achtentwintigste jaargang (2008) 2, oktober twenty eight edition (2008) 2, october

AANWINSTENLIJST BIBLIOTHEEK & DOCUMENTATIE van Cogis en het Veteraneninstituut ACQUISITION LIST LIBRARY & DOCUMENTATION of Cogis and the Veteran Institute achtentwintigste jaargang (2008) 2, oktober twenty eight edition (2008) 2, october

De opgenomen boeken en tijdschriftartikelen zijn in de regel ter inzage in de bibliotheek van de Stichting Cogis of het Veteraneninstituut. Deze Aanwinstenlijst is ingedeeld in verschillende categorieën (zie inhoudsopgave op pagina 2). Publicaties over oorlogsgetroffenen ook in de medische sfeer uit de Tweede Wereldoorlog zijn veelal te vinden onder oorlogscategorieën De boeken worden alleen binnen Nederland uitgeleend, het toesturen van boeken via de post kost €6,- per boek, inclusief porto. Van de tijdschriftartikelen worden voor €0,50 per pagina, met een minimumbedrag van €4,- per artikel, kopieën verstrekt.

The books and articles in this ACQUISITION LIST are all freely available for consultation in the library. The books are not lent out to persons or institutes outside of the Netherlands. Articles are being photocopied and sent to you at €0,50 per page, at a minimum of €4,- per article.

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INHOUDSOPGAVE

Algemene informatie / General information ................................................................... 3 Historische informatie / recht / educatie / Hstorical information - law......................... 5 Oorlogsgetroffenen, alle categorieen Europa, joods, burgers, verzet, kampverhalen / Victims of war ................................................................................................................. 11 (Voormalig) Nederlands-Indie / Former Dutch East Indies ......................................... 17 Vluchtelingen, hedendaagse oorlogen, transculturele psychiatrie / Refugees contemporary wars ........................................................................................................ 20 Psycho-sociale problematiek en de hulpverlening / Psychosocial issues consequences................................................................................................................. 26 Traumatische ervaringen / Traumatic experiences ..................................................... 33 PTSD / general PTSD...................................................................................................... 42 Behandeling / Treatment................................................................................................ 46 Kinderen / Children ........................................................................................................ 49 Ouderen / Elderly............................................................................................................ 52 Rampen - ongelukken / Disasters - accidents.............................................................. 53 (Seksueel) geweld / (Sexual) violence .......................................................................... 53 Veteranen / Veterans ...................................................................................................... 54 Tweede generatie / Second generation ...................................................................... 148

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Algemene informatie / General information Broek, Aart G. Geweld wil schaamte lozen : religie en etniciteit zijn niet op voorhand de grote boosdoeners / Aart G. Broek In: Groepen = = ISSN 1871-1146: (2007), issue 2, page 56-67. Geweld Etniciteit Schaamte Migranten

Dunk, H.W. von der In het huis van de herinnering : een cultuurhistorische verkenning / H.W. von der Dunk. Amsterdam : Bakker, 2007. - 422 p. : ill. ; 22 cm. - (Monografieën over Europese cultuur ; dl. 12) Met lit. opg., reg. ISBN 978-90-351-3058-6 CONTENTS Cultuurhistorische studie over de functie van de herinnering in de samenleving en in de beleving van wat mensen meemaken, met speciale aandacht voor de rol van de geschiedschrijving. Geheugen Collectief geheugen Geschiedenis Cultuur Mensbeelden Mythevorming Oorlogen twintigste eeuw Herinneringen Holocaust Beeldvorming s5 DUN

Groen, J.M.H. De onlosmakelijke band tussen professionaliteit en ethiek / J.M.H. Groen In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 6, page 349-360. Militairen Beroepsethiek Hoe ontwikkel je (militaire) professionaliteit? Professionaliteit moet garant staan voor deskundigheid en morele verantwoordelijkheid. Ze is geworteld in de eigen bestaansethiek. De eigen waarden, normen en belangen zijn altijd aanwezig en spelen een rol in de keuzes die iemand maakt. Het is dan ook belangrijk dat militairen leren reflecteren en zich bewust worden van hun eigen bestaansethiek. KOC

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Heijmans, Rianne Angst voor de toekomst bezweren : kunstenaar Ophuis schildert wat hij ondraaglijk vindt / Rianne Heijmans In: Cogiscope = ISSN 1871-1065: vol. 4 (2008), issue 1, page 28-31. Kunst Oorlogen Geweld Kunstenaar Ronald Ophuis schildert 'het ondraaglijke', hij wil het kwaad begrijpen om zo de angst daarvoor te bezweren. Redacteur Rianne Heijmans karakteriseert hem als 'een Orpheus die afdaalt in de onderwereld waar hij bang voor is, maar die hij tegelijkertijd ook wil verkennen en begrijpen.' De situaties en voorstellingen in zijn werk roepen vaak weerzin en zelfs agressie op. Ophuis wil mensen raken met zijn werk, maar 'de toon moet goed zijn: een stok is een stok, geen bijl.'

Houtert, R.J.J. van Friendly fire: overeenkomsten en verschillen tussen militaire netwerken en ziekenhuisorganisaties / R.J.J. van Houtert, P.C. Boer en B.J. Vos In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 5, page 295-309. Friendly fire Krijgsmacht Gezondheidszorg De moderne krijgsmacht en de gezondheidszorg kennen veelal netwerken van organisaties en mensen die in netwerken samenwerken. Krijgsmacht en gezondheidszorg investeren veel tijd, energie en geld om onbedoelde dood en letsel aan eigen kant (friendly fire) zoveel mogelijk te beperken. Anderzijds worden zij daarin vaak belemmerd door hun gekozen organsiatievorm, die vaak een aantal vervelende 'bijwerkingen' kent die juist averechts werken. De systeemtheoretische veiligheidsanalyse van complexe organisaties maakt het mogelijk te kijken naar problemen die voortvloeien uit organisatorische factoren rond een netwerkorganisatie. De communicaties en informatieoverdracht tussen organisatie-elementen staan daarbij centraal. Aan de orde komt wat krijgsmacht en gezondheidszorg doen om friendly fire-incidenten hanteerbaar te houden en hoe beide organisaties wellicht van elkaar kunnen leren bij het oplossen van problemen. KOC

Waal, Frans B. de Evolutionaire ethiek, agressie en geweld : lessen van primatenonderzoek / Frans B. de Waal, vert. door Maydo van Marwijk Kooy In: Groepen = ISSN 1871-1146: (2007), issue 2, page 42-51. Geweld Apen Agressie Gedrag Onderzoek Biologie

Westen, Hans van der Praktijkboek sponsoring en fondsenwerving voor non-profit organisaties : oriëntatie, stappenplan, werving : zorg & welzijn, onderwijs & wetenschap, kunst & cultuur, natuur &

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milieu, sport & recreatie / Hans van der Westen. - [2e herz. ed.]. - Zutphen : Walburg Pers, cop. 2006. - 256 p. : ill. ; 24 cm Uitg. onder verantwoordelijkheid van het Instituut voor Sponsoring en Fondsenwerving. 1e dr.: 2003. - Met lit. opg. ISBN 90-5730-351-5 Sponsoring Fondsenwerving Non-profit organisaties Praktijkboek s0.4 WES

Historische informatie / recht / educatie / Historical information - law Banning, Cees Balkan aan de Noordzee : over het Joegoslavië-tribunaal, over recht en onrecht / Cees Banning en Petra de Koning. - Amsterdam : Prometheus ; Rotterdam : NRC Handelsblad, 2005. - 303 p. : krt. ; 22 cm Met reg. - Bibliogr.: p. 292-295. ISBN 90-446-0498-8 Internationaal strafrecht Oorlogsmisdaden Balkanoorlogen (1991-1999) Joegoslavië-tribunaal s5.5 BAN

Biezeveld, Cees "Concentratiekampen in Nederland nu": Kamp Amersfoort / Cees Biezeveld In: Kontakt door Aantreden / Nationale Federatieve Raad van het Voormalig Verzet Nederland en Nederlandse Vereniging van Ex-Politieke Gevangenen = ISSN 0166-5537: vol. 63 (2008), issue 6-7 (juni-juli), page 12-13. Deel 1 van de drieluik "Concentratiekampen nu". Concentratiekampen Kamp Amersfoort Herinneringscentra Geschiedenis De kampen Amersfoort, Vught en Westerbork waren synoniem aan appèls, koude, honger, ziekte, vernedering, angst, dood.... Nu, zestig jaar na de oorlog, bestaan de kampen nog. Echter nu als Nationaal Monument en met geheel andere doelstellingen dan indertijd. De Expogé-redactie heeft de directeuren van deze Monumenten gevraagd iets te vertellen over de geschiedenis, de doelstellingen en de resultaten. Dit artikel gaat over Kamp Amersfoort.

Bos, Menno 'Heel Belgenland leek richting de grens te strompelen' / Menno Bos In: Historisch Nieuwsblad = ISSN 0927-2690: (2007), issue 9 (november), page 16-24. Eerste Wereldoorlog België Nederland

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Vluchtelingen Internering Geschiedenis In het najaar van 1914 stroomden 1 miljoen Belgische vluchtelingen Nederland binnen. De Nederlanders zetten zich massaal in voor de ontheemde Belgen. Door voedselschaarste en cultuurverschillen nam het enthousiasme in de loop van de oorlog behoorlijk af. Met 'zachte drang' probeerde men de Belgen over te halen weer naar huis te gaan; daaronder viel ook de internering in kampen.

Eefting, Henk De Bijzondere Rechtspleging 1944-1952 : rampzalige gevolgen voor politieke delinquenten en collaborateurs / Henk Eefting. - Soesterberg : Aspekt, 2007. - 453 p. : ill. ; 22 cm. - (Aspekt monografie) Met lit. opg. ISBN 90-5911-528-7 ISBN 978-90-5911-528-6 CONTENTS Kritisch historisch relaas over de berechting na de Tweede Wereldoorlog van NSB'ers en Nederlandse SS'ers. Oorlogsmisdrijven Strafrecht Collaboratie SS-ers NSB Kinderen van foute ouders s5.2 EEF

Graaff, Bob de Op de klippen of door de vaargeul? : de omgang van de historicus met (genocidaal) slachtofferschap / Bob de Graaff. - Amsterdam : Humanistics University Press, cop. 2006. - 109 p. ; 21 cm Uitgebereide tekst van inaugurele rede Universiteit Utrecht. - Met lit. opg. ISBN 90-6665-759-6 Slachtofferschap Genocide Herinnering Collectieve herinnering Geschiedschrijving Oratie Aan de hand van de holocaust schetst de auteur de spanningen die kunnen bestaan tussen de herinnering van de slachtoffers en geschiedschrijving. De Graaff doet een aantal aanbevelingen die vorm kunnen geven aan de zorgplicht van historici ten opzichte van overledenen en moeten voorkomen dat zij ertoe bijdragen dat collectieve traumatische gebeurtenissen een mythisch karakter krijgen en de opstap tot nieuw geweld vormen. s0.5 GRA

Hein, David P. Een oorlog die de mijne zou zijn : een geschiedenis van twee generaties / David P. Hein. Amsterdam [etc.] : Contact, 2008. - 237 p. ; 21 cm 6

ISBN 978-90-254-2719-1 CONTENTS Verslag van de ervaringen van een Nederlandse medewerker bij het oorlogstribunaal in Sarajevo. Onderduiken Rechtspraak Oorlogsmisdaden Eerste/tweede generatie Postconflictgebieden Sarajevo Dagboeken Egodocumenten s5.5 HEI

Janovicek, N. Oral history and ethical practice: towards effective policies and procedures / N. Janovicek In: Journal of Academic Ethics = ISSN 1570-1727: vol. 4 (2006), issue 1-4, page 157-174. Oral history Beroepsethiek Aborigionals This article examines how Canadian ethics policies affects historians who use oral history, and focuses on privacy and confidentiality, free and informed consent, and research involving Aboriginal peoples. The article concludes with recommendations for developing ethics policies that accord with historical methodology. KOC

Janssens, R.J.A. Op weg naar het Ruhrgebied (The Ruhr) is bij de (Nederlandse) Roer hevig gevochten : een trilogie / R.J.A. Janssens. - 3e herz. dr. - Den Haag : Stichting voor Sociaal Psychoanalytisch Onderzoek en Onderwijs, 2007. - 60 p. : ill., krt. ; 21 cm 1e dr.: 2006. - Met lit. opg. ISBN 978-90-812092-1-2 Tweede Wereldoorlog Bevrijding Roer (rivier) Geschiedenis s4 JAN KOC

Kreuning, Karel Sinti & Roma, gevangen in de schaduw van herinneringen (deel1)/ Karel Kreuning In: Informatiebulletin Stichting Nationaal Monument Kamp Amersfoort = ISSN 1574-2075: (2008), issue 24 (januari), page 15-29. Zigeuners Sinti & Roma Kamp Amersfoort Geschiedenis Oral history Europa

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Korte geschiedschrijving over de Sinti & Roma die o.a. door eeuwenlange discriminatie en stigmatisering, een eigen sterk naar binnen gerichte cultuur hebben waar veel belang wordt gehecht aan groeps- en familiebanden. Ook aandacht voor de vervolging van Sinti & Roma tijdens de Tweede Wereldoorlog.

Kreuning, Karel Sinti & Roma, gevangen in de schaduw van herinneringen (deel2)/ Karel Kreuning In: Informatiebulletin Stichting Nationaal Monument Kamp Amersfoort = ISSN 1574-2075: (2008), issue 25 (april), page 2-31. Zigeuners Sinti & Roma Kamp Amersfoort Geschiedenis Oral history Europa Naoorlogstijd Korte geschiedschrijving over de Sinti & Roma die o.a. door eeuwenlange discriminatie en stigmatisering, een eigen sterk naar binnen gerichte cultuur hebben waar veel belang wordt gehecht aan groeps- en familiebanden. Deel twee gaat vooral over de naoorlogstijd vanaf 1945.

Kromhout, Bas Ooggetuigen vertellen over Dolle Dinsdag: 'De teleurstelling was haast niet te verwerken' / Bas Kromhout In: Historisch Nieuwsblad = ISSN 0927-2690: (2008), issue 4 (mei ), page 23-30. Tweede Wereldoorlog Dolle Dinsdag Getuigenissen In 1950 hield het Rijksinstituut voor Oorlogsdocumentatie een landelijke enquête over Dolle Dinsdag. De honderden getuigenissen verdwenen in een archiefkast. Historisch Nieuwsblad kreeg na 57 jaar inzage (Sander Heijne deed archiefonderzoek). Reconstructie van een massapsychose.

Nj Laoire, C. To name or not to name: reflections on the use of anonymity in an oral archive of migrant life narratives / C. N¡ Laoire In: Social & Cultural Geography = ISSN 1470-1197: vol. 8 (2007), issue 3, page 373-390. Oral history Migranten Beroepsethiek Ierland This paper draws on an oral archive project on narratives of return migration in contemporary Ireland, as the basis for a discussion on the potential of life narrative research to destabilize meta-narratives and to contribute to the mapping of transformative geographies. It is argued that this kind of research requires the creation of safe spaces within which participants can tell their stories and articulate counter-narratives. At the same time, it is important to make their voices available to a wide audience and to recognize their authorial roles. There are contrasting perspectives in oral history and life narrative research on the use of anonymity to protect participants' identities, which reflect different disciplinary traditions and practices. The paper reflects on these different 8

perspectives and on the process of designing a research project that draws on multiple methodological influences. It concludes that it is possible to facilitate access to these voices, while at the same time providing safe conditions for the articulation of counternarratives, by providing anonymity where possible and desirable in agreement with the participant. KOC

Pijpers, B.M.J. Polemiek over het 'persistent conflict': 'The Bully versus the Phoenix' / B.M.J. Pijpers In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 5, page 276-285. Internationale politiek Krijgsmacht Polemologie Is het plicht van de westerse wereld om in te grijpen bij zogeheten 'falende staten' en hen te helpen? Zo ja, hoe moet dat dan en wat is de rol van Defensie daarbij? Bij de benadering van dit probleem zijn er twee stromingen. De eerste is die van een geïntegreerde aanpak om de falende staat de kans te geven zijn eigen weg te vinden. Militairen ondersteunen daarbij en scheppen voorwaarden. De tweede is die waarbij een dergelijke staat, min of meer gedwongen, in een westers patroon van democratie en recht wordt geplaatst. Welke positie neemt Nederland eigenlijk in? KOC

Reuling-Schappin, Marianne Jeugdige politieke delinquenten Van Hoesels analyse en therapie / Marianne ReulingSchappin In: Vraagstelling: vol. 1 (1994), issue 1 (winter), page 13-23. NSB NSB-jeugd Kinderen van foute ouders Politiek Reclassering Heropvoeding Onderzoek Jongeren uit NSB-gezinnen die bij het uitbreken van de oorlog minderjarig waren, hebben deel uitgemaakt van een omvangrijk sociaal-pedagogisch project, dat werd uitgevoerd in de periode 1945-1950. Zij werden geïnterneerd in speciale jeugdkampen en onderworpen aan een programma van politieke heropvoeding onder leiding van A.F.G. van Hoesel. Dit artikel is een weerslag van de ideeën en aanpak van Van Hoesel. Conclusie: 'politieke heropvoeding' liep uit op 'morele heropvoeding'.

Reuling-Schappin, M. Heropvoeding en reclassering van politiek besmette jeugd in Nederland, 1945-1950 / M. Reuling-Schappin In: Comenius = ISSN 1067-9163: vol. 11 (1991), page 347-362. NSB NSB-jeugd Kinderen van foute ouders Politiek Reclassering Heropvoeding 9

Onderzoek Jongeren uit NSB-gezinnen die bij het uitbreken van de oorlog minderjarig waren, hebben deel uitgemaakt van een omvangrijk sociaal-pedagogisch project, dat werd uitgevoerd in de periode 1945-1950. Zij werden geïnterneerd in speciale jeugdkampen en onderworpen aan een programma van politieke heropvoeding, gevolgd door intensieve reclassering. Het onderzoek naar deze 'politiek besmette jeugd' beoogt een beschrijving en analyse van dit proces van heropvoeding. Drie vragen staan hierin centraal: 1. naar het opvoedingsklimaat in de kampen; 2. naar de kritiek op dat klimaat vanuit de Stichting Toezicht Politieke Delinquenten, de instelling die met de reclassering was belast; en 3. naar de praktijk van het reclasseringstoezicht.

Reuling-Schappin, M. Kinderen in gevaar of gevaarlijke kinderen?: politieke heropvoeding van NSB-kinderen in tehuizen 1945-1950 / M. Reuling-Schappin In: Pedagogisch tijdschrift = ISSN 1069-2127: vol. 18 (1993), issue speciaal, page 147153. NSB NSB-jeugd Kinderen van foute ouders Loyaliteitsconflict Identiteit Politiek Heropvoeding Door de massale arrestatie van NSB-ers in 1945 bleven duizenden kinderen onverzorgd achter. Een aantal vond een voorlopig onderdak bij familie en bekenden, de overigen werden door de MG ondergebracht in inderhaast georganiseerde provisorische tehuizen onder hun supervisie. Om deze kinderen te 'zuiveren' van het nazi-virus werd een heropvoedingsprogramma opgezet: de achterliggende filosofie was dat men meende dat enkel door hen te leren begrijpen wat democratie en vaderlandsliefde eigenlijk is, deze kinderen weer volwaardige leden van de gemeenschap zouden kunnen worden

Slot, Eric De dood van een onderduiker : Louis van Gasteren en de waarheid / Eric Slot. Amsterdam : Mouria, cop. 2006. - 304 p. ; 21 cm Met lit. opg., reg. ISBN 90-458-5103-2 ISBN 978-90-458-5103-7 Onderzoek naar de dood van de joodse onderduiker Walter Oettinger die om verzetsredenen op zijn onderduikadres zou zijn omgebracht. Verzet Moord Geschiedenis Tweede Wereldoorlog s5 SLO

Verbij, Antoine Hitlers laatste slachtoffers, de verdrijving van de Duitsers uit Polen / Antoine Verbij In: Historisch Nieuwsblad = ISSN 0927-2690: (2008), issue 4 (mei ), page 16-23. Tweede Wereldoorlog Polen 10

Duitsland Naoorlogstijd Integratie Geweld Geschiedenis Tussen 1945 en 1950 verlieten bijna tien miljoen Duitsers Polen. Onder bizarre omstandigheden, mishandeld en gechicaneerd, stroomden ze naar wat er van Duitsland over was. Miljoenen Duitsers kwamen daarbij om het leven. Nog altijd drukt de geschiedenis van deze verdrijvingen zwaar op de verhouding tussen Duitsland en Polen.

Oorlogsgetroffenen, alle categorieen Europa, joods, burgers, verzet, kampverhalen / Victims of war Bloemen, Evert Meer aandacht voor medisch onderzoek in de asielprocedure in Nederland en de Europese Unie: het Care Full initiatief / Evert Bloemen, Erick Vloeberghs In: Mensenrechten en gezondheidszorg = ISSN 0927-2097: (2007), issue december (december), page 6-9. Vluchtelingen Asielzoekers Asielprocedure Gezondheid Psychische stoornissen PTSD Martelingen Onderzoek Het Care Full initiatief is een gezamenlijk project van Pharos, Amnesty International en Vluchtelingenwerk Nederland. Doel van het initiatief is om te komen tot een asielprocedure waarbij asielzoekers die mishandeld en gemarteld zijn, zo vroeg mogelijk opgespoord worden en waarbij medisch en psychologisch onderzoek meeweegt in de beoordeling van hun asielaanvraag.

Dorgeloo, Annemiek Good practices in de ggz : een handreiking voor succesvolle implementatie van interculturele good practices / Annemiek Dorgeloo, Aziza Sbiti en Astrid Kamperman In: CMG = ISSN 1572-5073: (2007), issue 3, page 154-160. Geestelijke gezondheidszorg Vluchtelingen Effectiviteit Onderzoek Vanuit de behoefte aan uitwisseling van kennis en ervaringen opgedaan met de zorgverlening aan migranten en vluchtelingen is Mikado begonnen met het beschrijven van 'good practices'.

Evers-Emden, Bloeme Een andere kijk op de gevolgen van de oorlog voor joden: lezing / Bloeme Evers-Emden In: Waffel: (2007), issue 33 (december), page 26-32. Holocaust Joden

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Kinderen Onderduiken Eerste generatie Tweede generatie Psychosociale gevolgen Veerkracht Zingeving Lezing door Bloeme Evers-Emden over de veerkracht, de beschermende factoren en carrière van de eerste generatie Holocaust-overlevenden. Bloeme Evers noemt dit de 'positieve gevolgen' van de Tweede Wereldoorlog.

Gans, Evelien Jaap en Ischa Meijer : een joodse geschiedenis / Evelien Gans. - Amsterdam : Bakker, 2008-.... - 2 dl. ; 25 cm Jodendom Familiegeschiedenis Holocaust Vader-zoon relatie Biografieën s1.1 GAN-1

Houwink ten Cate, Johannes Herdenken en herinneren hebben zin : mensenrechten een verstandelijke noodzaak / Johannes Houwink ten Cate In: Cogiscope = ISSN 1871-1065: vol. 4 (2008), issue 1, page 24-27. Herdenken Mensenrechten Holocaust Internationaal recht Geschiedenis Genocide Historisch gezien is de huidige voortgaande aandacht voor de shoah uniek, betoogt historicus Johannes Houwink ten Cate. Vergeten is namelijk de regel, niet het herinneren. We houden immers niet van slachtoffers? De volgehouden aandacht voor de shoah komt dan ook niet voort uit medeleven, maar uit welbegrepen eigenbelang: 'de verstandelijke overtuiging dat iedereen slachtoffer van vervolging kan zijn vanwege zijn of haar identiteit.'

Kinderen Kinderen die alles moesten goedmaken : hoe de oorlog doorwerkt in het leven van de Joodse naoorlogse generatie / samenst. Rosalie Anstadt, Adriaan Rottenberg ; naar een idee van André Agsteribbe. - [Amsterdam : JMW], cop. 2008. - 85 p. : ill. ; 24 cm Uitg. t.g.v. van het 60-jarig jubileum van JMW, de zorgcoordinator van Joods Nederland. Met reg. ISBN 978-90-803100-4-9 Holocaust Joden Tweede generatie Psychosociale gevolgen Citaten s8.1.2 KIN-I en II 12

Melching, Willem Nazi-Duitsland en de jodenvervolging : confrontatie met de slachtoffers / Willem Melching In: Cogiscope = ISSN 1871-1065: vol. 4 (2008), issue 1, page 4-7. Duitsland Politiek Holocaust Geschiedenis Joden Persoonlijke ervaringen Recensies Historicus Willem Melching bespreekt van Friedländer's omvangrijke studie 'NaziDuitsland en de Joden'. Hij noemt het een wonderlijk boek: 'enerzijds is het onleesbaar, anderzijds kun je het haast niet wegleggen.' Door het intensieve gebruik van primaire bronnen vertelt hij het verhaal van de holocaust op een bijzondere en zeker originele manier. Zo beschrijft hij gedetailleerd 'de kronkelweg naar Auschwitz', de ontwikkeling en realisering van de gedachte om de joden niet alleen uit te bannen, maar ook fysiek uit te roeien.

Mèle, E. L'héritage de Dachau dans l'oeuvre de Zoran Music = [The legacy of Dachau in the works of Zoran Music] In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 1 (fév), page 57-63. Verwerkingsproces Oorlogsgetroffenen Tekeningen The Slovenian painter Zoran Music (1909-2005) was sent to the concentration camp of Dachau in September 1944. He created there at the risk of his life 100 drawings of what he could see all around him: scenes of hanging, portraits of corpses, stack of bodies sometimes still alive. After the liberation of the camp, he settled in Venice where he started painting again. From 1970, the cycle "We are not the last" explored the visions of the life of a concentration camp which haunted him, first in his dreams then on the paper and the canvas. During the years before his death, Music was interested in portraiture. Then naked, old, and exhausted bodies were represented. In fact the huge task of Music consisted as years went by in struggling against the triumph of wrong by giving a face and an identity to anonymous victims of Nazi barbarity. In the evolution of his works with the reversal of latest years to self-portrait and the appropriation of himself as a subject, we can also see a kind of victory on the traumatic repetition which is here investigated by describing its modalities and stakes. [Author Abstract]

Mendelsohn, Daniël The lost : a search for six of the six million / Daniël Mendelsohn ; photogr. by Matt Mendelsohn. - New York, NY [etc.] : HarperPerennial, 2006. - 950 p. : ill. ; 24 cm Zoektocht naar de achtergronden van de oudoom van de auteur die samen met zijn gezin in een stadje in de Oekraïne tijdens de Holocaust werd vermoord, verweven met bespiegelingen over Bijbelse teksten en de geschiedenis van het joodse volk. Joden Holocaust Familiegeschiedenissen Biografieën 13

s2.2 MEN

Nationalitäten Nationalitäten im KZ / [met bijdr. van May B. Broda ... et al.]. - Dachau : Verlag Dachauer Hefte, 2006. - 246 p. : ill. ; 22 cm. - ( ; Heft 23) ISBN 978-3-9808587-8-6 Concentratiekampen Dachau Holocaust Joden Nederlanders Ravensbrück Staatlozen Ohrbeck Russen s2.5 DAC-13

Schaap, Dick Joodse krijgsgevangene met militaire eer begraven / Dick Schaap In: Checkpoint = ISSN 1567-8210: vol. 9 (2008), issue 3 (april), page 32-34. Krijgsgevangenen Joden Veteranen Krijgsgevangenkampen Krijgsgevangenkamp Deep Persoonlijke ervaringen Het verhaal van de joodse veteraan Ben de Jong (88). Hij heeft als enig lid van zijn familie de oorlog overleefd door gehoor te geven aan het Duitse bevel aan Nederlandse militairen om in krijgsgevangenschap terug te keren. Hij kwam terecht in het vrijwel onbekende krijgsgevangenkamp voor joden in Deep in Pommeren in Oost-Pruisen.

Scheffel-Baars, H.J. The dialogue as a helping hand. A report about the hands-on expertise of Kombi ; [met medew. van: Edith Nagel ... et al. ; vertaling door F.P.J. van der Werff]. - [S.I.] : Stichting Kombi, 2006. - 93 p. ; 31 cm Stichting Kombi Kinderen Oorlogsgetroffenen Eerste generatie Zelfhulpgroepen Verwerkingsproces Traumatische ervaringen Evaluatie Onderzoek s.8.1.1 SCH

Schneiders, Lies Jaap Polak : a happy holocaust survivor / Lies Schneiders In: Cogiscope = ISSN 1871-1065: vol. 4 (2008), issue 1, page 8-12. Oorlogsgetroffenen 14

Verenigde Staten Interviews Coping Joden Persoonlijke ervaringen Emigratie Jaap Polak is een 'oorlogsemigrant'. Na de oorlog vertrok hij naar de VS, naar zijn zeggen omdat zijn naoorlogse leven in Nederland te zeer door de holocaust werd gedomineerd. Hij vertelt Lies Schneiders over zijn oorlogservaringen, zijn overlevingsgedrag in het kamp en zijn schaamte over sommige voorvallen. In Amerika werkte en studeerde hij hard: 'geen tijd voor de holocaust'. In z'n huidige bestaan is daar juist wel veel tijd voor: vanuit het Anne Frank Center is hij betrokken bij tentoonstellingen en houdt hij voordrachten.

Sonke, Paul Dwangarbeider 3154 : het verhaal van Adrie Koopman in de Tweede Wereldoorlog / Paul Sonke. - Vlissingen : Den Boer/De Ruiter, 2007. - 80 p. : ill., krt. ; 24 cm Met lit. opg. ISBN 978-90-74576-92-5 CONTENTS Memoires van een Zeeuwse arbeider (1923) die in de Tweede Wereldoorlog in Letland als dwangarbeider moet werken. Tweede Wereldoorlog Arbeidsinzet Kamp Amersfoort Riga Naoorlogstijd Persoonlijke ervaringen Biografieën s4.2 SON

Surinaamse Surinaamse oorlogsveteranen van de Tweede Wereldoorlog 1939-1945, Korea-oorlog, 1951-1953. - [Paramaribo] : De Ware Tijd, [ca. 1984?]. - 64 p. : ill. ; 28 cm. - (De Ware tijd ; Speciale editie) Omslagtitel. : fl 4.00 Dl. 1: Interviews van Tony Wong met veteranen die deze oorlogen hebben overleefd. Tweede Wereloorlog Korea-oorlog Veteranen Suriname Interviews s8.2 SUR KOC

Venezia, Shlomo Sonderkommando Auschwitz / Shlomo Venezia ; met een inl. van Simone Veil ; [vert. uit het Frans: Zenotext ; foto's en tek.: Pantswowe Museum ... et al.]. - Antwerpen : Manteau ; [Amsterdam] : Ambo, cop. 2008. - 192 p., [16] p. pl. : ill. ; 22 cm Vert. van: Sonderkommando : dans l'enfer des chambres … gaz. - Paris : Albin Michel, 2007. - Met lit. opg. ISBN 978-90-223-2230-7 (Manteau) 15

ISBN 978-90-263-2101-6 (Ambo) Ooggetuigenverslag van de arbeid van een werkploeg van joodse mannen in Auschwitz. Holocaust Concentratiekampen Auschwitz Mauthausen Melk Ebensee Schuldgevoelens Naoorlogstijd Italië Persoonlijke ervaringen Interviews s2.2 VEN

Verloren Verloren stemmen : oorlog in de woorden van kinderen / [samengest. door] Zlata Filipovic en Melanie Challenger ; vert. [uit het Engels] door Bonella van Beusekom. - Amsterdam : Arena, cop. 2008. - 317 p., [8] p. pl. : ill. ; 24 cm Vert. van: Stolen voices : young people's war diaries, from World War I to Iraq. - New York [etc.] : Penguin Books, 2006. ISBN 978-90-6974-916-7 CONTENTS Bloemlezing van dagboekfragmenten van veertien jonge mensen die leefden in verschillende oorlogssituaties. Adolescenten Jongeren Oorlogen Eerste en Tweede Wereldoorlog Vietnam Balkan Isra"el Irak Dagboeken Egodocumenten In samenwerking met journaliste Melanie Challenger heeft Zlata Filipovic (zij werd bekend door haar oorlogsdagboek uit Sarajevo) de afgelopen jaren dagboekfragmenten verzameld die geschreven zijn door kinderen en jongeren vanuit de hele wereld. Vele van deze dagboeken zijn nooit gepubliceerd of inmiddels vergeten. We vernemen de wanhoop, het onbegrip en verdriet, maar ook plannen, ambities en geloof in de toekomst van kinderen in oorlogsgebieden. s9 FIL

Weerden, Jan van De oorlogsvlag : een indrukwekkend document over gewapend verzet, sabotage en spionage in de Tweede Wereldoorlog met als uitvalsbasis Noordoost-Overijssel en ZuidDrenthe / [Jan van Weerden]. - Hardenberg : Heijink, 2008. - 408 p. : foto's. ; 24 cm ISBN 978-90-813017-1-8 Verzet Geschiedenis

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Tweede Wereldoorlog Overijssel Drenthe Egodocumenten s3 WEE

(Voormalig) Nederlands-Indie / Former Dutch East Indies Bruggen-Rufi, Monique van Thuis west, Oost best. Geïndividualiseerde, cultuurgerichte muziektherapie bij Indisch Nederlandse ouderen / Monique van Bruggen-Rufi In: Tijdschrift voor vaktherapie = ISSN 1871-5052: vol. 4 (2008), issue 2, page 9-15. Creatieve therapie Muziektherapie Indische Nederlanders Ouderen Cultuur Hulpverlening Methoden en technieken Onderzoek Ouderen uit het voormalig Nederlands-Indië dragen een specifieke geschiedenis met zich mee. In de hulpverlening aan deze mensen is kennis van hun achtergrond van wezenlijk belang. Dit artikel gaat in op de historische, sociale, en culturele kenmerken van de Indische Nederlander en presenteert een verkennend onderzoek naar de effecten van ge± ïndividualiseerde, cultuurgerichte muziektherapie. Met behulp van de GIPobservatievragenlijst zijn de resultaten van een drietal metingen in kaart gebracht.

Dis, Adriaan van Totok / Adriaan van Dis ; collages Harald Vlugt. - Landgraaf : Herik, 1997. - [32] p. : ill. ; 22 cm. - (Zwarte reeks ; 37) Opl. van 299 genummerde en gesigneerde ex. - Met ill. ISBN 90-73036-57-7 Gedichten van de Nederlandse schrijver over zijn relatie met Indië en met zijn ouders. Totoks Gedichten s6 DIS

Eyden, Ton van der Arts en gezin in de Oost (1928-1946) / Ton van der Eyden. - Zutphen : Walburg Pers, cop. 2006. - 256 p. : ill., krt. ; 23 cm Bevat een aantal brieven van Theo van der Eyden en zijn gezinsleden. - Met lit. opg. ISBN 90-5730-452-X Memoires en brieven over het bewogen leven van een Nederlands artsengezin in Nederlands-Indië/Indonesië tijdens de jaren dertig en veertig, met name tijdens de Japanse bezetting (1942-1945) en de periode daarna. Krijgsgevangenen Interneringskampen Nederlands-Indië Indonesië Biografieën 17

Geschiedenis s6 EYD

Geen Geen haat, maar afkeer. Japanse kampbewakers in de ogen van geïnterneerden in Nederlands-Indië. Een vergelijking van dagboeken, memoires en interviews / Jasper van der Hoek. - [s.n. ; s.l.], 2006. - 123 p. ; 30 cm Masterscriptie Maatschappijgeschiedenis, Faculteit der Historische en Kunstwetenschappen, Erasmus Universiteit Rotterdam. - Met lit. opg.. Nederlands-Indië Interneringskampen Herinnering Geheugen Beeldvorming Memoires Ego-documenten Interviews Vergelijkend onderzoek Scripties s6.1 HOE Geen uitleen.

Graaff, Ant.P. de Eindelijk erkenning : met het vergeten leger in Indië / Ant.P. de Graaff. - Franeker : Van Wijnen, cop. 2008. - 140 p. : ill. ; 21 cm ISBN 978-90-5194-330-6 Politonele acties Indië-veteranen Geestelijke Verzorging Aalmoezenier Erkenning Dagboeken Egodocumenten s6.8 GRA

Klein Kranenburg, Diederick Molukse organisaties verhinderden integratie / Diederick Klein Kranenburg In: Historisch Nieuwsblad = ISSN 0927-2690: (2008), issue 3 (april), page 59-63. Molukkers KNIL Repatriëring Loyaliteit Integratie Isolatie Organisaties Overheid Nederland Al snel na hun aankomst in Nederland richtten de Molukse ex-KNIL-militairen organisaties op om hun belangen bij de Nederlandse overheid te verdedigen. De leiders van deze

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organisaties hielden echter vast aan de geïsoleerde positie van de Molukkers. Hun loyaliteit werd bovendien vaak afgedwongen door intimidatie en sociale uitsluiting.

