Postdisaster stress in the United States and Mexico: a cross-cultural test of the multicriterion conceptual model of posttraumatic stress disorder.

Data on symptoms of posttraumatic stress disorder (PTSD) were collected 6 months after Hurricanes Paulina (N = 200; Mexico) and Andrew (non-Hispanic n = 270; United States) using the Revised Civilian Mississippi Scale. A 4-factor measurement model that represented the accepted multicriterion conceptualization of PTSD fit the data of the U.S. and Mexican samples equally well. The 4 factors of Intrusion, Avoidance, Numbing, and Arousal correlated significantly and equivalently with severity of trauma in each sample. A single construct explained much of the covariance of the symptom factors in each sample. However, modeling PTSD as a unidimensional construct masked differences between samples in symptom severity. With severity of trauma controlled, the Mexican sample was higher in Intrusion and Avoidance, whereas the U.S. sample was higher in Arousal. The results suggest that PTSD is a meaningful construct to study in Latin American societies.

Genome of the bacterium Streptococcus pneumoniae strain R6.

Streptococcus pneumoniae is among the most significant causes of bacterial disease in humans. Here we report the 2,038,615-bp genomic sequence of the gram-positive bacterium S. pneumoniae R6. Because the R6 strain is avirulent and, more importantly, because it is readily transformed with DNA from homologous species and many heterologous species, it is the principal platform for investigation of the biology of this important pathogen. It is also used as a primary vehicle for genomics-based development of antibiotics for gram-positive bacteria. In our analysis of the genome, we identified a large number of new uncharacterized genes predicted to encode proteins that either reside on the surface of the cell or are secreted. Among those proteins there may be new targets for vaccine and antibiotic development.

A qualitative analysis of posttraumatic stress among Mexican victims of disaster.

In unstructured interviews, 24 Mexicans described survivors' responses to disasters in Guadalajara, Jalisco (n = 9), Homestead, Florida (n = 6), and Puerto Angel, Oaxaca (n = 9). This analysis assessed the extent to which symptom descriptions corresponded to the 17 criterion symptoms of PTSD. Nineteen participants (79%) mentioned from 1 to 9 criterion symptoms. Event-related distress, hypervigilance, recurrent recollections, and avoiding reminders were described most often. Only 3 criterion symptoms were never described. Twenty participants (83%) provided 109 separate expressions that could not be classified specifically as criterion symptoms. These phrases were sorted by 9 independent Mexican volunteers and cluster analyzed. Clusters composed of ataques de nervios, depression, lasting trauma, and somatic complaints provided the best description of the data.

Help-seeking comfort and receiving social support: the role of ethnicity and context of need.

Examined help-seeking comfort and receiving social support among Latinos, African Americans, and European Americans across two contexts: in a communitywide emergency (Hurricane Andrew) and 2 years later in a nonemergency situation. In general, help-seeking comfort was a strong predictor of received support. Notwithstanding many similarities between the groups, the effects of ethnicity differed according to the context. In emergency, all groups reported similarly high levels of help-seeking comfort and received support. In nonemergency, help-seeking comfort declined for blacks and whites but not for Latinos. Although all ethnic groups reported receiving less social support in nonemergency, the decline in received support across contexts was most dramatic for Latinos. Situational, cultural, and differential resource loss explanations are offered to account for the findings.

Characterological, situational, and behavioral risk factors for motor vehicle accidents: a prospective examination.

The occurrence of motor vehicle accidents (MVAs) was studied prospectively in a sample of 500 drivers aged 19-88. Over a 4-year interval from 1991 to 1995, 36% of these drivers had a minor accident and 9% had a serious (injury-producing) accident. Data collected in 1991 demonstrated that crashes could be predicted from a combination of pre-existing characterological, situational, and behavioral risk factors, and that these risk factors largely explained sex and age differences in accident rates. The best predictors of future MVAs were younger age, high hostility in combination with poor self-esteem, residence in a larger city, recent relocation, high job stress, prior MVAs, and self-reported tendencies to speed and disregard traffic rules. Failure to wear seat belts did not predict accidents but did significantly influence the severity of accidents that did occur; that is, those who had earlier reported using seat belts 'always' were less likely than others to be injured when accidents did occur. Financial stress increased the likelihood of involvement in more serious accidents.

