Showing papers on "Psychological intervention published in 1994"

Reducing risks for mental disorders: Frontiers for preventive intervention research.

Abstract: The understanding of how to reduce risk factors for mental disorders has expanded remarkably as a result of recent scientific advances This study, mandated by Congress, reviews those advances in the context of current research and provides a targeted definition of prevention and a conceptual framework that emphasizes risk reduction Highlighting opportunities for and barriers to interventions, the book draws on successful models for the prevention of cardiovascular disease, injuries, and smoking In addition, it reviews the risk factors associated with Alzheimer's disease, schizophrenia, alcohol abuse and dependence, depressive disorders, and conduct disorders and evaluates current illustrative prevention programs The models and examination provide a framework for the design, application, and evaluation of interventions intended to prevent mental disorders and the transfer of knowledge about prevention from research to clinical practice The book presents a focused research agenda, with recommendations on how to develop effective intervention programs, create a cadre of prevention researchers, and improve coordination among federal agencies

Does mental practice enhance performance

Abstract: Mental practice is the cognitive rehearsal of a task prior to performance. Although most researchers contend that mental practice is an effective means of enhancing performance, a clear consensus is precluded because (a) mental practice is often denned so loosely as to include almost any type of mental preparation and (b) empirical results are inconclusive. A meta-analysis of the literature on mental practice was conducted to determine the effect of mental practice on performance and to identify conditions under which mental practice is most effective. Results indicated that mental practice has a positive and significant effect on performance, and the effectiveness of mental practice was moderated by the type of task, the retention interval between practice and performance, and the length or duration of the mental practice intervention. Mental practice refers to the cognitive rehearsal of a task in the absence of overt physical movement. When a musician practices a passage by thinking it through or when an athlete prepares for an event by visualizing the steps required to perform the task, he or she is engaging in mental practice. A number of studies have examined the effects of mental practice on performance. Whereas the research of Kelsey (1961) and Ryan and Simons (1982) supports the efficacy of mental practice for enhancing performance, Beasley (1978) reported negative results. An astute reviewer may be able to estimate the direction and magnitude of effect of the relationship between mental practice and performance from the preponderance of evidence across the majority of studies. For example, Richardson (1967a) concluded that most studies support the efficacy of mental practice on performance. However, Richardson, and later Corbin (1972), noted that this evidence was inconclusive. Because different studies use different types of tasks, with different types of subjects, and report different study statistics, it is difficult if not impossible to integrate these disparate research studies on an intuitive level to draw firm conclusions on the effectiveness of mental practice. The purpose of this study was to integrate the literature on mental practice, summarize the overall effects of mental practice on performance, and specify the conditions under which mental practice is most effective.

The course of adult intellectual development.

Abstract: A program of research is summarized that represents the author's lifelong efforts to understand the adult life course of intellectual abilities. The Seattle Longitudinal Study has assessed mental abilities in more than 5,000 adults and has followed some for as long as 35 years. Integrative findings are provided on patterns and magnitudes of age changes, cohort differences, factor structure of mental abilities, antecedents for individual differences in aging trajectories, and interventions designed to remediate cognitive aging effects.

ADHD in the Schools: Assessment and Intervention Strategies

Abstract: Overview of ADHD. Assessment of ADHD in School Settings. ADHD and Learning Difficulties: What Is the Connection? Early Screening, Identification, and Intervention. School-Based Intervention Strategies. Medication Therapy. Adjunctive Interventions for ADHD. Communication with Parents, Professionals, and Students. Conclusions and Future Directions.

Preventing AIDS : theories and methods of behavioral interventions

Abstract: Introduction: The Role of Behavioral Interventions for HIV Prevention RJ DiClemente, JL Peterson Theories of Behavior Change: The Health Belief Model and HIV Risk Behavior Change IM Rosenstock, et al Interventions for Adolescents: SchoolBased Behavioral Interventions to Prevent HIV among Adolescents D Kirby, RJ DiClemente Interventions for Injection Drug Users: Behavioral Interventions for InTreatment Injection Drug Users L Roerich, et al Interventions for Women: Interventions for Sexual Partners of HIV-Infected or High-Risk Individuals NS Padian, et al Interventions for Homosexual and Bisexual Men: HIV Prevention for Gay and Bisexual Men in Metropolitan Cities R Hays, JL Peterson Conclusion: Lessons Learned from Behavioral Interventions JL Peterson, RJ DiClemente 9 additional articles Index

Infant dietary experience and acceptance of solid foods.