Lepeltak, Jan Changi, poort naar de hel. Strijd in Singapore / Jan Lepeltak In: MOESSON = ISSN 0165-6546: (2008), issue 2 (augustus), page 23-27. Nederlands-Indië Singapore Krijgsgevangenen Prisoners of War (POW) Changi-gevangenis Oorlogsmusea De Nederlanders vochten in 1942 samen met de Britten om het lot van Singapore. Het verlies van de Britse enclave was een teken aan de wand voor Nederlands-Indië. Overwinnaar Japan gebruikte Singapore als gevangenis voor de honderdduizenden krijgsgevangenen. De Singaporese Changi-gevangenis bood een adempauze voor de gevangengenomen Britten, Australiërs en ook duizenden Nederlanders tijdens hun reis naar Thailand en Birma. Sinds 2003 beschikt de Changi-gevangenis over een oorlogsmuseum.

Overgaauw, Aad Van boerderij naar rimboe : dienstplichtig soldaat in Nederlands-Indië (1948-1950) / Aad Overgaauw. - [S.l.] : F&N Eigen Beheer, 2007. - 195 p. : ill. ; 24 cm ISBN 978-90-78675-17-4 Indië-veteranen Zuid-Sumatra Ego-documenten Brieven Persoonlijke ervaringen s6.8 OVE KOC

Raben, Remco Indonesië erfde een ontregelde samenleving. Geweld tijdens de onafhankelijkheidsstrijd / Remco Raben In: Historisch Nieuwsblad = ISSN 0927-2690: (2008), issue 5-6 (juni-augustus), page 3742. Nederlands-Indië Geweld Onafhankelijkheidsstrijd Nederlanders Indonesiërs Chinezen Geschiedenis De Indonesische revolutie van 1945-1949 ging gepaard met veel bloedvergieten. Het geweld verankerde zich in de Indonesische maatschappij.

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Sprang, Alfred van Wij werden geroepen : de geschiedenis van de 7 December Divisie, met zweten en zwoegen geschreven door twintigduizend Nederlandse mannen / in inkt geboekstaafd door Alfred van Sprang. - 's-Gravenhage : Van Hoeve, 1949. - 243 p. : ill. ; 27 cm Politionele acties Militairen Indië-veteranen s6.8 SPR KOC

Vluchtelingen, hedendaagse oorlogen, transculturele psychiatrie / Refugees - contemporary wars Azizzada, S Geweld tegen vrouwen en het democratiseren van Afghanistan / S Azizzada In: Militaire Spectator = ISSN 0026-3869: vol. 176 (2007), issue 12 (december), page 560569. Dit artikel is een bewerkte versie van het paper Violence against Women in Afghanistan: Oppression and Politics of Violence, dat gepresenteerd werd tijdens de Afghanistanconferentie op 21 juni 2007 op de Universiteit Leiden. Afghanistan Geweld Vrouwen Eergerelateerd geweld Huiselijk geweld Seksueel geweld Cultuur Politiek Onderwijs Gezondheidszorg Overzichtsartikel over geweld tegen vrouwen in Afghanistan en de noodzaak om de positie van vrouwen van binnenuit te verbeteren.

Bolton, Paul Intervention for depression symptoms among adolescent survivors of war and displacement in northern Uganda. A randomized controlled trial / Paul Bolton...[et al.] In: JAMA: the journal of the American Medical Association = ISSN 0098-7484: vol. 298 (2007), issue 5 (augustus), page 519-527. Burgeroorlog Afrika Oeganda Kindoverlevenden Adolescenten Vluchtelingen Depressie Psychosociale problematiek Interventies Onderzoek

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Brocades Zaalberg, Thijs W. Soldiers and civil power : supporting or substituting civil authorities in modern peace operations / Thijs W. Brocades Zaalberg. - Amsterdam : Amsterdam University Press, cop. 2006. - 528 p. : ill. ; 24 cm Oorspr. proefschrift Universiteit van Amsterdam, 2005. - Bibliogr.: p. 431-448. - Lit. opg.: p. 453-522. - Met index. ISBN 90-5356-792-5 ISBN 978-90-5356-792-0 Militairen Vredesmissies Burgers Veiligheid Proefschriften Het scheppen van een veilige omgeving - het doel van de meeste vredesoperaties - is alleen mogelijk als de uitgezonden militairen beschikken over een ruim mandaat en voldoende flexibiliteit om burgertaken die niet of slecht worden vervuld over te nemen. Zo luidt in de kern de theorie die de auteur in zijn proefschrift ontwikkelt. Uit zijn uitgebreide vergelijkend onderzoek van uitzendingen van Vietnam tot Kosovo blijkt dat het probleem vaak ligt in een te beperkte opvatting van de missie. s8.7 BRO

Derluyn, Ilse Different perspectives on emotional and behavioural problems in unaccompanied refugee children and adolescents / Ilse Derluyn In: Ethnicity and Health = ISSN 1355-7858: vol. 12 (2007), issue 2 (april), page 141-162. Vluchtelingen Alleenstaande minderjarige asielzoekers (AMA'S) Kinderen Adolescenten Psychosociale problematiek Traumatische ervaringen Gedrag Methoden en technieken Onderzoek België This study aims, firstly, to investigate the prevelance of emotional and behavioural problems in unaccompanied refugee children and adolescents living in Belgium. Secondly, this study compares the perspectives of the adolescents with those of social workers on the adolescents' emotional well-being.

Ghorashi, Halleh Giving silence a chance : the important of life stories for research on refugees / Halleh Ghorashi In: = ISSN 1471-6925: vol. 21 (2008), issue 1, page 117-132. Vluchtelingen Iran Vrouwen Oral history Zwijgen

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In order to capture refugees' experiences and narratives it is necessary to create space within research to be able to notice the untold within the interviews. This article focuses on the ways that Iranian women refugees (in the Netherlands and the United States) narrate their experiences of the past and the present or stay silent when the experiences are too difficult to talk about. Including the moments of silence within the process of analysing the stories has helped the researcher to discover different layers within the interviews. The main argument of this article is that the combination of the life stories method and the comparative nature of the research have especially helped to find out about the different ways in which the past is positioned within the present narratives. The life stories in particular have created the necessary space to listen to the often untold stories of refugees. This has enabled the researcher to go beyond the expressed words in order to understand different layers of expression within the narratives.

Hillen, J.S.J. 3P: publiek, politiek en pers / J.S.J. Hillen In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 6, page 342-348. Publieke opinie Defensie Krijgsmacht Op 5 mei gaat het om vrede, in het besef dat dit kostbare goed niet allen gegeven is. Er zijn niet voor niets operaties in het buitenland waaraan ook de Nederlandse krijgsmacht deelneemt. In de onmiddelijke omgeving van de krijgsmacht spelen die 'P's': publiek, politiek en pers. Men zegt dat militaire acties tegenwoordig op de beeldbuis worden gewonnen. Misschien zijn de drie P's uiteindelijk hoofdzakelijk met zichzelf bezig. Waar ontwikkelingssamenwerking buiten het jaarlijks loven en bieden van de begroting gehouden, zou dat ook voor defensie moeten gelden. KOC

Leeuwen, J.M.D. van De inhuur van private militaire bedrijven in operatiegebieden / J.M.D. van Leeuwen In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 4, page 240-245. Private militaire bedrijven Krijgsmacht Nederland Beleid De Nederlandse militaire inzet in Uruzgan is afhankelijk van private bedrijven. De omvang van de huidige Nederlandse deelname is immers gebaseerd op het concept dat de logistiek voor een groot deel wordt uitbesteed. Daaraan zijn echter zowel politiek-militaire als juridische en ethische risico's verbonden. Deze risico's zijn te verkleinen door de controle en de greep op de ingehuurde bedrijven te vergroten. Het is hoog tijd voor een volwaardig politiek debat in Nederland over private militaire bedrijven. KOC

Leydesdorff, Selma De leegte achter ons laten : een geschiedenis van de vrouwen van Srebrenica / Selma Leydesdorff. - Amsterdam : Bakker, 2008. - 414 p. : ill., krt. ; 22 cm Met lit. opg. ISBN 978-90-351-3257-3 Srebrenica Oral history 22

Vrouwen Persoonlijke ervaringen Verwerking Hoogleraar Leydesdorff geeft door middel van opgetekende interviews met nabestaanden de herinneringen aan de val van Srebrenica weer, en vooral ook aan de jaren daaraan voorafgaand. De verhalen beginnen in 1992 met de Servische verovering van de regio rond Srebrenica in een campagne die tot doel had een groter Servië te creëren. Op 11 juli 1995, als de enclave op het punt staat in Servische handen te vallen, vluchten duizenden Moslims naar de VN-basis in Potocari.In Leydesdorffs boek wordt duidelijk hoe de vrouwen, die bij de val hun mannen en zonen verloren, om zijn gegaan met deze ervaringen. s5.5 LEY-I en s5.5 LEY-II

Moelker, René Hidden women : women in the Netherlands Armed Forces / René Moelker and Jolanda Bosch. - Breda : Faculty of Military Sciences of the NLDA, 2008. - 68 p. : tab. ; 24 cm. (Publications of the Faculty of Military Sciences ; no. 2008/01) Met lit. opg. - Index. ISBN 978-90-8892-004-2 Vrouwen Krijgsmacht Nederland Beleid s8.7 MOE

Oh, Oh, where have you been my blue-eyed son? : an existentialistic contribution to the understanding of war trauma and PTSD / Vladan Beara and Predrag Miljanović ; vert. [uit het Servo-Kroatisch] Dragana Radovanović and Nebojša Pajić. - Novi Sad : Centre for trauma, 2006. - 224 p.. ; 21 cm Vert. van: Gde si to bio, sine moj?. ISBN 86-9081511-2 Veteranen PTSD Servië Albanië Voormalig Joegoslavië Getuigenissen Existentialisme Beeldvorming Schuldgevoelens In dit boek komen veteranen uit Servië en Albanië aan het woord over hun ervaringen tijdens de verschillende oorlogen in voormalig Joegoslavië. Hoe denken zij over existentiële vragen zoals leven en dood, keuzevrijheid, eenzaamheid en zinloosheid. Wat hebben ze geleerd over de oorlog en hoe denken ze nu over vredesvraagstukken. s8.2 BEA

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Passamar, Marc Programme de santé mentale au décours du tsunami du 26 décembre 2004 (Banda Aceh, Sumatra) = Mental health program after the tsunami of December 2004, Banda Aceh, Sumatra / Marc Passamar, Bernard Vilamot et Gérard Rossinelli In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 1 (fév), page 49-57. Rampen Tsunami PTSD Community Mental Health A mental health program has been created and developed by Médecins du Monde in the post-immediate period following the tsunami of December 2004 at Banda Aceh (Sumatra, Indonesia). The authors recall the context of the disaster and the geopolitical situation, clinical medicine, and direct and indirect care. The emphasis is put on training and awareness of health actors and community leaders. [Author Abstract]

Rol De rol van NGO's en bedrijven in internationale organisaties / [Adviesraad Internationale Vraagstukken]. - Den Haag : Adviesraad Internationale Vraagstukken, AIV, 2006. - 42 p. ; 30 cm. - (Adviesraad Internationale Vraagstukken ; no. 51) Ook verschenen als online resource. - Met lit. opg. Internationale organisaties Non-gouvernementele organisaties Bedrijfsleven s8.7 ROL KOC

Serafin, Amy The missing, a hidden tragedy / Amy Serafin In: Red Cross Red Crescent = ISSN 1019-9349: (2008), issue 1, page 4-6. Oorlog Geweld Vermissing Families Psychotrauma Coping Uncertainty about the fate of their loved ones is a harsh reality for countless families of people unaccounted for as a result of armed conflict or internal violence. Much remains to be done to address this pressing humanitarian issue and to help families cope with the trauma.

Steinweg, K.K. Dealing realistically with fraticide / K.K. Steinweg In: Parameters = ISSN 0031-1723: (1995) (spr), page 4-29. Eigen vuur (Friendly fire) Geschiedenis Beleid Casuïstiek KOC

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Thuis Thuis is ergens tussen herkomst en toekomst: een literatuuronderzoek / Lidwien Raaphorst. - [s.n. ; s.l.], 2008. - 67 p. ; 30 cm Doctoraalscriptie Universiteit voor Humanistiek. - Met lit. opg.. Vluchtelingen Migranten Ballingen Gender Ontworteling Verlies Identiteit Zingeving Processen Scripties s8.6 RAA Geen uitleen

Walzer, Michael Oorlog en dood : over de rechtvaardige oorlog in onze tijd / Michael Walzer ; met essays van Marcel Becker, Désirée Verweij en Thomas Mertens. - Budel : DAMON, cop. 2008. 86 p. ; 22 cm Uitg. naar aanleiding van de Thomas More Lezing 2007 van het Soeterbeeck Programma van de Radboud Universiteit Nijmegen. - Met lit. opg. ISBN 978-90-5573-890-8 Rechtvaardige oorlog Ethiek Polemologie s8.7 WAL

Weine, S. Evaluating a multiple-family group access intervention for refugees with PTSD / S. Weine...et al. In: Journal of marital and family therapy: vol. 34 (2008), issue 2, page . 149-64. Vluchtelingen PTSD Gezinstherapie Behandeling Onderzoek Effectiviteit The purpose of this study was to analyze the effects of a multiple-family group in increasing access to mental health services for refugees with posttraumatic stress disorder (PTSD). This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from BosniaHerzegovina in Chicago. Adults with PTSD (n = 197) and their families were randomly assigned to receive either the intervention or a control condition. The results indicated that a multiple-family group was effective in increasing access to mental health services and that depression and family comfort with discussing trauma mediated the intervention effect. Further well-designed studies of family interventions are needed for developing evidence-based interventions for refugee families.

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Psycho-sociale problematiek en de hulpverlening / Psychosocial issues - consequences Bannink, Fredrike Gelukkig zijn en geluk hebben : zelf oplossingsgericht werken / Fredrike Bannink ; [ill.: Daan Mens]. - Amsterdam : Harcourt Book Publishers, cop. 2007. - 119 p. : ill. ; 24 cm Met lit. opg. ISBN 978-90-265-1803-4 CONTENTS Zelfhulpgids. Psychotherapie Cognitieve therapie Zelfhulp Oplossingsgerichte therapie Praktijkboek s7 BAN

Broeke, Erik ten Praktijkboek EMDR: casusconceptualisatie en specifieke patiëntengroepen / Erik ten Broeke, Ad de Jongh en Hans-Jaap Oppenheim (red.). - Amsterdam : Harcourt, 2008. 493 p. ; 25 cm Met lit. opg. Therapieën EMDR Behandeling PTSD Complexe PTSD Dissociatieve stoornissen Eetstoornissen Persoonlijkhidsstoornissen Cognitieve systeemtherapie Casuïstiek Methoden en technieken Interventies Resource Development and Installation (RDI) Cognitieve interventies Volwassenen Adolescenten Kinderen Protocollen s7.2 PRA

Cazabat, Eduardo H. Evolution historique du concept du dissociation = Historic evolution of the dissociation concept / Eduardo H. Cazabat In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 1 (fév), page 41-48. Geschiedenis Dissociatie

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Dissociatieve stoornissen The phenomenon of dissociation, just like that of psychic trauma, was one of the first topics studied in psychiatry, and then has been rapidly relegated to the background. In the last 20 years the study of childhood sexual abuse and of other forms of complex trauma, which provoke reactions ranging from single dissociation episodes to dissociative identity disorders (earlier named multiple personality disorder), has made the importance of the concept and of its study reappear. This paper presents a brief historic evolution of concept of dissociation and offers some prospects for its development. [Adapted from Author Abstract]

Dijkstra, Sietske Geweld en veerkracht in gezinnen : over posities, professionals en preventie van overdracht / Sietske Dijkstra. - Bilthoven : Dijkstra - Expertise in geweld binnen relaties, 2007. - 184 p. : ill. ; 22 cm Met lit. opg. ISBN 978-90-9021268-5 Huiselijk geweld Gezinnen Veerkracht Overdracht Mishandeling Kinderen Psychotrauma Preventie s8 DIJK

Erlich, Sheila Short-term group therapy with Holocaust survivors and the second generation / Sheila Erlich In: Group: the journal of the Eastern Group Psychotherapy Society = ISSN 1573-3386: vol. 26 (2002), issue 2 (juni), page 163-171. Holocaust Oorlogsgetroffenen Eerste generatie Tweede generatie Kortdurende groepstherapie Transgenerationele overdracht Behandeling Holocaust literature is replete with articles concerning the treatment of survivors in classical, long-term, and family therapy, in addition to second generations in self-help groups. A review of these treatments will follow. However, this literature is limited with respect to survivors (aged mid-20s to early 60s) in short-term group therapy. This paper is the first description of short-term group therapy with this population, and the first description of short-term group therapy with Holocaust survivors and the second generation who are not related.

Hafkenscheid, Anton Naar een gedragcode voor het uitbrengen van 'nieuwe'psychiatrische en psychologische meetinstrumenten : psychodiagnostisch gereedschap / Anton Hafkenscheid and Filip Raes 27

In: De Psycholoog = ISSN 0033-3115: vol. 43 (2008), issue 6, page 336-341. Meetinstrumenten Vragenlijsten Psychologie Veel van de Nederlandse psychologische meetinstrumenten zijn vertalingen van Amerikaanse of Britse vragenlijsten. Soms bestaan er verschillende Nederlandse vertalingen naast elkaar. Dit leidt tot verwarring en versnippering. Een gedragscode of richtlijnen voor onderzoekers zouden dit kunnen voorkomen.

Lemitre, Samuel Trauma et psychopathie : approaches psychanalytique et neuropsychologique intégrées = Trauma and psychopathy : integrating the psychoanalytical and neuropsychological / Samuel Lemitre In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 1 (fév), page 27-35. Kinderen Psychotrauma Lange termijn gevolgen Antisociale persoonlijkheid Geweld Psychopathologie Neuropsychologie According to the literature, there exists a link between experiences of early victimization and later development of psychopathy. Early experiences of body infringement and physical violence in particular seem to be the vectors of violent behaviours in adulthood. Several studies have suggested that antisocial disorders could be a developmental consequence of early and repeated psychotraumas. As part of a larger study aiming at exploring the nature of the link between body imprint of violence and later violent behaviours, this article describes the self-reported early experiences of potentially traumatizing events and PTSD symptoms in a sample of adult psychopaths. 33 adult psychopaths convicted for violent offences were selected in a French prison on the basis of a high score on Hare's psychopathic checklist-revised (" 28). Analysis of the interview material showed that more than 60% of the sample report have experienced serious illtreatments in childhood. About 30% show clear symptoms of PTSD and 45% show clear signs of dissociation. The author discusses possible implications of these findings and formulates psychodynamic hypotheses on the actual role of psychotrauma in the development of psychopathic disorders, integrating neuropsychological materials. [Author Abstract]

Pollak, Eva The Bielefeld Attachment Questionnaires : overview and empirical results of an alternative approach to assess attachment / Eva Pollak, Silke Wiegand-Grefe and Diether Höger In: Psychotherapy research = ISSN 1050-3307: vol. 17 (2008), issue 2, page 179-190. Hechting Vragenlijsten Methodiek Meetinstrumenten

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Pretorius, Werner M. Cognitive Behavioural Therapy Supervision: recommended practice / Werner M. Pretorius In: Behavioural and Cognitive Psychotherapy = ISSN 0141-3473: vol. 34 (2006), issue 4 (oktober), page 413-420. Cognitieve gedragstherapie Supervisie Kwaliteitszorg Behandeling Methoden en technieken In the absence of good quality evidence for the effectiveness of specific aspects or formats of Cognitive Behavioural Therapy (CBT) supervision, it is necessary to consider what is recommended as good quality CBT supervision. This review of the literature aims to provide an overview of the recommended practice of CBT supervision by considering general principles and goals of CBT supervision; the format of individual supervision sessions; the course and stages of CBT supervision; attending to supervisees' cognitions and affects; the importance of the supervisory relationship as well as the recording and rating of therapy sessions. This could provide a framework for setting standards to aspire to and stimulate further research in this field. Conforming to such practice would be an important step toward quality assurance in CBT supervision.

Quest A quest for alternative sociology / ed. by Kenji Kosaka and Masahiro Ogino. - Melbourne : TransPacific Press, 2008. - XI, 271 p. : ill., tab. ; 22 cm. - (Advanced social research series ; vol. 3) Sociologie 'Human Suffering' Rampen Sociale vraagstukken About social research that might serve to enhance human well-being.Twelve chapters are arranged in four sections: Unremedied suffering, 'Taming'suffering, Reciting suffering and multidimensional happiness. Part III contains the following chapters: Aging Japanes American atomic-bom survivors in Southern California / Kayoko C. Nakao and Satoshi Ikeno; From victims divided to victims united:the politics of war trauma in the Netherlands, 1945-1980 / Jolande Withuis; Can one still live happily after Chernobyl?/Bernard Paillard. s 8 Que

Roelofs, Saar Wie is er nu gek? : over kronkels in de therapeutische relatie / Saar Roelofs ; [cartoons Saar Roelofs]. - Schiedam : Scriptum, cop. 2008. - 175 p. : ill. ; 22 cm. - (Scriptum psychologie) ISBN 978-90-5594-582-5 geb. Psychotherapie Hulpverleners Therapeutische relatie Interactieproces Tegenoverdracht Diagnostiek Coping Macht Veerkracht 29

Lotgenoten Bijlmerramp Empathie Psycholoog Roelofs geeft in dit boek een analyse van de hulpverlening in de geestelijke gezondheidszorg. Zij bekritiseert het stellen van diagnoses en de koppeling hiervan aan een standaardbehandeling. Volgens Roelofs heeft de hulpverlener vele zwakke kanten, die zij dan ook uitgebreid belicht aan de hand van de begrippen overdracht en tegenoverdracht. Tevens verwerkt Roelofs in het boek de veerkracht van de hulpvrager en komen vele gevalsbeschrijvingen aan bod. s7 ROE-I en s7 ROE-II

Saussure, Thierry de La religion : bouillon de culture ou voie de guérison du trauma? = Religion, breeding ground or a possible way for the traumatized to recover / Thierry de Saussure In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 2 (mai), page 102-107. Religie Psychotrauma Bijbelteksten Behandeling

Schultz-Venrath, U. Mentalisierungsgestützte Gruppenpsychotherapie : Zur Veränderung therapeutischer Interventionsstile / U. Schultz-Venrath In: ISSN 0017 4947: vol. 44 (2008), issue 2, page 135-149. Mentaliseren Behandeling Mentalization Based Treatment (MBT) Interventies Groepstherapie Hulpverleners Attitude

Thys, Michel De gestilde psyche : over fascinatie, trauma en de doodsdrift / Michel Thys In: ISSN 1382-516x: vol. 14 (2008), issue 1, page 5-17. Psychoanalyse Psychotrauma Dood

Uitterhaegen, Bart Psycho-education and psychosocial support in the Netherlands; a program by and for refugees / Bart Uitterhaegen In: Intervention : the international journal of mental health, psychosocial work and counselling in areas of armed conflict = ISSN 1571-8883: vol. 3 (2005), issue 2, page 141147. Vluchtelingen Asielzoekers Psycho-educatie Psychosociale hulpverlening 30

Hulpverleners Community mental health Methoden en technieken Nederland This article is about a community based intervention program in the Netherlands. In this program, asylum seekers and refugees are trained to provide psycho-education and psychosocial support to fellow groups of refugees and asylum seekers. These trained refugees work in their own language and culture, with a professional coach from a local mental health institute. The group courses consist of psycho-education, psychosocial support and empowerment. On the one hand, they raise awareness of problems like trauma, mourning, stress, feelings of guilt, acculturation, alcohol and drug abuse. On the other hand they teach participants to cope with these problems, rediscover their strength and have confidence in their ability to move forward. Referral takes place when the need for further professional help (e.g. therapy) is identified. In this paper, emphasis is put on the training of trainers.

Vries-Geervliet, Liet de Het begeleiden van mensen met een traumatische ervaring / Liet de Vries-Geervliet. - 1e dr. - Soest : Nelissen, 2007. - 144 p. ; 24 cm. - (PM-reeks) Met lit. opg. ISBN 978-90-244-1776-6 Psychotrauma Slachtoffers Angst Hulpverlening Onderwijsleermiddelen Casuïstiek Behandeling Onmacht Verwerkingsproces Herziene versie van “Over trauma's gesproken". Voor de beginnende hulpverlener die te maken krijgt met getraumatiseerde cliënten. Bevat de volgende hoofdstukken: 1. Trauma's, 2. de angstreactie, 3. de reactie op angst, 4. de uitgeputte hulpvrager, 5. de vertwijfelde hulpvrager, 6. de onevenwichtige hulpvrager, 7. de schuldige hulpvrager, 8. de competenties van de hulpverlener, 9. hulpmiddelen (muziek, taal, beelden, sport en spel), 10. de professionaliteit van de hulpverlener. s8 VRI

Walthuis, Karen Wisselende contacten : de ontmaskering van de coachingsrelatie / Karen Walthuis ; [ill. Julian Kwan]. - [Schiedam] : Scriptum, cop. 2008. - 163 p. : ill. ; 22 cm. - (Scriptum psychologie) Met lit. opg. ISBN 978-90-5594-585-6 geb. CONTENTS Beschrijving van zes mogelijke basishoudingen van coaches en hun mogelijkheden tot verdere professionalisering. Coaching Relaties Coach

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Cliënten Proces s7 WAL

Winants, Y Uit de schaduw van de ander : huiselijk geweld geen privé-zaak meer ; evaluatieonderzoek. - Maastricht : Universiteit van Maastricht, 2007. - 128 p. : ill., tab. ; 23 cm Met lit. opg. en vragenlijsten. Geweld Huiselijk geweld Onderzoek Partners Vrouwen Groepstherapie Effectiviteit PTSD s8.5 Uit

Yalom, Irvin D. The theory and practice of group psychotherapy / Irvin D. Yalom ; with Molyn Leszcz. - 5th ed. - New York, N.Y. : Basic Books, cop. 2005. - xix, 668 p. : tab. ; 24 cm 1st ed.: 1970. - Includes bibliographical references and index. ISBN 0-465-09284-5 : œ32.50 ISBN 978-0-465-09284-0 : œ32.50 Groepstherapie Groepen Overdracht Contra-indicaties Groepsleden Effectiviteit Supervisie Specifieke groepen Interpersoonlijke theorieën Casuïstiek Psychotherapie s7.2 YAL

Zantinge, Else Marie Doctor, can you spare some time? : the role of workload in general practitioners'involvement in patients' mental health problems = Dokter, kunt u wat tijd missen? : de rol van de werklast van huisartsen in relatie tot hun betrokkenheid bij de psychische problemen van patiënten / Else Marie Zantinge. - [S.l. : Nivel], 2008. - 185 p. : ill. ; 24 cm Met lit. opg. - Met samenvatting in het Nederlands. Huisartsen Onderzoek Psychische problemen Werkdruk Proefschriften Elektronisch beschikbaar 32

Zizolfi, S. 'Roschach … Nuremberg' = Rorschach test from Nazi war criminals attending the Nuremberg trial / S. Zizolfi and I. Ruata In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 2 (mai), page 123-129. Roschach test Oorlogsmisdadigers Daders Persoonlijkheid

Traumatische ervaringen / Traumatic experiences Bakker, Heilwine A.H.M. Weerbaarheid voor reddingswerkers : voor professionals die zich inzetten voor orde, gezondheid en veiligheid / Heilwine A.H.M. Bakker. - Den Haag : SDU Uitgevers, 2007. 85 p. : ill. ; 21 cm + DVD. - (Handboeken voor de brandweer ; [6-4]) Met lit. opg. ISBN 978-90-12-12522-2 Beroepen Reddingswerkers Traumatische ervaringen Verwerkingsproces Zelfhulp s8.4 HEI

Bluglass, Kerry Hidden from the Holocaust : stories of resilient children who survived and thrived / Kerry Bluglass ; foreword by Anthony Clare. - Westport, Conn ; London : Praeger, 2003. - xiii, 271 p. : ill. ; 25 cm Includes bibliographical references (p. [255]-261) and index. ISBN 0-275-97486-3 : No price : Formerly CIP Kindoverlevenden Holocaust Kinderen Persoonlijke ervaringen Onderduikkinderen Veerkracht Persoonlijke ervaringen Oral history Nederland Polen Belgie Frankrijk From twins torn away from their family and separated, to a girl shut in a basement, maltreated and malnourished, the world of Jewish children who were hidden from the Nazis during the Holocaust becomes painfully clear in this volume. Psychiatrist Bluglass presents interviews with 15 adults who avoided execution in their childhoods thanks to being hidden, all of whom have since developed remarkably positive lives. s8.1.1.BLU

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Ehlers, A. A cognitive model of posttraumatic stress disorder / A. Ehlers and D.M. Clark In: Behaviour research and therapy = ISSN 0005-7967: vol. 38 (2000), issue 4, page 319345. PTSD Cognitie Modellen Overzichtsartikelen Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model. KOC

EvidenceEvidence- en practice-based psychiatrie : themanummer In:Tijdschrift voor psychiatrie = ISSN 0303 7339: vol. 50 (2008), issue 6, page 311-397. Evidence Based Practice Geschiedenis Evidence Based Medicine Onderzoek Themanummer waarin verschillende standpunten over EBM naar voren komen. s8 EVI Fairbank, John A. The epidemiology of trauma and trauma related disorders in children and youth / John A. Fairbank In: PTSD Research Quarterly = ISSN 1050 1835 (themanummer): vol. 19 (2008), issue 1, page 1-3. Kinderen PTSD Epidemiologie Lange termijn gevolgen Onderzoek Foa, Edna B. Prolonged exposure therapy for PTSD : therapist guide : emotional processing of traumatic experiences / Edna Foa, Elizabeth Hembree, Barbara Rothbaum. - New York ; Oxford : Oxford University Press, 2007. - viii, 146 p. ; 25 cm. - (Treatments that work) Formerly CIP. - Includes bibliographical references. ISBN 0-19-530850-6 pbk : œ19.99 34

ISBN 978-0-19-530850-1 pbk : œ19.99 PTSD Behandeling Cognitieve therapie Dit praktijkboek is een therapeutische gids voor hulpverleners die mensen met PTSD klachten behandelen.In uitgewerkte behandelsessies worden handvatten gegeven (zoals ademhalingsoefeningen en psycho-educatie) om de cliënt te leren omgaan met de traumatische gebeurtenis. Hierdoor treedt een daling in de angst- en PTSD-symptomen op. De behandeling is gebaseerd op de beginselen van Prolonged Exposure Therapy (PET) en Emotional Processing Theory. Van PET wordt gezegd dat de effectiviteit bewezen is. De bijlage bevat een formulier voor het afnemen van een interview over de traumatische gebeurtenis tijdens de eerste sessie. Bij dit boek hoort een werkboek voor de cliënt. s8 FOA

Gerwitz, A. Parenting practices as potential mechanisms for child adjustment following mass trauma / A. Gerwitz, M. Forgatch and E. Wieling In: Journal of marital and family therapy: vol. 34 (2008), issue 2, page 177-192. Ouder-kind relatie Psychotrauma Transgenerationele overdracht Sociale interactie Ouderschap Methodiek Interventies Behandeling Trauma research has identified a link between parental adjustment and children's functioning and the sometimes ensuing intergenerational impact of traumatic events. The effects of traumatic events on children have been demonstrated to be mediated through their impact on children's parents. However, until now, little consideration has been given to the separate and more proximal mechanism of parenting practices as potential mediators between children's adjustment and traumatic events. To shed some light in this arena, we review literature on trauma, adversity, and resilience, and discuss how parenting practices may mediate trauma and adverse environmental contexts. Using a social interaction learning perspective (Forgatch & Knutson, 2002; Patterson, 2005), we propose a prevention research framework to examine the role that parenting practices may play in influencing children's adjustment in the wake of trauma exposure. The article concludes by providing a specific model and role for evidence-based parenting interventions for children exposed to mass trauma

IJzermans, Joris Gevolgen van rampen voor de gezondheid : lessen van de Vuurwerkramp / Joris IJzermans In: Cogiscope = ISSN 1871-1065: vol. 4 (2008), issue 1, page 18-24. Rampen Vuurwerkramp Psychosomatiek Gezondheidszorg Onderzoek

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Lange-termijn gevolgen PTSD Rampenspecialist Joris IJzermans maakt een rondgang door de recente Nederlandse geschiedenis waar het rampen betreft. Hij schetst tussen de watersnoodramp en de Bijlmerramp een mentaliteitsomslag ten aanzien van slachtofferschap en nadien een professionalisering van de opvang en nazorg. Met name de lessen van de Bijlmerramp hebben bij navolgende calamiteiten geholpen om de zorg adequaat in te richten, onder meer door begeleidend onderzoek. Uit dat en vergelijkbaar onderzoek resulteert ook een overzicht van veel voorkomende psychische problemen en lichamelijke symptomen na een ramp.

Johnson, H. The development and maintenance of post-traumatic stress disorder (PTSD) in civilian adult survivors of war trauma and torture: a review / H. Johnson and A. Thompson In: Clinical psychology review = ISSN 0272-7358: vol. 28 (2008), issue 1, page 36-47. PTSD Burger-oorlogsgetroffenen Martelingen Overzichtsartikelen This review provides a comprehensive and critical summary of the literature as to the development and maintenance of post-traumatic stress disorder (PTSD) following civilian war trauma and torture. Prevalence rates are reviewed and predictors are discussed in terms of risk factors, protective factors, and factors that maintain PTSD. Most epidemiologically sound studies found relatively low rates of PTSD. There is good evidence of a dose-response relationship between cumulative war trauma and torture and development and maintenance of PTSD. There is also some evidence that female gender and older age are risk factors in development of PTSD. Some refugee variables may exacerbate symptoms of PTSD and contribute to their maintenance. Preparedness for torture, social and family support, and religious beliefs may all be protective against PTSD following war trauma and torture. Applicability of the concept of PTSD to non-western populations and areas for much needed further study are discussed. KOC

Jongedijk, Ruud De gevolgen van psychotraumatische ervaringen : meer dan PTSS alleen? : sleutelen aan een concept / Ruud Jongedijk In: Cogiscope = ISSN 1871-1065: vol. 4 (2008), issue 1, page 13-17. PTSD Diagnostiek Psychotrauma PTSS, een diagnostisch concept dat ruim 25 jaar geleden juichend werd ontvangen, maar dat ongeveer even lang ook is bekritiseerd, gewogen en vaak te licht bevonden, met allerlei hulpconstructies is gestut of juist uitgehold. Psychiater Ruud Jongedijk verkent het 'veld', de discussies en de nieuwe ontwikkelingen nu het PTSS-concept zich opnieuw een plaats moet verwerven in de nieuwe versie van de psychiaterbijbel, de Diagnostic & Statistical Manual of Mental Disorders.

