a mediator in the association of PTSS and general adjustment. Conclusions: Trauma responses to childhood cancer and its treatment have implications for the long-term adaptation of children and their families. Early signs and symptoms of posttraumatic stress and stressful Life experiences require early assessment and intervention.
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Predicting Posttraumatic Stress Symptoms in Mothers and Fathers of Survivors of Childhood Cancers
Journal of the American Academy of Child and Adolescent Psychiatry, 1998Co-Authors: Anne E Kazak, Margaret L. Stuber, Kathleen Meeske, Lamia P. Barakat, Donald Guthrie, Anna T. MeadowsAbstract:ABSTRACT Objective To predict posttraumatic stress symptoms in parents of survivors of childhood cancer, using as predictors the following: personality (trait anxiety); current family and individual variables (perceived Life Threat, perceived treatment intensity, Life events, family functioning, and social support); posttreatment variables (time since treatment ended, child anxiety, medical sequelae); and treatment events (age at diagnosis, radiation therapy, intensity of treatment). Method Mothers and fathers of 6- to 20-year-old survivors of childhood cancer (n = 331 families) completed a questionnaire battery in this two-site study. The outcome variable was the Posttraumatic Stress Disorder Reaction Index. Multiple regression and path analyses were used to test the model. Results For both mothers and fathers, anxiety was the strongest predictor of posttraumatic stress symptoms. The current family and individual variables also contributed significantly, particularly with respect to the individual contributions of perceived Life Threat, perceived treatment intensity, and social support. Objective medical data did not contribute to posttraumatic stress symptoms. Conclusions Parental anxiety warrants attention throughout the course of treatment for childhood cancer and after treatment ends. Beliefs about past and present Life Threats associated with cancer treatment and family and social support are other important targets for intervention.
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Predictors of Posttraumatic Stress Symptoms in Childhood Cancer Survivors
Pediatrics, 1997Co-Authors: Margaret L. Stuber, Anne E Kazak, Robert S Pynoos, Kathleen Meeske, Lamia P. Barakat, Donald Guthrie, Helen Garnier, Anna T. MeadowsAbstract:Objective. The diagnosis and treatment of childhood cancer are extremely stressful experiences, with psychological sequelae which can persist many years after the end of treatment. This study investigated the relative contributions of general anxiety, treatment intensity, medical sequelae of treatment, and the subjective appraisal of Life Threat and treatment intensity to later posttraumatic stress symptoms, such as intrusive memories, avoidance, and hypervigilance. Method. One hundred eighty-six childhood cancer survivors ages 8 through 20 years, off of treatment for more than 1 year, and their parents completed questionnaires. Medical sequelae of treatment and intensity of treatment were rated by a pediatric oncologist. Results. Significant, independent predictors of persistent posttraumatic stress symptoms included: 1) the survivor9s retrospective subjective appraisal of Life Threat at the time of treatment, and the degree to which the survivor experienced the treatment as “hard” or “scary”; 2) the child9s general level of anxiety; 3) history of other stressful experiences; 4) time since the termination of treatment (negative association); 5) female gender; and 6) family and social support. Mother9s perception of treatment and Life Threat contributed to anxiety and subjective appraisal for the survivor, but did not independently contribute to posttraumatic stress symptoms. Conclusions. Symptoms of posttraumatic stress seem to decrease with time, but are persistent in a subset of childhood cancer survivors. Other than time and gender, the predictors of posttraumatic stress symptoms are primarily subjective factors (ie, anxiety and subjective appraisal) rather than objective stressors of treatment and medical sequelae.
Stacey Youngmccaughan - One of the best experts on this subject based on the ideXlab platform.
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distinct trauma types in military service members seeking treatment for posttraumatic stress disorder
Journal of Traumatic Stress, 2018Co-Authors: Brett T Litz, Ateka A Contractor, Charla Rhodes, Katherine A Dondanville, Alexander H Jordan, Patricia A Resick, Stacey YoungmccaughanAbstract:: We examined the frequency of trauma types reported in a cohort of service members seeking treatment for posttraumatic stress disorder (PTSD) and compared symptom profiles between types. In this observational study, 999 service members (9.2% women; Mage = 32.91 years; 55.6% White) were evaluated using a standardized assessment procedure to determine eligibility for clinical trials. Participants were evaluated for DSM-IV-TR-defined PTSD using the PTSD Symptom Scale-Interview; all participants reported a Criterion A event. Independent evaluators rated descriptions of Criterion A events as belonging to trauma types at a high degree of reliability, κ = 0.80. Aggregated non-Life-Threat primary trauma types were more frequently endorsed than aggregated Life-Threat types, 95% CI [17.10%, 29.20%]. Participants who endorsed moral injury-self traumas had a higher level of reexperiencing (d = 0.39), guilt (hindsight bias, d = 1.06; wrongdoing, d = 0.93), and self-blame (d = 0.58) symptoms, relative to those who reported Life Threat-self. Participants who experienced traumatic loss had greater reexperiencing (d = 0.39), avoidance (d = 0.22), guilt (responsibility, d = 0.39), and greater peri- and posttraumatic sadness (d = 0.84 and d = 0.70, respectively) symptoms, relative to those who endorsed Life Threat-self. Relative to Life Threat-self, moral injury-others was associated with greater peri- (d = 0.36) and posttraumatic (d = 0.33) betrayal/humiliation symptoms, and endorsement of aftermath of violence was associated with greater peri- (d = 0.84) and posttraumatic sadness (d = 0.57) symptoms. War zone traumas were heterogeneous, and non-Life-Threat traumas were associated with distinct symptoms and problems.