Stability and change in stress, resources, and psychological distress following natural disaster: Findings from hurricane Andrew.

Abstract The stress, resource, and symptom levels of 241 residents of southern Dade County, Florida were assessed 6 and 30 months after Hurricane Andrew. Percentages meeting study criteria for depression and PTSD did not change over time. Whereas mean levels of intrusion and arousal decreased, depressive symptoms remained stable, and avoidance/numbing symptoms actually increased. Intrusion and arousal were associated more strongly with pre-disaster factors (gender, ethnicity) and within-disaster factors (injury, property loss) than with post-disaster factors (stress, resources), but the reverse was true for depression and avoidance. Changes over time in symptoms were largely explained by changes over time in stress and resources. The findings indicate that ongoing services are needed to supplement the crisis-oriented assistance typically offered to disaster victims.

Comparative distress levels of inner-city family members of homicide victims.

This study investigated the distress levels of 150 family members of homicide victims, as well as how pre-event, peri-event, and postevent variables were related to distress. Distress levels were very high, with 26% of the sample reporting clinical distress. Because it was not possible to say if this distress resulted from the homicide itself or from the fact that people who lose family members to homicide generally have lives rooted in stressful contexts, we compared the homicide sample to two sociodemographically comparable groups of 108 other trauma victims and 119 nonvictims selected from a larger epidemiological dataset. Homicide survivors were significantly more distressed than either group, suggesting that loss of a family member to homicide has definite clinical implications. Although event-related variables were somewhat predictive of distress, pre-event and postevent variables selected for this study had greater predictive utility.

DNA sequence sampling of the Streptococcus pneumoniae genome to identify novel targets for antibiotic development.

We initiated a survey of the Streptococcus pneumoniae genome by DNA sequence sampling. More than 9,500 random DNA sequences of approximately 500 bases average length were determined. Partial sequences sufficient to identify approximately 95% of the aminoacyl tRNA synthetase genes and ribosomal protein (rps) genes were found by comparing the database of partial sequences to known sequences from other organisms. Many genes involved in DNA replication, repair, and mutagenesis are present in S. pneumoniae. Genes for the major subunits of RNA polymerase are also present, as are genes for two alternative sigma factors, rpoD and rpoN. Many genes necessary for amino acid or cofactor biosynthesis and aerobic energy metabolism in other bacteria appear to be absent from the S. pneumoniae genome. A number of genes involved in cell wall biosynthesis and septation were identified, including six homologs to different penicillin binding proteins. Interestingly, four genes involved in the addition of D-alanine to lipoteicoic acid in other gram positive bacteria were found, even though the lipoteicoic acid in S. pneumoniae has not been shown to contain D-alanine. The S. pneumoniae genome contains a number of chaperonin genes similar to those found in other bacteria, but apparently does not contain genes involved in the type III secretion commonly observed in gram negative pathogens. The G+C content of S. pneumoniae genomic DNA is approximately 43 mole percent and the size of the genome is approximately 2.0 Mb as determined by pulsed-field gel electrophoresis. Many of the genes identified by sequence sampling have been physically mapped to the 19 different SmaI fragments derived from the S. pneumoniae genome. The database of random genome sequence tags (GSTs) provides the starting material for determining the complete genome sequence, gene disruption analysis, and comparative genomics to identify novel targets for antibiotic development.

Frequency and structure of precautionary behavior in the domains of hazard preparedness, crime prevention, vehicular safety, and health maintenance.

A sample of 831 adults were interviewed by researchers using a 72-item inventory about their precautionary behaviors and attitudes. Exploratory and confirmatory factor analyses conducted on random halves of the sample provided evidence of consistency and structure in precautionary behavior both within and across domains of concern. Hazard preparedness activities clustered into having basic supplies on hand, advance planning, and hazard alertness. Crime prevention acts organized according to person protection, neighborly cooperation, and professional guidance. Vehicular safety factored into auto care, responsible driving, and seat belt use. Health maintenance activities entailed healthy habits (diet and exercise), risk monitoring, and avoiding tobacco and alcohol. Higher order factor analyses evidenced intra-individual consistency in the use of Disciplined, Vigilant, and Proactive Behaviors across precautionary domains. At all levels, perceptions of the usefulness of precautionary measures were related strongly to the frequency of self-protective acts.