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Kleber, Rolf J. Weg van het trauma: dilemma's in kennis en toepassing en Trauma: dilemma's in kennis en toepassing; het symposium voorafgaand aan de oratie. - [S.l] : stichting KTP, 2007. 36 p. : Ill., foto's. ; 20 cm Oratie 9 februari 2007. - Lit.opg.: p. 19-21. Psychotrauma Determinisme Emoties Cultuur Redes Symposium PTSS Voorspellen Behandeling EMDR Cultuur Psychobiologie Hormonen Cognitieve gedragstherapie s8 KLE

Labbate, L.A. Posttraumatic stress symptoms among soldiers exposed to combat in the Persian Gulf / L.A. Labbate and M.P. Snow In: Hospital & community psychiatry = ISSN 0022-1597: vol. 43 (1992), issue 8, page 831833. PTSD Golfoorlog-veteranen Nachtmerries Alcoholmisbruik Gewonden Eigen vuur (Friendly fire) KOC

Laramie, J.A. Post-traumatic stress disorder at the end of life / J.A. Laramie In: Home healthcare nurse = ISSN 0884-741X: vol. 25 (2007), issue 5, page 293-298. PTSD Ouderen Overzichtsartikelen KOC

Liempt, S. van Slaapafwijkingen bij posttraumatische stressstoornis: overzicht van onderzoeksbevindingen / S. van Liempt, E. Vermetten, J.H.M. de Groen and H.G.M. Westenberg In: Tijdschrift voor psychiatrie = ISSN 0303 7339: vol. 49 (2007), issue 9, page 629-638. PTSD Slaapstoornissen

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Nachtmerries Overzichtsartikelen Achtergrond: Nachtmerries en insomniaklachten komen voor bij 70% van de patiënten met een posttraumatische stressstoornissen (PTSS). Deze slaapklachten zijn vaak lastig te behandelen terwijl de lijdensdruk groot is. De laatste decennia is een aantal onderzoeken uitgevoerd naar slaapafwijkingen bij PTSS-patiënten. Doel: Dit artikel geeft een overzicht van objectieve kenmerken - in tegenstelling tot zelfbeoordelingsmethoden van slaap bij PTSS-patiënten. Methode: Artikelen gepubliceerd in peer reviewed journals vanaf 1980 tot heden werden verzameld uit Medline en Embase met behulp van de zoektermen 'PTSD', 'sleep', 'nightmares', 'insomnia', 'polysomnography'. Resultaten: Afwijkingen van slaapefficiëntie, arousalregultatie, remslaap, deltaslaap en bewegingsonrust tijdens de slaap worden genoemd. Daarnaast wordt een correlatie beschreven tussen nachtmerries en slaapapnoes bij PTSS. In een aantal onderzoeken worden juist geen afwijkingen gevonden tijdens de slaap bij PTSS. Onderzoeken naar slaapafwijkingen bij PTSS zijn veelal uitgevoerd in kleine of heterogene groepen en de resultaten zijn daarom mogelijk niet consistent. Echter, ook resultaten van grote, meer homogene onderzoeken zijn niet altijd met elkaar in overeenstemming. Conclusie: Er is een discrepantie tussen de klinische relevantie van slaapklachten bij PTSS en eenduidige objectieve slaapafwijkingen. In de toekomst moeten afwijkingen nader geïdentificeerd worden om klachten te verklaren en therapeutische behandelmogelijkheden te kunnen ontwikkelen. KOC

Miller, L.J. Prazosin for the treatment of posttraumatic stress disorder sleep disturbances / L.J. Miller In: Pharmacotherapy = ISSN 0277-0008: vol. 28 (2008), issue 5, page 656-666. PTSD Slaapstoornissen Behandeling Psychofarmaca An estimated 70-87% of patients who suffer from posttraumatic stress disorder (PTSD) experience sleep disruption. These patients have distressing dreams or nightmares in which the traumatic event is reexperienced, and they also have difficulty in falling or staying asleep. Selective serotonin reuptake inhibitors are the treatment of choice for PTSD, but with the exception of fluvoxamine, they are often ineffective or only partially effective for sleep problems. Sedative-hypnotics may be helpful in the short term but are associated with tolerance and addiction potential. In the central nervous system, alpha(1)adrenergic receptors are known to be important in both the startle and sleep responses. Stimulation of these receptors may contribute to PTSD-related trauma-content nightmares. Prazosin, a highly lipophilic alpha(1)-adrenergic receptor blocker that is traditionally used to treat hypertension and benign prostatic hyperplasia, has been shown to decrease the occurrence of trauma nightmares in both combat veterans and patients with non-combat-related PTSD. The available data, although mostly from open-label trials, suggest that this agent also improves sleep quality and patients' sense of wellbeing and ability to function in daily activities. The optimum dose is unknown; however, a doserelated response appears to be evident. Clinicians should monitor for orthostatic hypotension, usually seen early in therapy, when prazosin is started in patients with PTSD. KOC

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Minnen, Agnes van Wie durft? : tien misverstanden over exposure bij de behandeling van PTSS-patiënten / Agnes van Minnen. - [S.l. : s.n.], 2008 (Nijmegen : Thieme MediaCenter). - 22 p. ; 24 cm Inaugurele rede Radboud Universiteit Nijmegen. ISBN 978-90-9023133-4 Exposure PTSD Psychotherapie Angststoornissen Behandeling Redes Exposure PTSD Psychotherapie Angststoornissen Behandeling Redes s8 MIN

Peres, Julio F.P. Traumatic memories : bridging the gap between funcional neuroimaging and psychotherapy / Julio F.P. Peres, Alexander McFarlane, Antonia G. Nasello and Kathryn A. Moores In: In: Australian and New Zealand journal of psychiatry = ISSN 0004-8674: vol. 42 (2008), issue 6, page 487-489. Traumatische herinneringen Geheugen PTSD Psychotherapie Neurologie Traumatic memories are diagnostic symptoms of post-traumatic stress disorder (PTSD), and the dual representation theory posits separate memory systems subserving vivid reexperiencing (non-hippocampally dependent) versus declarative autobiographical memories of trauma (hippocampally dependent). But the psychopathological signs of trauma are not static over time, nor is the expression of traumatic memories. Multiple memory systems are activated simultaneously and in parallel on various occasions. Neural circuitry interaction is a crucial aspect in the development of a psychotherapeutic approach that may favour an integrative translation of the sensory fragments of the traumatic memory into a declarative memory system. Conclusion: The relationship between neuroimaging findings and psychological approaches is discussed for greater efficacy in the treatment of psychologically traumatized patients.

Pomeroy, W.L. Trauma, regression, and recovery / W.L. Pomeroy In: Transactional Analysis Journal = ISSN 0362-1537: vol. 28 (1998), issue 4, page 331340. Psychotrauma Behandeling Regressietherapie

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This article explores the relationship between trauma and regression and suggests that regression is a consequence of trauma. A model is presented that describes human responses to trauma. The model provides an alternative for conceptualizing ego states, games, symbiosis, and regression by comparing ego states with neuropsychology. The process of recovery from catastrophic trauma is discussed, including the role of regressive therapy. KOC

Pomeroy, W.L. A working model for trauma: the relationship between trauma and violence / W.L. Pomeroy In: Pre- and Peri-natal Psychology Journal = ISSN 1097-8003: vol. 10 (1995), issue 2, page 89-101. Psychotrauma Geweld Verwerking Methoden en technieken Presents a working model to explain the relationship between trauma and violence suggests ways for dealing with them. Traumatized people choose violence to resolve their future conflicts and stress. Conversely, violence also leads to traumatic reactions. There are 3 resources which ensure trauma survival: Relational level (identity, power, autonomy, safety, connection, trust, boundaries and grounding), limbic level (fight, flee or freeze reflexes), and shock reflex level (rage, terror and numbness). The 3 categories of trauma responses include transformation and operating resource levels, rigid fundamentalist self and projecting out the unresolved traumas into interactions with the world, and fragmented self, involving rage, anxiety and numbness. Therapeutic processes focus on reconnecting clients to their lost resources and functional relational self so that their reliance on rigid fundamentalist, antisocial or destructive strategies is reduced. KOC

Regeer, Leo Over angst, geweld en terrorisme. Vanuit de Radar methode Regeer, angst regeert de politiek / Leo Regeer In: Tijdschrift voor Agressie Preventie = ISSN 1872-6534: vol. 2 (2008), issue 4, page 610. Terrorisme Geweld Angst Agressie Methoden en technieken Radar methode Regeer Interventies Preventie Interventies en preventie vanuit de Radar methode Regeer bij terrorisme, angst en geweld. Professioneel omgaan met (dreigend) terrorisme vanuit de Radar methode Regeer. Definities en kenmerken van hevige angst en voorbeelden van gedragskenmerken terrorisme in Radarniveaus.

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Rinne, Thomas The neuro-endocrine scars of sustained childhood abuse in adult female patients with borderline personality disorder / Thomas Rinne. - [S.l. : s.n.] ; Amsterdam : Universiteit van Amsterdam [Host], cop. 2002. - 125 p : ill Proefschrift Universiteit van Amsterdam. - Met lit. opg. - Met samenvatting in het Nederlands. ISBN 90-9015816-2 Borderline Psyhiatrie Endocrinologie Serotonine Persoonlijkheidsstoornissen Vrouwen Psychotrauma Kindermishandeling Psychofarmaca Antidepressiva Rinne deed tien jaar lang onderzoek naar de effecten van jeugdtrauma's onder patiënten met een borderline persoonlijkheidsstoornis. Een traumatische jeugd blijkt een sterke risicofactor om later een borderline-persoonlijkheid te ontwikkelen. Zestig procent van de borderliners is als kind langdurig mishandeld of seksueel misbruikt. Rinne onderzocht de neuroendocriene veranderingen en het effect van SSRI's met betrekking tot de normalisering van deze neuroendocriene veranderingen en de verbetering van de borderline-persoonlijkheidsstoornis. s8.5 RIN

Soir, Erik De Stress en trauma bij de politie / Erik De Soir, Patrick Van den Steene, Frédéric Daubechies. - Antwerpen ; Apeldoorn : Maklu, 2007. - 246 p. : ill. ; 24 cm. - (Politie praktijk boeken) Ook verschenen in het Frans o.d.t.: Stress et trauma au milieu policier. - Met lit. opg. ISBN 978-90-466-0057-3 CONTENTS Monografie met een overzicht van de literatuur over stress en trauma om zich nadien te richten op het domein van de psychotraumatologie en de principes van de eerste psychologische ondersteuning. Stress Politie Preventie Nazorg s8 SOI

Spitzer, Carsten Childhood maltreatment in patients with somatization disorder / Carsten Spitzeret al. In: In: Australian and New Zealand journal of psychiatry = ISSN 0004-8674: vol. 42 (2008), issue 4, page 335-341. Psychosomatiek Seksueel geweld Kindermishandeling Lange termijn gevolgen 41

Onderzoek There is converging evidence indicating a close association between trauma, particularly childhood trauma, and adult somatization, but studies using both structured interviews and self-report measures to assess childhood adversities in patients with somatization disorder are scarce. Methods: A total of 28 patients (82% women, mean age=41.7± «10.1years) meeting DSM-IV criteria for somatization disorder as confirmed by the Structured Clinical Interview for DSM-IV, Axis I (SCID-I) underwent the Structured Trauma Interview (STI) and the Childhood Trauma Questionnaire (CTQ). The comparison group consisted of 28 patients with major depression, but without a lifetime diagnosis of somatization disorder matched for gender and age. Results: Univariate analyses of both the STI and the CTQ data showed that somatizing patients had been exposed to childhood sexual and physical abuse significantly more often than major depressive disorder (MDD) patients. In logistic regression analysis with somatization disorder as the dependent variable, sexual abuse emerged as the only significant predictor, and the odds of having been sexually abused were ninefold higher in patients with somatization disorders relative to MDD subjects (odds ratio=9.39; 95% confidence interval=1.73-50.96). There were no differences between somatizing and depressed participants with respect to other types of maltreatment. Conclusion: Childhood sexual abuse is an important factor in the multifactorial aetiopathogenesis of somatization disorder. Diagnostic and therapeutic implications are discussed.

Wessa, Michèle Failure of extinction of fear responses in Posttraumatic stress disorder: evidence from second-order conditioning / Michèle Wessa, 3001 In: American Journal of Psychiatry = ISSN 0002-953x: vol. 164 (2007), issue 11 (november), page 1684-1692. PTSD Traumatische ervaringen Second-order conditioning Behandeling Methoden en technieken Onderzoek PTSD is characterized by the re-experiencing of a traumatic event, although the trauma itself occurred in the past. The extinction of the traumatic response might be impeded if trauma reminders maintain fear responses by their association with the original trauma through second-order conditioning.

PTSD / general PTSD Bodkin, J. Alexander Is PTSD caused by traumatic stress? / J. Alexander Bodkin, Harrison G. Pope, Michael J. Detke, James I. Hudson In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 176-182. Special issue on: Challenges to the PTSD construct and its database. PTSD Psychotrauma Depressie Diagnostiek Etiologie

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Sequential subjects (N=103) presenting for pharmacologic treatment of major depression were examined prior to treatment for history of traumatic experiences. Subjects were also examined for symptoms of posttraumatic stress disorder (PTSD). Two blinded raters subsequently judged whether subjects' experiences met DSM-IV criteria for trauma (criterion A of PTSD). Among 54 subjects scored by both raters as having experienced trauma, 42 (78%) met all other DSM-IV criteria for PTSD. Among 36 subjects scored by both raters as not having experienced trauma, 28 displayed all other DSM-IV criteria for PTSD--also a rate of 78%. This equivalence suggests that in a treatment-seeking population, caution should be exercised in attributing the PTSD syndrome to trauma.

Bryant, Richard A. Does dissociation further our understanding of PTSD? / Richard A. Bryant In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 183-191. Special issue on: Challenges to the PTSD construct and its database. PTSD Dissociatie Acute stress stoornis Peritrauma Peritraumatic dissociation, and other dissociative reactions, refer to alterations in awareness in the context of a traumatic experience. This review provides an overview of the current conceptualization of dissociation, critiques methodological approaches to studying dissociation, and reviews the evidence for the purported relationship between dissociative reactions and posttraumatic stress disorder. The evidence challenges the notion that a linear relationship exists between dissociation and psychiatric morbidity. Future research should abandon the global construct of dissociation, and study the specific responses that involve altered awareness under experimental conditions.

Casey, P. The imperative in PTSD: integrating biology and clinical practice / P. Casey In: Irish Journal of Psychological Medicine = ISSN 0790-9667: vol. 21 (2004), issue 1, page 4-5. PTSD Diagnostiek Neurobiologie This article discusses the neurobiology of, controversies surrounding, recall bias in, diagnosis of and malingering in posttraumatic stress disorder (PTSD). KOC

Coyne, James C. Posttraumatic stress syndromes: useful or negative heuristics? / James C. Coyne, Richard Thompson In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 223-229. Special issue on: Challenges to the PTSD construct and its database. PTSD Acute stress stoornis Dissociatie Nosologie Onderzoek Wetenschap

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The articles in this special issue provide a wide range of challenges to current conceptions, nosology, and assessment procedures for posttraumatic stress disorders. At best, they overcome the negative heuristic posed by these disorders, reopening issues that have preemptively been closed about dissociation, the presumed causal connection between a life threatening event and the symptoms of posttraumatic stress disorders, and the adequacy of checklist assessments of symptoms. They note discontinuities between current thinking about these disorders and the dominant thinking of the past. We make recommendations for more studies that similarly challenge the validity of current conceptions of posttraumatic disorders and dissociation, and the adequacy of checklist assessments of symptoms. With this goal, we note the value of studying ersatz posttraumatic stress response. Finally, we call for greater transparency in this literature with author disclosure of activity as expert witnesses.

Damiani, Carole La haine et le trauma ou felix culpa = hate and trauma ou felix culpa / Carole Damiani In: Revue Francophone du stress et du trauma = ISSN 1626-3375: vol. 8 (2008), issue 2 (mai), page 94-102. Haat Schuldgevoelens PTSD Behandeling Agressie Psychical trauma can trigger hate-induced behaviours and affects, mainly when it results from an intentionally committed transgressive act such as an aggression or rape. We must differentiate the traumatized subjects with only a transitory hate from those clinging to it permanently. We must also then identify the origins of this hate, such as the breaking of social links, the psychical distress experience and the 'passivation' and the lack of guilt. These distinctions influence the posttraumatic therapeutic technique, which will rely on the verbal expression of hate, traumatisms identification, depressive position elaboration and groupal casing restoration.

Jones, Edgar A paradigm shift in the conceptualization of psychological trauma in the 20th century / Edgar Jones, Simon Wessely In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 164-175. Special issue on: Challenges to the PTSD construct and its database. PTSD Psychotrauma Shell schock Neurosen Ziektewinst Lange-termijn effecten Tweede Wereldoorlog Vietnam The inclusion of posttraumatic stress disorder (PTSD) in DSM-III in 1980 represented a paradigm shift in the conceptualisation of post-trauma illness. Hitherto, a normal psychological reaction to a terrifying event was considered short-term and reversible. Long-term effects, characterized as "traumatic neurosis", were regarded as abnormal. Enduring symptoms were explained in terms of hereditary predisposition, early maladaptive experiences or a pre-existing psychiatric disorder. The event served merely

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as a trigger to something that existed or was waiting to emerge. Secondary gain, the benefits often but not solely financial that a person derived as a result of being ill, was considered the principal cause of any observed failure to recover. The recognition of PTSD reflected a diversion from the role of the group, in particular the "herd instinct", towards a greater appreciation of the individual's experience. From being the responsibility of the subject, traumatic illness became an external imposition and possibly a universal response to a terrifying and unexpected event. This shift from predisposition to the characteristics of the event itself reduced guilt and blame, while the undermining of secondary gain made it easier to award financial compensation.

McHugh, Paul M. PTSD: A problematic diagnostic category / Paul M. McHugh, Glenn Treisman In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 211-222. Special issue on: Challenges to the PTSD construct and its database. PTSD Stress Dissociatie Diagnostiek Combat fatigue Neurosen Vietnam Since the publication of Diagnostic and Statistical Manual of Mental Disorders (DSM)-III, posttraumatic stress disorder (PTSD) has become a remarkably dominant theme in mental health discourse and diagnostic practice. This development has been encouraged by the diagnosis being officially presumed to exist in acute, chronic, delayed, complex, subdromal, and even "masked" forms. Here, we present an historical and clinical review that indicates how, since 1980, the term PTSD (along with its dubious embellishments) replaced established views on mental responses to trauma to the detriment of patient care and psychiatric investigation. From this historical perspective, we review and evaluate the natural course of emotional and behavioral reactions to traumatic experiences, and as well their assessment, formulation, and therapeutic management in both civilian and military situations. From this we conclude that the concept of PTSD has moved the mental health field away from, rather than towards a better understanding of the natural psychological responses to trauma. A return to prior standards of diagnostic practice and therapeutic planning would greatly benefit patient care, rehabilitative services to veterans, and epidemiologic research.

Rosen, Gerald M. Editorial: Challenges to the PTSD construct and its database: The importance of scientific debate / Gerald M. Rosen, B. Christopher Frueh In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 161-163. Special issue on: Challenges to the PTSD construct and its database. PTSD Diagnostiek Statistieken Methoden en technieken Hulpverlening A special issue in the Journal of Anxiety Disorders on "Challenges to the PTSD construct and its database" comes at a time when the field of traumatic stress is reexamining itself and scholars are debating the validity of basic assumptions. Some have suggested that

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scientific debate concerning PTSD can be opposed to the interests of victims and to those who suffer the effects of severe trauma. Yet, scientific methods, and associated critiques, provide the best way to advance our knowledge, so that professionals can provide accurate information, sound advice, and non-harmful interventions to those in need.

Spitzer, Robert L. Saving PTSD from itself in DSM-V / Robert L. Spitzer, Michael B. First, Jerome C. Wakefield In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 233-241. Special issue on: Challenges to the PTSD construct and its database. PTSD DSM Acute stress stoornis Diagnostiek Papers in this special issue of the Journal of Anxiety Disorders concern critical issues and core assumptions that underlie the diagnostic construct of posttraumatic stress disorder. Rather than addressing specific points raised in these papers, we consider the issues and their implications for redefining PTSD and associated disorders in the DSM-V. Specific proposals are advanced to tighten definitional criteria for traumatic events and posttraumatic symptoms. We believe the more stringent criteria express the intent of the PTSD category and will promote more effective research on whether that intent was legitimate or based on misconceptions.

Young, Allan Trouble memories: reflections on the future / Allan Young, Naomi Breslau In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 230-232. Special issue on: Challenges to the PTSD construct and its database. PTSD Traumatische ervaringen Herinneringen DSM As represented in the DSMs, the PTSD syndrome coheres through cause and effect relations among diagnostic features. Research practices routinely ignore this essential characteristic, by atomizing the diagnostic features, especially the role of memory. The failure to confront this contradiction explains the failure of research to fully engage the pathological process that justifies the PTSD diagnostic classification. Several papers in this collection direct readers' attention to this fundamental problem. We are pessimistic that their insight will lead to positive results.

Behandeling / Treatment Beek, Fiet van Werken met levensverhalen en levensboeken : praktische handleiding voor begeleiders / Fiet van Beek en Martin Schuurman. - Houten : Bohn Stafleu Van Loghum, 2007. - 242 p. ; 25 cm Met lit. opg. ISBN 978-90-313-5170-1 CONTENTS Theoretische en praktische achtergrondinformatie over het werken met levensverhalen in verschillende sectoren van de zorgverlening. Levensverhalen 46

Hulpverlening Praktijkboeken Onderwijsleermiddelen Dit boek bevat drie onderdelen: 1. Achtergronden en basisprincipes, 2. Werken met levensverhalen en levensboeken in de praktijk en 3. Voorbeelden uit de praktijk (de Jeugdzorg, Verstandelijke Gehandicapten, GGZ en Ouderenzorg.) s7 BEE

Blokland-Vos, Judith Je vak in schema's. Deel 1: Vaktherapie binnen een kader van schematherapie / Judith Blokland-Vos, Greta Günther, Connie van Mook In: Tijdschrift voor vaktherapie = ISSN 1871-5052: vol. 4 (2008), issue 2, page 17-23. Creatieve therapie Dramatherapie Psychomotorische therapie Beeldende therapie Schematherapie Methoden en technieken Behandeling Hoe werk je als vaktherapeut concreet met schematherapie. In deel 1 wordt vanuit de drie disciplines dramatherapie, psychomotorische therapie en beeldende therapie de theorie van schematherapie in verband gebracht met vaktherapie.

Bot, Hanneke Babel in behandeling : groepstherapie met asielzoekers, vluchtelingen en tolken / Hanneke Bot en Frits van Hest In: MgV = ISSN 0024 8576: vol. 63 (2008), issue 5, page 388-399. Groepstherapie Tolken Hulpverleners Vluchtelingen

Bot, Hanneke Meertalige groepstherapie met tolken : deel 2 / Hanneke Bot en Frits van Hest In: Groepen :tijdschrift voor groepsdynamica en groepstherapie = ISSN 1871-1146: vol. 3 (2008), issue 2, page 21-36. Groepstherapie Tolken Grenzen Valkuilen

Farr, A Religion, spirituality, and medicine: psychiatrists' and other physicians' differing observations, interpretations, and clinical approaches / A Farr, M.D. Curlin en meerdere auteurs...[et al.] In: The American Journal of Psychiatry = ISSN 0002-953x: vol. 164 (2007), issue 12 (december), page 1825-1831. Religie Spiritualiteit Welzijn 47

Gezondheid Psychiatrie Behandeling Onderzoek This study compared the ways in which psychiatrists and nonpsychiatrists interpret the relationship between religion/spirituality and health and address religion/spirituality issues in the clinical encounter.

Guide A guide to treatments that work / ed. by Peter E. Nathan, Jack M. Gorman. - 3rd [ext. rev.] ed. - Oxford [etc.] : Oxford University Press, 2007. - XXV, 758 p. : ill. ; 26 cm Oorspr. uitg.: 1998. - Met lit. opg. en index. ISBN 0-19-530414-4 ISBN 978-0-19-530414-5 PTSD Behandeling Therapieën Psychiatrie Psychotherapie Gedragstherapie Psychofarmaca Psychische stoornissen Depressie Dementie Handboek s8 GUI

Gomperts, Wouter De verdubbeling van de wereld : weerstand in de therapie bij tweedegeneratie migratiegerelateerde identiteitsproblematiek / Wouter Gomperts In: Tijdschrift voor psychoanalyse = ISSN 1382 516x: vol. 14 (2008), issue 2, page 83-96. Identiteit Migranten Tweede generatie Casuïstiek Psychoanalyse

Hout, Ingrid van den Als de nood hoog is, is de aandacht nabij : Mindfulness Based Stress Reduction voor getraumatiseerde vluchtelingen / Ingrid van/den Hout en Pauline van Zon In: CMG = ISSN 1572-5073: (2007), issue 3, page 130-140. Mindfullness Vluchtelingen Methodiek Psychotrauma Effecten Meditatie Psycho-educatie Mindfulness als therapeutische methodiek is in opkomst. Een training op dit gebied is de Mindfulness Based Stress Reduction (MBSR). In Nederland wordt het stressreductie door 48

aandachttraining genoemd. Bij Equator, behandelprogramma voor getraumatiseerde vluchtelingen en asielzoekers van het AMC de Meren in Amsterdam, wordt voor deze doelgroep een aangepaste vorm van MBSR ontwikkeld

Vamos, Marina Case Report: Survivor guilt and chronic illness / Marina Vamos In: Australian and New Zealand journal of psychiatry = ISSN 0004-8674: vol. 31 (1997), issue 4, page 592-596. Ziekteverschijnselen Comorbiditeit Overlevingsschuld Behandeling To examine the grief reactions that may result in patients after a death occurs within a treatment setting for chronic illness, and in particular to look at the applicability of the concept of survivor guilt in these situations. Clinical picture: Two patients with endstage renal disease are described. Both presented states of pathological grief for fellow patients. Vulnerability existed in both patients in terms of previous unresolved mourning and in terms of strong feelings of comradeship with the dead patients. Both demonstrated features reminiscent of what has been termed the 'survivor syndrome'. Treatment: The treatment involved supportive psychotherapy allowing exploration of grief and its relationship to current psychosomatic crises. Outcome: Supportive psychotherapy successfully aided the resolution in one patient and made some difference in the other. Conclusion: The impact of death within a treatment unit is emphasised. Surviving patients may have significant distress relating to such bereavement and may need appropriate intervention.

Van den Bossche, Daan Developmental Transformations. Kennismaking met en implementatie van een dramatherapiemethode / Daan Van den Bossche, Marjo Baars In: Tijdschrift voor vaktherapie = ISSN 1871-5052: vol. 4 (2008), issue 2, page 3-8. Creatieve therapie Dramatherapie Methoden en technieken Developmental Transformations Supervisie Dit artikel introduceert de methode en de voornaamste basiprincipes van Developmental Transformations. Dit is een op improvisatie gebaseerde methode, waarbij spel ontstaat via spontaan opkomende bewegingen, geluiden, woorden, beelden en scènes die volgens het proces van de vrije associatie voortdurend worden getransformeerd. Het gaat in op de hier-en-nu interacties tussen therapeut en cliënt. De methode is breed inzetbaar: van stemmingsstoornissen, persoonlijkheidsstoornissen, gedragsstoornissen, trauma tot schizofrenie.

Kinderen / Children Lakho, Hameeda Geheim geweld / Hameeda Lakho ; [in samenw. met Siska Mulder ... et al.]. - [Amsterdam] : Arena, cop. 2005. - 236 p. ; 24 cm Met lit. opg. ISBN 90-6974-712-X 49

Via dit boek over haar persoonlijke ervaringen met kindermishandeling (zij werd als kind jarenlang ernstig mishandeld door haar vader en stiefmoeder) en kindermishandeling in het algemeen, vraagt de Pakistaans-Nederlandse auteur om meer aandacht voor en en openheid over kindermishandeling. Kindermishandeling Kinderen Egodocumenten Persoonlijke ervaringen van Pakistaans-Nederlandse vrouw die in haar jeugd door haar vader werd mishandeld. Zij vertelt wat er gebeurde, wat de mishandeling met haar heeft gedaan en hoe ze er mee omgaat. s8.5 LAK

Nader, Kathleen Understanding and assessing trauma in children and adolescents : measures, methods, and youth in context / Kathleen Nader. - New York [etc.] : Routledge, cop. 2008. - XVII, 562 p. : ill. ; 24 cm. - (Psychosocial stress ; 35) Met lit. opg. en index. ISBN 0-415-96073-8 ISBN 978-0-415-96073-1 Psychotrauma Kinderen Adolescenten Psychiatrie Psychopathologie Comorbiditeit Veerkracht Methoden en technieken Diagnostiek s8 NAD

Perry, Bruce D. De jongen die opgroeide als hond en andere verhalen uit de praktijk van een kinderpsychiater / Bruce D. Perry & Maia Szalavitz ; [vert. uit het Engels: Marie-Christine Ruijs]. - Schiedam : Scriptum, cop. 2007. - 293 p. ; 21 cm. - (Scriptum psychologie) Vert. van: The boy who was raised as a dog and other stories from a psychiatrist's notebook : what traumatized children can teach us about life. loss and healing. - New York : Basic Books, 2007. - Met lit. opg., index. ISBN 978-90-5594-529-0 Kindermishandeling Behandeling Verhalen Casuistiek Psychotrauma Veerkracht Psychiatrie Traumatische ervaringen Hersenen Empathie Kinderpsychiater Perry geeft in dit boek inzicht in wat traumatische ervaringen kunnen doen met kinderen. Hij bespreekt wat hij de verschillende kinderen aan behandeling heeft

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geboden en wat volgens hem de voorwaarden zijn voor bijvoorbeeld de ontwikkeling van inlevingsvermogen. Perry gaat ook in op de effecten van mishandeling op de hersenen van het kind. s8.5 PER

Samen Samen spelen. Samen helen! Dramatherapie ter preventie van psychopathologie bij kinderen die getuigen zijn geweest van een grootschalige schokkende gebeurtenis / L. Hendrickx. - [s.n. ; s.l.], 2008. - 60 p. ; 30 cm Met vragenlijsten. - Opleiding creatieve (drama)therapie, Hogeschool Zuyd Heerlen, Faculteit Gezondheid en Zorg. - Met lit. opg.. Kinderen Traumatische ervaringen Stress-reacties Psychosociale hulpverlening Preventie Cultuur Creatieve therapie Dramatherapie Methoden en technieken Werkvormen Scripties s7.2 HEN-I Geen uitleen

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Ouderen / Elderly King, Deborah A. Het ontstaan van 'gezinsintegriteit' op latere leeftijd / Deborah A. King In: Gezinstherapie wereldwijd = ISSN 1566-0206: vol. 18 (2007), issue 1, page 1-34. Levensfasen Volwassenen Ouderen Gezinnen Families Relaties Transformatie Zingeving Hulpverlening Onderzoek In dit artikel wordt het concept 'gezinsintegriteit' geïntroduceerd, dat verwijst naar de uiteindelijke positieve uitkomst van het streven van ouderen naar zingeving, binding en continuïteit binnen hun multigenerationele gezin. Objectief gezien, op het niveau van waarneembare relationele processen, komt dit aan het licht in drie onderling samenhangende competenties van het gezin als systeem: 1. de transformatie van relaties in de loop van de tijd op een manier die dynamisch is en reageert op de veranderende behoeften in de levenscyclus van individuele gezinsleden; 2. het oplossen en aanvaarden van eerdere verliezen of gezinsconflicten, zowel met overlevenden als de levenden; 3. gezamenlijke zingeving door individueel erfgoed en dat van het gezin en tussen generaties door te geven. Met casussen en voorbeeldvragen om de gezinsintegriteit te beoordelen.

Langen, Monique de Muziek op maat: werken met muziek in de psychogeriatrie / Monique de Langen In: Denkbeeld = ISSN 0926-7182: vol. 19 (2007), issue 6 (december), page 26-28. Ouderen Dementie Psychogeriatrie Muziektherapie Voorkeursmuziek Hulpverleners Mantelzorgers Vragenlijsten Muziek kan van grote invloed zijn op het welbevinden van ouderen met dementie. Hoe zit het met de muzikale wensen en voorkeuren van ouderen? Monique de Langen onderzocht hoe hulpverleners en mantelzorgers de voorkeursmuziek van dementerende ouderen kunnen achterhalen en hiervan gebruik kunnen maken.

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Rampen - ongelukken / Disasters - accidents Kilpatrick en meerdere auteurs, Dean G. The serotonin transporter genotype and social support and moderation of posttraumatic stress disorder and depression in hurricane-exposed adults / Dean G. Kilpatrick en meerdere auteurs[et al.] In: The American Journal of Psychiatry = ISSN 0002-953x: vol. 164 (2007), issue 11 (november), page 1693-1699. Rampen PTSD Depressie Volwassenen Erfelijkheid Onderzoek Disasters are associated with increased risk of posttraumatic stress disorder (PTSD) and major depression, but no study, to the authors' knowledge, has determined whether genotype interacts with disaster exposure and social support to moderate risk of these phenotypes. The authors tested the hypothesis that a polymorphism in the serotonin transporter gene (locus, SLC6A4; variant, serotonin 5-HTTLPR) moderates risk of posthurricane PTSD and major depression given high hurricane exposure and low social support. Method: The authors interviewed a household probability sample of adults 6-9 months after the 2004 hurricanes about hurricane exposure, social support, and posthurricane PTSD and major depression. DNA was collected from a subset of participants. Participants were 589 adults ages 18 and older from 38 Florida counties who provided valid DNA samples. Outcome measures were DSM-IV diagnoses of post-hurricane PTSD and major depression derived from structured interviews. Results: The low-expression variant of the 5-HTTLPR polymorphism increased risk of post-hurricane PTSD and major depression but only under the conditions of high hurricane exposure and low social support after adjustment for sex, ancestry (as determined by Bayesian clustering of genotypes), and age. Similar effects were found for major depression. High-risk individuals (high hurricane exposure, the low-expression 5-HTTLPR variant, low social support) were at 4.5 times the risk of developing PTSD and major depression of low-risk individuals. Conclusions: The low-expression variant of the 5-HTTLPR polymorphism modifies risk of postdisaster PTSD and major depression under conditions of high hurricane exposure and low social support, confirming and extending previous research.

(Seksueel) geweld / (Sexual) violence Klonsky, E. David Childhood sexual abuse and non-suicidal self-injury: meta-analysis / E. David Klonsky, 3001 In: The British Journal of Psychiatry = ISSN 0007-1250: vol. 192 (2008), page 166-170. Seksueel geweld Kinderen Zelfverwonding Volwassenen Onderzoek A meta-analysis was conducted to determine systematically the magnitude of the association between childhood sexual abuse and the self-injurious behaviour.

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Veteranen / Veterans Aiken, L.J. Memories of three wars: a nurse's story / L.J. Aiken In: Critical care nursing clinics of North America = ISSN 0899-5885: vol. 20 (2008), issue 1, page 67-71. Verpleegsters Vietnam Golfoorlog Irak Persoonlijke ervaringen This is the personal story of a civilian critical care nurse who has worked for several decades with war casualties. It begins with her memories of the Vietnam era and her reflections on that war. It then describes how the National Naval Medical Center in Bethesda, Maryland, prepared for the Desert Storm War and continues through the current war in Iraq. The article provides a glimpse of a long and meaningful nursing career and expresses the joy and satisfaction of caring for the wounded warriors of today's conflict. KOC

Al-Turkait, F.A. Post-traumatic stress disorder among wives of Kuwaiti veterans of the first Gulf War / F.A. Al-Turkait and J.U. Ohaeri In: Journal of anxiety disorders = ISSN 0887-6185: vol. 22 (2007), issue 1, page 18-31. PTSD Militairen Partners Golfoorlog Koeweit Diagnostiek OBJECTIVES: To assess post-traumatic stress disorder (PTSD) among wives of Gulf War Kuwaiti military men, divided into four groups according to degree of combat exposure: the retired, an active-in-the-army group (AIA) (involved in duties at the rear); an in-battle group (IB) (involved in combat); and a prisoners-of-war (POWs) group. To assess the relationship between wives' PTSD and indices of family adjustment, husbands' level of combat exposure, and PTSD status. METHOD: One hundred and seventy-six wives were assessed with the PTSD Checklist for DSM-IV, the family adjustment device, and for anxiety/depression. RESULTS: Fifty (28.4%) fulfilled criteria for probable PTSD. The prevalence was significantly associated with husbands' combat exposure, her presence in Kuwait, but not with husbands' PTSD status. Wives' PTSD was mostly predicted by their depression/anxiety scores. CONCLUSION: The findings support the salience of effective social support, and the need for women empowerment issues in psychosocial intervention for this group. KOC

Al-Turkait, F.A. Prevalence and correlates of posttraumatic stress disorder among Kuwaiti military men according to level of involvement in the first Gulf War / F.A. Al-Turkait and J.U. Ohaeri In: Depression and anxiety = ISSN 1091-4269: (2007) (oct).

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PTSD Militairen Golfoorlog Koeweit Diagnostiek First, to compare the prevalence and intensity of posttraumatic stress disorder (PTSD) among Kuwaiti military men, divided into four groups (50 subjects each) according to degree of exposure to war trauma: (1) the retired (retired before the invasion); (2) an active-in-the-army group (AIA) (involved in duties at the rear only); (3) an in-battle (IB) group (involved in combat); and (4) prisoners of war (POWs-captured during combat). Second, to compare the severity of impact of event, comorbid depression, and anxiety among the groups. Third, to evaluate the contribution of self-esteem and locus of control (LOC). Subjects were interviewed once, 6 years after the war, using: the Clinician Administered PTSD Scale; the Impact of Event Scale (IES); the Hopkins Symptom Checklist-25; the Internal-External LOC; and The Self-Esteem Scale. Subjects were aged 24-71 years (mean 37.9). Sixty-three subjects (31.5%) fulfilled criteria for PTSD, with the rate significantly higher among the POWs (48%) than the retired (24%) and IB (22%), reflecting the severity of IES. Avoidance symptoms were the most pronounced. Selfesteem was significantly lowest among the POWs and those with PTSD. External LOC was associated with PTSD, anxiety, and depression. Self-esteem was the only covariate of PTSD scores. LOC was a significant covariate for anxiety. The characteristics of PTSD in these veterans showed similarity with those from elsewhere. The prominence of selfesteem and avoidance symptoms implies that they should be part of focus for interventions. Focus on LOC should be from the perspective of anxiety. KOC

Ambler, D.M. Military families: opportunities and challenges / D.M. Ambler In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 59-61. Gezinnen Militairen Hulpverlening KOC

Andres, M. Uitzendervaringen van partners / M. Andres en R. Moelker In: Carré = ISSN 0165-7437: vol. 30 (2007), issue 7-8, page 15-19. Thuisfront Militairen Partners Kinderen Thuisfrontzorg is een heel bijzonder stukje personeelszorg. Het is belangrijk dat partners hun militairen op uitzending een hart onder de riem steken, maar even belangrijk is het dat het met de thuisblijvers ook goed gaat, want zij hebben het soms nog zwaarder dan de uitgezonden militairen. KOC

Ang, D.C. Predictors of incident chronic widespread pain among veterans following the First Gulf War / D.C. Ang...[et al.] 55

In: Clinical Journal of Pain = ISSN 0749-8047: vol. 22 (2006), issue 6, page 554-563. Pijn Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Objective: We sought to determine the predictors of incident chronic widespread pain (CWP), specifically, the effect of preexisting symptoms, stress, and psychosocial factors in the subsequent development of CWP among veterans from the first Gulf War (GW). Methods: We conducted a structured telephone survey (baseline) of military personnel originally from Iowa who were either eligible for or deployed to Operation Desert Shield/Desert Storm, approximately 5 years postconflict. We conducted a follow-up, clinical, in-person study of those who met a priori-defined outcomes of symptoms of cognitive dysfunction, depression, or CWP, and also a sample of those who did not meet any of the outcomes of interest. Results: A total of 370 of 602 evaluated GW veterans were free of CWP 5 years postconflict. At follow-up, 69 (19%) of these had developed CWP. A positive family history of medically unexplained persistent symptoms [odds ratio (OR)=4.8 (2.3, 13.2)] was strongly associated with CWP. At baseline, individuals who reported preexisting symptoms of bronchitis [OR=4.9 (1.9, 12.3)] and cognitive dysfunction [OR=2.1 (1.1, 4.2)] were more likely to develop CWP. Alcohol use [OR=0.2 (0.1, 0.7)] was protective against CWP. Rather than combat-related exposure per se, the perception of stress at the time of the GW [OR=1.6 (1.1, 2.3)] correlated with CWP. Discussion: Among the GW veterans evaluated longitudinally in this study, family history, predeployment symptoms, and the level of perceived stress during the GW were associated with subsequent development of CWP. KOC

Artiss, K.L. The combat soldier / K.L. Artiss In: Military Medicine = ISSN 0026-4075: vol. 165 (2000), issue 1, page 33-40. Golfoorlogsyndroom Golfoorlog-veteranen Sociologie The Gulf War illness problem is seen as a postwar syndrome related to veteran discontent rather than as a new phenomenon. K. L. Artiss proposes that application of social psychiatric thinking and workmen's compensation experience can help in understanding the problem. Social psychiatry has been neglected in the training of many psychiatrists so that they fail to understand the Army as a community and to recognize that a community's parts may develop symptom neuroses. Most psychiatrists know that a symptom neurosis will not disappear until it no longer serves its purpose. The young soldier may know that he is being trained for combat duty but manages to distance himself from the realities of military combat by creating a psychic reality that protects him. Social psychiatric emphasis is used to describe the soldier's response when brought face to face with himself as a combatant with overwhelming responsibilities and genuine lethal danger. KOC

Axelrod, B.N. Gulf War illness research: separating the wheat from the chaff / B.N. Axelrod and I.B. Milner In: Clinical Neuropsychologist = ISSN 1385-4046: vol. 14 (2000), issue 3, page 344-348.

