Influence of adjuvant mindfulness-based cognitive therapy (MBCT) on symptoms of post-traumatic stress disorder (PTSD) in veterans - results from a randomized control study.

Even 30 or more years after the end of a war, veterans can suffer from post-traumatic stress disorder (PTSD). In the present study, we explored the influence on symptoms of PTSD among Iranian veterans of the Iran-Iraq war of mindfulness-based cognitive therapy (MBCT) as add-on to a standard treatment with citalopram. Forty-eight male veterans with PTSD (mean age: 52.97 years) took part in this eight-week intervention study. Standard treatment for all patients consisted of citalopram (30-50 mg/day at therapeutic dosages). Patients were randomly assigned either to the treatment or to the control condition. Treatment involved MBCT delivered in group sessions once a week. Patients in the control condition met at the hospital with the same frequency and duration for socio-therapeutic events. At baseline and at study completion, patients completed questionnaires covering symptoms of PTSD, depression, anxiety, and stress. At study completion after eight weeks, scores for PTSD (re-experiencing events, avoidance, negative mood and cognition, hyperarousal), depression, anxiety, and stress were lower, but more so in the intervention than the control group. Data suggest that, as adjuvant to standard SSRI medication, MBCT is an effective intervention to significantly reduce symptoms of PTSD, depression, anxiety, and stress among veterans.

Malingering and PTSD: detecting malingering and war related PTSD by Miller Forensic Assessment of Symptoms Test (M-FAST).

BACKGROUND: Malingering is prevalent in PTSD, especially in delayed-onset PTSD. Despite the attempts to detect it, indicators, tools and methods to accurately detect malingering need extensive scientific and clinical research. Therefore, this study was designed to validate a tool that can detect malingering of war-related PTSD by Miller Forensic Assessment of Symptoms Test (M-FAST). METHODS: In this blind clinical diagnosis study, one hundred and twenty veterans referred to War Related PTSD Diagnosis Committee in Iran in 2011 were enrolled. In the first step, the clients received Psychiatry diagnosis and were divided into two groups based on the DSM-IV-TR, and in the second step, the participants completed M-FAST. RESULTS: The t-test score within two groups by M-FAST Scale showed a significant difference (t = 14.058, P < 0.0001), and 92% of malingering war-related PTSD participants scored more than 6 and %87 of PTSD group scored less than 6 in M-FAST Scale. CONCLUSIONS: M-FAST showed a significant difference between war-related PTSD and malingering participants. The ≥6 score cutoff was suggested by M-FAST to detect malingering of war-related PTSD.

Psychometric properties of acute stress disorder questionnaire for people exposed to Kerman earthquake.

BACKGROUND AND AIM: Some people exposed to disasters will suffer from acute stress disorder (ASD) due to the negative consequences of these disasters. Evaluating this disorder at a large scale requires a credible and standardized tool. Therefore, the current study aims to investigate the psychometric properties of the ASD questionnaire for people exposed to Kerman earthquake. METHODS: This is a descriptive-tooling study, conducted on 435 men and women older than 18 years living in earthquake-affected areas of Kerman Province (Kouh-e-Banan). The study was carried out using the Persian translating of the English version of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition ASD questionnaire on accessible individuals living in temporary residence tents in two initial and final stages and different stages of validity and reliability evaluation was carried out. The findings were analyzed using descriptive statistics and Pearson's correlation coefficient. RESULTS: During the evaluation of content validity, no questions were eliminated. To carry out factor analysis, sampling competence, and suitability of sample size were confirmed through Kaiser-Meyer-Olkin and Bartlett's tests. In the factor analysis stage, 14 items in three factors were defined. The factors were included reexperiencing and analysis, arousal (continuous irritability), and avoidance factors which together explained 59.43% of percentage distribution. In the next stage of evaluating divergent validity, the results indicated a significant and inverse correlation between ASD score and quality of life score (r = -0.43, P = 0.002) of the participants, while there was also a positive and significant correlation between ASD score and general health disorder score of the participants (r = 0.47, P < 0.0001). The reliability of the questionnaire was investigated using Cronbach's alpha, and inner class correlation coefficient was calculated to be 0.9. CONCLUSIONS: The tool investigated in this study has suitable validity and reliability and is effective for use by psychologists and relief workers for necessary interventions and prevention of ASD in disasters.

Differences in maladaptive schemas between patients suffering from chronic and acute posttraumatic stress disorder and healthy controls.

BACKGROUND: War, as a stressor event, has a variety of acute and chronic negative consequences, such as posttraumatic stress disorder (PTSD). In this context, early maladaptive schema-based problems in PTSD have recently become an important research area. The aim of this study was to assess early maladaptive schemas in patients with acute and chronic PTSD. METHOD: Using available sampling methods and diagnostic criteria, 30 patients with chronic PTSD, 30 patients with acute PTSD, and 30 normal military personnel who were matched in terms of age and wartime experience were selected and assessed with the Young Schema Questionnaire-Long Form, Beck Depression Inventory second version (BDI-II), the Beck Anxiety Inventory (BAI), and the Impact of Events Scale (IES). RESULTS: Both acute and chronic PTSD patients, when compared with normal military personnel, had higher scores for all early maladaptive schemas. Additionally, veterans suffering from chronic PTSD, as compared with veterans suffering from acute PTSD and veterans without PTSD, reported more impaired schemas related, for instance, to Self-Control, Social Isolation, and Vulnerability to Harm and Illness. DISCUSSION: The results of the present study have significant preventative, diagnostic, clinical, research, and educational implications with respect to PTSD.