Cerebral ventricular size in major depressive disorder: association with delusional symptoms.

Computerized tomograms (CT scans) and neuroendocrine challenges (TRH stimulation test and dexamethasone suppression test) were completed in 38 melancholic depressed hospitalized patients. There were no significant differences in ventricular size between delusional and nondelusional depressives. However, 5 of 20 delusional depressives (25%) in contrast to none of 18 nondelusional depressives had ventricular brain ratios greater than 2 standard deviations from the mean of 26 neurological controls. There were no demographic, clinical, or neuroendocrine differences between patients with enlarged ventricles and those with normal CT scans. Two of 5 patients with large ventricles were rehospitalized within the 1st year of ascertainment in contrast to 3 of the other 15 delusional depressed patients. The possible relevance of cerebral ventricular size for depressive disorder is discussed.

Age at onset and number of psychotic symptoms in bipolar I and schizoaffective disorder.

The authors rated 71 bipolar I patients on the basis of the number of different psychotic symptoms experienced during the course of their illness. Patients who became ill at a young age had significantly higher scores than patients with a later onset.

Sleep in fall/winter seasonal affective disorder: effects of light and changing seasons.

Disturbances of sleep are a hallmark of seasonal affective disorders (SAD), as they are of other mood disorders. Fall/winter SAD patients most often report hypersomnia. Among responses of 293 SAD patients on a symptom questionnaire, complaints of winter hypersomnia (80%) greatly exceeded insomnia (10%), hypersomnia plus insomnia (5%), or no sleep difficulty (5%). Increased sleep length in fall/winter is not unique to SAD. Among 1571 individuals across four latitudes surveyed at random from the general population, winter sleep increases of < or = 2 hr/day relative to summer were reported by nearly half. However, hypersomnia had a low correlation (r = 0.29) with the total number of other SAD symptoms that were reported in this sample. Ten SAD patients kept daily sleep logs across 1 yr that showed increases in fall and winter (sleeping most in October; least in May) whose maximum averaged 2.7 hr per day more weekend sleep than in spring and summer. These winter increases might have been somewhat attenuated since most received light therapy during part of the winter. Nocturnal EEG recordings of depressed SAD patients in winter showed decreased sleep efficiency, decreased delta sleep percentage, and increased REM density (but normal REM latency) in comparison with recordings: (1) from themselves in summer; (2) from themselves after > or = 9 days of light therapy; or (3) from age- and gender-matched healthy controls. Thus, the extent of fall/winter oversleeping recorded by our SAD patients did not differ dramatically from that reported by the general population, but sleep complaints of our SAD patients have been accompanied by features of sleep architecture that are different from healthy controls and are reversed by summer or by bright-light therapy.

Seasonal variations in mood and behavior in the general population: a factor-analytic approach.

In a mailed survey conducted at four centers--Nashua, NH; New York, NY; Washington, DC; and Sarasota, FL--1,671 respondents provided information on monthly variations in 10 behavioral categories representing extremes in the areas of mood, socializing, appetite, weight gain/loss, and sleep length. A 10-factor solution revealed the following factors: (1) a winter weight gain factor; (2) a winter depression factor; (3) a winter hypersomnia factor; (4) a summer weight gain factor; (5) a summer hypersomnia factor; (6) a summer depression factor; (7) a winter socializing factor; (8) a winter weight loss factor; (9) a fall depression factor; and (10) a possibly mixed factor. Factors consistent with winter seasonal affective disorder were positively correlated with latitude, while those consistent with summer seasonal affective disorder were negatively correlated with latitude.

Effect of daily variation in weather and sleep on seasonal affective disorder.

Analysis of daily self-ratings of energy for 10 patients diagnosed with seasonal affective disorder (SAD) revealed statistically significant seasonal patterns in eight patients (with all patients showing the most energy in the summer and the least energy in the winter). When weather was controlled for, the seasonal patterns in energy persisted in seven of the eight patients. In a lesser number of subjects (four), there were significant effects of weather after controlling for season; however, when the effects of weather on energy were examined separately for each season, 8 of the 10 subjects were found to be influenced by weather in at least one season. Daily sleep data showed statistically significant seasonal patterns in all 10 patients (with 6 subjects showing maximum sleep in winter and 4 in summer). As for the relationship between energy and sleep, a loss of energy appeared to predict longer sleep on that night and the next night (7 of 10 patients), whereas there was no evidence that prolonged sleep influenced energy on the following and subsequent days.