Abstract: Objective. To examine the effects of dietary experience and milk feeding regimen on acceptance of their first vegetable by 4-to 6-month-old infants. Design. Longitudinal study, of 26-days duration, observing infants aged 4 to 6 months at the start of the study. Random assignment to treatments, within-subject control. Setting. General community in a medium-sized mid-western town. Subjects. Thirty-six infants and their mothers. Subjects were solicited through birth records and advertisements in local newspapers. Interventions. Infants were randomly assigned to be fed one vegetable on 10 occasions, either salted or unsalted peas or green beans, for a 10-day period. Outcome measures. Infant intake of the vegetable consumed during the 10-day exposure period; intake of salted and unsalted versions: (1) before the 10-day exposure period, (2) immediately after the exposure period; and (3) after a 1-week period of delay. Intake of a control food was also measured before and after repeated consumption of the vegetable. Adult ratings of the infants9 videotaped responses during test feedings were also obtained before and after the exposure period. Results. After 10 opportunities to consume the vegetable, all infants significantly increased their intake (P Conclusions. Infants increase their acceptance (reflected both in changes in intake and in behavioral response) of a novel food after repeated dietary exposure to that food. Relative to formula-feeding, breast-feeding may facilitate the acceptance of solid foods.

Prevention of suicide: aspirations and evidence

Abstract: The Health of the Nation white paper set a target for 15% reduction in overall suicide rates by the year 2000. If the targets are to be achieved interventions must be identified which are of proved effectiveness. This paper examines the evidence on the available interventions and points of access to the population at risk. No single intervention has been shown in a well conducted randomised controlled trial to reduce suicide. The greatest potential seems to arise from limiting the availability of methods. In particular it is likely that the introduction of the catalytic convertor will lead to reduced lethality of care exhausts and reductions in suicide using this method. General practitioner education programmes, the effectiveness of lithium and maintenance antidepressants, and limits on the quantity of medicines available over the counter or on prescription should all be evaluated. Particular high risk groups include people recently discharged from psychiatric hospitals and those with a history of parasuicide. Many social processes affect suicide rates and these rather than specific interventions may help or hinder the ability to realise the Health of the Nation targets. Well conducted trials are essential to distinguish complex social processes from the effects of specific interventions for suicide prevention. This review of the available evidence offers little support for the aspiration that the posited targets can be achieved on the basis of current knowledge and current policy.

Stress, risk, and resilience in children and adolescents: Processes, mechanisms, and interventions.

Abstract: Dedication Preface Robert Haggerty and Lonnie Sherrod 1. A triad for our times: stress, risk, and resilience Norman Garmezy 2. Context and process in research on risk and resilience Susan Gore and John Eckenrode 3. Parental divorce and children's well being: a focus on resilience Robert Emery and Rex Forehand 4. Mechanisms and processes of adolescent bereavement David Clark, Robert Pynoos, and Ann Goebel 5. Risk, resilience, and development: the multiple ecologies of black adolescents in the United States Saundra Murray Nettles and Joseph Pleck 6. The stress-illness association in children: a perspective from the biobehavioral interface Ronald Barr, W. Thomas Boyce, and Lonnie Zeltzer 7. Child and adolescent depression: covariation and comorbidity in development Bruce Compas and Constance Hammon 8. The school-based promotion of social competence: theory, research, practice, and policy Maurice Elias and Roger Weissberg 9. Intervention research: lessons from research on children with chronic disorders I. Barry Pless and Ruth E. K. Stein 10. Stress research: accomplishments and tasks ahead Michael Rutter .

Clinicians as Caregivers: Role of Attachment Organization in Treatment

Abstract: The relationship between case managers' attachment organization and interventions used with clients who have serious psychopathological disorders was examined. Adult Attachment Interviews were administered to 27 clients and their 18 case managers. Interviews were coded by means of Kobak's Q-set, which yields scores for secure-insecure and preoccupied-dismissing attachment strategies. Case managers were interviewed during each of 5 months regarding their most recent interventions; interventions were coded for depth of intervention and attention to dependency needs. Compared with secure case managers, insecure case managers attended more to dependency needs and intervened in greater depth with preoccupied clients than they did with dismissing clients. Case managers who were more preoccupied intervened with their clients in greater depth than did case managers who were more dismissing.

Imagery interventions in sport.

