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Objective: Cushing’s disease (CD) may cause atrophy of different regions of the human brain, mostly affecting the hippocampus and the cerebellum. This study evaluates the use of 3-T MRI of newly diagnosed patients with CD to detect atrophic degeneration with voxel-based volumetry Methods: [for full text, please go to the a.m. URL], 68. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 7. Joint Meeting mit der Society of British Neurological Surgeons (SBNS)

This quantitative-qualitative case study focuses on processes of personal transformation in chronic physical disease in order to further our understanding of the posttraumatic growth construct. Semistructured interviews were conducted with women suffering from Systemic Lupus Erythematosus. The validity of the posttraumatic growth construct is assessed comparing results obtained by a standardized measure (Posttraumatic Growth Inventory) to individual pictorial and verbal depictions of personal transformation processes. Detailed examinations of three cases evidenced the validity of subjective appraisals of posttraumatic growth. Also, the Posttraumatic Growth Inventory covered all facets of positive growth processes as portrayed by individual depictions. However, the concept of posttraumatic growth neglects negatively evaluated processes of personal transformation. The consequences of this conceptual bias are discussed with respect to clinical care as well as contradictory results seen in empirical research. Posttraumatic loss and destruction is suggested as a second dimension for the representation of personal transformation in chronic physical disease.

This pilot study tested the validity of a 1-item visual assessment method originally developed to evaluate suffering in chronic illness that has been adapted for use with patients who have been exposed to traumatic events. The Pictorial Representation of Illness and Self Measure (PRISM) was administered 5 times during the course of a posttraumatic stress disorder (PTSD) treatment outcome study (N = 29). The PRISM scores declined significantly under trauma-focused psychotherapy and differentiated between participants with and without PTSD diagnoses. Test-retest reliability over a 6-month period was high (r = .85). PRISM showed significant correlations with measures of PTSD, depression, and psychopathology symptom load (r = -.38 to r = -.81; convergent validity). At the same time, PRISM was not significantly related to trauma history (discriminant validity). Illustrations of symptom time courses indicated that PRISM was more closely related to trauma-specific psychopathology than to nontrauma-specific psychopathology (discriminant validity) and sensitive to change. In summary, PRISM appears to be a valid tool for the assessment of trauma-related suffering and adds to multimethod approaches in trauma research.

Posttraumatic nightmares are considered as a reexperiencing symptom of the DSM-IV posttraumatic stress disorder (PTSD) diagnosis. Different types of posttraumatic nightmares, however, may differ in their relation to psychopathology. Thirty-two children were longitudinally assessed 10 days, 2 months, and 6 months after traffic accidents. Occurrence and characteristics of nightmares were examined and their relation to psychopathology assessed. Thirty-four percent of children reported posttraumatic nightmares during at least one assessment. Exact replicative nightmares at baseline assessment predicted PTSD symptoms 2 and 6 months postaccident, but not depressive symptoms. Exact replicative nightmares revealed the strongest cross-sectional association with trauma-specific psychopathology but not with depression. The authors conclude that posttraumatic nightmares--especially exact replicative ones--may be closely related to psychopathological mechanisms of posttraumatic stress in children.

Objective Posttraumatic stress disorder (PTSD) is associated with high rates of psychiatric comorbidity. Existing theories consider comorbidity as a consequence of PTSD (model 1), PTSD and comorbidity as a consequence of shared factors of vulnerability (model 2), and comorbidity as a consequence of trauma-type specific mechanisms (model 3). Method To compare the explanatory value of these models, we assessed PTSD (model 1), sense of coherence (model 2) and satisfaction with health (model 3) and symptoms of anxiety and depression as indicators of comorbidity 5 days (t1) and 6 months (t2) postaccident in 225 injured accident survivors. Structural equation models representing models 1 to 3 were tested separately and combined. Results Combined, models 1 and 3 explained 82% of the variance of comorbid symptoms at t2. Posttraumatic stress disorder and satisfaction with health (t2) exerted strong influences on comorbid symptoms. Conclusion Comorbidity besides PTSD is best described by an integration of competing explanatory models.