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Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek Overzichtartikelen Clinical research of veterans' illnesses from the neuropsychology and medical literature are reviewed. Some studies reveal no significant findings, while others indeed detect a higher incidence of clinical and laboratory abnormalities in veterans of Operations Desert Storm and Desert Shield. It is noted that neuropsychological deficits are negligible and more often associated with affective, than cognitive, disruption. Some explanations of the results are offered, as are recommendations regarding the utility of clinical research. KOC

Baker, F.M. Establishing a geriatric psychiatric consultation in a VA medical center / F.M. Baker and B. Chrismer In: American Journal of Geriatric Psychiatry = ISSN 1064-7481: vol. 3 (1995), issue 4, page 348-352. Veteranen Ouderen Hulpverlening Evaluaties Describes the establishment of a geriatric psychiatry consultation-liaison team (GPCLT) at a VA medical center (VAMC) that previously had no organized geriatric psychiatric service. Geriatric psychiatric consultation was required by 3 intermediate-care units treating older, chronically medically ill veterans with psychiatric symptoms or disorders. The GPCLT comprised a Black female geriatric psychiatrist and a White male social worker. This combination of disciplines maximized skills, and the ethnic-gender differences of team members addressed questions of racial tension and gender issues between patients and VAMC staff. The compliance with recommendations of the GPCLT, its selection as a clinical site for a university affiliated geriatric psychiatry fellowship program, and the increase in the total hours of social work time assigned to the GPCLT documented the positive perception of the team by both the VAMC and the affiliated university. KOC

Barber, J.A. Monitoring the Dissemination of Peer Support in the VA Healthcare System / J.A. Barber...[et al.] In: Community mental health journal = ISSN 0010-3853: (2008) (may). Zelfhulpgroepen Veteranen Evaluaties This study illustrates a monitoring system for peer support programs, focusing on Vet-toVet, a program for veterans with chronic psychiatric disorders. The sample consisted of 1,847 anonymous surveys from 38 veteran peer support programs. Program satisfaction and recovery orientation were positively associated with duration and frequency of participation in peer support. Program satisfaction was also associated with the Vet-to-Vet model and location at a VA medical center (vs. other model & location types). Payment for peer facilitators was positively associated with recovery orientation, spirituality, and

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engagement in meaningful activity. Additional research using experimental design methods is needed to determine the impact of peer support on mental health outcomes. KOC

Batten, S.V. Integrative outpatient treatment for returning service members / S.V. Batten and S.J. Pollack In: Journal of clinical psychology = ISSN 0021-9762: (2008) (jun). Militairen Hulpverlening Irak Afghanistan Casuïstiek Veterans returning from Operations Enduring and Iraqi Freedom (OEF/OIF) frequently present with multiple psychological and physical symptoms. The authors propose an innovative approach in which primary care providers, polytrauma specialists, vocational rehabilitation specialists, and mental health clinicians work together to provide care that is not simply concurrent, but truly integrated. All members of this interdisciplinary team must provide a consistent message that supports treatment engagement and progress. The authors illustrate this approach with a case report of a soldier deployed to both OEF and OIF, requiring subsequent treatment for joint pain, headaches, mild traumatic brain injury, posttraumatic stress disorder, depression, and substance abuse. Despite the emphasis on early intervention, treatment engagement and retention remain challenges in this population. KOC

Beckham, J.C. Preliminary findings from a clinical demonstration project for veterans returning from Iraq or Afghanistan / J.C. Beckham...[et al.] In: Military Medicine = ISSN 0026-4075: vol. 173 (2008), issue 5, page 448-451. Stoppen met roken Veteranen Afghanistan Irak Military veterans are at high risk for nicotine dependence. This clinical demonstration project used invitational letters, referral to the National Cancer Institute's Smoking Quitline, and local Veteran Affairs prescriptions for tobacco cessation to evaluate whether this lowcost method would potentially reduce smoking in separated veterans who served in Afghanistan and Iraq. Three cohorts (500 each) of recently separated veterans from Afghanistan and Iraq were contacted by survey letters. Interested veterans received follow-up telephone calls using standardized scripts. They were referred to the National Cancer Institute's Smoking Quitline (1-877-44U-QUIT) and offered local Veteran Affairs pharmacologic treatment for smoking cessation. Forty-three percent of respondents who were smokers were interested in the clinical program; of these, 77% participated. At 2 months follow-up, 38% of participants self-reported maintained smoking abstinence. Results suggested that the intervention was feasible and assisted the small number of veterans who participated. KOC

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Bell, I.R. Cognitive dysfunction and disability in geriatric veterans with self-reported intolerance to environmental chemicals / I.R. Bell In: Journal of Chronic Fatigue Syndrome = ISSN 1057-3321: vol. 3 (1997), issue 3, page 15-42. Chemische stoffen Veteranen Ouderen Golfoorlogssyndroom The symptom of sensitivity or intolerance to low levels of environmental chemicals (CI) is a characteristic of several clinical conditions, such as multiple chemical sensitivity, chronic fatigue syndrome, fibromyalgia, and the "Persian Gulf Syndrome." This study examined the prevalence and health patterns of CI in 160 elderly veterans. 37% of the sample endorsed the screening question asking whether they considered themselves "especially sensitive to certain chemicals." The CI group reported a significantly higher rate of physical disability, an increased susceptibility to becoming sick, and decreased rates of cigarette smoking and alcohol use. The groups did not differ in depression level or in past occupational chemical exposures. However, the CI group scored significantly lower on a cognitive dysfunction screening test and showed verbal memory performance consistent with early dementia. Subdividing the Ss by depression, the depressives without CI reported the highest rate of prior occupational exposure to pesticides. The subgroup with both CI and depression performed most poorly on the attention/concentration screening. The data suggest that CI as a symptom is extremely common in older male veterans and may be a marker for increased risk of further cognitive decline. KOC

Bergen, L. van De waarde van historische kennis voor medisch-polemologische kwesties / L. van Bergen In: Nederlands Militair Geneeskundig Tijdschrift = ISSN 0369-4844: vol. 61 (2008), issue 3, page 100-104. Geneeskunde Geschiedenis Polemologie Het belang van geschiedkundige kennis is en wordt heden ten dage vaak onderstreept door een bonte stoet van mannen en vrouwen van fikse (inter)nationale en onderwijskundige statuur - al dan niet omdat zij ons met ge- dan wel misbruik van die geschiedenis ervan willen overtuigen dat zij het bij het rechte eind hebben. Zonder kennis van de geschiedenis, zo houden zij ons voor, weten we niet waar we vandaan komen en hoe we zijn geworden wat we zijn. Een volk of land zonder historische kennis is een volk of land dat zichzelf niet kent. Zonder kennis van historische wortels van een bepaalde situatie, kan die situatie niet worden gekend en begrepen. Problemen die er mee samenhangen of uit voortkomen, kunnen dan niet worden opgelost. KOC

Bieliauskas, L.A. What Persian Gulf War Syndrome? / L.A. Bieliauskas and R.S. Turner In: Clinical Neuropsychologist = ISSN 1385-4046: vol. 14 (2000), issue 3, page 341-343. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek 59

Overzichtartikelen Reviews reports of physical and neuropsychological syndromes putatively associated with service in the Persian Gulf War and ostensibly providing evidence for Gulf War Syndrome (GWS). Major methodological weaknesses are identified in the studies and it is contended that there is no solid evidence for GWS at this time. Suggestions are given for future investigations of symptoms associated with service during the Gulf War which may accurately lead to a tangible identification of a war-related illness entity. KOC

Bijkerk, Rein Veteranen met een missie : humanitaire initiatieven door oud-militairen in voormalige uitzendgebieden / Rein Bijkerk en Fred Lardenoye. - Doorn : Stichting het Veteraneninstituut ; Amsterdam : Nationale Commissie voor Internationale Samenwerking en Duurzame Ontwikkeling, 2008. - 23 p. : ill. ; 21± Ë24 cm Omslagtitel. - Een verkennend onderzoek in opdracht van Stichting Veteraneninstituut (SVi) en de Nationale Commissie voor Internationale Samenwerking en Duurzame Ontwikkeling (NCDO). - Eindrapport juni 2008. Ontwikkelingssamenwerking Humanitaire hulpverlening Veteranen Militairen s8.2 BIJK KOC

Binder, L.M. Comparison of MMPI-2 profiles of Gulf War veterans with epileptic and nonepileptic seizure patients / L.M. Binder...[et al.] In: Assessment = ISSN 1073-1911: vol. 7 (2000), issue 1, page 73-78. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom As part of a larger study of illnesses related to service in the Gulf War, Minnesota Multiphasic Personality Inventory-2 (MMPI-2) profiles of epileptic seizure patients; nonepileptic seizure (NES) patients; Gulf War veterans with unexplained cognitive, psychological, musculoskeletal, fatigue, or dermatologic symptoms; and asymptomatic Gulf War veterans were analyzed. There were 70 people in each group. Seizure diagnosis was based upon intensive EEG monitoring. Gulf War cases were mildly abnormal on MMPI-2 Scales Hs and D and significantly higher than controls on 8 of 10 MMPI-2 clinical scales, but they were significantly lower than NES patients on several scales including Hs and Hy. KOC

Binder, L.M. Medically unexplained symptoms and neuropsychological assessment / L.M. Binder and K.A. Campbell In: Journal of Clinical and Experimental Neuropsychology = ISSN 1380-3395: vol. 26 (2004), issue 3, page 369-392. Onverklaarde lichamelijke klachten (OLK) Syndromen 60

Golfoorlog-syndroom Diagnostiek Several illnesses expressed somatically that do not have clearly demonstrated pathophysiological origin and that are associated with neuropsychological complaints are reviewed. Among them are nonepileptic seizures, fibromyalgia, chronic fatigue syndrome, Persian Gulf War unexplained illnesses, toxic mold and sick building syndrome, and silicone breast implant disease. Some of these illnesses may be associated with objective cognitive abnormalities, but it is not likely that these abnormalities are caused by traditionally defined neurological disease. Instead, the cognitive abnormalities may be caused by a complex interaction between biological and psychological factors. Nonepileptic seizures serve as an excellent model of medically unexplained symptoms. Although nonepileptic seizures clearly are associated with objective cognitive abnormalities, they are not of neurological origin. There is evidence that severe stressors and PTSD are associated with immune system problems, neurochemical changes, and various diseases; these data blur the distinctions between psychological and organic etiologies. Diagnostic problems are intensified by the fact that many patients are poor historians. Patients are prone to omit history of severe stressors and psychiatric problems, and the inability to talk about stressors increases the likelihood of suffering from physiological forms of stress. KOC

Binder, L.M. Neurobehavioral deficits associated with chronic fatigue syndrome in veterans with Gulf War unexplained illnesses / L.M. Binder...[et al.] In: Journal of the International Neuropsychological Society = ISSN 1355-6177: vol. 7 (2001), issue 7, page 835-839. Golfoorlogsyndroom Chronische vermoeidheidssyndroom (CVS) Golfoorlog-veteranen Notes that Gulf War unexplained illnesses (GWUI) are a heterogeneous collection of symptoms of unknown origin known to be more common among veterans of the Gulf War than among nonveterans. This study focused on 1 of these unexplained illnesses. The authors tested the hypothesis that in a sample of Persian Gulf War veterans chronic fatigue syndrome (CFS) was associated with cognitive deficits on computerized cognitive testing after controlling for the effects of premorbid cognitive differences. Armed Forces Qualification Test (AFQT) data acquired around the date of induction into the military was obtained for 94 veterans of the Gulf War, 32 with CFS (mean age 28.78 yrs) and 62 healthy controls (mean age 29.55 yrs). Results indicate that controls performed better than Ss diagnosed with CFS on the AFQT. Cognitive deficits were associated with CFS on 3 of 8 variables after the effect of premorbid AFQT scores was removed with ANCOVA. KOC

Binneveld, Hans Beter worden op bevel. De psychisch gewonde soldaat en het ontstaan van de militaire psychiatrie / Hans Binneveld In: Kleio = ISSN 0165-6449: vol. 48 (2007), issue 8 (december), page 30-33. Eerste Wereldoorlog Militairen Shell shock Militaire psychiatrie

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Therapieën Geschiedenis Overzichtsartikel over de gevechtssituatie en de spanningen in de loopgraven tijdens de Eerste Wereldoorlog, de psychische problemen die daarmee gepaard gingen en het ontstaan van de militaire psychiatrie.

Bormann, J.E. A spiritually based group intervention for combat veterans with posttraumatic stress disorder: feasibility study / J.E. Bormann...[et al.] In: Journal of holistic nursing = ISSN 0898-0101: (2008) (mar). PTSD Veteranen Behandeling Groepstherapie Spiritualiteit Purpose: To assess the feasibility, effect sizes, and satisfaction of mantram repetition-the spiritual practice of repeating a sacred word/phrase throughout the day-for managing symptoms of posttraumatic stress disorder (PTSD) in veterans. Design: A two group (intervention vs. control) by two time (pre- and postintervention) experimental design was used. Methods: Veterans were randomly assigned to intervention (n = 14) or delayedtreatment control (n = 15). Measures were PTSD symptoms, psychological distress, quality of life, and patient satisfaction. Effect sizes were calculated using Cohen's d. Findings: Thirty-three male veterans were enrolled, and 29 (88%) completed the study. Large effect sizes were found for reducing PTSD symptom severity (d = -.72), psychological distress (d = -.73) and increasing quality of life (d = .70). Conclusions: A spiritual program was found to be feasible for veterans with PTSD. They reported moderate to high satisfaction. Effect sizes show promise for symptom improvement but more research is needed. KOC

Brandwijk, Klazien van 'Kom heel terug!': hoe krijgen ouders hun kinderen terug na een uitzending? / Klazien van Brandwijk In: Checkpoint = ISSN 1567-8210: vol. 9 (2008), issue 3 (april), page 18-20. Vredesmissies (VN) Veteranen Indië-veteranen Cambodja-veteranen Uruzgan Thuisfront Ouders Angst Hoe kijken ouders naar hun kinderen die uitgezonden zijn (geweest) en hoe wordt er tegen ouders aangekeken? Een overzichtsartikel vanaf de Tweede Wereldoorlog tot nu. Van onbegrip tot betere communicatiemiddelen en erkenning.

Broek, Patricia van den Liefde onder vuur : gesprekken met soldaten en hun geliefden: van Nederlands-Indië tot Afghanistan / Patricia van den Broek. - [Tilburg] : Nieuwland, cop. 2008. - 150 p. ; 22 cm Met lit. opg. 62

ISBN 978-90-8645-028-2 Nederlandse militairen en hun partners vertellen hoe de uitzending naar een oorlogsgebied hun relatie heeft beïnvloed. Militairen Veteranen Vredesmissies Relaties Partners Thuisfront Interviews Persoonlijke ervaringen Psychosociale gevolgen s8.2 BRO

Brown, T.M. Gulf War syndrome: polysomnographic study of eight cases / T.M. Brown, S.A. Fleishman and M.F. Casanova In: Journal of Chronic Fatigue Syndrome = ISSN 1057-3321: vol. 2 (1996), issue 1, page 41-51. Golfoorlogsyndroom Chronische vermoeidheidssyndroom Golfoorlog-veteranen Diagnostiek Examined whether patients complaining of the "Gulf War Syndrome" might have hidden sleep disorders, or psychiatric disorders, similar to what has been described in patients with chronic fatigue syndrome and fibromyalgia. Eight consecutive Gulf War veterans (aged 28-49 yrs) from the VA Gulf War Registry and Evaluation program complaining of fatigue and other symptoms, were psychiatrically and polysomnographically screened. One S was found to have major depression and posttraumatic stress disorder (PTSD), while another had PTSD alone. The sleep diagnoses assigned to the 8 Ss were as follows: 3 Ss had sleep apnea syndrome, one of whom also had periodic limb movements of sleep disorder. Four Ss met criteria for periodic limb movements of sleep disorder. Four Ss had clinically significant sleep state-misperceptions. All of the patients' symptoms were reported as occurring subsequent to Gulf War deployment, and not prior to deployment. It is concluded that as with the classic fatigue syndromes such as chronic fatigue syndrome and fibromyalgia, Gulf War Syndrome patients may benefit from a more thorough investigation of their sleep and psychiatric status. KOC

Calhoun, P.S. Interpersonal trauma, war zone exposure, and posttraumatic stress disorder among veterans with schizophrenia / P.S. Calhoun...[et al.] In: Schizophrenia research = ISSN 0920-9964: vol. 91 (2007), issue 1-3, page 210-216. PTSD Schizofrenie Veteranen Diagnostiek The present study examined the prevalence of war zone exposure, interpersonal trauma and post-traumatic stress disorder (PTSD) in veterans with primary schizophrenia hospitalized on a VA inpatient psychiatric unit. Data were collected on a sample of male

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veterans (N=165) with a primary diagnosis of schizophrenia or schizoaffective disorder, who were consecutively admitted to a VAMC inpatient psychiatric unit. The prevalence of interpersonal trauma exposure and comorbid PTSD were assessed. Analyses also explored differences between those patients who had been identified with PTSD to those who screened positive but had not been previously identified as having PTSD. Ninety-six percent of the sample endorsed interpersonal trauma or exposure to a war zone. The prevalence of PTSD was 47% (n=78), although only 14% (n=11) of those who screened positive for PTSD had a diagnosis of PTSD in their medical record. Among those screening positive, having a chart diagnosis of PTSD was associated with more severe PTSD symptoms and combat exposure. Results suggest that PTSD is highly prevalent and under-diagnosed among veterans with schizophrenia. Increased assessment of trauma and PTSD in this population is warranted. KOC

Campion, B.H. Psychological morbidity during the 2002 deployment to Afghanistan / B.H. Campion...[et al.] In: Journal of the Royal Army Medical Corps = ISSN 0035-8665: vol. 152 (2006), issue 2, page 91-93. Geestelijke gezondheid Militairen Afghanistan Groot-Brittannië Questionnaires were completed by military personnel on arrival (n=1,696) in Kabul, Afghanistan and then again on departure (n=1,134). Analysis of the 113 personnel who completed both the arrivals and departures questionnaire revealed a lower alcohol use score after deployment (AUDIT mean difference (post-deployment - pre-deployment) = 0.39, 95% confidence interval (CI) = - 1.25 - +0.47) and no significant change to mental health (GHQ mean difference = 0.55, 95% CI = -0.07 - +1.17). An increase in psychosomatic symptoms (GHQ A mean difference = 0.22, 95% CI = -0.03 - +0.47) is considered to result from the adverse conditions, but it is not supported by other mental ill health markers. In conclusion, there appeared to be no negative effect on mental health from deployment to Afghanistan. KOC

Casarett, D. A nationwide VA palliative care quality measure: the family assessment of treatment at the end of life / D. Casarett...[et al.] In: Journal of palliative medicine = ISSN 1096-6218: vol. 11 (2008), issue 1, page 68-75. Ouderen Veteranen Pallatieve zorg Evaluaties OBJECTIVES: To evaluate the FATE (Family Assessment of Treatment at End of Life) Survey for use as a nationwide quality measure in the VA health care system. DESIGN: Nationwide telephone survey. SETTING: Five VA medical centers. PARTICIPANTS: Eligible patients received inpatient or outpatient care from a participating VA facility in the last month of life. One respondent/patient was selected using predefined eligibility criteria and invited to participate. MEASUREMENTS: The FATE survey consists of 32 items in 9 domains: Well-being and dignity (4 items), Information and communication (5 items),

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Respect for treatment preferences (2 items), Emotional and spiritual support (3 items), Management of symptoms (4 items), Choice of inpatient facility (1 item), Care around the time of death (6 items), Access to VA services (4 items), and Access to VA benefits after the patient's death (3 items). RESULTS: Interviews were completed with 309 respondents. The FATE showed excellent psychometric characteristics, with good homogeneity (e.g., Cronbach (alpha = 0.91) and no evidence of significant ceiling effects. The FATE also demonstrated good discriminant validity. For instance, FATE scores varied across facilities (range 44-72; Kruskal Wallis test p < 0.001). Patients who were seen by a palliative care service had better scores (mean 66 versus 52; rank sum test p < 0.001), as did patients who were referred to hospice (67 versus 49; rank sum test p < 0.001). CONCLUSIONS: The FATE survey offers an important source of quality data that can be used to improve the end-of-life care of all veterans, regardless of the type of care they receive or their site of death. KOC

Chalder, T. Prevalence of Gulf war veterans who believe they have Gulf war syndrome: questionnaire study / T. Chalder...[et al.] In: British Medical Journal = ISSN 0959 8138: vol. 323 (2001), issue 7311, page 473-476. Gezondheid Golfoorlog-veteranen Golfoorlogsyndroom Groot-Brittannië Determined how many veterans who served in the Gulf war believe they have "Gulf war syndrome" (GWS), examined factors associated with this belief, and compared the health status of Ss who believe they have GWS with those who do not. 2,961 Ss completed a questionnaire asking whether Ss believe they have GWS and about symptoms, fatigue, psychological distress, post-traumatic stress, physical functioning, and Ss' perception of their health. Results show that 17.3% of the respondents believed they had GWS. Ss belief was associated with having poor health, not serving in the army when responding to the questionnaire, and having received a high number of vaccinations before deployment to the Gulf. The strongest association with Ss' belief that they had GWS was knowing another person who also thought they had GWS. The authors conclude that substantial numbers of British Gulf war veterans believe they have GWS. It is concluded that a combination of biological, psychological, and sociological factors are associated with the belief of having GWS, and that these factors should be addressed in clinical practice. KOC

Ciccone, D.S. Chronic fatigue syndrome in male gulf war veterans and civilians: a further test of the single syndrome hypothesis / D.S. Ciccone, L. Weissman and B.H. Natelson In: Journal of health psychology = ISSN 1359-1053: vol. 13 (2008), issue 4, page 529-536. Golfoorlogsyndroom Chronische-vermoeidheidssyndroom Golfoorlog-veteranen Burgers Vergelijkend onderzoek Different modes of fatigue onset in male Gulf War veterans versus male civilians raise the possibility that chronic fatigue syndrome (CFS) may not be a single disease entity. We addressed this issue by comparing 45 male veterans with CFS to 84 male civilians who

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satisfied identical case criteria. All were evaluated for fibromyalgia (FM), multiple chemical sensitivity and psychiatric comorbidity. CFS was more likely to present in a sudden flu-like manner in civilians than veterans (p < .01) and comorbid FM was more prevalent in civilians (p < .01). These findings question the assumption that all patients with CFS suffer from the same underlying disorder. KOC

Clark, M.E. Pain and combat injuries in soldiers returning from Operations Enduring Freedom and Iraqi Freedom: implications for research and practice / M.E. Clark...[et al.] In: Journal of rehabilitation research and development = ISSN 0748-7711: vol. 44 (2007), issue 2, page 179-194. Gewonden Pijn Militairen Irak Hulpverlening Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) have resulted in a growing number of seriously injured soldiers who are evacuated to the United States for comprehensive medical care. Trauma-related pain is an almost universal problem among these war-injured soldiers, and several military and Department of Veterans Affairs initiatives have been implemented to enhance pain care across the continuum of medical services. This article describes several innovative approaches for improving the pain care provided to OEF and OIF military personnel during acute stabilization, transport, medicalsurgical treatment, and rehabilitation and presents summary data characterizing the soldiers, pain management services provided, and associated outcomes. We also identify some of the pain assessment, classification, and treatment challenges emerging from work with this population and provide recommendations for future research and practice priorities. KOC

Clark, M.E. Post-deployment pain: a need for rapid detection and intervention / M.E. Clark In: Pain Medicine = ISSN 1526-2375: vol. 5 (2004), issue 4, page 333-334. Pijn Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Pain, typically of musculoskeletal or unexplained origin, was one of the most common symptoms reported by military personnel deployed to the Persian Gulf prior, during, and following the 1991 Gulf War. Despite the brief duration of armed conflict and the limited number of casualties, almost 15% of US Persian Gulf War (PGW) veterans have pursued treatment for Gulf War-related problems. We examined summary medical data for 619 post-deployment personnel enrolling for treatment at a large southeastern VA medical center from 2002 to the present. Over 50% of those reporting some pain (23.1% of the total) had scores exceeding the VA's national trigger for significant pain (pain > 4). The high rate of pain problems in this sample is consistent with the report that the most frequent diagnoses among all AIW veterans are diseases of the musculoskeletal system which affect approximately 30% of those enrolling in VA healthcare services. As we

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improve in our success in the early identification of pain-related problems we also must expect increased demands on pain care resources. By anticipating the needs of returning AIW military personnel and implementing corresponding changes in healthcare systems responsible for their care we may be able to minimize their suffering while maximizing their potential for improvement. KOC

Coleman, P.G. Identity loss and recovery in the life stories of Soviet World War II veterans / P.G. Coleman and A. Podolskij In: The Gerontologist = ISSN 0016-9013: vol. 47 (2007), issue 1, page 52-60. Identiteit Tweede Wereldoorlog Veteranen Rusland Oekraine PURPOSE: We examined the adjustment to societal change following the fall of communism in a group of Soviet war veterans from Russia and the Ukraine. The focus of the study was on the dynamics of identity development, and especially generativity, in a period of intense social upheaval. DESIGN AND METHODS: We administered measures of self-esteem, life satisfaction, and generativity to 50 World War II veterans from five distinct areas of the former Soviet Union. We also conducted life-history interviews and made a thematic analysis of the transcripts. RESULTS: Despite the loss of the system of government and values that had dominated their lives, most participants demonstrated positive well-being, and especially a high sense of generativity. They described their experience of societal change as having disturbed their past, present, and future sense of self. Most, however, had found ways of reaffirming a generative identity. For some, this meant maintaining a Soviet identity; for others, it meant taking a critical view of the history through which they had lived. The principal sustaining element among the participants as a whole was hope in their own families' future. IMPLICATIONS: Major societal change of the kind experienced by Soviet war veterans in later life poses a challenge to a continued sense of generativity. These elderly veterans were able to meet this challenge, providing evidence of their resilience and the continuing strength of family bonds in the former Soviet Union at this time of debate about national identity. KOC

Cook, D.B. Perceived exertion in fatiguing illness: Gulf War veterans with chronic fatigue syndrome / D.B. Cook...[et al.] In: Medicine & Science in Sports & Exercise = ISSN 0195-9131: vol. 35 (2003), issue 4, page 569-574. Gezondheid Golfoorlog-veteranen Bewegingsinspanning Chronische vermoeidheidssyndroom (CVS) Golfoorlogsyndroom It has been reported that ratings of perceived exertion are elevated in chronic fatigue syndrome. We have challenged this notion by examining perceived exertion in civilian females with CFS and expressing the data relative to exercise capacity. The purpose of the present investigation was to further examine RPE during exercise in a unique

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population of CFS patients. Gulf veterans. Thirty-four GV performed a maximal exercise test on a cycle ergometer. After a 3-min warm-up, exercise intensity increased by 30 W every minute until exhaustion. RPE were obtained during the last 15 s of each minute using Borg's CR-10 scale. With the exception of peak VE, there were no significant differences in any peak exercise variables. Repeated measures ANOVA revealed significantly higher RPE at each power output examined. Both group main effects and the interaction were eliminated when self-reported fatigue symptoms were controlled for in the analyses. Power functions for RPE as a function of relative oxygen consumption were not different between groups and were significantly greater than a linear value of 1.0. Our results show that RPE are greater in GV with CFS regardless of whether the data were expressed in terms of absolute or relative exercise intensity. KOC

Cooper, D.F. Home-based primary care: the care of the veteran at home / D.F. Cooper, O.R. Granadillo and C.M. Stacey In: Home healthcare nurse = ISSN 0884-741X: vol. 25 (2007), issue 5, page 351-322. Thuiszorg Veteranen Hulpverlening Department of Veterans Affairs (VA) Overzichtsartikelen Home-Based Primary Care is a program designed by the Department of Veteran Affairs (VA) to care for frail, medically complex, elderly veteran patients in their home setting. Unique to the VA, the program has similarities and differences in relation to typical Medicare/Medicaid home health and hospice programs. The VA has demonstrated success in maintaining the patients' independence and quality of life as well as exceptional management of chronic disease and prevention. KOC

Coy, J. Peacetime clinical experience with 'fracticide': a veterans hospital experience / J. Coy and K. Steinweg In: Military Medicine = ISSN 0026-4075: vol. 161 (1996), issue 11, page 701-703. Eigen vuur (Friendly fire) Gewonden Casuïstiek It is very important for those involved in military medicine to understand the difference between fratricide, accidents, and other causes of wounding. The military medical care provider is often considered an authority on wounding. This is usually not the case. The three examples discussed in this paper illustrate some of the basic misconceptions about "friendly fire" and the appropriate use of the term "fratricide." KOC

Crombie, H.D. Limb loss in war: historical perspective / H.D. Crombie In: Connecticut medicine = ISSN 0010-6178: vol. 72 (2008), issue 1, page 39-40. Gehandicapten Gewonden Militairen 68

Geschiedenis KOC

David, A.S. Cognitive functioning and disturbances of mood in UK veterans of the Persian Gulf war: a comparative study / A.S. David...[et al.] In: Psychological Medicine = ISSN 0033 2917: vol. 32 (2002), issue 8, page 1357-1370. PTSD Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Groot-Brittannië Notes that complaints of poor memory and concentration are common in veterans of the 1991 Persian Gulf War as are other symptoms. Despite a large research effort, such symptoms remain largely unexplained. A comprehensive battery of neuropsychological tests and rating scales was administered to 341 UK servicemen (aged 22-62 yrs) who were returnees from the Gulf War and peace keeping duties in Bosnia, plus non-deployed military controls. All were drawn from a large randomized survey. Most were selected on the basis of impaired physical functioning defined operationally. Group comparisons reveal an association between physical functioning and symptoms of depression, posttraumatic stress reactions, increased anger and subjective cognitive failures. Poorer performance on some general cognitive measures, sequencing and attention was also seen in association with being 'ill', but virtually all differences disappeared after adjusting for depressed mood or multiple comparisons. Deployment was also associated with symptoms of post-traumatic stress and subjective cognitive failures, independently of health status, as well as minor general cognitive and constructional impairment. KOC

Dekel, R. Marital relations among former prisoners of war: contribution of posttraumatic stress disorder, aggression, and sexual satisfaction / R. Dekel and Z. Solomon In: Journal of family psychology = ISSN 0893-3200: vol. 20 (2006), issue 4, page 709-712. PTSD Agressie Relaties Partners Krijgsgevangenen In this study, the authors examined the marital adjustment, spousal aggression, and sexual satisfaction of prisoners of war (POWs) 3 decades after their release. More specifically, the authors examined the extent to which impaired marital relations among former POWs are an outcome of their captivity or of the posttraumatic stress disorder (PTSD) that some of them developed. The authors compared 25 former POWs with PTSD, 85 former POWs without PTSD, and 104 control veterans. The findings reveal that the marital problems of former POWs are more related to PTSD than to their captivity. PTSD is related to decreased marital satisfaction, increased verbal aggression, and heightened sexual dissatisfaction among former POWs. KOC

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Dohrenwend, B.P. War-related posttraumatic stress disorder in Black, Hispanic, and majority White Vietnam veterans: the roles of exposure and vulnerability / B.P. Dohrenwend...[et al.] In: Journal of traumatic stress= ISSN 0894-9867: vol. 21 (2008), issue 2, page 133-141. PTSD Vietnam-veteranen Rassenverschillen Diagnostiek Elevated prevalence rates of chronic posttraumatic stress disorder (PTSD) have been reported for Black and Hispanic Vietnam veterans. There has been no comprehensive explanation of these group differences. Moreover, previous research has relied on retrospective reports of war-zone stress and on PTSD assessments that fail to distinguish between prevalence and incidence. These limitations are addressed by use of recordbased exposure measures and clinical diagnoses of a subsample of veterans from the National Vietnam Veterans Readjustment Study (NVVRS). Compared with Majority White, the Black elevation is explained by Blacks' greater exposure; the Hispanic elevation, by Hispanics' greater exposure, younger age, lesser education, and lower Armed Forces Qualification Test scores. The PTSD elevation in Hispanics versus Blacks is accounted for mainly by Hispanics' younger age. KOC

Druss, B.G. Depressive symptoms and health costs in older medical patients / B.G. Druss...[et al.] In: American Journal of Psychiatry = ISSN 0002-953x: vol. 156 (1999), issue 3, page 477479. Depressie Ouderen Kosten Hulpverlening Veterans Administration (VA) Assessed the association between depressive symptoms and health costs for a national Veterans Administration (VA) sample. The Rand Depression Index was administered to 1,316 medical or surgical inpatients over the age of 60 at 9 VA hospitals. Scores were merged with utilization, demographic, and hospital data from national VA inpatient and outpatient files. Medical costs for respondents with the highest quartile of symptoms were approximately $3,200-or 50%-greater than medical costs for those in the least symptomatic quartile. Depressive symptoms were not associated with any statistically significant mental health expenditures. The study extends previous reports of the high medical costs associated with depressive disorders to an older, public sector population. The mechanisms underlying increased medical costs associated with depressive symptoms, while the subject of much speculation in the literature, still remain largely unknown. KOC

Dumas, Vincent Een man van Sta-Vast : de inzet voor vrijheid en veiligheid / Vincent Dumas. [Soesterberg] : Contour, 2008. - 258 p. : ill. ; 22 cm Met lit. opg. ISBN 90-5911-729-8 ISBN 978-90-5911-729-7 70

Leven, gedachtegoed en werk van Prosper Ego, oprichter en voorman van het Oud Strijders Legioen. Indië-veteranen Oud-Strijders Legioen (OSL) Internationale politiek Biografieën s8.2 DUM

Edlund, M.J. Beliefs about depression and depression treatment among depressed veterans / M.J. Edlund...[et al.] In: Medical care = ISSN 0025-7079: vol. 46 (2008), issue 6, page 581-589. Depressie Veteranen Behandeling INTRODUCTION: Because of the misunderstanding and stigmatization of mental health disorders and treatment, health beliefs may be important in treatment seeking for depression. It is important to understand patients' beliefs about mental health disorders and mental health treatment to improve systems of care. METHODS: We studied beliefs about depression and depression treatment among patients in a randomized trial of a chronic care intervention to improve depression treatment in the Veterans Administration healthcare system (n = 395). The Depression Beliefs Inventory was used to assess beliefs regarding: (1) perceived need for depression treatment, (2) the efficacy of depression treatment, and (3) treatment barriers, including stigma, at baseline and 6 months. We calculated descriptive statistics on patients' baseline beliefs, and used multiple regression to investigate the extent to which beliefs changed in intervention and treatment as usual patients between baseline and 6-month assessments. We used logistic regression to investigate the relationship between beliefs and antidepressant initiation, adherence and clinical response. RESULTS: At baseline, 73% of our sample believed that they had depression, and 66% believed that taking antidepressants would be helpful for their depression. However, the depression intervention had few effects on beliefs, and individual beliefs were generally not associated with taking medication or clinical response. However, a summary measure of beliefs was found to have predictive validity with respect to initiating and adhering to antidepressant treatment. DISCUSSION: Our results highlight the potential difficulty in modifying individuals' attitudes regarding depression and depression treatment in chronic care models for depression interventions. KOC