Abstract: The use of imagery processes in the regulation and enhancement of sports performance is examined in this review paper Research studies in this area are reviewed and four general categories of research are identified: 1) mental practice, 2) precompetition imagery, 3) comparisons of successful and unsuccessful competitors, and 4) mediating variables The conclusion is reached that mental practice research has produced equivocal results and the reasons for this are examined The argument is made that the mental practice model for research into imagery processes in sports is nonproductive Suggestions for future research directions are offered and guidelines for productive imagery research in sport are provided

The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions

Abstract: The role of stressful life events in the progress of various skin conditions was studied retrospectively in patients who presented with either psoriasis (where there is some agreement about the importance of stress), urticaria, acne, alopecia and non-atopic eczema (where there is some uncertainty regarding the role of stress), or malignant melanoma, fungal infection, basal cell carcinoma and melanocytic naevi (where stress is considered less relevant). When patients in the three groups were matched for age, those with psoriasis were more likely to report that the experience of stress pre-dated the onset and exacerbations of their condition than patients with other skin diseases. For the psoriasis patients the most common types of life events were family upsets (such as bereavements), and work or school demands, but chronic difficulties were also common. There was no relationship between the severity of stress and time to onset or exacerbations. The results support the notion that stress is more likely to be associated with the onset of psoriasis than other conditions, but also that there may be considerable individual variation in the ability to cope, suggesting that psychological interventions may be helpful for particular patients.

Prospective study of predictors of attendance for breast screening in inner London.

Abstract: OBJECTIVE--To investigate the predictors of first-round attendance for breast screening in an inner city area. DESIGN--Prospective design in which women were interviewed or completed a postal questionnaire before being sent their invitation for breast screening. Sociodemographic factors, health behaviours, and attitudes, beliefs, and intentions were used as predictors of subsequent attendance. A randomised control group was included to assess the effect of being interviewed on attendance. SETTING--Three neighbouring health districts in inner south east London. PARTICIPANTS--A total of 3291 women aged 50-64 years who were due to be called for breast screening for the first time. The analysis of predictors was based on a subsample of 1301, reflecting a response rate of 75% to interview and 36% to postal questionnaire. MAIN RESULTS--Attendance was 42% overall, and 70% in those who gave an interview or returned a questionnaire. There was little evidence for an interview effect on attendance. The main findings from the analysis of predictors are listed below. (These were necessarily based on those women who responded to interview/questionnaire and so may not be generalisable to the full sample.) (1) Sociodemographic factors: Women in rented accommodation were less likely to go for screening but other indicators of social class and education were not predictive of attendance. Age and other risk factors for breast cancer were unrelated to attendance, as was the distance between home and the screening centre. Married or single women were more likely to attend than divorced, separated, or widowed women, and black women had a higher than average attendance rate; however, neither of these relationships was found in the interview sample. (2) Health behaviours: Attenders were less likely to have had a recent breast screen, more likely to have had a cervical smear, more likely to go to the dentist for check ups, and differed from non-attenders with regard to drinking frequency. Exercise, smoking, diet change, and breast self-examination were unrelated to attendance. (3) Attitudes, beliefs, and intentions: The two best predictors were measures of the perceived importance of regular screening for cervical and breast cancer and intentions to go for breast screening. Also predictive were beliefs about the following: the personal consequences of going for breast screening, the effectiveness of breast screening, the chances of getting breast cancer, and the attitudes of significant others (the woman9s husband/partner and children). Women who reported a moderate amount of worry about breast cancer were more likely to attend than those at the two extremes. CONCLUSIONS--Attenders and non-attenders differ in two broad areas: the health related behaviours they engage in and the attitudes, beliefs, and intentions they have towards breast cancer and breast screening. The latter are potentially amenable to change, and though different factors may operate among women who do not respond to questionnaires, the findings offer hope that attendance rates can be improved by targeting the relevant attitudes and beliefs. This could be done by changing the invitation letter and its accompanying literature, through national and local publicity campaigns, and by advice given by GPs, practice nurses, and other health professionals. It is essential that such interventions are properly evaluated, preferably in randomised controlled studies.

An Evaluation of An Anti-Bullying Intervention in Toronto Schools

Abstract: This paper describes the development of the Toronto Anti-Bullying Intervention. The effectiveness of the Anti-Bullying Intervention was examined with quantitative and qualitative data gathered before and 18 months after its implementation. The results of this research confirm that bullying continues to be a pervasive problem in Toronto schools. There were some improvements in students' reports of bullying as assessed at the individual, peer, and school levels. Over the first 18 months of the program, children reported increased teacher interventions to stop bullying. More bullies indicated that teachers had talked to them, but there were no differences in the proportion of bullies or victims who had discussed their problems with parents. Fewer children indicated that they could join in a bullying episode following the intervention. There was an increase in the number of children who admitted to bullying, but a decrease in the number of children who had been victimized during the past five days. These inco...

