Negative psychometric outcomes: Self-report measures and a follow-up telephone survey

Abstract

(Solomon, 1989a) along with high levels of depression, anxiety and obsessive preoccupations (Solomon, 1989b), as well as impaired social functioning, disturbed family relationships, and decline in job performance (Solomon, 1989~). Many of these veterans also presented with multiple somatic complaints (Solomon, 1988a).Throughout the years following the Lebanon war, veterans with combat-related PTSD were followed up clinically by the Combat Reaction Unit of the Department of Mental Health, which provided them counselling, support and treatment. Combat casualties in Israel are at the focus of a great deal of public attention, and all possible efforts are made in order to provide them with adequate treatment and rehabilitation. Every CSR casualty had, therefore, access to a free treatment program implemented by the IDF. A network of trained and experienced clinicians situated throughout the country provided a large variety of treatment resources encompassing every mode of treatment that was conceived as helpful (e.g., pharmacotherapy, individual psychotherapy, family consultation, etc.).Yet in spite of the effort not to leave a single PTSD casualty without access to treatment, the general feeling was that conventional treatment modes were not working. These impressions were reinforced by research findings which failed to show significant treatment-related improvement in the cohort of CSR veterans with PTSD from the Lebanon war. The accumulating disappointment with the outcome of 3 years of organized effort to treat PTSD casualties with conventional approaches led to the initiation of the Koach project, aimed at treating PTSD veterans by less conventional modes of treatment (see Solomon ef al., 1991a). However, the need to accompany this new project by rigorous scientific evaluation was also clear: any claim for success in the treatment of PTSD could raise hopes in hundreds of casualties. In order to be accepted, the project had to be empina l l y evaluated and compared with the natural course of PTSD in patients who did not participate in the program. An evaluation team, independent from the team that implemented the project, was therefore established. The aim of this team was to assess the project's effectiveness.From its outset, the Koach project was accompanied by empirical evaluations supervised by the same team that carried out the follow-up studies. In order to assess the effectiveness of the project we examined the degree to which its stated aims were achieved. More specifically, we evaluated the extent to which treatment in Koach contributed towards eliminating PTSD, reducing general psychiatric symptomatology, improving social Negative Psychometric Outcomes 227 functioning in various areas, and increasing self-confidence in their ability to function in combat. METHOD SubjectsTwo groups of subjects participated in this study. The first group consists of 40 reserve CSR soldiers who were treated in the Koach project.These soldiers were selected from among several hundred CSR veterans who participated in the fo...

Paradoxical and less paradoxical effects of thought suppression A critical review

“…As another example, there are indications that unstructured exposure to trauma reminders might be harmful in the treatment of PTSD (e.g., Boudewyns & Hyer, 1990;Johnson et al, 1996). On a related note, Solomon et al (1992) found that treating PTSD veterans with prolonged exposure to military cues may result in exacerbation of PTSD symptoms. Commenting on these disappointing findings, Littrell (1998) concluded that confronting painful memories and thoughts will only yield benefit if the treatment also encourages cognitive restructuring of the traumatic experiences.…”

Individual Differences in Posttraumatic Distress: Problems with the DSM-IV Model

“…A massive treatment program for Israeli defence forces found that those who participated in a multimodal residential 9-month program were worse off than controls (252). Longstay inpatient treatment of US Vietnam veterans showed reversion to disorder after discharge (253).…”

The use of individual goal‐setting and ongoing evaluation in the treatment of combat‐related chronic PTSD

“…Consequently, extreme caution needs to be exercised in interpreting the results. This is especially so in view of other sets of outcome measures which do not indicate any clear patterns of change in the trainees' behavior and psychological well-being (see Solomon et aL, 1992b).…”