Ellis, N. Compensation and wellness: a conflict for veterans' health / N. Ellis, A. Mackenzie and R. Mobbs In: Australian health review = ISSN 0156-5788: vol. 32 (2008), issue 2, page 308-312. Vergoedingen Gezondheidszorg Veteranen Australië Beleid In Australia greater attention is being given to health determinants, and the dominance of treatment in health policy and budgets is giving away some ground to prevention, health promotion, rehabilitation and disability management. This creates a dilemma for

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compensation systems: should the inclusion criteria be broadened to match the new thinking or should a narrower definition of "disease, injury or death" be retained? This issue is explored in the context of war syndromes among veterans. While veterans experience symptoms more frequently and more severely than military and community controls, their patterns of symptoms are not unique. Current compensation and benefit programs can create iatrogenic effects. It is concluded that compensation systems should be kept as safety nets while resources are provided to improve the capacity of primary health care caregivers, community organisations and veterans with war syndromes and their families to better deal with these problems. Adapting compensation systems to promote wellness through self-management health partnerships is one way of directing resources to individuals and their families. Action research at the community level with veterans, their families, their organisations, primary health care organisations, policy makers and researchers would allow this sector to work out the best way to apply existing efficacious tools to these modern health problems. KOC

Elnitsky, C. Veterans Health Administration's pain research portfolio and publications / C. Elnitsky, M. Bryan and R.D. Kerns In: Journal of rehabilitation research and development = ISSN 0748-7711: vol. 44 (2007), issue 2, page xi-xviii. Pijn Veteranen Onderzoek Department of Veterans Affairs (VA) KOC

Engel, C.C. "Mirror, mirror..." whose explanation is the fairest?: evolving notions of somatization and idiopathic physical symptoms / C.C. Engel In: CNS Spectrums = ISSN 1092-8529: vol. 11 (2006), issue 3, page 187-188. Syndromen Golfoorlog-syndroom Onverklaarde lichamelijke klachten (OLK) Somatization disorder, multiple chemical sensitivities, chronic fatigue syndrome, fibromyalgia, Gulf War syndrome, neurasthenia, irritable bowel syndrome, conversion disorder... diopathies one and all. These syndromes and the many others like them have perhaps one overriding commonality: enormous unexplained heterogeneity. Patients and clinicians gaze into the suffering and impact of these symptoms and see as many potential causes as there are symptom combinations. Some clinicians decide to ignore idiopathic symptoms entirely, pretending they are inconsequential. This view flies in the face of evidence; idiopathic symptoms occur in a third of all primary care patients, routinely extend doctors' clinic day, are associated with mental disorders, and limit patient functioning. Psychiatry has entered a unique period of reflection, openness, and serious calls for the dissolution of somatoform disorders as diagnostic entities. This issue of CNS Spectrums charts a similar course, offering several cutting-edge syntheses on idiopathic physical symptoms. KOC

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Engel Jr., C.C. Post-war syndromes: illustrating the impact of the social psyche on notions of risk, responsibility, reason, and remedy / C.C. Engel Jr. In: The Journal of the American Academy of Psychoanalysis and Dynamic Psychiatry = ISSN 1546-0371: vol. 32 (2004), issue 2, page 321-334. Syndromen Golfoorlogsyndroom Sociologie The 20th century offered many examples of post-war syndromes such as Da Costa's syndrome, irritable heart, shell shock, effort syndrome, medical evacuation syndrome, post-traumatic stress disorder, and Gulf War syndrome. These post-war syndromes occur under conditions of substantial medical and scientific uncertainty, conditions that potentially magnify the impact of social context on clinical care for these syndromes. This article reviews the social circumstances surrounding four postwar syndromes. The case is made that social context has significantly impacted professional and lay perceptions of causal mediators, relevant risk factors, defining symptoms, and appropriate therapies for these syndromes. Furthermore, it is argued that social context influences what parties are held responsible for post-war syndromes, and what clinical disciplines are ultimately deemed appropriate to provide legitimate post-war illness care. KOC

Engelhard, I.M. Memory consistency for traumatic events in Dutch soldiers deployed to Iraq / I.M. Engelhard, M.A. van den Hout and R.J. McNally In: Memory = ISSN 0193-4511: vol. 16 (2008), issue 1, page 3-9. PTSD Geheugen Veteranen Irak Nederland Retrospective accounts of traumatic events are consistently associated with symptoms of post-traumatic stress disorder (PTSD). This has often been interpreted as causal impact of such events on psychological functioning, but recent studies suggest that the causal direction is (partly) reversed: high levels of PTSD symptoms may be associated with amplified recollections of precipitating traumatic events. The aim of this prospective study was to index the consistency with which Dutch Army soldiers reported traumatic stressors and nontraumatic stressors on their deployment to Iraq, and to examine to what extent PTSD symptoms and pre-existing reporting biases, such as that arising from neuroticism, affect memory inconsistency. Retrospective accounts of stressors were highly variable over time. Individuals with higher levels of PTSD symptoms and neuroticism, lower levels of extraversion, and fewer prior missions, were more prone to increased reporting over time. KOC

Engelhard, I.M. Nadere toelichting op het posttraumatische stress-stoornis / I.M. Engelhard In: Carré = ISSN 0165-7437: vol. 31 (2008), issue 5, page 44-46. PTSD Leeftijd Militairen 73

Irak Afghanistan Diagnostiek KOC

Engelhard, I.M. Stress en trauma na een militaire uitzending in Irak / I.M. Engelhard, M.A. van den Hout en J. Weerts In: De Psycholoog = ISSN 0033-3115: vol. 42 (2007) (dec), page 649-653. PTSD Militairen Irak Nederland Diagnostiek In onderstaand onderzoek werd gekeken of Nederlandse militairen door een uitzending in Irak posttraumatische stressstoornis (PTSS) opliepen, en, zo ja, hoe groot dit probleem nu werkelijk is. Dit blijkt vijf maanden na de uitzending meet te vallen wanneer men rekening houdt met het feit dat mensen PTSS-symptomen kunnen hebben, zonder hier echt last van te hebben, en dat klachten die mensen aangeven niet altijd te maken hebben met ervaringen tijdens de uitzending. KOC

Everitt, B. Searching for a Gulf war syndrome using cluster analysis / B. Everitt...[et al.] In: Psychological Medicine = ISSN 0033 2917: vol. 32 (2002), issue 8, page 1371-1378. Gezondheid Golfoorlog-veteranen Golfoorlogsyndroom Groot-Brittannië Examined whether Gulf and non-Gulf veterans could be distinguished by their patterns of symptom reporting. A k-means cluster analysis was applied to 500 randomly sampled veterans from each of 3 United Kingdom military cohorts of veterans; those deployed to the Gulf conflict between 1990 and 1991; to the Bosnia peacekeeping mission between 1992 and 1997; and military personnel who were in active service but not deployed to the Gulf (Era). Sociodemographic, health variables and scores for 10 symptom groups were calculated. The gap statistic indicates the 5-group solution as 1 that provided a particularly informative description of the structure in the data. Cluster 1 consisted of low scores for all symptom groups. Cluster 2 had veterans with highest symptom scores for musculoskeletal symptoms and high scores for psychiatric symptoms. Cluster 3 had high scores for psychiatric symptoms and marginally elevated scores for the remaining 9 symptom groups. Cluster 4 had elevated scores for musculoskeletal symptoms only and cluster 5 was distinguishable from the other clusters in having high scores in all symptom groups, especially psychiatric and musculoskeletal. KOC

Ferguson, E. Gulf War and illness by association / E. Ferguson and H.J. Cassaday In: British Journal of Psychology = ISSN 0007-1269: vol. 90 (1999), issue 4, page 459475. Golfoorlogsyndroom 74

Golfoorlog-veteranen Diagnostiek Overzichtsartikelen Reviews the evidence for the construct of Gulf War Syndrome(s) (GWS). The authors then explore the evidence for one of the main theories of GWS, chronic organophosphateinduced delayed polyneuropathy (R. Haley and T. Kurt, 1997). Finally, the authors present a psycho-neuroendocrine model that can account for the variability in symptoms (following S. Maier and L. Watkins, 1998) and show how associative processes could account for the persistence of symptoms on return from the Gulf. The symptoms of GWS closely correspond to the physiological and behavioral sequelae of an interleukin-1 (IL-1) mediated sickness response. The authors propose that this response can account for the variability in its symptomatology. Furthermore, the persistence of GWS can be accounted for by an associative process, whereby the smells/tastes of war become linked with the physiological reaction to environmental stressors encountered in the Gulf and/or the "cocktail" of drugs given to the soldiers. As required, the IL-1 response is conditionable. KOC

Ferguson, E. Individual differences in the temporal variability of medically unexplained symptom reporting / E. Ferguson...[et al.] In: British Journal of Health Psychology = ISSN 1359-107X: vol. 9 (2004), issue 2, page 219-240. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Non-specific or medically unexplained symptoms account for up to 35% of outpatient referrals. In contrast to the literature on affect, little is known about how people frame daily symptoms and how these patterns are influenced by individual differences. Three fixed occasion diary studies over an 8-day period (one on ill veterans of the Gulf War and two on healthy undergraduates) and a single cross-sectional survey (on ill Gulf War veterans) were conducted. The severity and frequency of daily symptoms were assessed in all daily diary samples, together with the Big 5 personality domains in one of the undergraduate samples and in the survey of veterans. The data were analysed using auto-correlations and hierarchical multivariate linear modelling. In all the chronically ill and healthy samples, the data suggested potential cyclical patterns for symptom severity reporting. With regard to the frequency of symptom reporting, the veterans showed a pattern of constant symptom reporting. Finally, the relationship between the reported severity of symptoms was attenuated by intellect and surgency. There is evidence that daily experiences of symptom severity are framed relative to each other and this relationship is influenced by personality. KOC

Ferguson, E. Odors and sounds as triggers for medically unexplained symptoms: a fixed-occasion diary study of Gulf War veterans / E. Ferguson, H.J. Cassaday and P.A. Bibby In: Annals of Behavioral Medicine = ISSN 0883-6612: vol. 27 (2004), issue 3, page 205214. Gezondheid Onverklaarde lichamelijke klachten

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Golfoorlog-veteranen Golfoorlogsyndroom Background: Both laboratory studies on healthy volunteers and epidemiological evidence from patient samples indicate that odor can act as a trigger for the reporting of medically unexplained symptoms (MUSs). Purpose: The relationship between concurrent experiences of odor and MUSs has not been explored in a patient sample. Methods: This study used an 8-day fixed-occasion diary study, in which 17 veterans of the Persian Gulf War completed diary assessments of (a) the intensity and duration of odor and sound and (b) MUS severity. Results: The results showed that the intensity of odor was positively associated with the severity on the same day and subsequent days' symptoms, whereas the duration of odor was negatively related to the severity of MUS reporting on the same day. Conclusions: These results are consistent with an associative mechanism underlying symptom reporting in veterans. By contrast, the duration, but not the intensity, of sound was related to the severity of MUS reporting on the same day. KOC

Ferguson, E. Theoretical accounts of Gulf War Syndrome: from environmental toxins to psychoneuroimmunology and neurodegeneration / E. Ferguson and H.J. Cassady In: Behavioural Neurology = ISSN 0953-4180: vol. 13 (2001), issue 3-4, page 133-147. Golfoorlogsyndroom Golfoorlog-veteranen Neurobiologie Overzichtsartikelen Reviews evidence suggesting that nonspecific illness behavior symptoms can be explained more parsimoniously as a single symptom cluster than as a set of separate illnesses such as Gulf War Syndrome (GWS) and chronic fatigue syndrome. This superordinate syndrome could have its biological basis in the activity of pro-inflammatory cytokines (particularly interleukin-1), that give rise to the 'sickness response.' It is further argued that the persistence of non-specific illness in chronic conditions like GWS may be (in part) attributable to a bio-associative mechanism (1999). Such associative mechanisms could be mediated through the hypothalamus and limbic system via vagal nerve innervation and would provide an explanation for the persistence of a set of symptoms that should normally be short lived and self-limiting. The authors also present evidence that the pattern of symptoms produced by the pro-inflammatory cytokines reflects a shift in immune system functioning towards a (T-helper-1) Thl profile. This position contrasts with other immunological accounts of GWS that suggest that the immune system demonstrates a shift to a Th2 (allergy) profile. KOC

Forbes, D. A field test of group based exposure therapy with 102 veterans with war-related posttraumatic stress disorder / D. Forbes...[et al.] In: Journal of traumatic stress= ISSN 0894-9867: vol. 21 (2008), issue 2, page 150-157. PTSD Veteranen Behandeling Group-based exposure therapy (GBET) Evaluaties

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Group-based exposure therapy (GBET) was field-tested with 102 veterans with warrelated posttraumatic stress disorder (PTSD). Nine to 11 patients attended 3 hours of group therapy per day twice weekly for 16-18 weeks. Stress management and a minimum of 60 hours of exposure was included (3 hours of within-group war-trauma presentations per patient, 30 hours of listening to recordings of patient's own war-trauma presentations and 27 hours of hearing other patients' war-trauma presentations). Analysis of assessments conducted by treating clinicians pre-, post- and 6-month posttreatment suggests that GBET produced clinically significant and lasting reductions in PTSD symptoms for most patients on both clinician symptoms ratings (6-month posttreatment effect size delta = 1.22) and self-report measures with only three dropouts. KOC

Forbes, D. Mechanisms of anger and treatment outcome in combat veterans with posttraumatic stress disorder / D. Forbes...[et al.] In: Journal of traumatic stress= ISSN 0894-9867: vol. 21 (2008), issue 2, page 142-149. PTSD Woedeaanvallen Agressie Alcoholmisbruik Behandeling Research has identified anger as prominent in, and an influence on, treatment outcome for military veterans with posttraumatic stress disorder (PTSD). This study examined factors influencing the relationship between anger and outcome to improve treatment effectiveness. Participants comprised 103 veterans attending PTSD treatment. Measures of PTSD and comorbidity were obtained at intake and 9-month follow-up. Measures also included potential mediators of therapeutic alliance, social support, problematic/undermining relationships and fear of emotion. Path analyses supported anger as a predictor of treatment outcome, with only fear of anger and alcohol comorbidity accounting for the variance between anger and outcome. To improve treatment effectiveness, clinicians need to assess veterans' anger, aggression, and alcohol use, as well as their current fear of anger and elucidate the relationship between these factors. KOC

Ford, J.D. Posttraumatic stress symptomatology is associated with unexplained illness attributed to Persian Gulf War military service / J.D. Ford...[et al.] In: Psychosomatic Medicine = ISSN 0033-3174: vol. 63 (2001), issue 5, page 842-849. PTSD Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Determined if war zone trauma or posttraumatic stress symptomatology (PTSS) is associated with illnesses reported by Gulf War veterans that were documented by medical examination but not attributable to a medical diagnosis. 1,119 veterans were screened and 237 cases and 113 controls were identified by medical examination for a case-control study comparing US Persian Gulf War military veterans with or without medically documented, but unexplained, symptoms. Multivariate logistic regression and crossvalidation analyses examined self-report measures of demographics, subjective physical

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symptoms and functioning, psychiatric symptoms, stressors, war zone trauma, and PTSS, to identify correlates of case-control status. PTSS and somatic complaints were independently associated with case status, as were war zone trauma and depression. Age, education, and self-reported health, stress-related somatization, pain, energy/fatigue, illness-related functional impairment, recent stressors, and anxiety were univariate correlates of case status. PTSS related to war zone trauma warrants additional research study and attention in clinical screening and assessment as a potential contributor to the often debilitating physical health problems experienced by Persian Gulf War veterans. KOC

Frances, A.J. Identifying illness: pitfalls and discoveries / A.J. Frances and J.C. Beckham In: Psychosomatic Medicine = ISSN 0033-3174: vol. 60 (1998), issue 6, page 669-670. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek Comments on the article by M. J. Roy et al (see record 1998-11685-001) which addressed the question of whether Gulf War Syndrome is a distinct disorder caused by toxic exposure. The authors consider this research to be a useful corrective against the possibly overinclusive subsuming within the Gulf War rubric of all psychiatric symptomatology that arises in its veterans. However, one study cannot make a conclusive case against the possibility of this syndrome, especially given the state of the evidence and the inherent methodological complexity of the question. KOC

Frank, J.D. Demoralization and unexplained illness in two cohorts of American soldiers overseas / J.D. Frank and J.B. Frank In: Journal of Nervous and Mental Disease = ISSN 0022 3018: vol. 184 (1996), issue 7, page 445-446. Stress Onverklaarde lichamelijke klachten (OLK) Golfoorlog-veteranen Tweede wereldoorlog Militairen Examines the unexplained illnesses that were documented in both veterans of the Persian Gulf War and in soldiers stationed in the Philippines during World War II. In both groups, patients exhibited similar symptoms (including weakness, fatigue, and headaches) that could not be attributed to any one source. Because troops in both settings also experienced intensely confusing and threatening information about their personal safety, the authors suggest that the symptoms represent physiological reactions to a demoralizing stress. KOC

Frayne, S.M. Gender disparities in Veterans Health Administration care: importance of accounting for veteran status / S.M. Frayne...[et al.] In: State legislatures = ISSN 0147-6041: vol. 46 (2008), issue 5, page 549-553. Sekseverschillen Hulpverlening 78

Veterans Health Administration (VHA) BACKGROUND: In an effort to assess and reduce gender-related quality gaps, the Veterans Health Administration (VHA) has promoted gender-based research. Historically, such appraisals have often relied on secondary databases, with little attention to methodological implications of the fact that VHA provides care to some nonveteran patients. OBJECTIVES: To determine whether conclusions about gender differences in utilization and cost of VHA care change after accounting for veteran status. DESIGN: Cross-sectional. SUBJECTS: All users of VHA in 2002 (N = 4,429,414). MEASURES: Veteran status, outpatient/inpatient utilization and cost, from centralized 2002 administrative files. RESULTS: Nonveterans accounted for 50.7% of women (the majority employees) but only 3.0% of men. Among all users, outpatient and inpatient utilization and cost were far lower in women than in men, but in the veteran subgroup these differences decreased substantially or, in the case of use and cost of outpatient care, reversed. Utilization and cost were very low among women employees; women spouses of fully disabled veterans had utilization and costs similar to those of women veterans. CONCLUSIONS: By gender, nonveterans represent a higher proportion of women than of men in VHA, and some large nonveteran groups have low utilization and costs; therefore, conclusions about gender disparities change substantially when veteran status is taken into account. Researchers seeking to characterize gender disparities in VHA care should address this methodological issue, to minimize risk of underestimating health care needs of women veterans and other women eligible for primary care services. KOC

Frayne, S.M. Medical profile of women veterans administration outpatients who report a history of sexual assault occurring while in the military / S.M. Frayne...[et al.] In: Journal of Women's Health & Gender-Based Medicine = ISSN 1524-6094: vol. 8 (1999), issue 6, page 835-845. Seksueel geweld Militairen Vrouwen To profile differences in current physical symptoms and medical conditions among women users of Veterans Administration (VA) health services with and without a self-reported history of sexual assault sustained during military service, a cross-sectional analysis of a nationally representative, random sample of 3,362 women veterans was conducted. A self-administered survey asked whether women had sustained sexual assault while in the military and requested information about a spectrum of physical symptoms and medical conditions. A history of sexual assault while in the military was reported by 23% of women VA users and was associated with current physical symptoms and medical conditions in every domain assessed. Among women reporting a history of sexual assault while in the military, 26% endorsed >12 of 24 symptoms/conditions, compared with 11% of women with no reported sexual assault history. Clinicians need to be attuned to the high frequency of sexual assault occurring while in the military reported by women VA users and its associated array of current physical symptoms and medical conditions and should consider screening patients for a sexual violence history, especially patients with multiple physical symptoms. KOC

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French, L.M. Assessing and treating veterans with traumatic brain injury / L.M. French and G.W. Parkinson In: Journal of clinical psychology = ISSN 0021-9762: (2008) (jun). Hersenletsel Militairen Irak Afghanistan Behandeling Casuïstiek Conflicts in Iraq and Afghanistan have resulted in greater proportions of service members with traumatic brain injury than in prior conflicts. These brain injuries range from the mild (concussion) to severe, and have enormous implications for clinical practice with these soldiers. The highly stressful and dangerous context in which these injuries are sustained set them apart in significant ways from brain injuries seen in civilian settings. The associated emotional toll of the environment and comorbid injuries, often resulting from blast exposure, complicates the clinical picture. In this article, the authors describe the complex presentations in this population of traumatically brain injured combat veterans and illustrate with case vignettes. KOC

Gabriel, R. Gulf war syndrome may be post-conflict dysfunction / R. Gabriel...[et al.] In: British Medical Journal = ISSN 0959 8138: vol. 324 (2002), issue 7342, page 914. Gezondheid Golfoorlog-veteranen Golfoorlogsyndroom Groot-Brittannië Comments on the article by T. Chalder, et al (see record 2001-11410-003) which found that 17% of the 2961 Gulf war veterans surveyed believe themselves to be suffering from Gulf war syndrome. The veterans' belief was reinforced if they knew someone with similar symptoms. The current authors argue that this represents post-conflict dysfunction expressed according to health beliefs prevailing at the time the questionnaire was administered. The current authors also maintain that a major omission in Chalder at al's discussion was a lack of consideration of the role of the media in reporting Gulf veterans' illnesses. KOC

Gamma, A. The spectra of neurasthenia and depression: course, stability and transitions / A. Gamma...[et al.] In: European Archives of Psychiatry and Clinical Neuroscience = ISSN 0940-1334: vol. 257 (2007), issue 2, page 120-127. Neurasthenie Depressie Golfoorlogsyndroom Diagnostiek Background: Neurasthenia has had a chequered history, receiving changing labels such as chronic fatigue or Gulf war syndrome. Neurasthenia is recognized by ICD-10, but not by DSM-IV. Its course, longitudinal stability and relationship to depression is not well 80

understood. Methods: In a stratified community sample (n = 591), representative of 2600 persons of the canton of Zurich, Switzerland, neurasthenia and depression were assessed in six structured interviews between ages 20 and 41. Course, stability and comorbidity were examined. A severity spectrum of neurasthenia and depression from symptoms to diagnosis was taken into account. Results: The annual prevalence of a neurasthenia diagnosis increased from 0.7% to 3.8% from age 22-41, while mere symptoms became less prevalent. Intra-individual courses improved in 40% and deteriorated in about 30% of symptomatic cases. The most frequent symptoms overall, besides criterial exhaustion, were increased need for sleep, over-sensitivity, nervousness and difficulty concentrating. Cross-sectional associations and overlap with depression were strong. Longitudinal stability of ICD-neurasthenia was low. Conclusions: Neurasthenia is intermittent, overlaps significantly with depression, and shows improvement and deterioration over time to roughly equal measures. KOC

Gerardi, M. Virtual reality exposure therapy using a virtual Iraq: case report / M. Gerardi...[et al.] In: Journal of traumatic stress= ISSN 0894-9867: vol. 21 (2008), issue 2, page 209-213. PTSD Veteranen Irak Behandeling Virtual reality exposure (VRE) Posttraumatic stress disorder (PTSD) has been estimated to affect up to 18% of returning Operation Iraqi Freedom (OIF) veterans. Soldiers need to maintain constant vigilance to deal with unpredictable threats, and an unprecedented number of soldiers are surviving serious wounds. These risk factors are significant for development of PTSD; therefore, early and efficient intervention options must be identified and presented in a form acceptable to military personnel. This case report presents the results of treatment utilizing virtual reality exposure (VRE) therapy (virtual Iraq) to treat an OIF veteran with PTSD. Following brief VRE treatment, the veteran demonstrated improvement in PTSD symptoms as indicated by clinically and statistically significant changes in scores on the Clinician Administered PTSD Scale (CAPS; Blake et al., 1990) and the PTSD Symptom Scale Self-Report (PSS-SR; Foa, Riggs, Dancu, & Rothbaum, 1993). These results indicate preliminary promise for this treatment. KOC

Geuze, E. Neural correlates of associative learning and memory in veterans with posttraumatic stress disorder / E. Geuze, E. Vermetten, M. Ruf, C.S. de Kloet and H.G. Westenberg In: Journal of psychiatric research = ISSN 0022-3956: vol. 42 (2008), issue 8, page 659669. PTSD Geheugen Veteranen Neurobiologie Impaired attention and memory are symptoms frequently associated with posttraumatic stress disorder (PTSD). Although patients with PTSD frequently report memory difficulties and empirical research provides support for a memory deficit in PTSD, as of yet, no fMRI study has adequately investigated the neural correlates of learning and memory of neutral

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(i.e. not trauma related) material in patients with PTSD compared to controls. Twelve male veterans with PTSD, and twelve male veterans without PTSD, were recruited, and matched for age, region and year of deployment. Encoding and retrieval of 12 word-pair associates was assessed during fMRI in both experimental groups. Compared to controls veterans with PTSD revealed underactivation of the frontal cortex, and overactivation of the temporal cortex during the encoding phase. Retrieval of the paired associates resulted in underactivation of right frontal cortex, bilateral middle temporal gyri, and the left posterior hippocampus/parahippocampal gyrus in patients with PTSD. Deficits in memory performance in PTSD appear to be related to altered activity in fronto-temporal areas during both the encoding and retrieval phase of memory processing. KOC

Geuze, E. Reduced GABAA benzodiazepine receptor binding in veterans with post-traumatic stress disorder / E. Geuze, B.N. van Berckel, A.A. Lammertsma, R. Boellaard, C.S. de Kloet, E. Vermetten and H.G. Westenberg In: Molecular psychiatry = ISSN 1359-4184: vol. 13 (2008), issue 1, page 74-83. PTSD Veteranen Neurobiologie Gamma-aminobutyric acid (GABA(A)) receptors are thought to play an important role in modulating the central nervous system in response to stress. Animal data have shown alterations in the GABA(A) receptor complex by uncontrollable stressors. SPECT imaging with benzodiazepine ligands showed lower distribution volumes of the benzodiazepineGABA(A) receptor in the prefrontal cortex of patients with post-traumatic stress disorder (PTSD) in one, but not in another study. The objective of the present study was to assess differences in the benzodiazepine-GABA(A) receptor complex in veterans with and without PTSD using [(11)C]flumazenil and positron emission tomography (PET). Nine drug naive male Dutch veterans with deployment related PTSD and seven male Dutch veterans without PTSD were recruited, and matched for age, region and year of deployment. Each subject received a [(11)C]flumazenil PET scan and a structural magnetic resonance imaging scan. Dynamic 3D PET scans with a total duration of 60 min were acquired, and binding in template based and manually defined regions of interest (ROI) was quantified using validated plasma input and reference tissue models. In addition, parametric binding potential images were compared on a voxel-by-voxel basis using statistical parametric mapping (SPM2). ROI analyses using both template based and manual ROIs showed significantly reduced [(11)C]flumazenil binding in PTSD subjects throughout the cortex, hippocampus and thalamus. SPM analysis confirmed these results. The observed global reduction of [(11)C]flumazenil binding in patients with PTSD provides circumstantial evidence for the role of the benzodiazepine-GABA(A) receptor in the pathophysiology of PTSD and is consistent with previous animal research and clinical psychopharmacological studies. KOC

Geuze, E. Thinner prefrontal cortex in veterans with posttraumatic stress disorder / E. Geuze, H.G. Westenberg, A. Heinecke, C.S. de Kloet, R. Goebel and E. Vermetten In: NeuroImage = ISSN 1053-8119: (2008) (mar). PTSD Veteranen

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Neurobiologie Structural neuroimaging studies in posttraumatic stress disorder (PTSD) have focused primarily on structural alterations in the medial temporal lobe, and only a few have examined grey matter reductions in the cortex. Recent advances in computational analysis provide new opportunities to use semi-automatic techniques to determine cortical thickness, but these techniques have not yet been applied in PTSD. Twenty-five male veterans with PTSD and twenty-five male veterans without PTSD matched for age, year and region of deployment were recruited. All the subjects were scanned using MRI. Subjects' brains were aligned using cortex-based alignment in a region of interest based approach. Individual cortical thickness maps were calculated from the MR images. Regions of interest examined included the bilateral superior frontal gyri, bilateral middle frontal gyri, bilateral inferior frontal gyri, bilateral superior temporal gyri, and bilateral middle temporal gyri. In a large number of patients and controls, IQ scores and memory scores were also obtained. Individual cortical thickness maps were calculated from the MR images. Veterans with PTSD revealed reduced cortical thickness in the bilateral superior and middle frontal gyri, the left inferior frontal gyrus, and the left superior temporal gyrus. Veterans with PTSD performed significantly worse on memory measures compared to control veterans. Cortical thickness correlated with memory measures in the veterans without PTSD, but not in the veterans with PTSD. Cortical thinning in these regions may thus correspond to functional abnormalities observed in patients with PTSD. KOC

Goldberg, K.C. The epidemiology of health problems in returning Operation Iraqi Freedom and Operation Enduring Freedom veterans: a national and North Carolina-based summary / K.C. Goldberg In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 31-34. Gezondheid Veteranen Irak Operation Enduring Freedom Epidemiologie KOC

Golier, J.A. Enhanced cortisol suppression to dexamethasone associated with Gulf War deployment / J.A. Golier...[et al.] In: Psychoneuroendocrinology = ISSN 0306 4530: vol. 31 (2006), issue 10, page 11811189. PTSD Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Objective: To examine whether PTSD or post-deployment health symptoms in veterans of the first Gulf War (Operation Desert Shield/Storm) are associated with enhanced suppression of the pituitary-adrenal axis to low-dose dexamethasone (DEX). Method: Plasma cortisol and lymphocyte glucocorticoid receptor (GR) number were measured at 08:00 h on two consecutive days, before and after administration of 0.5 mg of DEX at 23:00 h in 42 male Gulf War veterans (14 without psychiatric illness, 16 with PTSD only,

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and 12 with both PTSD and MDD) and 12 healthy male veterans not deployed to the Gulf War or another war zone. Results: In the absence of group differences in basal cortisol levels or GR number, Gulf War veterans without psychiatric illness and Gulf War veterans with PTSD only had significantly greater cortisol suppression to DEX than non-deployed veterans and Gulf War veterans with both PTSD and MDD. Gulf War deployment was associated with significantly greater cortisol suppression to DEX controlling for weight, smoking status, PTSD, and MDD; PTSD was not associated with response to DEX. Among Gulf War veterans musculoskeletal symptoms were significantly associated with cortisol suppression and those who reported taking anti-nerve gas pills (i.e., pyridostigmine bromide) during the war had significantly greater DEX-induced cortisol suppression than those who did not. Conclusions: The data demonstrate that alterations in neuroendocrine function are associated with deployment to the Gulf War and postdeployment musculoskeletal symptoms, but not PTSD. Additional studies are needed to examine the relationship of enhanced glucocorticoid responsivity to deployment exposures and chronic unexplained medical symptoms in Gulf War veterans. KOC

Golier, J.A. Twenty-four hour plasma cortisol and adrenocorticotropic hormone in Gulf War veterans: relationships to posttraumatic stress disorder and health symptoms / J.A. Golier...[et al.] In: Biological Psychiatry = ISSN 0006 3223: vol. 62 (2007), issue 10, page 1175-1178. PTSD Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Background: We aim to characterize the baseline functioning of the hypothalamicpituitary-adrenal (HPA) axis in Gulf War veterans (GWV) and examine the extent to which posttraumatic stress disorder (PTSD) and unexplained health symptoms--which commonly co-occur--have similar or different biological correlates. Methods: Thirty-one GWV, 20 with current PTSD and 11 without current or lifetime PTSD, and 16 healthy nondeployed subjects not exposed to the Gulf War theater underwent medical and psychiatric examination followed by blood sampling every half-hour over 24 hours for the measurement of cortisol and adrenocorticotropic hormone (ACTH). Results: Gulf War veterans without PTSD or another psychiatric disorder had significantly lower 24-hour plasma ACTH levels, a significantly higher cortisol:ACTH ratio, and no difference in cortisol levels compared to nondeployed subjects and to GWV with PTSD, controlling for body mass index (BMI). Among GWV, health symptoms (mood and cognitive symptoms) were positively associated with, and hyperarousal symptoms were negatively associated with, the cortisol: ACTH ratio. Additionally, the self-reported acute effects of pesticides and of pyridostigmine bromide during deployment were associated with lower ACTH levels, controlling for BMI and PTSD. Conclusions: The data provide evidence of HPA axis dysregulation in Gulf War veterans, which may be related to Gulf War deployment exposures. Despite the overlap of chronic unexplained health symptoms and PTSD in GWV, these symptom constellations appear to be biologically distinct. KOC

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Golomb, B.A. Acetylcholinesterase inhibitors and Gulf War illnesses / B.A. Golomb In: Proceedings of the National Academy of Sciences of the United States of America = ISSN 0027-8424: vol. 105 (2008), issue 11, page 4295-3000. Golfoorlogsyndroom Golfoorlog-veteranen Chemische middelen Increasing evidence suggests excess illness in Persian Gulf War veterans (GWV) can be explained in part by exposure of GWV to organophosphate and carbamate acetylcholinesterase inhibitors (AChEis), including pyridostigmine bromide (PB), pesticides, and nerve agents. Evidence germane to the relation of AChEis to illness in GWV was assessed. Many epidemiological studies reported a link between AChEi exposure and chronic symptoms in GWV. The link is buttressed by a dose-response relation of PB pill number to chronic symptoms in GWV and by a relation between avidity of AChEi clearance and illness, based on genotypes, concentrations, and activity levels of enzymes that detoxify AChEis. Triangulating evidence derives from studies linking occupational exposure to AChEis to chronic health symptoms that mirror those of ill GWV. Illness is again linked to lower activity of AChEi detoxifying enzymes and genotypes conferring less-avid AChEi detoxification. AChEi exposure satisfies Hill's presumptive criteria for causality, suggesting this exposure may be causally linked to excess health problems in GWV. KOC

Gould, M. The war at home / M. Gould In: Health service journal = ISSN 0952-2271: vol. 8 (2008), issue 2, page 3-12. Gewonden Militairen Groot-Brittannië Hulpverlening The Royal Centre tor Defence Medicine at Selly Oak Hospital, Birmingham, is the main receiving unit for military casualties. Six Ministry of Defence hospitals treat elective military and civilian cases. Since November 2007, veterans with service-related conditions have been entitled to priority NHS treatment. Priory Group hospitals provide care for 350 military patients a year. Gaps in NHS services are filled by charities such as the exservices mental welfare society Combat Stress. KOC

Grassman, D. Wounded warriors: their last battle / D. Grassman In: Home healthcare nurse = ISSN 0884-741X: vol. 25 (2007), issue 5, page 299-304. Gewonden Militairen Hulpverlening Overzichtsartikelen KOC

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Gross, M.L. Why treat the wounded?: warrior care, military salvage, and national health / M.L. Gross In: American journal of bioethics = ISSN 1526-5161: vol. 8 (2008), issue 2, page 3-12. Gewonden Militairen Gezondheidszorg Verenigde Staten Beleid Because the goal of military medicine is salvaging the wounded who can return to duty, military medical ethics cannot easily defend devoting scarce resources to those so badly injured that they cannot return to duty. Instead, arguments turn to morale and political obligation to justify care for the seriously wounded. Neither argument is satisfactory. Care for the wounded is not necessary to maintain an army's morale. Nor is there any moral or logical connection between the right to health care (a universal human right) and the duty to defend one's nation (a local political duty). Once badly wounded, soldiers enjoy the same right to medical care as any similarly ill or injured individual. National health care systems grasp this point and offer few additional health care benefits to veterans. In the United States, however, lack of universal health coverage skews the debate to focus on special entitlements for veterans without considering the health care rights that other citizens enjoy. KOC

Haigh, S. The Veterans Affairs health care system in North Carolina / S. Haigh In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 27-30. Veteranen Hulpverlening Department of Veterans Affairs (VA) North Carolina Beleid KOC

Haley, R.W. Use of structural equation modeling to test the construct validity of a case definition of Gulf War syndrome: invariance over developmental and validation samples, service branches and publicity / R.W. Haley, G.D. Luk en F. Petty In: Psychiatry Research = ISSN 0165-1781: vol. 102 (2001), issue 2, page 175-200. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek To replicate the syndrome-like structure identified by exploratory factor analysis of symptom reports from 249 Gulf War veterans of a Naval reserve battalion (the developmental sample), the authors administered a symptom questionnaire to 335 Gulf War veterans who served primarily in active-duty US Army units living in North Texas (the validation sample). On the basis of goodness-of-fit criteria, a structural equation model (Model 1) with 4 symptom scales loading on each of 3 1st-order latent syndrome factors (impaired cognition, confusion-ataxia, central pain) fit both samples well and was invariant across both samples. Additional models validated a higher-order latent factor (a single Gulf War syndrome) explaining the variances and covariances of the 1st order factors, 4 86

additional symptom scales loading on the higher order factor, and 4 possible secondary factor loadings that also fit the data well. All structural models were invariant across the cohorts of the validation sample surveyed before and after intense publicity following publication of the case definition. These findings suggest that the apparent syndrome structure of a single Gulf War syndrome with 3 variants may be found widely and justify a confirmatory sample survey of Gulf War era veterans. KOC