Intervention Research: Design and Development for Human Service

Abstract: Contents Foreword * Preface * I. Conceptual Overview * An Integrative Perspective on Intervention Research * Conducting Intervention Research--The Design and Development Process * II. Problem Analysis and Project Planning * Problem-Centered Intervention Research--Methods of the Second Type * Planning for Intervention Research * III. Information Gathering and Synthesis * Information Science Methods for Knowledge Retrieval--Basic Approaches and Emerging Trends * Meta-Analysis in Intervention Research--Methods and Implications * Systematic Research Synthesis--Conceptual Integration Methods of Meta-Analysis * IV. Design * Design of Social Intervention * Intervention Design for Practice--Enhancing Social Supports for High Risk Youth and Families * V. Early Development and Pilot Testing * Pilot Testing and Early Development of a Model of Case Management Intervention * Field Testing and Data Gathering of Innovative Practice Interventions in Early Development * VI. Evaluation and Advanced Development * Evaluation, Advanced Development and the Unilateral Family Therapy Experiment * Intervention Research as an Interorganizational Exchange * VII. Dissemination * Skills Training Modules--A Strategy for Dissemination and Utilization of a Rehabilitation Innovation * Disseminating Intervention Research in Academic Settings--A View from Social Work * Afterword--Competencies for Intervention Research * Appendix: Illustrative Practice Tools--Design and Development Products of Intervention Research * Subject Index * Name Index

Testing the Generalizability of Intervening Mechanism Theories: Understanding the Effects of Adolescent Drug Use Prevention Interventions

Abstract: Outcome research has shown that drug prevention programs based on theories of social influence often prevent the onset of adolescent drug use. However, little is known empirically about the processes through which they have their effects. The purpose of the present study was to evaluate intervening mechanism theories of two program models for preventing the onset of adolescent drug use. Analyses based on a total of 3077 fifth graders participating in the Adolescent Alcohol Prevention Trial revealed that both normative education and resistance training activated the causal processes they targeted. While beliefs about prevalence and acceptability significantly mediated the effects of normative education on subsequent adolescent drug use, resistance skills did not significantly predict subsequent drug use. More impressively, this pattern of results was virtually the same across sex, ethnicity, context (public versus private school students), drugs (alcohol, cigarettes, and marijuana) and levels of risk and was durable across time. These findings strongly suggest that successful social influence-based prevention programs may be driven primarily by their ability to foster social norms that reduce an adolescent's social motivation to begin using alcohol, cigarettes, and marijuana.

Pain prevalence, severity and impact in a clinic sample of multiple sclerosis patients

Abstract: Previous studies have reported variable prevalence of pain in multiple sclerosis (MS) and have not documented the impact of pain on daily living. In this consecutive series, we report on data collected from structured interviews with 85 patients seen within a 16-month period at a regional referral clinic. The prevalence of pain for the month preceding assessment was 53%. There were no significant differences between patients who did and those who did not report pain on the basis of patient demographics (age, gender) and disease characteristics (disease subtype, duration and neurologic symptom severity). Disease duration and neurologic symptom severity were significantly correlated with the number of hours of pain per week but were not correlated with pain severity, the number of pain sites or pain-related distress. There was wide variability in the number of pain hours/week reported with 17.6% of the sample reporting continuous pain for the month preceding assessment. Sixty-five percent of patients with pain reported taking medications for pain and 90% of these patients evaluated their medication(s) as 50% effective or better. Nevertheless, patients with pain reported poorer mental health and more social-role handicap. Discussion focuses on the need for routine assessment of pain and the comprehensive evaluation of the effectiveness of pain interventions in the therapeutic management of patients with MS.

Tuberculosis and the Health Care Worker: A Historical Perspective

Abstract: Many hospital outbreaks of tuberculosis have occurred in recent years in the United States, resulting in tuberculosis infection and disease among health care workers and patients. Several hospital workers have died of nosocomially acquired multidrug-resistant tuberculosis. Assuring the safety of the health care worker with respect to tuberculosis has become an urgent priority. A review of the medical literature of the past 100 years reveals that our current view of tuberculosis care as an occupational hazard emerged only in the 1950s, after a fierce and extensive debate. Many authorities had felt that care of the tuberculous patient conferred a health advantage to the care provider. This paper reviews this debate and considers steps taken decades ago, before our current environmental interventions were available to ensure the safety of the health care worker.