Effect of recombinant human insulin-like growth factor-I on progression of ALS. A placebo-controlled study. The North America ALS/IGF-I Study Group.

The objective of this study was to investigate the safety and efficacy of recombinant human insulinlike growth factor-I (rhIGF-I) in the treatment of sporadic ALS. A double-blind, placebo-controlled, randomized study of 266 patients was conducted at eight centers in North America. Placebo or rhIGF-I (0.05 mg/kg/day or 0.10 mg/kg/day) was administered for 9 months. The primary outcome measure was disease symptom progression, assessed by the rate of change (per patient slope) in the Appel ALS rating scale total score. The Sickness Impact Profile (SIP), a patient-perceived, health-related quality of life assessment, was a secondary outcome variable. Progression of functional impairment in patients receiving high-dose (0.10 mg/kg/day) rhIGF-I was 26% slower than in patients receiving placebo (p = 0.01). The high-dose treatment group was less likely to terminate the study due to protocol-defined markers of disease symptom progression, and members in this group exhibited a slower decline in quality of life, as assessed by the SIP. Patients receiving 0.05 mg/kg/day of rhIGF-I exhibited trends similar to those associated with high-dose treatment, suggesting a dose-dependent response. The incidence of clinically significant adverse experiences was comparable among the three treatment groups. Recombinant human insulin-like growth factor-I slowed the progression of functional impairment and the decline in health-related quality of life in patients with ALS with no medically important adverse effects.

System influences on posthomicide beliefs and distress.

Criminal justice system experiences in 150 family members of homicide victims were investigated. The study had two goals: (a) to document the experiences of homicide survivors in the criminal justice system, including case outcomes, criminal justice system activities, and satisfaction with system personnel; and (b) to determine if experiences with the police impacted posthomicide beliefs (cognitive assumptions about the world and one's relationship to it) and psychological distress. The sample, which was identified through the Medical Examiner's Office, was drawn from all criminal homicides from 1.5 to 5 years prior to selection. Results showed that family members of homicide victims were very dissatisfied with their experiences in the criminal justice system. Additionally, whereas objective system outcomes (e.g., arrest) did not directly affect posthomicide beliefs and distress, subjective system outcomes (e.g., police satisfaction) directly affected beliefs and indirectly affected distress. There was some support for both equity theory and a cognitive theory of change, the two theories that guided the model specification.

Received and perceived social support in times of stress: a test of the social support deterioration deterrence model.

The authors evaluated the impact of receiving social support on subsequent levels of perceived social support and psychological distress in 2 independent samples of victims of severe natural disasters: Hurricane Hugo (n = 498) and Hurricane Andrew (n = 404). A social support deterioration deterrence model was proposed that stipulated that postdisaster mobilization of received support counteracts the deterioration in expectations of support often experienced by victims of major life events. LISREL analyses of data collected 12 and 24 months after Hugo and 6 and 28 months after Andrew provided strong evidence for the hypothesized model: Perceived support mediated the long-term effects on distress of both scope of disaster exposure and postdisaster received support. Theoretical and application issues of social support are discussed.

The revised Civilian Mississippi Scale for PTSD: reliability, validity, and cross-language stability.

Examined in two studies the psychometric properties of a revised 30-item version of the civilian form of the Mississippi Scale for Combat-Related Posttraumatic Stress Disorder (PTSD) developed by Keane, Caddell, and Taylor (1988). Study 1, whose sample was composed of 37 bilingual adults who had experienced a variety of traumatic events, was undertaken primarily to examine the linguistic equivalence of a Spanish translation of the scale. High cross-language stability was demonstrated, and both English and Spanish versions showed high internal consistency. Study 2, which used a sample of 404 victims of Hurricane Andrew, provided additional evidence of scale reliability and also showed that the scale correlates in meaningful ways with known traumatic stressors. Together the results indicate that the scale is applicable to different populations and events and constitutes a valid and reliable self-report, measure of PTSD.