Hallarman, L. The military history as a vehicle for exploring end-of-life care with Veterans #152 / L. Hallarman and C. Kearns In: Journal of palliative medicine = ISSN 1096-6218: vol. 11 (2008), issue 1, page 104105. Militaire geschiedenis Oral history Ouderen Veteranen Pallatieve zorg Casuïstiek KOC

Hetebrij, B. Terugkeerconferenties Dutchbat III 1996/2006: The war at home: who pacifies the peacekeepers? / B. Hetebrij In: Kernvraag = ISSN 0924-4468: (2006), issue 2, page 37-55. Geestelijke verzorging Dutchbat Srebrenica Veteranen Hulpverlening KOC

Hetebrij, B. Van isolement naar verbondenheid: voor de werkelijkheid kan men de ogen sluiten, maar niet voor de herinnering / B. Hetebrij In: Tijdschrift voor Humanistiek = ISSN 1567-7117: vol. 8 (2007) (apr-mei), page 79-90. Geestelijke verzorging Veteranen Srebrenica Voormalig-Joegoslavië KOC

Hetebrij, B. Van isolement naar verbondenheid: voor de werkelijkheid kan men de ogen sluiten, maar niet voor de herinnering / B. Hetebrij In: Tijdschrift voor Humanistiek = ISSN 1567-7117: vol. 8 (2007), issue 29, page 79-90. Bosnië-veteranen Srebrenica Geestelijke verzorging Casuïstiek 87

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Hetebrij, L.W.A. Een humanistisch perspectief op werken met veteranen (1) / L.W.A. Hetebrij In: Carré = ISSN 0165-7437: vol. 31 (2008), issue 3, page 14-17. Geestelijke verzorging Veteranen Hulpverlening De geestelijke verzorging heeft zich via een convenant laten opnemen in het landelijke zorgsysteem van veteranen. Humanistisch raadsman drs. L.W.A. hetebrij legt uit hoe hij daar in zijn regio vorm aan geeft en van welke wetenschappelijke basis hij uit gaat. Het belang van de zorg voor veteranen ligt volgens Hetebrij niet in de mobilisering van aandacht voor het "grote leed", maar in de erkenning van hun grote prestaties. KOC

Hetebrij, L.W.A. Een humanistisch perspectief op werken met veteranen (2) / L.W.A. Hetebrij In: Carré = ISSN 0165-7437: vol. 31 (2008), issue 3, page 11-13. Geestelijke verzorging Veteranen Hulpverlening De geestelijke verzorging heeft zich via een convenant laten opnemen in het landelijke zorgsysteem van veteranen. Humanistisch raadsman drs. L.W.A. hetebrij legt uit hoe hij daar in zijn regio vorm aan geeft en van welke wetenschappelijke basis hij uit gaat. Van belang is zijn aantekening dat het belang van de zorg voor veteranen niet ligt in de mobilisering van aandacht voor het "grote leed", maar in de erkenning van hun grote prestaties. Het eerste deel van dit artikel verscheen in Carré nr. 3. KOC

Hinton, D.E. Orthostatic panic attacks among Vietnamese refugees / D.E. Hinton...[et al.] In: Transcultural Psychiatry = ISSN 1363-4615: vol. 44 (2007), issue 4, page 515-544. Orthostatische hypotensie Syndromen Golfoorlog-syndroom Vluchtelingen Vietnam Viewed historically and cross-culturally, orthostatic-induced dizziness, i.e., dizziness caused by standing up from a sitting or a lying position, forms a key aspect of many syndromes: irritable heart (American Civil War), effort syndrome (World War I and World War II), chronic fatigue syndrome (contemporary USA), Gulf War syndrome (contemporary USA), and orthostatic dysregulation (contemporary Japan). Among Vietnamese refugees attending a psychiatric clinic, this study documents a high rate of orthostatic panic (OP), as well as certain processes seemingly generating these panic attacks, viz., flashbacks and culturally specific catastrophic cognitions. Case examples are used to demonstrate OP's phenomenology and relevance to clinical care. To illustrate the mechanisms producing OP, we adduce the multiplex model of panic generation. Culturally appropriate care of Vietnamese refugees should include assessment and treatment of OP. KOC

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Hoare, T. Caring for veterans / T. Hoare In: Australian Nursing Journal = ISSN 1320-3185: vol. 14 (2007), issue 7, page 37. Veteranen Hulpverlening Australië KOC

Hoejenbos, M.J.J. Een missie voor Defensie: veteranen en overtollig geneeskundig materieel / M.J.J. Hoejenbos In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 5, page 256-262. Ontwikkelingssamenwerking Krijgsmacht Militairen Veteranen Veteranen met een missie Binnen de doelstellingen van de ministers van Defensie, Buitenlandse Zaken en Ontwikkelingssamenwerking is een breder gebruik van militair-geneeskundige kennis en overtollig militair geneeskundig materieel mogelijk. Het zwaartepunt hoeft niet louter bij CIMIC (Civil-Military Cooperation) te liggen, want ook v¢¢r of na een missie kunnen er betrekkingen zijn met een land. Soms door persoonlijke contacten, soms door specifieke activiteiten in 'focuslanden' die op de agenda staan van Defensie/Internationale Militaire Samenwerking (IMS). Het ondersteunen van deze projecten kan leiden tot een betere psychosociale verwerking van een missie bij defensiepersoneel, terwijl sommige landen op den duur een bijdrage kunnen leveren aan Nederlandse (defensie-)activiteiten in het kader van ontwikkelingssamenwerking. KOC

Hom, J. Neuropsychological correlates of Gulf War Syndrome / J. Hom, R.W. Haley and T.L. Kurt In: Archives of Clinical Neuropsychology = ISSN 0887-6177: vol. 12 (1997), issue 6, page 531-544. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek Compared the neuropsychological and psychological performances of 26 ill Gulf War veterans to 20 well veterans from the same military unit. Neurocognitive functions assessed included intelligence, abstraction and problem-solving, attention and concentration, memory and learning, language and visual-spatial function, and sensorimotor abilities. Psychological function was measured by self-report questionnaires. Results indicate global and consistently poorer intellectual and neurocognitive function among the ill veterans compared to the control veterans. A generalized pattern of neuropsychological deficit was evident for the ill veterans. Psychological profiles of the ill veterans were similar to those in general medical patients. KOC

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Hoof, E. van The symptoms and psychiatric status of the Bijlmermeer plane crash disaster: similarities with chronic fatigue syndrome and gulf war syndrome / E. van Hoof...[et al.] In: Journal of Chronic Fatigue Syndrome = ISSN 1057-3321: vol. 11 (2003), issue 3, page 3-21. Golfoorlogsyndroom Chronische vermoeidheidssyndroom (CVS) Bijlmermeerramp Vergelijkend onderzoek On October 4,1992, the El Al Boeing crashed in the residential quarter 'Bijlmermeer' in Amsterdam (The Netherlands). In the years after the plane crash, local residents and assistance personnel began reporting a variety of unusual symptoms not unlike those reported by patients with chronic fatigue syndrome (CFS) and Gulf War Syndrome (GWS). The aim of this study was to define the symptom constellations reported by the patients and assess the possible causes of the illness. Standardized psychological questionnaires (MMPI-II, SCL-90, KPS and a complaints checklist) were used to screen for psychological changes and to describe the symptoms reported by the patients. Differences between local residents and assistance personnel, gender differences, Mycoplasma-infected and Mycoplasma non-infected patients were monitored. The major symptoms reported were extreme fatigue, non-restorative sleep, concentration-problems, memory problems and muscle and joint pains. Similar to patients with Gulf War Syndrome and CFS, a deregulation of the immune-competence through a combination of toxic material exposure and psychological stressors associated with increased opportunistic infections may be the most likely etiological hypothesis. KOC

Horner, R.D. Amyotrophic lateral sclerosis among 1991 Gulf War veterans: evidence for a time-limited outbreak / R.D. Horner In: Neuroepidemiology = ISSN 0251-5350: vol. 31 (2008), issue 1, page 28-32. Amyotrophic lateral sclerosis (ALS) Golfoorlog-veteranen Golfoorlogsyndroom Diagnostiek Background: In follow-up to recent reports of an elevated risk of amyotrophic lateral sclerosis (ALS) among 1991 Gulf War veterans, we analyzed the distribution of disease onset times to determine whether the excess risk was time limited. Methods: This secondary analysis used data from a population-based series of ALS cases identified between 1991 and 2001 among the 2.5 million military personnel who were on active duty during the 1991 Gulf War. Annual standardized incidence ratios (SIR) were calculated for all cases and for those with disease onset before age 45 years. Results: Forty-eight of 124 cases occurred among those deployed to the Persian Gulf region during the war. The annual SIR for deployed military personnel did not demonstrate a monotonically increasing trend for either all cases (chi(2) = 0.11, d.f. = 1, p = 0.74) or for cases under 45 years of age at onset (chi(2) = 2.41, d.f. = 1, p = 0.12). The highest risk was observed in 1996, declining thereafter. Among military personnel who were not deployed to the Gulf region, the level of risk remained fairly constant during the 11-year period. Conclusions: The excess risk of ALS among 1991 Gulf War veterans was limited to the decade following the war. KOC 90

Horowitz, M.J. A prediction of delayed stress response syndromes in Vietnam veterans / M.J. Horowitz and G.F. Solomon In: Journal of Social Issues = ISSN 0022-4537: vol. 31 (1975), issue 4, page 67-80. PTSD Vietnam-veteranen Diagnostiek Posits that over the next years civilian mental health professionals will (a) encounter stress response syndromes in Vietnam veterans, (b) misread etiological factors, and (c) be unable to treat such persons effectively. This paper attempts to describe the types of problems which may be expected (e.g., nightmares, moods and emotional storms, and direct or symbolic behavioral repetitions) and suggests special approaches (e.g., conceptual labeling) which will be required and may assist the treatment process. KOC

Hotopf, M. Gulf war illness-better, worse, or just the same?: a cohort study / M. Hotopf...[et al.] In: British Medical Journal = ISSN 0959 8138: vol. 327 (2003), issue 7428, page 13701372. Golfoorlogsyndroom Golfoorlog-veteranen Bosnië-veteranen Cohort studies Seeks to describe changes in the health of Gulf war veterans studied in a previous occupational cohort study and compare outcome with comparable non-deployed military personnel, and to determine whether differences in prevalence between Gulf veterans and controls at follow up can be explained by greater persistence or greater incidence of disorders. Ss were military personnel who served in the 1991 Persian Gulf war, personnel who served on peacekeeping duties to Bosnia, and military personnel who were deployed elsewhere ("Era" controls). Results indicated that Gulf war veterans experienced a modest reduction in prevalence of fatigue and psychological distress but a slight worsening of physical functioning on the SF-36. Compared with the other cohorts Gulf veterans continued to experience poorer health on all outcomes, although physical functioning also declined in Bosnia veterans. Era controls showed both lower incidence of fatigue than Gulf veterans, and both comparison groups showed less persistence of fatigue compared with Gulf veterans. Gulf war veterans remain a group with many symptoms of ill health. The excess of illness at follow up is explained by both higher incidence and greater persistence of symptoms. KOC

Hotopf, M. Risk factors for continued illness among Gulf War veterans: A cohort study / M. Hotopf...[et al.] In: Psychological Medicine = ISSN 0033 2917: vol. 34 (2004), issue 4, page 747-754. Golfoorlogsyndroom Golfoorlog-veteranen Cohort studies We aimed to test the hypotheses that Gulf War veterans who were older; had more severe symptoms; had more exposures during deployment; had increased psychological distress and believed they had 'Gulf War syndrome' would experience greater fatigue and poorer 91

physical functioning at follow-up. Gulf War veterans who responded to an earlier retrospective cohort study were followed with a postal survey. Outcome was measured on the Chalder fatigue questionnaire, the General Health Questionnaire and the Medical Outcome Study Short-Form 36. Of those surveyed, 73.8% responded. Officer status was associated with a better outcome. A similar lack of association was found for exposures and physical functioning and GHQ-12 score. 'Gulf War syndrome' attribution was associated with a worse outcome for GHQ-12 and physical functioning even after controlling for severity of symptoms at baseline. This study suggests that while multiple vaccination and military exposures are important risk factors for the onset of symptoms in Gulf War veterans, these are not important risk factors for persistence of such symptoms. Instead the severity of the initial symptoms; psychological distress and attributions may be more important determinants of outcome. KOC

Hout, W. in 't Geestelijke verzorging betekent veel voor militairen en veteranen / W. in 't Hout In: Carré = ISSN 0165-7437: vol. 28 (2005), issue 6, page 34-37. Geestelijke verzorging Veteranen Hulpverlening Welke vragen komen er op je af? Wat is kenmerkend voor de geestelijke begeleiding van (oud-)militairen die gediend hebben tijdens vredesoperaties en van uitgezonden militairen in oorlogssituaties? In dit artikel een eerste antwoord, gebaseerd op eigen uitzendervaringen en impressies uit de dagelijkse praktijk van het veteranenpastoraat. Geestelijke zorg heeft baat bij het tijdig onderkennen van de kernvragen van deze (oud)militairen en hun thuisfront. KOC

Hout, W. in 't Pastorale zorg voor uitgezonden militairen en veteranen: een algemene beschouwing over diagnostiek en begeleiding / W. in 't Hout In: Kernvraag = ISSN 0924-4468: (2006), issue 2, page 29-35. Geestelijke verzorging Veteranen Hulpverlening KOC

Huiting, E. Ruimte bieden om het echte verhaal te vertellen: Dominee Wim in 't Hout neemt afscheid als geestelijk verzorger voor de veteranen / E. Huiting In: Dubbel Accent = ISSN 0168-227x: vol. 27 (2007), issue 4, page 3-5. Geestelijke verzorging Veteranen Hulpverlening KOC

Hull, L. Self-reported health of Persian Gulf war veterans: a comparison of help-seeking and randomly ascertained cases / L. Hull...[et al.] In: Military Medicine = ISSN 0026-4075: vol. 167 (2002), issue 9, page 747-752. 92

Gezondheid Golfoorlog-veteranen Golfoorlogsyndroom Groot-Brittannië Examined the degree to which Persian Gulf War veterans present for clinical assessment, and compared findings with a subset of veterans voluntarily attending a medical assessment program (MAP). 3,529 United Kingdom Armed Forces personnel (aged 25-58 yrs) who served in the Persian Gulf conflict completed questionnaires concerning demographic characteristics, symptoms, health perceptions, physical functioning, psychological distress, posttraumatic stress symptoms, and health attributions. 173 of these Ss had previously attended a MAP. Results show that MAP Ss were more likely to be female, older, and working part time or not working at all. MAP Ss exhibited poorer health perceptions and reported higher levels of illness, and they differed in terms of their health attributions. The perception of having Gulf War syndrome and attributing health problems to Gulf War service were the most powerful predictors of MAP attendance, even when controlling for physical functioning level. It is concluded that health beliefs rather than symptoms are more important predictors of attendance of MAPS, and that Gulf War veterans who attend MAPs have different characteristics than those who do not. MAP patients are unrepresentative of the wider deployment to the Persian Gulf. KOC

Humphreys, K. Do enhanced friendship networks and active coping mediate the effect of self-help groups on substance abuse?/ K. Humphreys...[et al.] In: Annals of behavioral medicine = ISSN 0883-6612: vol. 21 (1999), issue 1, page 54-60. Zelfhulpgroepen Drugsmisbruik Alcoholmisbruik Veteranen Evaluaties Self-help groups are the most commonly sought source of help for substance abuse problems, but few studies have evaluated the mechanisms through which they exert their effects on members. The present project evaluates mediators of the effects of self-help groups in a sample of 2,337 male veterans who were treated for substance abuse. The majority of participants became involved in self-help groups after inpatient treatment, and this involvement predicted reduced substance use at 1-year follow-up. Both enhanced friendship networks and increased active coping responses appeared to mediate these effects. Implications for self-help groups and professional treatments are discussed. KOC

Hunt, S.C. Clinical management of Gulf War veterans with medically unexplained physical symptoms / S.C. Hunt, R.D. Richardson and C.C. Engel Jr. In: Military Medicine = ISSN 0026-4075: vol. 167 (2002), issue 5, page 414-420. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Discusses a model for the clinical management of medically unexplained physical symptoms (MUPS) in Persian Gulf War veterans. The model identifies predisposing,

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precipitating, and perpetuating factors contributing to the emergence and clinical course of MUPS. Predisposing factors, which render individuals more susceptible to MUPS, include heredity, biological diathesis, early-life adversity, chronic illness, and chronic distress or mental illness. Precipitating factors include biological stress, acute physical illness, psychological stressors, acute psychiatric disorders, and epidemic health concerns. Perpetuating factors include harmful illness beliefs, labeling effects, misinformation, workplace and social support factors, negative health habits, chronic illness, and poor integration in the treatment system. It is concluded that the collaborative model for managing MUPS reduces distress and assists in the rehabilitation of Gulf War veterans. KOC

Hyer, L. Posttraumatic stress disorder: silent problem among older combat veterans / L. Hyer[et al.] In: Psychotherapy: Theory, Research, Practice, Training = ISSN 0033-3204: vol. 32 (1995), issue 2, page 348-364. PTSD Veteranen Ouderen Behandeling Examines posttraumatic stress disorder (PTSD) among older Vietnam combat veterans. It is suggested that PTSD among these veterans is generally chronic, silent, and exacerbated by the problems of aging. These Ss with PTSD can be divided into those with full PTSD and those with partial PTSD. Studies are cited showing prevalence rates for PTSD. The difficulties in measuring PTSD are described. Several moderating variables influence the expression of trauma problems at later life, including the presence of other stressors, health status, social support, and comorbidity. Several forms of therapy are considered, including cognitive behavioral therapy, reminiscence, and relaxational desensitization. Also, several treatment suggestions are given, advocating interventions of a stuck narrative in an aging population. KOC

Hynes, D.M. Veterans' access to and use of Medicare and Veterans Affairs health care / D.M. Hynes...[et al.] In: Medical care = ISSN 0025-7079: vol. 45 (2007), issue 3, page 214-223. Veteranen Department of Veterans Affairs (VA) Medicare Hulpverlening OBJECTIVES: We examined the impact of access to care characteristics on health care use patterns among those veterans dually eligible for Medicare and Veterans Affairs (VA) services. METHODS: We used a retrospective, cross-sectional design to identify veterans who were eligible to use VA and Medicare health care in calendar year 1999. We analyzed national VA utilization and Medicare claims data. We used descriptive and multivariable generalized ordered logit analyses to examine how patient, geographic, and environmental factors affect the percent reliance on VA and Medicare inpatient and outpatient services. RESULTS: Of the 1.47 million veterans in our study population with outpatient use, 18% were VA-only users, 36% were Medicare-only users, and 46% were both VA and Medicare users. Among veterans with inpatient use, 24% were VA only, 69%

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were Medicare only, and 6% were both VA and Medicare users. Multivariable analysis revealed that veterans who were black or had a higher VA priority were most likely to rely on the VA. Patient with higher risk scores were most likely to rely on a combination of VA and Medicare health care. Patients who lived farther from VA hospitals were less likely to rely on VA health care, particularly for inpatient care. Patients living in urban areas with more health care resources were less likely to rely on VA health care. CONCLUSIONS: VA health care provides an important safety net for vulnerable populations. Targeted approaches that carefully consider the simultaneous impacts of VA and Medicare policy changes on minority and high-risk populations are essential to ensure veterans have access to needed health care. KOC

Jackson, G.L. Detecting traumatic brain injury among veterans of Operations Enduring and Iraqi Freedom / G.L. Jackson, N.S. Hamilton and L.A. Tupler In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 43-47. Hersenletsel Veteranen Irak Operation Enduring Freedom Diagnostiek KOC

Jakupcak, M. Posttraumatic stress and its relationship to physical health functioning in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA health care / M. Jakupcak...[et al.] In: The Journal of nervous and mental disease = ISSN 0022-3018: vol. 196 (2008), issue 5, page 425-428. PTSD Fysieke gezondheid Veteranen Afghanistan Irak Diagnostiek The relationship between posttraumatic stress and physical health functioning was examined in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA care. Iraq and Afghanistan War veterans (N = 108) who presented for treatment to a specialty postdeployment care clinic completed self-report questionnaires that assessed symptoms of posttraumatic stress disorder (PTSD), chemical exposure, combat exposure, and physical health functioning. As predicted, PTSD symptom severity was significantly associated with poorer health functioning, even after accounting for demographic factors, combat and chemical exposure, and health risk behaviors. These results highlight the unique influence of PTSD on the physical health in treatment seeking Iraq and Afghanistan War veterans. KOC

Johnson, K.M. Frequency of mastalgia among women veterans: association with psychiatric conditions and unexplained pain syndromes / K.M. Johnson...[et al.] 95

In: Journal of General Internal Medicine = ISSN 0884-8734: vol. 21 (2006), issue 3, page S70-S75. Mastalgia Onverklaarde lichamelijke klachten (OLK) Psychische stoornissen Diagnostiek Objective: To determine the prevalence and frequency of mastalgia and its association with psychiatric conditions and unexplained pain syndromes. Design, Setting, and Participants: Cross-sectional mailed survey completed by 1,219 female veterans enrolled at the VA Puget Sound Health Care System in 1998. Measurements: Breast pain in the past year, unrelated to pregnancy, was categorized as infrequent (<= monthly) or frequent (>= weekly) mastalgia. Surveys assessed posttraumatic stress disorder (PTSD), depression, panic disorder, and alcohol misuse with validated screening tests, as well as self-reported past-year chronic pelvic pain, fibromyalgia, and irritable bowel syndrome. Results: The response rate was 63%. Fifty-five percent of the respondents reported pastyear mastalgia. Of these, 15% reported frequent mastalgia. Compared to women without mastalgia, women reporting frequent mastalgia were more likely to screen positive for PTSD (odds ratio [OR] 5.2, 95% confidence interval [CI] 3.2 to 8.4), major depression (OR 4.2, 2.6 to 6.9), panic disorder (OR 7.1, 3.9 to 12.8), eating disorder (OR 2.6, 1.5 to 4.7), alcohol misuse (OR 1.8, 1.1 to 2.8), or domestic violence (OR 3.1, 1.9 to 5.0), and to report fibromyalgia (OR 3.9, 2.1 to 7.4), chronic pelvic pain (OR 5.4, 2.7 to 10.5), or irritable bowel syndrome (OR 2.8, 1.6 to 4.8). Women with infrequent mastalgia were also more likely than women without mastalgia to screen positive for PTSD, depression, or panic disorder, or report pelvic pain or irritable bowel syndrome, although associations were weaker than with frequent mastalgia. Conclusions: Like other unexplained pain syndromes, frequent mastalgia is strongly associated with PTSD and other psychiatric conditions. Clinicians seeing patients with frequent mastalgia should inquire about anxiety, depression, alcohol misuse, and trauma history. KOC

Jones, E. Post-combat syndromes from the Boer war to the Gulf war: a cluster analysis of their nature and attribution / E. Jones...[et al.] In: British Medical Journal = ISSN 0959 8138: vol. 324 (2002), issue 7333, page 321-324. Oorlogssyndromen Golfoorlogsyndroom Geschiedenis Investigated whether post-combat syndromes have existed after modern wars and what relation they bear to each other. Medical and military records were reviewed for 1,856 veterans randomly selected from war pension files awarded from 1,872 and from the Medical Assessment Programme for Gulf war veterans. The authors examined characteristic patterns of symptom clusters and their relation to war, diagnosis, predisposing physical illness, and exposure to combat. Servicemen's changing attributions for post-combat disorders were also studied. Three varieties of post-combat disorder were identified--a debility syndrome (associated with the 19th and early 20th centuries), somatic syndrome (related primarily to WWI), and a neuropsychiatric syndrome (associated with WWII and the Gulf conflict). The era in which the war occurred was overwhelmingly the best predictor of cluster membership. The authors conclude that all modern wars have been associated with a syndrome characterized by unexplained medical symptoms. The form that these assume, the terms used to describe them, and the explanations offered by

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servicemen and doctors seem to be influenced by advances in medical science, changes in the nature of warfare, and underlying cultural forces. KOC

Kalra, H. Caregiver burden in anxiety disorders / H. Kalra...[et al.] In: Current opinion in psychiatry = ISSN 0951-7367: vol. 21 (2008), issue 1, page 70-73. Angststoornissen PTSD Overdracht Gezinnen PURPOSE OF REVIEW: Family burden research has primarily focused on severe mental disorders. Despite the high prevalence and chronic disabling nature of anxiety disorders, family burden has been relatively neglected in our understanding of their impact on caregivers. The paper reviews the available evidence on caregivers' burden in different anxiety disorders. FINDINGS: Obsessive-compulsive disorder and posttraumatic stress disorder are the only anxiety disorders that have been studied in this regard, while there is a significant lack of data about other anxiety disorders. Caregiver burden in obsessivecompulsive disorder is equivalent to that of severe mental disorders like schizophrenia and affective disorders. Spouses/partners and children experience a significant degree of burden in looking after their relatives with posttraumatic stress disorder. SUMMARY: Available limited data indicates an adverse impact on families looking after their relatives with anxiety disorders such as obsessive-compulsive disorder and posttraumatic stress disorder. There is an urgent need for further research to increase our understanding of family burden and, accordingly, to support families involved in the care of patients with anxiety disorders. The impact of caregiver burden on disease and recovery in anxiety disorders also needs to be addressed in future research. KOC

Karczmar, A. Anticholinesterases: dramatic aspects of their use and misuse / A. Karczmar In: Neurochemistry International = ISSN 0197-0186: vol. 32 (1998), issue 5-6, page 401411. Psychofarmaca Golfoorlogsyndroom While the lore of anticholinesterases (antiChEs), particularly physostigmine and its natural source, the Calabar bean predates our scientific era, the pharmacological development of physostigmine analogues and related agents and of the antiChEs of the organophosphorus (OP) type, is a matter of the last 2 centuries; this development has reached an exponential character in the last 50 years. This review relates some of the uses and misuses of these drugs. First, the author focuses on the clinical applications of antiChEs in the treatment of Senile Dementia of Alzheimer's Type (SDAT) and on the uses and misuses of antiChEs in this area. Second, the author discusses the applied use of antiChEs as insecticides. Their employment may mean the difference between life and starvation but there are notable dangers with this application of OP drugs. Finally, there is the significant and tragic development of the OP drugs as warfare agents and tools for terrorists and rogue states; the author discusses the several types of toxicity of OP agents and their mechanisms. The enigma of the Persian Gulf War Syndrome is stressed. KOC

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Kelly, M.M. Effects of military trauma exposure on women veterans' use and perceptions of Veterans Health Administration care / M.M. Kelly...[et al.] In: Journal of general internal medicine = ISSN 0884-8734: (2008) (apr). Seksueel geweld Hulpverlening Veterans Health Administration (VHA) Veteranen Vrouwen Beleid BACKGROUND: Few studies have addressed how military trauma exposure, particularly sexual assault and combat exposure, affects women veterans' use and perceptions of Veterans Health Administration (VHA) care. OBJECTIVE: The aim of the present study was to evaluate the effects of military sexual assault and combat exposure on women veterans' use and perceptions of different aspects of VHA care. DESIGN: Cross-sectional telephone survey of a national sample of women veterans. PARTICIPANTS: Women from the VA's National Registry of Women Veterans. MEASUREMENTS: Sociodemographic characteristics, VHA care utilization, perceptions of care. RESULTS: Women veterans with histories of military sexual assault reported more use of VHA services, but less satisfaction, poorer perceptions of VHA facilities and staff, and more problems with VHA services compared to women veterans without histories of sexual assault. Combat exposure was related to more problems with VHA staff, although few other differences were observed for women with and without histories of combat exposure. CONCLUSIONS: Findings provide information on areas that can be targeted with respect to caring for women veterans exposed to military sexual trauma and combat exposure, including improving interactions with VHA staff and the ease of using VHA services. KOC

Kerns, R.D. Research on pain and pain management in Veterans Health Administration: promoting improved pain care for veterans through science and scholarship / R.D. Kerns In: Journal of rehabilitation research and development = ISSN 0748-7711: vol. 44 (2007), issue 2, page vii-x. Pijn Veteranen Onderzoek Department of Veterans Affairs (VA) KOC

Kilshaw, S. Gulf War syndrome: a reaction to psychiatry's invasion of the military? / S. Kilshaw...[et al.] In: Culture, medicine and psychiatry = ISSN 0165-005X: (2008) (mar). Golfoorlogsyndroom Golfoorlog-veteranen Interviews Following the 1991 Gulf War, a number of soldiers who fought there began to complain of various symptoms and disorders, the collection of which came to be known as Gulf War syndrome (GWS). A debate has raged about the nature and cause of this illness, with many suggesting that it is a psychiatric condition. GWS continues to be a contested illness, yet there is no disputing that many Gulf veterans are ill. This article considers the 98

way in which GWS sufferers understand their illness to be physical in nature and the way in which they negotiate and resist psychological theories of their illness. Based on 14 months of ethnographic fieldwork in the United Kingdom, data for this article were collected mainly by in-depth, semistructured interviews with GWS sufferers, their family members, doctors, and scientists, as well as healthy Gulf veterans. A total of 93 informants were interviewed, including 67 UK Gulf veterans, most of whom were ill. The paper argues that despite the increasing presence of psychiatry in military discourse, GWS reveals the way that people are able to transform, negotiate and even negate its power and assumptions. KOC

Kilshaw, S. Toxic emissions: the role of semen in GWS narratives / S. Kilshaw In: Anthropology & Medicine = ISSN 1364-8470: vol. 14 (2007), issue 3, page 251-258. Golfoorlogsyndroom Golfoorlog-veteranen Mannelijkheid Sociologie Etnografie Interviews Narratives about Gulf War Syndrome (GWS) contain discussions of sex and reproduction and there is a high level of anxiety about these subjects. Although similar to other medically unexplained conditions, GWS has distinctive features. The most salient of these is its contagious nature, with the main vehicle for contamination being semen. GWS sufferers believe their semen to be affected by their participation in the Gulf War. This paper focuses on a number of specific symptoms described by Gulf veterans including: Burning Semen Syndrome, low libido, impotence and birth defects and aims to interpret why certain symptoms became powerful markers of the condition. Furthermore, the paper looks at the meaning conveyed by such symptom reporting. Data were generated from 14 months ethnographic fieldwork in the UK including participant observation, semi-structured interviews and document analysis. Concerns about lack of potency, toxicity and quality suggest that semen itself is a substance in which social concerns are enacted. The paper argues that such a focus on and anxiety about semen suggests that GWS narratives express concerns about masculinity, or, more precisely a loss of masculinity. KOC

Kimerling, R. Evaluation of universal screening for military-related sexual trauma / R. Kimerling...[et al.] In: Psychiatric services = ISSN 1075-2730: vol. 59 (2008), issue 6, page 635-640. Seksueel geweld Veteranen Militairen Diagnostiek OBJECTIVES: In response to growing concerns about sexual violence as an underrecognized traumatic consequence of military service, Veterans Health Administration policy requires universal screening for sexual trauma sustained during military service. This prospective study, the first to evaluate national efforts to screen for military sexual trauma, investigated whether sexual trauma screening is associated with increased utilization of mental health services. METHODS: This study examined data for all male (N=540,381) and female (N=33,259) veterans who had valid responses to

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screens for military sexual trauma in 2005. The use of mental health services during the three months after screening was examined for persons who screened positive for military sexual trauma and for those who screened negative. Findings were stratified by use of mental health services in the six months before the screening. RESULTS: Compared with negative screens, positive screens were associated with significantly increased rates of postscreen mental health treatment. A more than twofold increase was observed for patients without previous use of mental health treatment (women: relative risk [RR]=2.52, 95% confidence interval [CI]= 2.38-2.66; men: RR=2.47, 95% CI=2.34-2.61). In this group, the number of positive screens needed for one additional patient to access treatment was 5.5 for women and 7.2 for men. CONCLUSIONS: Our findings suggest that detection via screening is associated with increased rates of mental health treatment. An effective screening program that promotes detection of sexual trauma and access to mental health care can help to reduce the burden of psychiatric illness for those who have experienced military sexual trauma. KOC

Kirby, A.C. Smoking in help-seeking veterans with PTSD returning from Afghanistan and Iraq / A.C. Kirby...[et al.] In: Addictive behaviors = ISSN 0306-4603: (2008) (may). PTSD Veteranen Roken Zelfhulpgroepen Afghanistan Irak Diagnostiek Past research has shown that veterans and individuals with posttraumatic stress disorder (PTSD) have increased rates of smoking. However, the rates of smoking in younger helpseeking veterans returning from Afghanistan and Iraq, and possible correlates of smoking among this population are unknown. In this study, we evaluated the rate of lifetime and current smoking among a sample of 90 returning male veterans diagnosed with PTSD. Fifty-nine percent reported a lifetime history of smoking including 32% that were current smokers. Current smokers were significantly younger than non-smokers. Current smokers (mean age=31) reported a mean age of smoking onset as 15.86 with a pack year history of 8.89. These smokers reported on average five previous quit attempts. According to a stages of change model, one-half of the smokers were in the contemplation phase of stopping smoking (50%), 29% were in the pre-contemplation phase and 21% were in the preparation phase. The results are placed in the context of non-psychiatric and psychiatric smokers. KOC

Kiser, K. Coming home / K. Kiser In: Minnesota medicine = ISSN 0026-556X: vol. 90 (2008), issue 12, page 10-11. Nazorg Militairen Verenigde Staten KOC

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Klaassens, E.R. Mental health of Dutch Peacekeeping Veterans 10-25 years after deployment / E.R. Klaassens, T. van Veen, J.M.P. Weerts and F.G. Zitman In: European psychiatry = ISSN 0924-9338: (2008) (may). Geestelijke gezondheid Veteranen Nederland Lange-termijn effecten OBJECTIVE: This report describes the mental health of Dutch peacekeeping veterans, 10--25 years after deployment, and its association with deployment-related traumatic events. METHOD: We randomly selected a group of 1046 peacekeeping veterans, who participated in military missions in Lebanon, former Yugoslavia, and various other missions between 1979 and 1997. We sent a questionnaire assessing current levels of psychological distress (Brief Symptom Inventory -- BSI), and a questionnaire assessing trauma related to deployment. RESULTS: Psychological data were available for 729 veterans. In 83% of the veterans, no significant psychological distress was found, whereas 17% scored above the BSI cut-off for psychopathology. Interestingly, this percentage was equal to that in a non-patient norm group. CONCLUSION: From this finding we concluded that 10--25 years post-deployment, Dutch peacekeeping veterans do not show more psychological distress than the general Dutch population. In addition, we did not find a significant association between trauma exposure 10--25 years ago and current BSI scores. Moreover, trauma-exposure explained only 9% of the variance in psychological distress. Thus, although military peacekeeping operations may have a strong impact on the lives of soldiers, in this group of veterans they do not seem to have caused severe psychological distress10--25 years after deployment. KOC

Koenig, H.G. Depressive symptoms and nine-year survival of 1,001 male veterans hospitalized with medical illness / H.G. Koenig...[et al.] In: American Journal of Geriatric Psychiatry = ISSN 1064-7481: vol. 7 (1999), issue 2, page 124-131. Depressie Mortaliteit Veteranen Ouderen Examined the effects of depressive symptoms on after-discharge survival of hospitalized medically ill male veterans. Psychosocial and physical health evaluations were performed on a consecutive sample of 1,001 patients aged 20-39 (16%) and 65-102 yrs (84%). Ss or surviving family members were later contacted by telephone, and Cox proportionalhazards regression modeled the effects of depressive symptoms on time-to-death, controlling for demographics and social, psychiatric, and physical health. Follow-up was obtained on all 1,001 patients (average observation time, 9 yrs), during which 667 patients died (67%). Patients with depressive symptoms were significantly less likely to survive. For every 1-point increase on the 12-item Brief Carroll Depression Rating Scale, the hazard of dying increased by 10%. Age did not significantly affect the association between depressive symptoms and mortality. Depressive symptoms during acute hospitalization are a predictor of shortened survival. KOC