Conduct Disorder: Long-Term Outcomes and Intervention Effectiveness

Abstract: Objective To review the literature on conduct disorder in two areas: long-term outcome and the effects of interventions. Method The sources of the articles for review were computer searches, but the articles were selected for this review to illustrate key findings in the long-term outcome area and to review critically four intervention strategies to prevent or treat conduct disorder, namely, parent- and family-targeted programs, social-cognitive programs, peer and school-based programs, and community programs. Results Conduct problems in childhood predict the same increased rates of psychiatric disorder overall in men and women but the patterns are different: for externalizing disorders, the prediction is stronger in men and for internalizing disorders, the prediction is stronger in women. In the intervention domain, the literature provides limited evidence of the effectiveness of either primary or secondary prevention. Conclusions Prospective studies of community samples of children provide the best opportunity to understand more thoroughly the adult outcomes of conduct disorder. Because of the heavy burden of suffering of conduct disorder, and the limited effectiveness of clinical interventions, there is a compelling argument in favor of an increased emphasis on primary prevention efforts.

Mass media and school interventions for cigarette smoking prevention: effects 2 years after completion.

Abstract: The long-term cigarette smoking prevention effects of mass media and school interventions were assessed. Adolescents in two communities received both mass media and school interventions; those in two matching communities received only school interventions. Surveys of 5458 students were conducted at baseline in grades 4 through 6 and 2 years after the 4-year interventions were completed, when students were in grades 10 through 12. Students exposed to the media-plus-school interventions were found to be at lower risk for weekly smoking (odds ratio = 0.62, 95% confidence interval = 0.49, 0.78) than those receiving school interventions only, indicating that the effects of the combined interventions persisted 2 years after the interventions' completion.

Stress inoculation for reduction of burnout: A conservation of resources approach

Abstract: We evaluated the efficacy of two programs designed to reduce stress among nurses by increasing their coping resources. The interventions were based on principles of Stress Inoculation Training and Conservation of Reources stress theory. A dual resource intervention targeted the enhancement of both social support and mastery resources. A single resource intervention targeted the enhancement of only mastery resources. Both interventions were contrasted to a no intervention control condition. Participants in the dual resource intervention experienced significant enhancements in social support and mastery compared to the no intervention control. The social support enhancement persisted through a five-week follow-up. Participants in the dual resource intervention with low initial levels of social support or mastery experienced significant reductions in psychological distress. Participants in the single resource intervention experienced a slight enhancement in mastery compared to the no intervention co...

Abnormal Psychology in a Changing World

Abstract: 1. Perspectives on Abnormal Psychology. 2. Classification and Assessment of Abnormal Behavior. 3. Methods of Therapy and Treatment. 4. Stress, Psychological Factors, and Health. 5. Anxiety Disorders. 6. Dissociative and Somatoform Disorders. 7. Mood Disorders and Suicide. 8. Personality Disorders. 9. Substance Abuse and Dependence. 10. Eating Disorders, Obesity, and Sleep Disorders. 11. Gender Identity Disorder, Paraphilias, and Sexual Dysfunctions. 12. Schizophrenia and Other Psychotic Disorders. 13. Abnormal Behavior in Childhood and Adolescence. 14. Cognitive Disorders and Disorders Related to Aging. 15. Violence and Abuse. 16. Abnormal Psychology and Society.

Cognitive-behavioral interventions

Abstract: Anxiety has long been a central issue in the field of psychology, having played a key role in the development of several theories, the assessment of psychological constructs, and the evaluation of forms of psychological treatment. More recently, the formal diagnostic categories of anxiety disorders have been empirically investigated, and the treatment of anxiety disorders (primarily focused on behavioral and cognitive interventions with adult populations) has received meaningful research endorsement (e.g., Barlow, Cohen, Waddell, Vermilyea, Klosko, Blanchard, & Di Nardo, 1984; Butler, Cullington, Munby, Amies, & Gelder, 1984; Clark, 1986). Taking into account childhood developmental concerns, a promising therapeutic intervention for children with anxiety disorders is emerging (e.g., Kane & Kendall, 1989; Kendall et al., 1992).