Prevalence of seasonal affective disorder at four latitudes.

The Seasonal Pattern Assessment Questionnaire (SPAQ) was mailed to a sample population balanced for sex and randomly selected from local telephone directories in four areas: Nashua, NH, New York, NY, Montgomery County, MD, and Sarasota, FL. On the basis of responses to this questionnaire, prevalence rates of winter seasonal affective disorder (winter SAD), summer seasonal affective disorder (summer SAD), and subsyndromal winter SAD were estimated for the four areas. Rates of winter SAD and subsyndromal SAD were found to be significantly higher at the more northern latitudes, while no correlation was found between latitude and summer SAD. The positive correlation between latitude and prevalence of winter SAD applied predominantly to the age groups over 35.

Multiple sclerosis and latitude: a new perspective on an old association.

For 68 years latitude has been identified as an important risk factor in the occurrence of multiple sclerosis (MS), but not satisfactory explanation has been offered for this relationship. Epidemiological studies of MS, however, have failed to take into account the degree of change in the amount of ambient light over the course of the year, a variable which is closely related to photoperiod and latitude. Seasonal affective disorder (SAD), another illness for which latitude is a risk factor, appears to be related to the decrease in ambient light during the winter months, and offers some relevant insights into the geographical distribution of risk for developing MS. Researchers have found a relationship between degree of reported seasonal difficulties in a population sample and altered immunological function. Furthermore, the effects of bright light on mood have been shown to be regulated through the eye. We hypothesize that the risk of developing MS is related to impairment of the immune system caused by light deprivation prior to adulthood.

Long-term effects of childhood maltreatment history on gender-related personality characteristics.

OBJECTIVE: The aim of the study was to test the hypothesis that different types of gender-related personality attributes are associated with a past history of different types of childhood maltreatment. METHOD: A survey was administered to 1,060 male soldiers and 305 female soldiers in the U.S. Army. The survey instrument included the Extended Personal Attributes Questionnaire (EPAQ) which is a self-assessment instrument of personality characteristics associated with gender, and includes measures of positive masculinity (self-assertive/instrumental traits), positive femininity (expressive/interpersonal traits), negative masculinity (hyper masculine/macho traits), and negative femininity (subordination of self to others). The survey instrument also included the Childhood Trauma Questionnaire (CTQ), which contains scales measuring sexual abuse, physical-emotional abuse, physical neglect, and emotional neglect, and four questions on childhood sexual abuse developed for a national survey of U.S. adults. RESULTS: Negative masculinity was predicted by male gender, younger age, and childhood physical-emotional abuse. Negative femininity was predicted by physical-emotional abuse and sexual abuse. The relationship to sexual abuse was mainly evident for males. Positive femininity was positively correlated with sexual abuse for females and negatively correlated with sexual abuse for males. Positive masculinity was negatively correlated with emotional neglect for males but not for females. Positive femininity was negatively correlated with emotional neglect for both genders. CONCLUSIONS: Childhood abuse was associated with the presence of negative gender-related attributes; childhood neglect was associated with absence of positive gender-related attributes. Childhood physical abuse was associated with negative masculine attributes in both genders. Childhood sexual abuse was associated with positive feminine attributes in females, and negative feminine attributes in males. The finding for females is counterintuitive, and is discussed in the light of the clinical literature on certain types of adaptation to incest.

Impact of childhood abuse history on psychological symptoms among male and female soldiers in the U.S. Army.