Examining comorbidity and posttraumatic stress disorder in a Vietnam veteran population using the MMPI-2.

Examined the discriminant validity of the MMPI-2 in assessing comorbidity in a posttraumatic stress disorder (PTSD) Vietnam veteran population. The Structured Clinical Interview for the DSM-III-R (SCID) was used to diagnose veterans and to classify them into four groups: PTSD Only, PTSD with mood disorders, PTSD with other anxiety disorders, and PTSD with mood and anxiety disorders. All groups had clinical elevations on scales F, 1, 2, 3, 4, 6, 7, 8, 0, PK, and PS, with peak elevations on scales 8, 7, and 2. The PTSD Only group's MMPI-2 scores were not significantly lower than other groups' scores. The PTSD+Mood/Anxiety group was significantly more elevated on scales 2 and 7 than the PTSD Only and PTSD+Anxiety group but did not otherwise show significantly higher scale elevations than others groups. No significant differences existed between groups on scales F, L, K, PK, and PS. Implications of these results for PTSD and the current diagnostic system are explored.

In search of altruistic community: patterns of social support mobilization following Hurricane Hugo.

Twelve months after Hurricane Hugo, 1,000 disaster victims and nonvictims were asked about social support they exchanged following the hurricane. Victims of disaster received and provided very high levels of tangible, informational, and emotional support. Disaster exposure (loss and harm) was a strong predictor of help received and a modest predictor of help provided. However, postdisaster help was not distributed equally and disaster exposure was more strongly related to social support in some groups than in others. Race, education, and age most consistently moderated the impact of disaster exposure on receipt of postdisaster support. Blacks and less educated victims received less help than similarly affected victims who were white or more educated. Relative disadvantage of being old in receiving support was not the case for those elderly disaster victims who experienced threats to their lives or health. Some subgroups of victims were relied upon disproportionately for providing assistance. Implications for social support research are addressed.

Software trapping: a strategy for finding genes in large genomic regions.

We present an approach to the gene identification phase of positional cloning that combines sparse sampling of DNA sequences from large genomic regions with computational analysis. We call the method "software trapping." The goal is to find coding exons while avoiding massive DNA sequence determination and contig assembly. Instead, rapid sequence sampling is combined with exon screening software such as a newly developed package called XPOUND to identify coding sequences. We have tested the approach using a set of model genomic sequences with known intron/exon structures as well as with bona fide P1 genomic clones. The results suggest that the strategy is a useful complement to other methods for finding genes in poorly characterized regions of genomes.

Psychological distress following criminal victimization in the general population: cross-sectional, longitudinal, and prospective analyses.

Samples of 105 violent crime victims, 227 property crime victims, and 190 nonvictims provided normative data regarding levels of psychological distress following criminal victimization. At points approximately 3 months, 9 months, and 15 months postcrime, symptoms of depression, somatization, hostility, anxiety, phobic anxiety, fear of crime, and avoidance were assessed. Although crime victims showed substantial improvement between 3 and 9 months, thereafter they did not. Over the course of the study, violent crime victims remained more distressed than did property crime victims who, in turn, remained more distressed than nonvictims. Regression analyses revealed that the effects of crime could not be accounted for by precrime differences between victims and nonvictims in either social status or psychological functioning. However, lasting effects were often contingent on the occurrence of subsequent crimes.

Culture and domestic violence: the ecology of abused Latinas.

This study examined the predictors of domestic violence within a sample of 60 immigrant Latinas, of whom 30 had sought assistance for abuse and 30 had sought other family services. Hypotheses were derived from several frameworks relevant to understanding abuse--intrapsychic (learned helplessness), interpersonal (family violence), and feminist theory. Findings related to the specific formulations were subsequently combined into a model of abuse in which the mutuality of communication within the couple mediates the effects of husband's intoxication and environmental stressors on the occurrence/severity of abuse. The study points out the inadequacy of relying on any one existing theory and supports the idea of taking an ecological approach to the study of abuse in specific populations.