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Kremen, W.S. Genes, environment, and time: the Vietnam Era Twin Study of Aging (VETSA)/ W.S. Kremen...[et al.] In: Twin research and human genetics = ISSN 1832-4274: vol. 9 (2006), issue 6, page 1009-1022. Tweelingen Vietnam-veteranen Cognitie The Vietnam Era Twin Study of Aging (VETSA) is a large-scale investigation of cognitive aging from middle to later age. The intended sample of 1440 twin subjects is recruited from the Vietnam Era Twin Registry (VETR), a registry of middle-aged male-male twin pairs who both served in the military during the Vietnam conflict (1965-1975). VETSA employs a multitrait multimethod approach to cognitive assessment to focus on the genetic and environmental contributions to cognitive processes over time, as well as the relative contributions to cognitive aging from health, social, personality, and other contextual factors. The cognitive domains of episodic memory, working memory, abstract reasoning, and inhibitory executive functioning are assessed through neuropsychological testing. In addition, VETSA obtains the participant's score on the Armed Forces Qualification Test, taken at the time of induction into the military around age 20 years, and re-administers the test. Two other projects--VETSA Cortisol and VETSA Magnetic Resonance Imaging--are also in progress using subsamples of the VETSA twins. Prior waves of data collection by VETSA investigators using the VETR have provided historical data on physical and mental health, while future waves of VETSA data collection are planned every 5 years. These methods will provide data on multiple phenotypes in the same individuals with regard to genetic and environmental contributions to cognitive functioning over time, personality and interpersonal risk and protective factors, stress and cortisol regulation, and structural brain correlates of aging processes. KOC

Kremer, W.S. Pretrauma cognitive ability and risk for posttraumatic stress disorder: a twin study / W.S. Kremer...[et al.] In: Archives of general psychiatry = ISSN 0003-990X: vol. 64 (2007), issue 3, page 361368. PTSD Cognitie Tweelingen Vietnam-veteranen CONTEXT: Cognitive deficits are associated with posttraumatic stress disorder (PTSD), but whether such deficits reflect sequelae or risk factors is not fully resolved. OBJECTIVE: To determine, in a representative sample, whether preexposure cognitive ability is associated with risk for PTSD, and whether that risk is genetically mediated. Design, Setting, and PARTICIPANTS: The co-twin-control study involved 2386 male Vietnam-era twin veterans with a mean (SD) age of 41.9 (2.7) years, a population-based sample of men who were in military service during this era. Cognitive ability scores were obtained just before military induction at a mean (SD) age of 19.7 (1.5) years. Participants included only individuals who were exposed to potentially traumatic events and underwent preexposure cognitive testing. MAIN OUTCOME MEASURES: Armed Forces Qualification Test (of cognitive ability) percentile scores and PTSD diagnosed by means of structured interviews. RESULTS: We found a significant dose-response relationship between 102

preexposure cognitive ability and risk for PTSD. After controlling for confounders, the highest cognitive ability quartile had a 48% lower risk than the lowest ability quartile (P<.001). Non-PTSD-concordant pairs had the highest scores; PTSD-concordant pairs had the lowest scores; and PTSD-discordant pairs had intermediate scores. Differences in Armed Forces Qualification Test scores within twin pairs were significant only in PTSDdiscordant pairs (P=.04) and were accounted for specifically by the discordant dizygotic pairs (P=.002). Genetic influences on preexposure cognitive ability explained 5% of the variation in PTSD, but 100% of that relationship was explained by common genes. CONCLUSIONS: Preexposure cognitive ability is a risk or a protective factor for PTSD. The variance in PTSD explained by preexposure cognitive ability is accounted for entirely by common genetic factors. Lower cognitive ability may be a marker of less adaptive coping against adverse mental health consequences of exposure to potentially traumatic events. Further study of the potential mechanisms through which cognitive ability confers risk is needed. KOC

Kudler, H. Identifying and treating post deployment mental health problems among new combat veterans / H. Kudler and K. Straits-Tröster In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 39-42. Geestelijke gezondheid Veteranen Behandeling Diagnostiek KOC

Kuehn, B.M. VA, military seek office-based PTSD care / B.M. Kuehn In: JAMA = ISSN 0098-7484: vol. 299 (2008), issue 16, page 1885-1886. PTSD Militairen Hulpverlening Beleid KOC

LAHolt, M. Insights into the medical management of brain injured veterans / M. LAHolt and J. Rupright In: Missouri medicine = ISSN 0026-6620: vol. 105 (2008), issue 2, page 150-152. Hersenletsel Veteranen Irak Behandeling Many Iraqi war veterans are returning from their tours of duty with a multitude of medical problems. For those who have had traumatic brain injuries, their clinical picture can become clouded with neuro-cognitive and mood disturbances. Early recognition and interdisciplinary rehabilitation combined with proper neuropharmacology can make it possible to alleviate some of the problems facing this population. KOC

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Lange, G. Cognitive functioning in Gulf War Illness / G. Lange...[et al.] In: Journal of Clinical and Experimental Neuropsychology = ISSN 1380-3395: vol. 23 (2001), issue 2, page 240-249. Golfoorlogsyndroom Golfoorlog-veteranen Cognitie A comprehensive neuropsychological battery was administered to 48 veterans (mean age 35.5 yrs) with Gulf War Illness (GWI) characterized by severe fatigue (GV-F) and 39 healthy veterans (GV-H; mean age 34.3 yrs). Subjects were matched on intelligence and did not differ on age, gender, race, and alcohol consumption. Compared to GVs-H, GVs-F were significantly impaired on four tasks: three attention, concentration, information processing tasks and one measure of abstraction and conceptualization. After considering the presence of post-war Axis I psychopathology, GWI remained a significant predictor of cognitive performance on one of the attention, concentration, and information processing tasks and one abstraction and conceptualization measure. Performance on the remaining two attention, concentration, and information processing tasks was only significantly predicted by Axis I psychopathology with post-war onset. The results suggest that Gulf War Illness is associated with some aspects of cognitive dysfunction in Gulf Veterans, over and above the contribution of psychopathology. KOC

Lange, G. Psychiatric diagnoses in Gulf War veterans with fatiguing illness / G. Lange...[et al.] In: Psychiatry Research = ISSN 0165-1781: vol. 89 (2000), issue 1, page 39-48. Golfoorlogsyndroom Psychische stoornissen Golfoorlog-veteranen Determined whether Gulf War Illness (GWI) could be explained by the presence of psychiatric disorders as assessed by Diagnostic and Statistical Manual of Mental Disorders-III-Revised (DSM-III-R). To reduce the heterogeneity amongst Persian Gulf War veterans with GWI (PGV-F), only those were studied who presented with severe fatigue as a major complaint and also fulfilled clinical case definitions for Chronic Fatigue Syndrome, Idiopathic Chronic Fatigue, and/or Multiple Chemical Sensitivity. A total of 95 Registry PGVs were examined; 53 presented with GWI and 42 did not report any post-war health problems (PGV-H). All Ss were assessed for the presence of DSM-III--R Axis I psychiatric disorders. Compared to PGV-Hs, 49% of PGV-Fs had similar post-war psychiatric profiles: either no, or only one, psychiatric disorder was diagnosed. Psychiatric profiles of the remaining 51% of PGV-Fs were significantly different from PGV-Hs in that most of these veterans suffered from multiple post-war psychiatric diagnoses. The presence of psychiatric disorders as assessed by DSM-III--R criteria cannot explain symptoms of Gulf War Illness among all Persian Gulf veterans with severe fatiguing illness. KOC

Larson, G.E. Psychiatric diagnoses in historic and contemporary military cohorts: combat deployment and the healthy warrior effect / G.E. Larson, R.M. Highfill-McRoy and S. Booth-Kewley In: American journal of epidemiology = ISSN 0002-9262: (2008) (apr). Psychische stoornissen 104

Veteranen Mariniers Irak Operation Enduring Freedom Cohortstudies Research studies have identified heightened psychiatric problems among veterans of Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). However, these studies have not compared incidence rates of psychiatric disorders across robust cohorts, nor have they documented psychiatric problems prior to combat exposure. The authors' objectives in this study were to determine incidence rates of diagnosed mental disorders in a cohort of Marines deployed to combat during OIF or OEF in 2001-2005 and to compare these with mental disorder rates in two historical and two contemporary military control groups. After exclusion of persons who had been deployed to a combat zone with a preexisting psychiatric diagnosis, the cumulative rate of post-OIF/-OEF mental disorders was 6.4%. All psychiatric conditions except post-traumatic stress disorder occurred at a lower rate in combat-deployed personnel than in personnel who were not deployed to a combat zone. The findings suggest that psychiatric disorders in Marines are diagnosed most frequently during the initial months of recruit training rather than after combat deployment. The disproportionate loss of psychologically unfit personnel early in training creates a "healthy warrior effect," because only those persons who have proven their resilience during training remain eligible for combat. KOC

Lavretsky, H. Predictors of two-year mortality in a prospective "UPBEAT" study of elderly veterans with comorbid medical and psychiatric symptoms / H. Lavretsky...[et al.] In: American Journal of Geriatric Psychiatry = ISSN 1064-7481: vol. 10 (2002), issue 4, page 458-468. Depressie Angst Comorbiditeit Veteranen Ouderen Medical inpatients of nine VA medical centers (N=2,657) were screened for symptoms of depression, anxiety, and alcohol abuse and followed for 24 months. Survivors were compared with deceased subjects on the severity of symptoms of depression, anxiety, alcohol abuse, and self-rated health. Mortality was predicted by the length of hospitalization, as well as poor self-rated health at baseline. The severity of depressive symptoms and poor self-rated health measured at the time closest to the time of death also predicted mortality. Lack of improvement in symptoms of depression and anxiety at 6 months was associated with higher rates of mortality. KOC

Lavretsky, H. Symptoms of depression and anxiety predict mortality in elderly veterans enrolled in the UPBEAT program / H. Lavretsky...[et al.] In: Journal of Psychopathology and Behavioral Assessment = ISSN 0882-2689: vol. 18 (2003), issue 2, page 183-184. Depressie Angst

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Comorbiditeit Veteranen Ouderen In this letter, the authors report on predictors of 24 mo mortality in a convenience sample of 94 male veterans, age 60 yrs and over. The depression and anxiety subscales of the Mental Health Index were used to measure the frequency and severity of anxiety and depression symptoms at screening and follow up. 24 mo mortality was high (21%) in the sample of severely medically ill veterans with comorbid depression and/or anxiety, when the 24 mo rate is compared to the 4% annual mortality in the general population 60 yrs and older. It is noteworthy that meeting threshold criteria for both depression & anxiety still predicted mortality. KOC

Laylander, J.A. A nutrient/toxin interaction theory of the etiology and pathogenesis of chronic pain-fatigue syndromes: Part I / J.A. Laylander In: Journal of Chronic Fatigue Syndrome = ISSN 1057-3321: vol. 5 (1999), issue 1, page 67-91. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek Magnesium deficiency plus concomitant fluoride excess (MDFE) Recent research suggests that Chronic Fatigue Syndrome (CFS), Fibromyalgia Syndrome (FMS), and Persian Gulf Syndrome (PGS) may represent the effects of dysfunctions involving the central and/or peripheral nervous system, neuroendocrine system, neuromuscular system, immune system, metabolism, or sleep patterns. Each systemic dysfunction is accepted here as being central to these syndromes but not causal. This review introduces the theory that the syndromes listed above represent finitely variable combinations of multiple systemic dysfunctions which all share a common underlying etiology at the subcellular level: magnesium deficiency plus concomitant fluoride excess (MDFE). Detailed evidence which supports the theory is presented in a companion review (see record 2000-05682-003), along with treatment suggestions and a call for clinical trials to test this theory. KOC

Laylander, J.A. A nutrient/toxin interaction theory of the etiology and pathogenesis of chronic pain-fatigue syndromes: Part II / J.A. Laylander In: Journal of Chronic Fatigue Syndrome = ISSN 1057-3321: vol. 5 (1999), issue 1, page 93-126. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek Magnesium deficiency plus concomitant fluoride excess (MDFE) This review is a companion paper to a review (see record 2000-05682-002) which proposes that Chronic Fatigue Syndrome, Fibromyalgia Syndrome, and Persian Gulf Syndrome represent finitely variable combinations of multiple systemic dysfunctions which share a common underlying etiology at the subcellular level: magnesium deficiency plus concomitant fluoride excess (MDFE). This review covers the evidence in favor of the

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theory and lists treatment suggestions and calls for clinical trials to test the theory presented. KOC

Lewis-Fern ndez, R. Elevated rates of current PTSD among Hispanic veterans in the NVVRS: True prevalence or methodological artifact?/ R. Lewis-Fern ndez...[et al.] In: Journal of traumatic stress= ISSN 0894-9867: vol. 21 (2008), issue 2, page 123-132. PTSD Vietnam-veteranen Rassenverschillen Diagnostiek The elevated rate of current posttraumatic stress disorder (PTSD) among Hispanic Vietnam veterans has been attributed to culturally based expressiveness that inflates symptom self-reports. To investigate this possibility, the authors conducted three hypothesis-driven analyses with National Vietnam Veterans Readjustment Study (NVVRS) data from the Structured Clinical Interview for DSM-III-R (SCID-) diagnosed subsample of male Vietnam Theater veterans (N = 260). First, persistence of the Hispanic elevation after adjusting for war-zone stress exposure initially suggested the effect of greater expressiveness. Second, symptom-based analyses isolated this effect to the self-report Mississippi Scale for Combat-Related PTSD and not to the clinician-rated SCID interview. Third, objective measures of functioning did not reveal a unique Hispanic pattern of lower impairment associated with current PTSD. These tests suggest that greater Hispanic expressiveness does not account for the Hispanic elevation in current PTSD in the NVVRS SCID-diagnosed subsample. KOC

Lijn, J. van der Grenzen aan de Nederlandse capaciteit voor deelname aan vredesoperaties: het sturen van onze jongens en meisjes is complexer dan op het eerste gezicht lijkt / J. van der Lijn In: Carré = ISSN 0165-7437: vol. 31 (2008), issue 5, page 28-32. Vredesoperaties Krijgsmacht Nederland Beleid Hoe komt het dat een krijgsmacht van 62.000 personeelsleden door internationale operaties waarbij 2000 militairen betrokken zijn, al op zijn tenen moet lopen? Het antwoord is niet ingewikkeld. Lees onderstaand artikel. Nader beschouwd is het al wonderbaarlijk dat Nederland 2000 mensen weet uit te zenden. KOC

Lillis, J. Assessing spirituality/religiosity in the treatment environment: the Treatment Spirituality/Religiosity Scale / J. Lillis...[et al.] In: Journal of substance abuse treatment = ISSN 0740-5472: (2008) (apr). Alcoholmisbruik Drugsmisbruik Veteranen Behandeling Spiritualiteit 107

Treatment Spirituality/Religiosity Scale (TSRS) Validaties There has been much interest in measuring and evaluating the role of spirituality/religiosity (S/R) in substance use disorder (SUD) treatment. This study presents the initial evaluation of a new measure of S/R in the treatment environment: the Treatment Spirituality/Religiosity Scale (TSRS). The TSRS has 10 items and can be completed by both patient and staff to measure the emphasis on S/R in a given treatment program, which may have important implications for patient-program fit. Data on the TSRS were gathered from 3,018 patients and 329 staff members from 15 residential SUD treatment programs within the Department of Veterans Affairs Health Care System. The TSRS showed good internal consistency (alpha = .77), a single-factor structure, close agreement between patients and staff members (r = .93), and good discriminant validity. The TSRS appears to be a brief, easily administered, and potentially useful measure of the emphasis on S/R in residential SUD treatment programs. KOC

Lincoln, A.E. The war-related illness and injury study centers: a resource for deployment-related health concerns / A.E. Lincoln...[et al.] In: Military Medicine = ISSN 0026-4075: vol. 171 (2006), issue 7, page 577-585. PTSD Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Combat veterans often return from deployment having experienced a wide range of exposures, symptoms, and medical conditions. The Department of Veterans Affairs established war-related illness and injury study centers to serve combat veterans with unexplained illnesses. We report the exposures, clinical status, and utilization of 53 combat veterans who participated in the National Referral Program (NRP) from January 2002 until March 2004. Participants were primarily male (81%) and served in the Persian Gulf War (79%). Common diagnoses were chronic fatigue syndrome (n = 23, 43%), neurotic depression (n = 21, 40%), and post-traumatic stress disorder (n = 20, 38%). Selfreported exposures related to weaponry, disease prophylaxis, environmental hazards, stress, and poor hygiene. A small increase in mean SF-36V mental component scores (2.8 points, p = 0.009) and use of rehabilitation therapies (1.6 additional visits, p = 0.018) followed the NRP referral. The small gain in mental function suggests that the NRP may benefit combat veterans with long and complex medical histories. KOC

Lindem, K. Neuropsychological performance in Gulf War era veterans: motivational factors and effort / K. Lindem...[et al.] In: Journal of Psychopathology and Behavioral Assessment = ISSN 0882-2689: vol. 25 (2003), issue 2, page 129-138. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom

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Assuming that the underlying etiology of unexplained health-related symptoms in returning Gulf War (GW) veterans is multifactorial, the possible role of feigning or exaggeration of symptoms is worth consideration as a contributing factor. The present study assessed the relationship between motivation to perform well during neuropsychological assessment and objective neuropsychological test performance. Motivation was measured as the score on a visual memory task (Test of Memory Malingering, TOMM) of low difficulty. Participants included 77 veterans from the cohorts of GW- (n = 58) and Germanydeployed (n = 19) GW-era veterans described in two other papers in this issue who were administered the TOMM. Most veterans earned perfect or near-perfect scores on the TOMM (48-50/50). Scores <=47 were associated with lower scores on neuropsychological tasks assessing attention, executive functions, and memory. Variability in test performance within and between tasks measuring similar functions was also found in participants with lower TOMM scores. KOC

Lukas, C.V. Implementation of a clinical innovation: the case of advanced clinic access in the Department of Veterans Affairs / C.V. Lukas...[et al.] In: The Journal of ambulatory care management = ISSN 0148-9917: vol. 31 (2008), issue 2, page 94-108. Gezondheidszorg Veteranen Innovaties Beleid Healthcare organizations seeking to improve clinical practices often have disappointing results because the planned innovations are not successfully implemented. To increase the understanding of implementation, we analyzed the national spread of an ambulatory innovation in the Department of Veterans Affairs. This study provides support for a conceptual model that posits that the extent to which a clinical innovation is implemented will be affected by factors in 3 domains: (1) intentional activities to introduce, spread, and support the innovation; (2) the attitudes and capabilities of clinic staff responsible for implementing the innovation; and (3) the context of the facility in which the innovation is being introduced. Among the strongest predictors of successful implementation, management support for the innovation and clinic team knowledge and skills to make changes successfully were significant across both primary care and specialty clinics. KOC

Marshall, A.C. Gulf war depleted uranium risks / A.C. Marshall In: Journal of exposure science & environmental epidemiology = ISSN 1559-0631: vol. 18 (2008), issue 1, page 95-108. Verarmd uranium Golfoorlog Balkan Militairen US and British forces used depleted uranium (DU) in armor-piercing rounds to disable enemy tanks during the Gulf and Balkan Wars. Uranium particulate is generated by DU shell impact and particulate entrained in air may be inhaled or ingested by troops and nearby civilian populations. As uranium is slightly radioactive and chemically toxic, a number of critics have asserted that DU exposure has resulted in a variety of adverse

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health effects for exposed veterans and nearby civilian populations. The study described in this paper used mathematical modeling to estimate health risks from exposure to DU during the 1991 Gulf War for both US troops and nearby Iraqi civilians. The analysis found that the risks of DU-induced leukemia or birth defects are far too small to result in an observable increase in these health effects among exposed veterans or Iraqi civilians. The analysis indicated that only a few ( approximately 5) US veterans in vehicles accidentally targeted by US tanks received significant exposure levels, resulting in about a 1.4% lifetime risk of DU radiation-induced fatal cancer (compared with about a 24% risk of a fatal cancer from all other causes). These veterans may have also experienced temporary kidney damage. Iraqi children playing for 500 h in DU-destroyed vehicles are predicted to incur a cancer risk of about 0.4%. In vitro and animal tests suggest the possibility of chemically induced health effects from DU internalization, such as immune system impairment. Further study is needed to determine the applicability of these findings for Gulf War exposure to DU. Veterans and civilians who did not occupy DU-contaminated vehicles are unlikely to have internalized quantities of DU significantly in excess of normal internalization of natural uranium from the environment. KOC

Martin, E.M. Traumatic brain injuries sustained in the Afghanistan and Iraq wars / E.M. Martin...[et al.] In: The American journal of nursing = ISSN 0002-936X: vol. 108 (2008), issue 4, page 4047. Hersenletsel Militairen Afghanistan Irak Verpleging Casuïstiek Because these injuries can go unrecognized, nurses stateside need to know how to recognize possible cases and how to help. OVERVIEW: When traumatic brain injury (TBI) occurs simultaneously with more obviously life-threatening wounds, it may go unrecognized. Civilians and military personnel working in or near combat zones are at risk for this injury. Blast-related and closed-head injuries, rather than penetrating injuries, constitute the majority of TBIs in this population. The authors describe the experiences of the Defense and Veterans Brain Injury Center team at Walter Reed Army Medical Center in Washington, DC, and present a composite case to illustrate the nurse's role in the assessment and care of the TBI patient. KOC

Matthieu, M.M. Evaluation of gatekeeper training for suicide prevention in veterans / M.M. Matthieu...[et al.] In: Archives of suicide research = ISSN 1381-1118: vol. 12 (2008), issue 2, page 148-154. Zelfmoord Veteranen Preventie Evaluaties Clinical providers and "front line" nonclinical staff who work with veterans, families, and communities are natural gatekeepers to identify and to refer veterans at risk for suicide. A national cohort (n = 602) of community based counseling center staff from the U.S.

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Department of Veterans Affairs (VA) participated in an evaluation of a brief standardized gatekeeper training program and a scripted behavioral rehearsal practice session. A significant difference in knowledge and self efficacy was observed from pre to post (p < .0001) with the nonclinicians showing larger effect sizes for knowledge (0.96 vs. 0.42) and self efficacy (0.89 vs. 0.41). Gatekeeper training for suicide prevention shows promise for increasing the capacity of VA staff to work with at risk veterans. KOC

McDiarmid, M.A. Health surveillance of Gulf War I veterans exposed to depleted uranium: updating the cohort / M.A. McDiarmid...[et al.] In: Health physics = ISSN 0017-9078: vol. 93 (2007), issue 1, page 60-73. Verarmd uranium Golfoorlogveteranen Gezondheid A cohort of seventy-four 1991 Gulf War soldiers with known exposure to depleted uranium (DU) resulting from their involvement in friendly-fire incidents with DU munitions is being followed by the Baltimore Veterans Affairs Medical Center. Biennial medical surveillance visits designed to identify uranium-related changes in health have been conducted since 1993. On-going systemic exposure to DU in veterans with embedded metal fragments is indicated by elevated urine uranium (U) excretion at concentrations up to 1,000-fold higher than that seen in the normal population. Health outcome results from the subcohort of this group of veterans attending the 2005 surveillance visit were examined based on two measures of U exposure. As in previous years, current U exposure is measured by determining urine U concentration at the time of their surveillance visit. A cumulative measure of U exposure was also calculated based on each veteran's past urine U concentrations since first exposure in 1991. Using either exposure metric, results continued to show no evidence of clinically significant DU-related health effects. Urine concentrations of retinol binding protein (RBP), a biomarker of renal proximal tubule function, were not significantly different between the low vs. high U groups based on either the current or cumulative exposure metric. Continued evidence of a weak genotoxic effect from the on-going DU exposure as measured at the HPRT (hypoxanthine-guanine phosphoribosyl transferase) locus and suggested by the fluorescent in-situ hybridization (FISH) results in peripheral blood recommends the need for continued surveillance of this population. KOC

McDonald, S.D. Factorial invariance of posttraumatic stress disorder symptoms across three veteran samples / S.D. McDonald...[et al.] In: Journal of Traumatic Stress = ISSN 0894-9867: vol. 21 (2008), issue 3, page 309-317. PTSD DSM-IV Nosologie Research generally supports a 4-factor structure of posttraumatic stress disorder (PTSD) symptoms. However, few studies have established factor invariance by comparing multiple groups. This study examined PTSD symptom structure using the Davidson Trauma Scale (DTS) across three veteran samples: treatment-seeking Vietnam-era veterans, treatment-seeking post-Vietnam-era veterans, and Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veteran research participants. Confirmatory

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factor analyses of DTS items demonstrated that a 4-factor structural model of the DTS (reexperiencing, avoidance, numbing, and hyperarousal) was superior to five alternate models, including the conventional 3-factor model proposed by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV; American Psychiatric Association, 1994). Results supported factor invariance across the three veteran cohorts, suggesting that cross-group comparisons are interpretable. Implications and applications for DSM-IV nosology and the validity of symptom measures are discussed. KOC

McFee, R.B. Gulf war servicemen and servicewomen: the long road home and the role of health care professionals to enhance the troops' health and healing / R.B. McFee In: Disease-a-month = ISSN 0011-5029: vol. 54 (2008), issue 5, page 265-333. Gezondheid Golfoorlogveteranen Hulpverlening KOC

McNally, Richard J. Can we solve the mysteries of the National Vietnam Veterans Readjustment Study? / Richard J. McNally In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 192-200. Special issue on: Challenges to the PTSD construct and its database. PTSD Vietnam-veteranen Irak Veteranen Epidemiologie Onderzoek The National Vietnam Veterans Readjustment Study (NVVRS) researchers reported that 30.9% of all men who served in that conflict developed posttraumatic stress disorder (PTSD) even though only about 15% had been assigned to combat units. Scholars, mainly historians, have questioned the accuracy of the PTSD prevalence rate. The purpose of this article is to evaluate the merits of several hypotheses adduced to explain the high apparent PTSD prevalence in the NVVRS. Empirical and conceptual analysis suggests that malingering is unlikely to account for many cases. Also, deployment to Vietnam in the absence of exposure to classic traumatic stressors is likewise unlikely to account for many cases. There are three plausible explanations for the high prevalence rate of PTSD in the NVVRS. First, DSM-III-R PTSD criteria, used in the NVVRS, did not require that symptoms produce impairment. Accordingly, some PTSD-positive cases may actually have been leading productive lives, despite occasional nightmares, or other stress responses. Second, some men assigned to non-combat duty (e.g., medics) may have been exposed to PTSD-inducing stressors. Third, some respondents may have invoked the Vietnam-PTSD narrative to make sense of postwar psychological difficulties having diverse causes unrelated to their military service. These three factors likely contribute to the high PTSD prevalence rate in the NVVRS.

McNally, R.J. Can we solve the mysteries of the National Vietnam Veterans Readjustment Study? / R.J. McNally 112

In: Journal of anxiety disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 192-200. PTSD Vietnam-veteranen National Vietnam Veterans Readjustment Study (NVVRS) Diagnostiek The National Vietnam Veterans Readjustment Study (NVVRS) researchers reported that 30.9% of all men who served in that conflict developed posttraumatic stress disorder (PTSD) even though only about 15% had been assigned to combat units. Scholars, mainly historians, have questioned the accuracy of the PTSD prevalence rate. The purpose of this article is to evaluate the merits of several hypotheses adduced to explain the high apparent PTSD prevalence in the NVVRS. Empirical and conceptual analysis suggests that malingering is unlikely to account for many cases. Also, deployment to Vietnam in the absence of exposure to classic traumatic stressors is likewise unlikely to account for many cases. There are three plausible explanations for the high prevalence rate of PTSD in the NVVRS. First, DSM-III-R PTSD criteria, used in the NVVRS, did not require that symptoms produce impairment. Accordingly, some PTSD-positive cases may actually have been leading productive lives, despite occasional nightmares, or other stress responses. Second, some men assigned to non-combat duty (e.g., medics) may have been exposed to PTSD-inducing stressors. Third, some respondents may have invoked the Vietnam-PTSD narrative to make sense of postwar psychological difficulties having diverse causes unrelated to their military service. These three factors likely contribute to the high PTSD prevalence rate in the NVVRS. KOC

McNally, R.J. Psychology: psychiatric casualties of war / R.J. McNally In: Science = ISSN 0193-4511: vol. 313 (2008), issue 5789, page 923-924. Psychiatrische stoornissen Oorlog KOC

Meijler, Frits L. Mijn oorlog, mijn hart / Frits L. Meijler. - Houten : Sapienta, cop. 2007. - 390 p. : ill. ; 22 cm Met lit. opg. en reg. ISBN 978-90-8562-052-5 Joden Onderduiken Tweede Wereldoorlog Indië-veteranen Medische beroepen Cardiologie Autobiografieën s8.2 MEIJ KOC

Menon, P. Hippocampal dysfunction in Gulf War Syndrome: a proton MR spectroscopy study / P. Menon...[et al.] In: Brain Research = ISSN: vol. 1009 (2004), issue 1-2, page 189-194. Golfoorlogsyndroom 113

Golfoorlog-veteranen Vietnam-veteranen Neurobiologie The pathogenesis of Gulf War Syndrome (GWS) is not clearly understood. Data exist to suggest that GWS may originate from a combination of chronic fatigue and sensitivity to the exposure of exogenous agents. Since the head region of hippocampus is highly vascularized and thus vulnerable to toxic substances in circulation, we postulated that hippocampal impairment occurs in GWS. To test this, single volume localized in vivo proton MR spectroscopy (MRS) studies of the left and right hippocampi of consenting Gulf War veterans (N=15; 10 with GWS, and 5 without GWS) and control Vietnam veterans (N=6) were conducted in accordance with approved human study protocols. The N-acetyl aspartate (NAA) to creatine and choline to creatine ratios were computed from the spectra. The NAA/creatine ratio of the GWS group (N=10) was found to be significantly lower than that of the entire control group (N=11) or the unaffected GW control group (N=5). No laterality differences were observed among any of the three groups. The choline/creatine ratio of the GWS group was not different from that for either control group. To check the existence of any relationship between age and the NAA/creatine ratios, the entire study population was grouped into those below or above the median age (44.3 years). It was found that the NAA/Cre ratio of the younger group (only Gulf War veterans) was significantly lower than that of the older group. The lower NAA/creatine ratio for the GWS group points to the existence of hippocampal dysfunction. KOC

Militaire Militaire psychiatrie in Nederland. De opvang van Nederlandse militairen tussen 19451965 / M.G.H. Slotboom. - [s.n. ; s.l.], 2008. - 60 p. ; 30 cm Mastertraject Medische Geschiedenis, Vrije Universiteit Amsterdam. - Met lit. opg.. Militairen Veteranen Nederlands-Indië Indië-veteranen Vietnam Korea Korea-veteranen Terugkeer en opvang Nazorg PTSD Militaire psychiatrie Scripties s8.2 SLO Geen uitleen

Miller, C.S. Toxicant-induced loss of tolerance / C.S. Miller In: Addiction = ISSN 0965-2140: vol. 96 (2001), issue 1, page 115-139. Gezondheid Golfoorlog-veteranen Golfoorlogsyndroom Discusses toxicant-induced loss of tolerance as appearing to bridge the gap between drug addiction and abdiction (multiple chemical intolerance), with the potential to explain

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illnesses such as certain cases of asthma, migraine headaches and depression, as well as chronic fatigue syndrome, fibromyalgia and Gulf War syndrome. The author argues that both addiction and chemical intolerance involve a fundamental breakdown in innate tolerance, resulting in an amplification of various biological effects, particularly withdrawal symptoms. While addicts seek further exposures so as to avoid unpleasant withdrawal symptoms, chemically intolerant individuals shun their problem exposures, but also to avoid unpleasant withdrawal symptoms. These observations raise critical questions: do addictive drugs and environmental pollutants initiate an identical disease process? Once this process begins, can both addictants and pollutants trigger symptoms and cravings? Toxicant-induced loss of tolerance is seen as opening a new window between the fields of addiction and environmental medicine, one with the potential to transform neighboring realms of medicine, psychology, psychiatry and toxicology. KOC

Miranda, M.L. Spatial analysis of the etiology of amyotrophic lateral sclerosis among 1991 Gulf War veterans / M.L. Miranda...[et al.] In: Neurotoxicology = ISSN 0161-813X: (2008) (jun). Amyotrophic lateral sclerosis (ALS) Golfoorlog-veteranen Golfoorlogsyndroom BACKGROUND: Veterans of the 1991 Gulf War have an increased risk of amyotrophic lateral sclerosis (ALS), but the etiology is unknown. OBJECTIVES: This study sought to identify geographic areas with elevated risk for the later development of ALS among military personnel who served in the first Gulf War. METHODS: A unified geographic information system (GIS) was constructed to allow analysis of secondary data on troop movements in the 1991 Gulf War theatre in the Persian Gulf region including Iraq, northern Saudi Arabia, and Kuwait. We fit Bayesian Poisson regression models to adjust for potential risk factors, including one relatively discrete environmental exposure, and to identify areas associated with elevated risk of ALS. RESULTS: We found that service in particular locations of the Gulf was associated with an elevated risk for later developing ALS, both before and after adjustment for branch of service and potential of exposure to chemical warfare agents in and around Khamisiyah, Iraq. CONCLUSIONS: Specific geographic locations of troop units within the 1991 Gulf War theatre are associated with an increased risk for the subsequent development of ALS among members of those units. The identified spatial locations represent the logical starting points in the search for potential etiologic factors of ALS among Gulf War veterans. Of note, for locations where the relative odds of subsequently developing ALS are among the highest, specific risk factors, whether environmental or occupationally related, have not been identified. The results of spatial models can be used to subsequently look for risk factors that follow the spatial pattern of elevated risk. KOC

Mohamed, S. Pharmacotherapy of PTSD in the U.S. Department of Veterans Affairs: diagnostic- and symptom-guided drug selection / S. Mohamed and R.A. Rosenheck In: Journal of clinical psychiatry = ISSN 0160-6689: (2008) (jun), page 1-7. PTSD Veteranen Psychofarmaca

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Behandeling BACKGROUND: Although increasing numbers of war veterans are seeking treatment for posttraumatic stress disorder (PTSD) at the U.S. Department of Veterans Affairs (VA), information on the role of psychotropic pharmacotherapy in their treatment has not been available. METHOD: Records of psychotropic prescriptions for all VA patients diagnosed with ICD-9 PTSD (N = 274,297) in fiscal year 2004 (October 1, 2003, to September 30, 2004) were examined. Descriptive statistics and multivariable logistic regression were used to identify veteran characteristics and measures of service use that were associated with receipt of any psychotropic medication and, among users of such medications, with use of each of 3 medication classes: antidepressants, anxiolytics/sedative-hypnotics, and antipsychotics. RESULTS: Most veterans diagnosed with PTSD received psychotropic medication (80%), and among these, 89% were prescribed antidepressants, 61% anxiolytics/sedative-hypnotics, and 34% antipsychotics. Greater likelihood of medication use was associated with greater mental health service use and comorbid psychiatric disorders. Among comorbidities, medication-appropriate comorbid diagnoses were the most robust predictors of use of each of the 3 medication subclasses, i.e., depressive disorders were associated with antidepressant use, anxiety disorders with anxiolytic/sedative-hypnotic use, and psychotic disorders with antipsychotic use. Use of anxiolytics/sedative-hypnotics and antipsychotics in the absence of a clearly indicated diagnosis was substantial. CONCLUSION: Diverse psychotropic medication classes are extensively used in the treatment of PTSD in the VA. While disease-specific use for both PTSD and comorbid disorders is common, substantial use seems to be unrelated to diagnosis and thus is likely to be targeted at specific symptoms (e.g., insomnia, anxiety, nightmares, and flashbacks) rather than diagnosed illnesses. A new type of efficacy research may be needed to determine symptom responses to psychotropic medications as well as disorder responses, perhaps across diagnoses. KOC

Monson, C.M. Change in posttraumatic stress disorder symptoms: do clinicians and patients agree? / C.M. Monson...[et al.] In: Psychological assessment = ISSN 1040-3590: vol. 20 (2008), issue 2, page 131-138. PTSD Veteranen Diagnostiek Hulpverleners Patiënten This study assessed the longitudinal association between clinician and patient ratings of posttraumatic stress disorder (PTSD) symptoms over the course of 2 different randomized clinical trials of veterans with chronic PTSD. One trial, the Department of Veterans Affairs Cooperative Study 420 (CSP 420; N = 360) compared trauma-focused and presentcentered group therapies, and the 2nd trial compared cognitive processing theory and a waitlist control condition (N = 60). Linear mixed effects modeling revealed significant associations between clinician ratings (Clinician-Administered PTSD Scale; CAPS; D. D. Blake et al., 1990) and patient ratings (Posttraumatic Stress Disorder Checklist; PCL; F. W. Weathers, B. T. Litz, J. A. Herman, J. A. Huska, & T. M. Keane, 1993) in total and symptom clusters of PTSD. Contrary to hypothesis, the amount of change on the CAPS ranged from .75 to .82 standard deviations for every 1 standard deviation change on the PCL. The CAPS and PCL were more closely associated in the trauma-focused vs. present-centered treatment condition in CSP 420, and especially regarding hyperarousal

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symptoms. When comparing categorization of clinically significant change on the CAPS and PCL, the authors found no differences in the percentages of agreement between clinicians and patients in improvement and exacerbation. The value of multimodal assessment of PTSD treatment outcomes is discussed. KOC

Morrison, J. Our favorite tips for interviewing veterans / J. Morrison and J. Boehnlein In: The Psychiatric clinics of North America = ISSN 0193-953X: vol. 30 (2007), issue 2, page 269-273. Interviews Veteranen Hulpverlening Like many mental health patients, veterans often come to psychiatrists with their defenses raised by past experience with caregivers whom they perceive as lacking in understanding. Although health care professionals' own veteran and combat status sometimes can afford instant credibility, not all providers have wartime experience to use in developing rapport with their patients. To connect rapidly and effectively with their sometimes suspicious patients, they must find other ways to speed rapport. This article discusses the issues of establishing rapport, keeping an open mind, and dealing with questions about the clinician's own opinions that arise in interviewing veterans. KOC