The long-term psychological effects of four different types of childhood maltreatment were examined among 1,072 male and 305 female soldiers on active duty in the United States Army. The predictor variables included four subscales from the Childhood Trauma Questionnaire (CTQ)-(1) physical-emotional abuse, (2) sexual abuse, (3) emotional neglect, and (4) physical neglect. An additional sexual abuse variable based on the four screening questions developed by Finkelhor, Hotaling, Lewis, and Smith (1990) was also included. Outcome was measured by the Brief Symptom Inventory and a dissociation scale developed by Briere and Runtz (1988). MANOVAs were conducted for each outcome measure. Physical-emotional abuse contributed to most of the effects. However, sexual abuse contributed additional significant effects to all of the subscales. In general, males and females showed similar outcomes, but certain gender differences were noted.

Life events and symptomatic recovery of army spouses following Operation Desert Storm.

The relation between life events and psychiatric symptoms among wives of soldiers deployed to the Persian Gulf during Operation Desert Storm (ODS) was examined. Psychiatric symptoms were measured, using the 25-item Hopkins Symptom Checklist (HSCL), at two times, once while the soldiers were away and a second time several months after they returned. In a multiple regression analysis, symptoms at Time 2 were predicted by post-Desert Storm events as well as by events and emotional stressors that occurred during the military operation. The strongest predictor of post-Desert Storm events was pre-Desert Storm events. The impact of the deployment was also assessed on the basis of respondents' symptom profiles over time. Although 70% of the respondents were symptomatic during the deployment, 40% had recovered by Time 2; only 24% were symptomatic at both times. Even in the latter group, there was an improvement in symptoms between Time 1 (T1) and Time 2 (T2).

Social support, family separation, and well-being among military wives.

The effects on general well-being of perceived social support, stress, and the Stress X Support interaction were examined in a sample of military wives. Support was defined as the perception of being able to count on another military wife for help with a personal or family problem. Stress was defined as the amount of time spent in the field by the soldiers in the husbands' units. Stress was found to have an adverse effect on well-being only among those who did not perceive themselves as having social support, which is consistent with the buffering hypothesis of social support. Major predictors of social support included husband's rank, type of unit, and stress. This suggests that to some extent stress itself stimulates adaptation by motivating individuals to enlist support from others. This may be a partial explanation of the buffering effect found in this study.

Psychological and physical health effects of sexual assaults and nonsexual traumas among male and female United States Army soldiers.

Lifetime trauma history was assessed in a health study of active duty United States Army soldiers. Five hundred fifty-five male and 573 female soldiers in the sample were asked whether they had ever experienced 14 different potentially traumatic experiences, including sexual assaults, violent stressors to self, and terrifying events that occurred to others and were secondarily traumatic through exposure by gaining information or as a witness to the event. Most soldiers had experienced multiple traumas, and premilitary exposure to events was much more common than exposure to events after entering the military. Global measures of current psychological distress and physical health symptoms were predicted by the lifetime number of sexual assaults and traumas to self. Social support from military unit leaders moderated the relationship between accumulated exposure to traumas and both health measures, whereas unit cohesion was directly associated with fewer mental health problems.

Predictors of general well being among Army wives.

Predictors of general well being were examined in a sample of Army wives who participated in the second and third iterations of the Unit Manning System Family Health Study. Nine variables measured at time 1 (including social supports, personality, domains of life satisfaction, and military life stress) and two aspects of husbands' duty schedule measured at time 2 were regressed on general well being (GWB) measured at time 2. Significant predictors of GWB at time 2 included GWB at time 1, personality, and predictability of husband's schedule at time 2. When GWB at time 1 was excluded from the model, other significant predictors emerged, including financial satisfaction, marital satisfaction, and number of days in the past 6 months that husband was away in the field.

Patterns of seasonal change in mood and behavior: an example from a study of military wives.

Three hundred ninety-seven Army wives located in Germany, California, and Texas answered a series of questions on seasonal changes in mood and behavior as part of a general health survey. Subjects living in Germany reported significantly more symptoms associated with winter seasonal effective disorder than those living in Texas or California.

Psychological effects of sexual harassment, appraisal of harassment, and organizational climate among U.S. Army soldiers.

