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Numerous studies have demonstrated explicit and working memory deficits related to posttraumatic stress disorder (PTSD), but few have addressed longitudinal changes in memory functioning. There is some evidence to suggest an interactive effect of PTSD and aging on verbal memory decline in Holocaust survivors (Yehuda et al., 2006). However, the longitudinal trajectory of neuropsychological functioning has not been investigated in Vietnam veterans, a younger but substantial population of aging trauma survivors. We administered tests of visual and verbal memory, and working memory to derive different dependent measures in veterans between the ages of 41 and 63, the majority of whom served in the Vietnam War. Twenty-five veterans with PTSD and 22 veterans without PTSD were assessed over two time points (mean age at follow-up = 54.0; mean inter-test interval = 34 months). The PTSD+ group, consisting of veterans with chronic, primarily combat-related PTSD, did not show a significant change in PTSD symptoms over time. Compared to veterans without PTSD, veterans with PTSD showed a greater decline in delayed facial recognition only, and this decline was extremely subtle. (JINS, 2009, 15, 853–861.)
This chapter describes the interface of mental health and disaster. The burden of mental illness for families, communities, and nations is substantial, and the mental illness that follows extreme traumatic events is part of this global burden. Accurate and real-time health surveillance information on the population rates of mental health and illness and the barriers to care are needed to address the mental and behavioral health-care needs of disaster populations. The chapter discusses the range of psychological and behavioral responses to disaster, from subsyndromal symptoms of distress, to initial behavior, distress and health risk behaviors, to the development of specific psychiatric disorders. Cognitive-behavioral psychotherapeutic interventions for children and adults with complex grief are under investigation. The chapter focuses on the complexity of modeling psychopathology after disaster-posttraumatic stress disorder (PTSD). The conceptualization of postdisaster pathology and PTSD requires a broader view across domains of suffering, altered functional capacity, and disability.
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