Parenting and Early Development Among Children of Drug-Abusing Women: Effects of Home Intervention

Abstract: Objective. To evaluate the efficacy of home intervention with drug-abusing women on parenting behavior and attitudes, and on children9s development. Design. A randomized, clinical trial of 60 drug-abusing women recruited prenatally and randomized into an intervention (n = 31) or comparison (n = 29) group. There were no group differences in gestational age, 1-minute Apgar scores, duration of hospital stay, or neonatal abstinence score. Intervention infants were slightly heavier (P = .098) and had slightly lower 5-minute Apgar scores (P = .089). Most mothers were single, African-American, multiparous, and non-high school graduates from low income families. Approximately 40% of the women were human immunodeficiency virus (HIV)-positive, all admitted to either cocaine and/or heroin use, and 62% had a history of incarceration. Intervention and comparison group women did not differ on any background variables. Interventions. All children received primary care in a multidisciplinary clinic. Biweekly home visits were provided by a nurse beginning before delivery and extending through 18 months of life. The intervention was designed to provide maternal support and to promote parenting, child development, the utilization of informal and formal resources, and advocacy. Measurements. Behavioral measures included self-reported ongoing drug abuse, compliance with primary care appointments, and an observation of the child-centered quality of the home (HOME Scale). Parenting attitudes were measured by the Child Abuse Potential Inventory (CAPI) and the Parenting Stress Index. The CAPI was administered before initiating the intervention and the Parenting Stress Index was administered when the children were 3 months of age. Both scales were repeated when the children were 18 months of age. Developmental status was measured with the Bayley Scales of Infant Development administered at 6, 12, and 18 months. Analyses. Repeated measures multivariate analyses of variance were used to examine changes in parenting attitudes and children9s development. Analyses of covariance were used to examine compliance with primary care appointments and the quality of the home. Logistic regression was used to examine ongoing drug abuse. Birth weight and maternal education were used as covariates in all analyses. To control for social desirability, the faking-good index of the CAPI was included as a covariate in analyses involving self-report measures. Main results. Women in the intervention group were marginally more likely to report being drug-free (P = .059) and were compliant with primary care appointments for their children (P = .069). Based on the HOME Scale, women in the intervention group were more emotionally responsive (P = .033) and provided marginally more opportunities for stimulation (P = .065). At 18 months parents reported more normative attitudes regarding parenting and more child-related stress than they had initially, but the differences were not related to intervention status. At 6 months infants in the intervention group obtained marginally higher cognitive scores (P = .099); at 12 and 18 months there were no differences. Conclusions. The findings suggest a cautious optimism regarding the efficacy of early home intervention among drug-abusing women in promoting positive behaviors. Subsequent investigations of home intervention should include larger sample sizes and more intensive options.

A review of unrecognized mental illness in primary care. Prevalence, natural history, and efforts to change the course.

Abstract: Studies of the prevalence, natural history, and outcome of unrecognized mental illness in general medical outpatient settings were reviewed. Approximately half of the patients with a psychiatric disorder were not recognized as having a mental illness by their primary care physician. The natural history of unrecognized mental illness suggests a poorer clinical course of anxiety disorders but not for depressive disorders. Most interventions demonstrated a significant improvement in the physician's ability to identify and treat psychiatric disorders but had a minimal effect on patient symptoms and no effect on short-term health care use. Although primary care physicians do not recognize psychiatric disorders in a high percentage of patients, efforts to improve recognition may not lead to decreased patient suffering or decreased health care costs.

Psychological sequelae following the Gulf War. Factors associated with subsequent morbidity and the effectiveness of psychological debriefing.

Abstract: Background The aim was to study the effect of brief counselling and psychological debriefing following a trauma on subsequent morbidity. Method We investigated psychological morbidity in 62 British soldiers whose duties included the handling and identification of dead bodies of allied and enemy soldiers during the Gulf War. Of these soldiers, 69% received a psychological debriefing on completion of their duties. The subjects completed by post a demographic questionnaire, the General Health Questionnaire (GHQ-28) and the Impact of Events Scale. Results After nine months 50% had evidence of some psychological disturbance suggestive of posttraumatic stress disorder (PTSD); 18% had sought professional help; 26% reported relationship difficulties. Neither prior training nor the psychological intervention appeared to make any difference to subsequent psychiatric morbidity. Morbidity at nine months was more likely in those with a history of psychological problems and those who believed their lives had been in danger in the Gulf. Conclusions These findings show that a psychological debriefing following a series of traumatic events or experiences does not appear to reduce subsequent psychiatric morbidity and highlights the need for further research in military and civilian settings.