This study examines the effects of three types of unwanted sexual experiences in the workplace on the psychological well-being of male and female U.S. Army soldiers, and the mediating or moderating roles of appraisal of sexual harassment, organizational climate, and the sociodemographic profile of victims. A survey was administered to 1,060 male soldiers and 305 female soldiers between May and July, 1995, at three Army posts in the United States. Unwanted sexual experiences were found to be significant predictors of psychological symptoms for male and female soldiers. Certain aspects of organizational climate and appraisal of sexual harassment were also significant predictors of psychological symptoms.

Childhood antecedents of psychological adaptation to military life.

This study examined the impact of a history of childhood abuse and neglect on soldiers' adaptation to Army life including commitment to the Army, confidence in leaders, and perceptions of unit cohesion and readiness. Childhood abuse and neglect were measured by the 30-item Childhood Trauma Questionnaire (CTQ) which comprises four subscales-sexual abuse, physical-emotional abuse, emotional neglect, and physical neglect. Information was obtained through a survey of 1,051 male soldiers and 305 female soldiers from combat support and combat service support units located at three different Army posts in the United States. The study found that of the four CTQ subscales, emotional neglect was the only variable predicting lower unit cohesion and lower confidence in leaders for both male and female soldiers even after controlling for concurrent psychological symptoms and sociodemographic variables. Emotional neglect during childhood may have a negative impact on soldiers' ability to access social support within their units, a factor that has been shown to prevent psychological breakdown in combat.

The measurement of childhood trauma among male and female soldiers in the U.S. Army.

One thousand three hundred sixty-five soldiers from the U.S. Army completed a 30-item version of the Childhood Trauma Questionnaire (CTQ) together with four questions on sexual abuse developed for a national survey of U.S. adults. A four-factor solution to the CTQ produced four subscales that were similar to those found in the original study, namely (1) emotional neglect, (2) physical and emotional abuse, (3) sexual abuse, and (4) physical neglect. We found that half of female soldiers reported a childhood history of sexual abuse, compared with one-sixth of male soldiers. Half of both male and female soldiers reported a childhood history of physical abuse. Combined abuse histories were noted in 34% of female and 11% of male soldiers. Abused soldiers reported more psychological symptoms on the Brief Symptom Inventory than nonabused soldiers. The CTQ and screening questions are discussed as possible tools for eliciting histories of abuse from soldiers.

Demographic and psychosocial risk factors for preterm delivery in an active duty pregnant population.

The effects of work climate, pregnancy transitions stress, maternal medical conditions, health risk behaviors, psychological health, and demographic characteristics were examined among 269 pregnant military women. The study found that single and separated/divorced military women were at greater risk for preterm delivery than married women. Unmarried participants were more likely to belong to ethnic minorities, were lower ranking, less educated, and reported a greater number of medical conditions than married participants. Psychosocial variables distinguished the three marital status groups--married, single, and separated/divorced--but none of these variables was related to preterm delivery. In a logistic regression analysis, marital status was a more significant predictor of preterm delivery than were medical conditions.

Gender-related personal attributes and psychological adjustment among U.S. Army soldiers.

Personality characteristics associated with successful adaptation to military life are often described in gender-related terms. However, valid, reliable measures of gender-related personality characteristics have not been established for military populations. The purpose of this study was to validate an instrument for measuring gender-related personality characteristics in an active duty population. The Extended Personal Attributes Questionnaire was administered to 1,060 male soldiers and 305 female soldiers in U.S. Army support units. Results of a factor analysis indicated that there are three separate factors. The first denotes negatively valued aggressive traits (Negative Masculinity), the second denotes negatively valued passive traits (Negative Femininity), and the third combines positive instrumental and positive expressive traits, referred to as the Combined factor. Although positive instrumental traits (referred to as Masculinity) were related to fewer psychological symptoms, Negative Masculinity and Negative Femininity were associated with increased psychological symptoms. Positive expressive traits (referred to as Femininity) were unrelated to psychological symptoms.

Psychiatric symptomatology across the menstrual cycle in women reporting high, medium, and low levels of premenstrual change.

We examined general well-being across the menstrual cycle in women reporting minimal, mild, and moderate to severe premenstrual dysphoric changes. Those reporting moderate to severe changes had lower general well-being during the premenstrual phase of the menstrual cycle.