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O'Connor TG, Marvin RS, Rutter M, Olrick JT, Britner PA; English and Romanian Adoptees Study Team. (2003)
Child-parent attachment following early institutional deprivation.
Dev Psychopathol. 2003 Winter;15(1):19-38.

ABSTRACT Child-parent attachment quality with an adoptive caregiver at age 4 years was examined in a sample of 111 children adopted into the United Kingdom following early severe deprivation in Romania and a comparison group of 52 nondeprived within-United Kingdom adoptees. Findings indicated that, compared with nondeprived adoptees, children who experienced early severe deprivation were less likely to be securely attached and more likely to show atypical patterns of attachment behavior; ordinary forms of insecure attachment were not associated with deprivation. Within the sample of deprived adoptees, there was a dose-response association between duration of deprivation and disturbances in attachment behavior. In addition, a minority of children who experienced severe early deprivation were classified as avoidant, secure, or dependent using conventional classification strategies, despite also exhibiting atypical patterns of attachment behaviors, and this was also more likely among children exposed to prolonged deprivation. The results raise both theoretical and methodological implications for attachment research on very deprived children.

Olio, Karen and Cornell, William (2000).
The Facade of Scientific Documentation: A Case Study of Richard Ofshe's Analysis of the Paul Ingram Case    reprint request
American Psychological Association's journal Psychology, Public Policy, and Law. Psychology

Osterman JE ; Hopper J, Heran WJ, Keane TM, van der Kolk BA. (2001)
Boston University School of Medicine, 850 Harrison Ave., Dowling 7 S, Boston, MA 02118, USA.
Awareness under anesthesia and the development of posttraumatic stress disorder.
Gen Hosp Psychiatry 2001 Jul-Aug;23(4):198-204

ABSTRACT Failure of general anesthesia to render a patient insensate, termed "awareness," is estimated to affect between 40,000 and 140,000 patients in the US each year. This study investigated the occurrence of post-traumatic stress disorder (PTSD) in subjects who reported a past episode of intraoperative awareness. We inquired about intraoperative and postoperative experiences and studied the relationship between various surgical experiences and currently meeting the diagnosis of PTSD. Sixteen postawareness subjects and 10 postgeneral anesthesia controls completed the Clinician Administered PTSD Scale (CAPS), a standardized clinical rating scale for PTSD, and a questionnaire about peri-operative experiences. Nine of 16 subjects (56.3%), a mean of 17.9 postoperative years, and no controls met diagnostic criteria for current PTSD (X(2)= 8.6, df = 1, P<.01). Common intraoperative experiences included an inability to communicate, helplessness, terror, and pain. Postawareness patients had significant postoperative distress related to feeling unable to communicate, unsafe, terrified, abandoned and betrayed. Perioperative dissociative experiences predicted having current PTSD. Being conscious during surgery is a traumatic event that may result in developing chronic PTSD. Further studies should include prospective designs of prevalence and long-term psychological, social, and overall health effects, and ways of preventing and treating awareness-induced PTSD.

Osuch, Elizabeth A; Benson, Brenda E; Geraci, Marilla; Podell, Daniel; Herscovitch, Peter; McCann, Una D; Post, Robert M. (2001)
Regional cerebral blood flow correlated with flashback intensity in patients with posttraumatic stress disorder.
Biological Psychiatry (ISSN: 0006-3223), v. 50, no. 4, pp. 246-253 (August 15, 2001).

ABSTRACT BACKGROUND: Nuclear imaging studies have examined cerebral bloodflow (rCBF) in subjects with PTSD using symptom evocation paradigms. To date, no such studies have investigated rCBF as related to subjects' reports of flashback intensity. METHODS: Subjects with varying traumatic histories and longstanding PTSD were studied Using [O-15]-H2O positron emission tomography with an auditory script of their traumatic event. 8 subjects had three resting scans followed by their script and additional scans. Heart rate responses as well as the presence of flashbacks and their intensity, were recorded. rCBF was correlated with flashback intensity in each subject's scan. Combined analysis of all subjects' data yielded common regions related to the flashback experience. RESULTS: rCBF correlated directly with flashback intensity in the brainstem, lingula, bilateral insula, right putamen and left hippocampal and perihippocampal, somatosensory and cerebellar regions. Inverse correlations with rCBF were found in bilateral dorsolateral prefrontal, right fusiform and right medial temporal cortices. CONCLUSIONS: This study correlated flashback intensity and rCBF in a group of patients with chronic PTSD suggesting involvement of brainstem, and areas associated with motor control, complex visual/spatial cues and memory. KEY WORDS: PTSD, trauma provocation, PET, cerebral perfusion, functional neuroimaging