PTSD may trigger early memory loss

People diagnosed with Post-Traumatic Stress Disorder may experience age-related memory problems earlier than non-traumatized people, according to research summarized on nature.com. In a study of Holocaust survivors, Mount Sinai School of Medicine researcher Rachel Yehuda found that even those who had recovered from emotional trauma were more likely to suffer memory problems later in life than members of a control group. The full study is in press at Biological Psychiatry.

Report cites poor disaster care for mentally disabled

The National Council on Disability has issued a report on the treatment of people with psychiatric disabilities during the aftermath of Hurricane Katrina. The NCD is quite critical of disaster relief agencies, particularly the Red Cross. (Click here for coverage by AP reporter Kevin Freking.)

In a press release, the NCD listed the report's major findings:

• In violation of federal policy and law, people with psychiatric disabilities were discriminated against during evacuation, rescue, and relief phases
• Mismanaged evacuations resulted in the loss, mistreatment, and inappropriate institutionalization of people with psychiatric disabilities
• People with psychiatric disabilities were not included in disaster planning or relief and recovery efforts
• Disaster management efforts often failed because no individual or office had responsibility, accountability, and authority for disability related issues
• Disaster plans were shortsighted and relief services were terminated prematurely

Click here for the full report, which includes recommendations for future disasters.

Beta-blocking traumatic memories

In the Toronto Globe and Mail, Anne McIlroy writes a lengthy story about experiments using drugs known as beta blockers to protect against Post-Traumatic Stress Disorder. Researchers are testing whether the drugs can alter traumatic memories by limiting production of stress hormones. McIlroy notes several of the ethical questions involved.

Can news retraumatize victims?

Crime victims whose cases are reported in the media are more likely to have negative emotional reactions to that coverage than positive ones, but there is no indication that such coverage leads to Post-Traumatic Stress Disorder, researchers say in a study published in the latest issue of the journal European Psychologist.

Swiss researchers Andreas Maercker and Astrid Mehr surveyed a group of crime victims to see what psychological effects news coverage had on those victims. Maercker and Mehr identified two "contradictory hypotheses": the "support hypothesis," which suggests that media coverage might help victims by providing social recognition or other validation, thus supporting recovery; and the "retraumatization hypothesis," which suggests that media coverage leads victims to reexperience the traumatic event, impeding recovery and leading to increased PTSD symptoms.

Maercker and Mehr write:

The results of the present study do not validate the support hypothesis. Positive emotional reactions were reported only rarely and respondents whose cases were reported in the media were not better off at the 6-month follow up. Only partial support was found for the alternative hypothesis of retraumatization. On the one hand, the high levels of distress reported in reaction to the media coverage lent support to the hypothesis. On the other hand, there are no indications that media reports are associated with longer-lasting negative effects on the level of PTSD symptoms. This partial validation of the retraumatization hypothesis should be investigated further, with more elaborate assessments and study designs.

As a practical consequence of our findings, we would like to stress that people who suffer more from PTSD tend to evaluate the media coverage of their case in more negative terms. We conclude that the media should be more careful in selecting individuals to interview or report on after a traumatic event. Persons with higher psychological well-being seem to have somewhat less negative responses to reports on their cases. Persons with lower psychological well-being may be retraumatized to a certain extent by finding themselves the focus of media attention. Again, this conclusion needs further evaluation and research.

Report: PTSD real, DSM valid

A report from the Institute of Medicine, commissioned by the Department of Veterans Affairs, has affirmed that guidelines for diagnosing and assessing Post-Traumatic Stress Disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, Volume IV, are legitimate.

This finding would seem to be obvious, but it represents a victory for veterans groups, who had viewed the VA's request for the report as an attempt to undermine veterans' PTSD-related disability claims. (Click here for background from VA Watchdog's Larry Scott.)

Here is the IOM statement:

At the request of the Department of Veterans Affairs, the Institute of Medicine conducted a study on Post-Traumatic Stress Disorder (PTSD). The committee reviewed and commented on the diagnosis and assessment of PTSD and known risk factors for its development.

The committee found that PTSD is a well characterized medical disorder and that the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria for diagnosing PTSD are evidence-based, widely accepted, and widely used.

According to the committee’s report, PTSD should be diagnosed and assessed by a health professional with experience in diagnosing psychiatric disorders (e.g., primary care physicians, nurses, social workers) using the DSM-IV criteria. Ideally, this diagnosis should take place in a private setting with a face-to-face interview that can last an hour or more.

Additionally, while screening and diagnostic instruments might help in the diagnosis and assessment of PTSD, these tools cannot substitute for an evaluation by an experienced professional.

The committee wrote that because all veterans deployed to a war zone are at risk for the development of PTSD, it would be prudent for health professionals to query veterans about their wartime experiences and their symptoms, when presenting at primary care and other health facilities (inpatient or outpatient).