Distinguishing PTSD, Complex PTSD, and Borderline Personality Disorder: A latent class analysis

Background: There has been debate regarding whether Complex Posttraumatic Stress Disorder (Complex PTSD) is distinct from Borderline Personality Disorder (BPD) when the latter is comorbid with PTSD. Objective: To determine whether the patterns of symptoms endorsed by women seeking treatment for childhood abuse form classes that are consistent with diagnostic criteria for PTSD, Complex PTSD, and BPD. Method: A latent class analysis (LCA) was conducted on an archival dataset of 280 women with histories of childhood abuse assessed for enrollment in a clinical trial for PTSD. Results: The LCA revealed four distinct classes of individuals: a Low Symptom class characterized by low endorsements on all symptoms; a PTSD class characterized by elevated symptoms of PTSD but low endorsement of symptoms that define the Complex PTSD and BPD diagnoses; a Complex PTSD class characterized by elevated symptoms of PTSD and self-organization symptoms that defined the Complex PTSD diagnosis but low on the symptoms of BPD; and a BPD class characterized by symptoms of BPD. Four BPD symptoms were found to greatly increase the odds of being in the BPD compared to the Complex PTSD class: frantic efforts to avoid abandonment, unstable sense of self, unstable and intense interpersonal relationships, and impulsiveness. Conclusions: Findings supported the construct validity of Complex PTSD as distinguishable from BPD. Key symptoms that distinguished between the disorders were identified, which may aid in differential diagnosis and treatment planning

Family violence, war, and natural disasters: A study of the effect of extreme stress on children's mental health in Sri Lanka

Catani C, Jacob N, Schauer E, Kohila M, Neuner F. Family violence, war, and natural disasters: a study of the effect of extreme stress on children's mental health in Sri Lanka. BMC Psychiatry. 2008;8(1): 33.BACKGROUND: The consequences of war violence and natural disasters on the mental health of children as well as on family dynamics remain poorly understood. Aim of the present investigation was to establish the prevalence and predictors of traumatic stress related to war, family violence and the recent Tsunami experience in children living in a region affected by a long-lasting violent conflict. In addition, the study looked at whether higher levels of war violence would be related to higher levels of violence within the family and whether this would result in higher rates of psychological problems in the affected children. METHODS: 296 Tamil school children in Sri Lanka's North-Eastern provinces were randomly selected for the survey. Diagnostic interviews were carried out by extensively trained local Master level counselors. PTSD symptoms were established by means of a validated Tamil version of the UCLA PTSD Index. Additionally, participants completed a detailed checklist of event types related to organized and family violence. RESULTS: 82.4% of the children had experienced at least one war-related event. 95.6% reported at least one aversive experience out of the family violence spectrum. The consequences are reflected in a 30.4% PTSD and a 19.6% Major Depression prevalence. Linear regression analyses showed that fathers' alcohol intake and previous exposure to war were significantly linked to the amount of maltreatment reported by the child. A clear dose-effect relationship between exposure to various stressful experiences and PTSD was found in the examined children. CONCLUSION: Data argue for a relationship between war violence and violent behavior inflicted on children in their families. Both of these factors, together with the experience of the recent Tsunami, resulted as significant predictors of PTSD in children, thus highlighting the detrimental effect that the experience of cumulative stress can have on children's mental health

Codependence and conduct disorder: Feminine versus masculine coping responses to abusive parenting practices

This study supported the hypothesis that codependence reflects a stereotypically feminine coping strategy to environmental stressors, while conduct disorder represents an alternate coping response reflecting stereotypically masculine behaviors. High school students ( N = 218; 81% Anglo-American, 8% Asian-American, 5% Hispanic-American) completed measures of femininity/masculinity, codependence, conduct disorder, and unhealthy parenting practices. Multiple regression analyses revealed that codependence is related to parental abuse and femininity ( R = .50). A marginal relationship between codependence and parental alcoholism was mediated by parental abuse, calling into question the validity of the codependence construct. Conduct disorder was related to parental abuse, masculinity, parental alcoholism, and gender ( R = .62). The tendency to label stereotypically feminine coping strategies as pathological, while ignoring a more prevalent and destructive masculine coping strategy is discussed.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/45612/1/11199_2005_Article_BF01548255.pd

Teachers' attitudes towards reporting child sexual abuse: problems with existing research leading to new scale development

This paper details a systematic literature review identifying problems in extant research relating to teachers’ attitudes towards reporting child sexual abuse, and offers a model for new attitude scale development and testing. Scale development comprised a five-phase process grounded in contemporary attitude theories including: a) developing the initial item pool; b) conducting a panel review; c) refining the scale via an expert focus group; d) building content validity through cognitive interviews; e) assessing internal consistency via field testing. The resulting 21-item scale displayed construct validity in preliminary testing. The scale may prove useful as a research tool, given the theoretical supposition that attitudes may be changed with time, context, experience, and education. Further investigation with a larger sample is warranted