Nagelkirk, P.R. Aerobic capacity of Gulf War veterans with chronic fatigue syndrome / P.R. Nagelkirk...[et al.] In: Military Medicine = ISSN 0026-4075: vol. 168 (2003), issue 9, page 750-755. Gezondheid Golfoorlog-veteranen Bewegingsinspanning Chronische vermoeidheidssyndroom (CVS) Golfoorlogsyndroom A large overlap exists between the diagnosis of chronic fatigue syndrome (CFS) and the unexplained symptoms reported by many Gulf War veterans (GV). Previous investigations have reported reduced aerobic capacity in civilians with CFS. The present investigation examined metabolic responses to maximal exercise in GVs with CFS compared with healthy GVs. Cardiorespiratory and metabolic responses were recorded during a maximal exercise test on a cycle ergometer. The groups were not different in any demographic category or self-reported physical activity. No differences were observed between groups for maximal oxygen uptake, heart rate, exercise time, or workload achieved. Likewise, no differences were observed at submaximal intensities. Compared with healthy controls, GVs who report multiple medically unexplained symptoms and meet criteria for CFS do not show a decreased exercise capacity. Thus, it does not appear that the pathology of the GVs with CFS includes a deficiency with mobilizing the cardiopulmonary system for strenuous physical effort. KOC

Nelson, C. Veterans' mysterious maladies: studies continue to examine the effects of depleted uranium on returning soldiers / C. Nelson 117

In: State legislatures = ISSN 0147-6041: vol. 34 (2008), issue 5, page 28-29. Onverklaarde lichamelijke klachten Veteranen Verarmd uranium KOC

Nelson, K.M. Veterans using and uninsured veterans not using Veterans Affairs (VA) health care / K.M. Nelson, G.A. Starkebaum and G.E. Reiber In: Public Health Reports = ISSN 0094-6214: vol. 122 (2007), issue 1, page 93-100. Veteranen Department of Veterans Affairs (VA) Verzekeringen Hulpverlening OBJECTIVES: The objectives of this study were to: (1) examine veteran reliance on health services provided by the Veterans Health Administration (VA), (2) describe the characteristics of veterans who receive VA care, and (3) report rates of uninsurance among veterans and characteristics of uninsured veterans. METHODS: The authors analyzed data from the 2000 Behavioral Risk Factor Surveillance System. Using bivariate and multivariate analyses, the association of veteran's demographic characteristics, health insurance coverage, and use of VA services were examined. Veterans not reporting VA coverage and having no other source of health insurance were considered uninsured. RESULTS: Among veteran respondents, 6.2% reported receiving all of their health care at the VA, 6.9% reported receiving some of their health care at the VA, and 86.9% did not use VA health care. Poor, less-educated, and minority veterans were more likely to receive all of their health care at the VA. Veterans younger than age 65 who utilized the VA for all of their health care also reported coverage with either private insurance (42.6%) or Medicare (36.3%). Of the veterans younger than age 65, 8.6% (population estimate: 1.3 million individuals) were uninsured. Uninsured veterans were less likely to be able to afford a doctor or see a doctor within the last year. CONCLUSIONS: Veterans who utilized the VA for all of their health care were more likely to be from disadvantaged groups. A large number of veterans who could use VA services were uninsured. They should be targeted for VA enrollment given the detrimental clinical effects of being uninsured. KOC

Nicolson, G.L. Gulf War illnesses: chemical, biological and radiological exposures resulting in chronic fatiguing illnesses can be identified and treated / G.L. Nicolson...[et al.] In: Journal of Chronic Fatigue Syndrome = ISSN 1057-3321: vol. 11 (2003), issue 1, page 135-154. Gezondheid Golfoorlog-veteranen Golfoorlogsyndroom Chronische vermoeidheidssyndroom (CVS) Behandeling Gulf War illnesses involve multiple, complex chronic signs and symptoms that loosely fit the clinical criteria for Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME) and/or Fibromyalgia Syndrome (FMS). Most Gulf War illness patients had multiple exposures: (a) complex chemical mixtures, including organophosphate pesticides, antinerve agents, carbamates and possibly nerve and blister agents, (b) radiological sources,

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subjecting patients to both heavy metal and radiation effects, and (c) biological sources, including bacteria and toxins and the effects of multiple vaccines. Chemically exposed patients may benefit by removing offending chemicals and depleting toxic chemicals from the patient's system and other symptomatic treatments. Patients with systemic infections, including mycoplasma and other chronic bacterial infections, can be treated with antibiotics and additional nutritional supplementation. Some patients may have their illness linked to radiological exposures, and a minority to battlefield stress. The vaccines are a prime suspect for immune dysfunction and chronic infections. The multiple, complex exposures resulted in poorly defined chronic illnesses, but subsets of Gulf War illness can be identified and effectively treated using appropriate ... KOC

Nye, E.C. Attachment organization in Vietnam combat veterans with posttraumatic stress disorder / E.C. Nye...[et al.] In: Attachment & human development = ISSN 1461-6734: vol. 10 (2008), issue 1, page 41-57. PTSD Vietnam-veteranen Hechting Attachment organization in a combat-related PTSD sample was investigated and compared with previously published clinical and non-clinical samples. The association between insecure attachment and unresolved mourning classification (U-loss) and between U-loss and PTSD symptoms was investigated. Vietnam combat veterans diagnosed with PTSD and in treatment (N = 48) were administered the Adult Attachment Interview, the SCID-IV, and CAPS. The PTSD sample was like non-clinical samples in the incidence of secure attachment (50%), but were more commonly unresolved. Veterans with insecure attachment organizations were more likely than those with secure attachment to be classified U-loss. U-loss classification was associated with greater likelihood of comorbid anxiety disorders and PTSD avoidance/numbing symptoms. The results suggest that while insecure attachment organization is associated with unresolved mourning in response to loss, it is not differentially associated with combat-related PTSD. The relationship between U-loss and PTSD is discussed in light of current literature. KOC

O'Brien, C. Difficulty identifying feelings predicts the persistence of trauma symptoms in a sample of veterans who experienced military sexual trauma / C. O'Brien...[et al.] In: The Journal of nervous and mental disease = ISSN 0022-3018: vol. 196 (2008), issue 3, page 252-255. PTSD Alexithymia Seksueel geweld Militairen Veteranen The current study examined the prospective association between alexithymia and the persistence of trauma symptoms in a clinical sample of 175 male and female veterans who experienced sexual trauma during military service (military sexual trauma; MST). Trauma symptoms decreased significantly over the course of a specialized residential treatment program. Difficulty identifying feelings was related to persistence of the following

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trauma symptoms: overall symptoms, sexual abuse trauma symptoms, dissociative symptoms, and anxiety. Men exhibited more persistent symptoms overall, more persistent sexual problems, and more sexual abuse trauma symptoms compared with women (over and above controlling for symptoms at intake). The results speak to the significant role that difficulty identifying feelings has in the treatment of PTSD. In addition, the results suggest that MST has different implications for men compared with women. Specifically, men who were sexually abused in the military experienced greater persistence of symptoms compared with women, especially in the areas of sexual functioning. KOC

Oddone, E.Z. Veterans Affairs Research and Development: using science to improve health care for veterans / E.Z. Oddone and S. Eisen In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 35-37. Veteranen Hulpverlening Department of Veterans Affairs (VA) Onderzoek Beleid VA has a rich tradition in supporting research in areas that span basic science to health system implementation. Its unique success is tied to the fact that researchers are focused on issues that arise from a unique population--our nation's veterans. Moreover, because VA is the largest integrated health system in the country and because the health system must manage an annual budget, there is a keen interest among VA health administrators to apply research that enhances quality and efficiency of care. Furthermore, because these findings overlap with the general population, VA Research & Development programs can be applicable on a much broader scale. KOC

Odent, M. Primal health research: four essays. III. Vaccinations: prevention of disease can be a cause of ill health / M. Odent In: Journal of Prenatal & Perinatal Psychology & Health = ISSN: vol. 16 (2002), issue 3, page 279-287. Vaccinaties Golfoorlogsyndroom Preventie The year 2000 will be remembered as a turning point in the history of vaccinations. Today the main question should concern the interactions between the great number of vaccines routinely offered to modern babies. Researchers, practitioners and parents should think first in terms of good health and bad health. This is not easy to do especially when you have been brainwashed with the dangerous concept of 'preventive medicine', which suggests that health is the absence of disease and that the longer the list of diseases you prevent, the healthier you are. The year 2000 has offered opportunities to realize that the prevention of disease may itself be a cause of ill health. On the one hand we have learned from studies of the 'Gulf war syndrome'. On the other hand we have learned from studies about child mortality in the third world. Today it would be ethical to start long term prospective randomized controlled studies. This is the most reliable method to evaluate the ratio of benefits to risks for any medical procedure. Where mass vaccinations are concerned, it would be unethical (or immoral) to continue the current programmes without

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starting prospective randomized controlled studies of the non-specific effects on health of different combinations of vaccines. KOC

Oliver, A. Public-sector health-care reforms that work?: a case study of the US Veterans Health Administration / A. Oliver In: Lancet = ISSN 0140-6736: vol. 371 (2008), issue 9619, page 1211-1213. Veterans Health Administration (VHA) Hulpverlening Beleid KOC

Pavic, L. Smaller right hippocampus in war veterans with posttraumatic stress disorder / L. Pavic...[et al.] In: Psychiatry research = ISSN 0165-1781: vol. 154 (2007), issue 2, page 191-198. PTSD Hippocampus Veteranen Neurobiologie Chronic stress can putatively cause damage in the human hippocampus, but evidence of damage has not been consistently shown in studies on hippocampal morphology in posttraumatic stress disorder (PTSD). We compared hippocampal volumes in PTSD patients and normal subjects. Using a 3D T1-weighted GRE magnetic resonance imaging sequence, we measured hippocampal volumes in 15 war veterans with combat-related chronic PTSD and 15 case-matched normal controls. Although war veterans, our PTSD subjects were not professional soldiers and were mobilized shortly before they were exposed to a very specific combat-related trauma over a 3-day period. In our study, the period between traumatic exposure and imaging was considerably shorter, on average, 9 years, compared with at least two decades in previous studies on subjects with combatrelated PTSD. Moreover, our subjects were free of any comorbidity, treatment or medication. The right hippocampus was significantly smaller in PTSD subjects than in healthy controls. The left hippocampus was also smaller in PTSD subjects than in controls, but the difference was not significant. In all PTSD subjects, the right hippocampus was smaller than the left (on average, 7.88%). Our results show smaller volume of the right hippocampus in PTSD patients than in normal subjects. KOC

Pearn, J. Traumatic stress disorders: A classification with implications for prevention and management combat soldier / J. Pearn In: Military Medicine = ISSN 0026-4075: vol. 165 (2000), issue 6, page 434-440. PTSD Militairen Nosologie Preventie Beleid Management and prevention of acute and post-traumatic stress disorders (PTSDs) are current themes of great importance to the defense health services of many nations. 121

Currently, 2-8% of service members deployed on combat operations, UN peacekeeping tasks, and humanitarian and disaster relief operations present with one or more stress disorders within 3 yrs of deployment. The management of acute stress disorders and the prevention and management of PTSDs necessitate an understanding of the nosology of this group of illnesses. Research into some preventive options--such as critical incident stress debriefing--also necessitates the selection of syndrome-specific Ss during case finding if controversies about the efficacy of such interventions are to be resolved. Diagnostic features, a summary of the nosological evolution, and differential treatment options are presented for 5 acute operational stress disorders (acute combat stress disorder, conversion reactions, the counter-disaster syndrome, peacekeeper's acute stress syndrome, and the Stockholm syndrome) and for 11 post-traumatic disorders, including classic PTSD, chronic fatigue syndrome, Gulf War syndrome, peacekeeper's stress syndrome, survivor's guilt syndrome, and the syndrome of lifestyle and cultural change. KOC

Pessler, F. A histomorphometric analysis of synovial biopsies from individuals with Gulf War Veterans' Illness and joint pain compared to normal and osteoarthritis synovium / F. Pessler...[et al.] In: Clinical rheumatology = ISSN 0770-3198: (2008) (apr). Golfoorlogsyndroom Golfoorlog-veteranen Neurobiologie Vergelijkend onderzoek We compared histologic, immunohistochemical, and vascular findings in synovial biopsies from individuals with Gulf War Veterans Illness and joint pain (GWVI) to findings in normal and osteoarthritis (OA) synovium. The following parameters were assessed in synovial biopsies from ten individuals with GWVI: lining thickness, histologic synovitis score, and vascular density in hematoxylin & eosin-stained sections; and CD68+ lining surface cells and CD15+, CD3+, CD8+, CD20+, CD38+, CD68+, and Ki-67+ subintimal cells and von Willebrand Factor+ vessels immunohistochemically. Comparisons were made to synovial specimens from healthy volunteers (n = 10) and patients with OA or RA (n = 25 each). Histologic appearance and quantitative assessments were nearly identical in the GWVI and normal specimens. Vascular density was between 25% (H & E stains; p = 0.003) and 31% (vWF immunostains; p = 0.02) lower in GWVI and normal specimens than in OA. CD68+ macrophages were the most common inflammatory cells in GWVI (45.3 +/- 10.1 SEM cells/mm(2)) and normal synovium (45.6 +/- 7.4) followed by CD3+ T cells (GWVI, 15.1 +/- 6.3; normal, 27.1 +/- 9.2), whereas there were practically no CD20+, CD38+, and CD15+ cells. All parameters except lining thickness and CD15 and CD20 expression were significantly higher in OA. Five (20%) OA specimens contained significant fractions of humoral immune cells in mononuclear infiltrates, although the overall differences in the relative composition of the OA mononuclear infiltrates did not reach statistical significance compared to GWVI and normal synovium. In summary, the GWVI and normal synovia were indistinguishable from each other and contained similar low-grade inflammatory cell populations consisting almost entirely of macrophages and T cells. KOC

Peterson, A.L. Combat stress casualties in Iraq. Part 1: behavioral health consultation at an expeditionary medical group / A.L. Peterson, M.T. Baker and K.R. McCarthy

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In: Perspect Psychiatr Care = ISSN 0031-5990: vol. 44 (2008), issue 3, page 146-158. PTSD Militairen Irak Hulpverlening PURPOSE. We review the role of military mental health professionals in consulting with inpatient medical patients and staff at a combat hospital and aeromedical evacuation staging facility in Iraq. CONCLUSIONS. Behavioral health consultation with medical and surgical patients during hospitalization and prior to aeromedical evacuation can help identify patients with combat stress exposure that may require future mental health followup. PRACTICE IMPLICATIONS. Extensive use of civilian mental health practitioners including nurse psychotherapists and psychiatric nurse practitioners will be needed to provide psychiatric care for the large number of U.S. veterans who return from deployment with combat stress related disorders. KOC

Peterson, A.L. Combat stress casualties in Iraq. Part 2: psychiatric screening prior to aeromedical evacuation / A.L. Peterson, M.T. Baker and K.R. McCarthy In: Perspective in Psychiatric Care = ISSN 0031-5990: vol. 44 (2008), issue 3, page 159168. PTSD Militairen Irak Hulpverlening TOPIC. Exposure to combat-related trauma is a leading cause of posttraumatic stress disorder. Deployed military mental health practitioners serve important roles in the assessment, diagnosis, and aeromedical evacuation of psychiatric patients from the combat zone. PURPOSE. To review the role of military mental health professionals working with psychiatric patients at a combat hospital and aeromedical staging facility in Iraq. SOURCE OF INFORMATION. Military operating instructions, existing theoretical and research literature, and personal experiences of the authors while deployed to Iraq. CONCLUSIONS. Psychiatric screening can help reduce risk in potentially unstable mental health patients prior to aeromedical evacuation. Civilian nurse psychotherapists and advanced practice psychiatric nurses will be needed to provide psychiatric follow-up care for the large number of military veterans returning from combat. KOC

Pukhalsky, A.L. HPA axis exhaustion and regulatory T cell accumulation in patients with a functional somatic syndrome: recent view on the problem of Gulf War veterans / A.L. Pukhalsky...[et al.] In: Journal of neuroimmunology = ISSN 0165-5728: (2008) (apr). Golfoorlogsyndroom Golfoorlog-veteranen Neurobiologie The authors proceeded from the assumption that physical and mental symptoms of functional somatic syndromes (including those observed in Gulf War veterans) are based on both underactivity of hypothalamic-pituitary-adrenal (HPA) axis and excessive accumulation of regulatory T cells (Tregs). Permanent psychogenic stress coupled with

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high antigen loading leads to gradual depletion of HPA axis, which is manifested by the reduction of stress-induced cortisol response. Under stress hormone deficiency, Tregs begin to play a principal role in anti-inflammatory mechanisms and each new proinflammatory stimulus increases their number. Superfluous accumulation of active Tregs results in malfunction of Th1 cells in the brain that leads to the appearance of neurodegeneration foci, which seems to be an anatomic substance for various cognitive and psychological symptoms. New approaches to the treatment of such conditions are also discussed. KOC

Rademaker, A.R. Self-reported early trauma as a predictor of adult personality: a study in a military sample / A.R. Rademaker, E. Vermetten, E. Geuze, A. Muilwijk and R.J. Kleber In: Journal of clinical psychology = ISSN 0021-9762: vol. 64 (2008), issue 7, page 863875. Psychotrauma Persoonlijkheid Militairen Exposure to early trauma has frequently been linked to adult psychopathology, including personality disorders. This cross-sectional study explored the relationship between personality and retrospectively rated levels of early trauma in 242 soldiers. Multiple regression analyses showed a significant relationship between early trauma and adult personality as exposure to emotional trauma predicted levels of self-directedness and cooperativeness on the Temperament and Character Inventory (TCI; C. R. Cloninger, T. R. Przybeck, D. M. Svrakic, & R. D. Wetzel, 1994). Overall, these results suggest that early emotional trauma may be related to personality dimensions associated with poor impulse control and interpersonal behavior. These results are noteworthy considering that they were obtained in a healthy sample. They show that early trauma may become ingrained in personality and hamper the potential to effectively engage in social interactions, increasing the risk of emotional and cognitive problems. KOC

Ravensbergen, Niek B. Groeten van Bronbeek / [tekst en samenstelling: Niek B. Ravensbergen ; red.: J.L.P. van den Akker ... et al.]. - Utrecht : Matrijs, cop. 2008. - 72 p. : ill. ; 22 cm Uitg. door de Stichting Matrijs. - Met lit. opg. ISBN 978-90-5345-363-6 geb. Verzorgingstehuizen Bronbeek Veteranen Prentbriefkaarten s0.7 RAV KOC

Rees Vellinga, N. van Rapport Nazorg Thuisfront: de ervaringen van het thuisfront met uitzending en zorg in 2007 / N. van Rees Vellinga. - Den Haag : Gedragswetenschappen, 2008. - 20 p. : tab. ; 30 cm GW-rapport 07-143. Nazorg 124

Thuisfront Partners s8.2 REE KOC

Riddle, M.S. Self-reported combat stress indicators among troops deployed to Iraq and Afghanistan: an epidemiological study / M.S. Riddle...[et al.] In: Comprehensive psychiatry = ISSN 0010-440X: vol. 20 (2008), issue 2, page 131-138. Geestelijke gezondheid Militairen Irak Afghanistan Epidemiologie Evident mental health needs among combat veterans after their return from combat have been described, whereas available data describing the mental health status of military personnel during deployment are few. Data were collected from personnel systematically selected from current combat regions participating in a rest and recuperation program in Doha, Qatar. Overall, 40620 troops completed a clinic screening form between October 2003 and January 2005. Rates of self-reported depression among troops in Afghanistan were lower than those of Iraq (32.3 vs 69.7 per 10000, P < .0001). Feelings of depression and self-harm were inversely correlated with rank (4-level ordinal grouping) (beta(Coef) = .21, P = .0006; beta(Coef) = -0.49, P < .00001, respectively). Distinct temporal trends found in reported combat stress and monthly mortality rates were noted. These data support previous reports of higher mental health problems among troops in Iraq as compared with troops in Afghanistan and lower health care-seeking behavior overall. In an effort to remove barriers to care and minimize combat stress effects, it is critical to recognize mental health needs and initiate services during combat deployments. KOC

Riep, N.C. Evaluatie personeelszorg: rondom uitzendingen 2006 en 1ste kwartaal 2007 / N.C. Riep. Den Haag : Gedragswetenschappen, 2008. - 21 p. : tab. ; 30 cm GW-rapport 07-122. Nazorg Militairen Defensie s8.2 RIE KOC

Riep, N.C. Rapportage: Evaluatie adaptatie / N.C. Riep. - Den Haag : Gedragswetenschappen, 2008. - 57 p. : tab. ; 30 cm GW-rapport 08-042. Nazorg Militairen Defensie s8.2 RIE KOC

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Rivera, P.A. Problem-solving training for family caregivers of persons with traumatic brain injuries: a randomized controlled trial / P.A. Rivera...[et al.] In: Archives of physical medicine and rehabilitation = ISSN 0003-9993: vol. 89 (2008), issue 5, page 931-941. Trainingen Mantelzorg Hersenletstel OBJECTIVE: To test the hypothesis that a problem-solving training program would lower depression, health complaints, and burden, and increase well-being reported by community-residing family caregivers of persons with traumatic brain injuries (TBIs). DESIGN: Randomized controlled trial. SETTING: General community. PARTICIPANTS: Of the 180 people who expressed interest in the study, 113 did not meet eligibility criteria. A consenting sample of family caregivers were randomized into a problem-solving training group (4 men, 29 women; average age, 51.3y) or an education-only control group (34 women; average age, 50.8y). Care recipients included 26 men and 7 women in the intervention group (average age, 36.5y) and 24 men and 10 women in the control group (average age, 37.2y). INTERVENTION: Problem-solving training based on the D'Zurilla and Nezu social problem-solving model was provided to caregivers in the intervention group in 4 in-home sessions and 8 telephone follow-up calls over the course of their yearlong participation. Control group participants received written educational materials and telephone calls at set intervals throughout their 12 months of participation. MAIN OUTCOME MEASURES: Caregiver depression, health complaints, well-being, and social problem-solving abilities. RESULTS: Hierarchical linear models revealed caregivers receiving problem-solving training reported significant decreases in depression, health complaints, and in dysfunctional problem-solving styles over time. No effects were observed on caregiver well-being, burden, or constructive problem-solving styles. CONCLUSIONS: Problem-solving training provided in the home appears to be effective in alleviating distress and in decreasing dysfunctional problem-solving styles among family caregivers of persons with TBI. Methodologic limitations and the implications for interventions and future research are discussed. KOC

Rizzo, A.A. Virtual Iraq: initial results from a VR exposure therapy application for combat-related PTSD / A.A. Rizzo...[et al.] In: Studies in health technology and informatics = ISSN 0926-9630: (2008), issue 132, page 420-425. PTSD Veteranen Irak Behandeling Virtual reality exposure (VRE) Post Traumatic Stress Disorder (PTSD) is reported to be caused by traumatic events that are outside the range of usual human experience including (but not limited to) military combat, violent personal assault, being kidnapped or taken hostage and terrorist attacks. Initial data suggests that at least 1 out of 6 Iraq War veterans are exhibiting symptoms of depression, anxiety and PTSD. Virtual Reality (VR) delivered exposure therapy for PTSD has been used with reports of positive outcomes. The aim of the current paper is to present the rationale and brief description of a Virtual Iraq PTSD VR therapy application 126

and present initial findings from its use with PTSD patients. Thus far, Virtual Iraq consists of a series of customizable virtual scenarios designed to represent relevant Middle Eastern VR contexts for exposure therapy, including a city and desert road convoy environment. User-centered design feedback needed to iteratively evolve the system was gathered from returning Iraq War veterans in the USA and from a system deployed in Iraq and tested by an Army Combat Stress Control Team. Clinical trials are currently underway at Ft. Lewis, Camp Pendleton, Emory University, Weill Cornell Medical College, Walter Reed Army Medical Center, San Diego Naval Medical Center and 12 other sites. KOC

Rombouts, B. Omgang met stressvolle gebeurtenissen: verschillen tussen veteranen van het Korps Mariniers & veteranen van andere krijgsmachtdelen in probleemgerichte en emotiegerichte coping / B. Rombouts en M. Tjon. - S.l. : [Rombouts, Tjon], 2008. - 44 p. : tab. ; 30 cm Masterprogramma Klinische Psychologie aan de Universiteit Utrecht. Stress Veteranen Korps Mariniers Coping s8.2 ROM KOC

Rosen, Gerald M. Pseudo-PTSD / Gerald M. Rosen, Steven Taylor In: Journal of Anxiety Disorders = ISSN 0887-6185: vol. 21 (2007), issue 2, page 201-210. Special issue on: Challenges to the PTSD construct and its database. PTSD Pseudo-PTSD (geveinsde PTSD) Simulatie Zelfverwonding Veteranen Psudo-posttraumatic stress disorder (Pseudo-PTSD) refers to cases in which patients presentation is but a simulation of the actual clinical syndrome. The problem of pseudoPTSD has been neglected by many clinicians and researchers, who often rely on the assumption that a patients reported symptoms can be accepted as valid. The purpose of this article is to (a) consider the divers causes of Pseudo-PTSD, (b) emphasize the importance of the DSM-IVs guideline to rule out malingering, and (c) discuss the implications that pseudo-PTSD has for research and clinical practice.

Ross, J.S. Use of recommended ambulatory care services: is the Veterans Affairs quality gap narrowing? / J.S. Ross...[et al.] In: Archives of internal medicine = ISSN 0003-9926: vol. 168 (2008), issue 9, page 950958. Kwaliteit Hulpverlening Veterans Affairs medical centers (VAMCs) Evaluaties

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BACKGROUND: Veterans Affairs medical centers (VAMCs) provide better preventive and chronic disease care when compared with other health care organizations, although recent health care quality improvement initiatives outside the VAMC sector may have narrowed quality differences. METHODS: Using the nationally representative 2000 and 2004 surveys of the Behavior Risk Factor Surveillance System, which included 152,310 community-dwelling insured adults in 2000 and 251,570 in 2004, we compared selfreported use of 17 recommended ambulatory care services for cancer prevention, cardiovascular risk reduction, diabetes mellitus management, and infectious disease prevention among insured adults receiving and not receiving care at VAMCs. RESULTS: A total of 2852 insured adults (1.9%) received care at VAMCs in 2000 and 7155 (2.4%) received care at VAMCs in 2004. Use of 9 of the 17 services was greater in 2004 when compared with 2000 (P < or = .05). In 2000, receiving VAMC care was associated with greater use of 6 of the 17 services; in 2004, receiving VAMC care was associated with greater use of 12 of the 17 services (P < or = .05). In 2004, greater use among these 12 services ranged from 10% greater use of cholesterol screening to 40% greater use of colorectal cancer screening. For 13 of the 17 services, the likelihood of service use among adults receiving VAMC care when compared with adults not receiving VAMC care was not significantly different in 2004 than in 2000. However, this likelihood was significantly greater (for VAMC vs non-VAMC use) in 2004 than in 2000 for breast cancer screening (relative risk [RR], 1.21 [95% confidence interval {CI}, 1.15-1.25] vs 0.80 [95% CI, 0.580.98]; P < .001), dilated eye examination among adults with diabetes (RR, 1.12 [95% CI, 1.07-1.15] vs 1.01 [95% CI, 0.88-1.09]; P = .04), and influenza (RR, 1.30 [95% CI, 1.241.36] vs 1.06 [95% CI, 0.89-1.21]; P = .006) and pneumococcal (RR, 1.27 [95% CI, 1.231.31] vs 1.04 [95% CI, 0.86-1.21]; P = .005) vaccinations. CONCLUSION: Despite increasing emphasis on quality of care and improved performance throughout the US health care system, adults receiving VAMC care remain more likely to receive recommended ambulatory care. KOC

Sacks, M.B. Self-mutilative behaviors in male veterans with posttraumatic stress disorder / M.B. Sacks...[et al.] In: Journal of Psychiatric Research = ISSN 0022-3956: vol. 42 (2008), issue 6, page 487494. PTSD Zelfmutulatie Veteranen Self-mutilative behaviors (SMB) were examined in a sample of male veterans with posttraumatic stress disorder (PTSD). The primary objective was to determine the prevalence of SMB and any physical, cognitive, or affective antecedents and correlates for these behaviors. Participants included 509 male veterans with PTSD and levels of PTSD, depression, alcohol use, hostility, and impulsivity were evaluated to determine if these variables were related to SMB. Antecedents and sequelae of SMB were also examined to generate hypotheses regarding the functions of these behaviors. A second type of habit behavior, body-focused repetitive behaviors (BFRB), was also examined as part of the study. Findings indicated that veterans who engaged in either type of habit behavior were younger than those who did not engage in SMB or BFRB. Veterans reporting SMB also reported higher levels of PTSD, depression, hostility, and impulsivity compared to the BFRB and no-habit groups. Examination of habit antecedents and sequelae showed support for the automatic-positive reinforcement function of SMB. These findings are

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discussed in the context of research and treatment involving male veterans with PTSD who engage in SMB. KOC

Sarac-Hadzihalilovic, A. Stress, memory and Bosnian war veterans / A. Sarac-Hadzihalilovic, A. Kulenovic and A. Kucukalic In: Bosnian journal of basic medical sciences = ISSN 1512-8601: vol. 8 (2008), issue 2, page 135-140. Stress Geheugen Veteranen Voormalig Joegoslavië The aim of this study was to analyze cognitive dysfunction in PTSD. The testing included 79 Bosnian Army veterans, who participated in Bosnian war from 1992 to 1995. Out of 79 tested war veterans, 45 of developed PTSD while 34 did not. The veterans without PTSD where included in the control group. All the war veterans were of the same education level (secondary education) and between 30 and 50 years of age. Rivermead Behavioral Memory Test - RBMT was applied to all the subjects. The test was originally developed for the purpose of everyday memory problems identification. Clear goal of the 10 RBMT subtests is simulation of everyday life situations. PTSD group achieved significantly lower results than the control group. Results of the total score showed highly significant difference between PTSD and control group. Value of the t-test is t=10,056 with significance level of p<0,001. The same conclusion stands for any RBMT subtest. Numerous psychological studies on PTSD patients show more prominent psychological deficit in war veterans. Our study clearly confirms that finding. KOC

Scherrer, J.F. Posttraumatic stress disorder; combat exposure; and nicotine dependence, alcohol dependence, and major depression in male twins / J.F. Scherrer...[et al.] In: Comprehensive psychiatry = ISSN 0010-440X: vol. 49 (2008), issue 3, page 297-304. PTSD Depressie Alcoholmisbruik Roken Comorbiditeit Diagnostiek Combat exposure is associated with increased risk of psychiatric and substance use disorders in veterans. However, it is not known whether combat exposure independently increases risk for these disorders or whether this association is accounted for by genetic vulnerability common to posttraumatic stress disorder (PTSD). This article tests competing explanations for the association of combat exposure and PTSD with nicotine dependence (ND), alcohol dependence (AD), and major depression (MD). Data were obtained from 6099 members of the Vietnam Era Twin Registry, a national registry of male-male twin pairs who served in the military during the Vietnam era. Twin models were fit to estimate the genetic and environmental variance common and specific to Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, lifetime diagnoses of PTSD, combat trauma, and 3 comorbid conditions: ND, AD, and MD. Variance specific to ND, AD, and MD was due to genetic factors (48%, 36%, and 12%, respectively) and unique

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environmental factors (36%, 42%, and 58%, respectively). After accounting for variance common to PTSD, no residual genetic and environmental variance overlapped between combat and ND, combat and AD, and combat and MD. Combat exposure is not independently associated with lifetime ND, AD, and MD. The association of combat exposure with these 3 disorders is due to genetic and unique environmental contributions in common with PTSD. These findings suggest comorbid PTSD may represent a genetically mediated vulnerability to psychopathology after trauma. KOC

Schneiderman, A.I. Understanding sequelae of injury mechanisms and mild traumatic brain injury incurred during the conflicts in Iraq and Afghanistan: persistent postconcussive symptoms and posttraumatic stress disorder / A.I. Schneiderman, E.R. Braver and H.K. Kang In: American journal of epidemiology = ISSN 0002-9262: (2008) (apr). Hersenletsel PTSD Veteranen Irak Afghanistan Diagnostiek A cross-sectional study of military personnel following deployment to conflicts in Iraq or Afghanistan ascertained histories of combat theater injury mechanisms and mild traumatic brain injury (TBI) and current prevalence of posttraumatic stress disorder (PTSD) and postconcussive symptoms. Associations among injuries, PTSD, and postconcussive symptoms were explored. In February 2005, a postal survey was sent to Iraq/Afghanistan veterans who had left combat theaters by September 2004 and lived in Maryland; Washington, DC; northern Virginia; and eastern West Virginia. Immediate neurologic symptoms postinjury were used to identify mild TBI. Adjusted prevalence ratios and 95% confidence intervals were computed by using Poisson regression. About 12% of 2,235 respondents reported a history consistent with mild TBI, and 11% screened positive for PTSD. Mild TBI history was common among veterans injured by bullets/shrapnel, blasts, motor vehicle crashes, air/water transport, and falls. Factors associated with PTSD included reporting multiple injury mechanisms (prevalence ratio = 3.71 for three or more mechanisms, 95% confidence interval: 2.23, 6.19) and combat mild TBI (prevalence ratio = 2.37, 95% confidence interval: 1.72, 3.28). The strongest factor associated with postconcussive symptoms was PTSD, even after overlapping symptoms were removed from the PTSD score (prevalence ratio = 3.79, 95% confidence interval: 2.57, 5.59). KOC

Schnurr, P.P. Physician-diagnosed medical disorders in relation to PTSD symptoms in older male military veterans / P.P. Schnurr, A Spiro III and A.H. Paris In: Health Psychology = ISSN 0278-6133: vol. 19 (2000), issue 1, page 91-97. PTSD Gezondheid Veteranen Ouderen Huisartsen The association between physician-diagnosed medical disorders and combat-related posttraumatic stress disorder (PTSD) symptoms was examined in 605 male combat

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veterans of World War II and the Korean conflict. Physician exams were performed at periodic intervals beginning in the 1960s. PTSD symptoms were assessed in 1990. Cox regression was used to examine the onset of each of 12 disorder categories as a function of PTSD symptoms, controlling for age, smoking, alcohol use, and body weight at study entry. Even with control for these factors, PTSD symptoms were associated with increased onset of arterial, lower gastrointestinal, dermatologic, and musculoskeletal disorders. There was only weak evidence that PTSD mediated the effects of combat exposure on morbidity. Possible mediators of the relationship between combat exposure, PTSD, and physical morbidity are discussed. KOC

Schoeman, J.R. Meer plicht dan passie: Nederland over zijn krijgsmacht en veteranen / J.R. Schoeman In: Militaire Spectator = ISSN 0026-3869: vol. 177 (2008), issue 6, page 320-330. Publieke opinie Krijgsmacht Militairen Veteranen Nederland Wat zijn de opvattingen en beelden die Nederland heeft van zijn krijgsmacht, zijn militairen en zijn veteranen? Voor een deel blijken die opvattingen en beelden geruststellend rotsvast te zijn, maar voor een ander deel zijn ze zorgwekkend onjuist. Er is nadrukkelijk sprake van simplificering of misschien beter gezegd: stereotypering. De maatschappelijke opvattingen over veteranen in de loop der jaren worden opgelijnd en toegelicht. Wat is de relatie tussen een verminderde presentie van de krijgsmacht en ons collectieve denken? Ook wordt nagegaan welke plaats hedendaagse militairen en hun optreden hebben gekregen in de moderne populaire cultuur. KOC

Schüssler, Bert Naar eer en geweten / door Bert Schüssler. - Diemen : De Bookmakers, 1998. - 242 p. : ill. ; 21 cm Ondertitel op omslag: Kroniek van een bewogen militair leven. - Auteursnaam op omslag: G.J. Schüssler. ISBN 90-804045-3-5 pbk. Militairen Nederlands-Indië Korea Suriname Veteranen Persoonlijke ervaringen Autobiografieën s3.4 SCH

Servatius, R.J. Mild interoceptive stressors affect learning and reactivity to contextual cues: toward understanding the development of unexplained illnesses / R.J. Servatius and K.D. Beck In: Neuropsychopharmacology = ISSN 0893-133X: vol. 30 (2005), issue 8, page 14831491. Onverklaarde lichamelijke klachten (OLK) 131

Golfoorlog-syndroom Psychofarmaca Muizenstudies Contextual learning is evident with repeated experiences with agents and treatments that induce frank illness and interoceptive stress. Here, we examined whether acute treatment with mild interoceptive stressors (low doses of pyridostigmine bromide (PB), neostigmine bromide (NB), and interleukin (IL)-1beta ) may serve as unconditional stimuli supporting contextual learning. Rats were exposed to interoceptive and exteroceptive stressors in contexts distinguished by visual or olfactory cues. Acoustic startle responses (ASRs) were measured the day following exposure and 2 weeks thereafter, without delivery of the unconditional stimuli. The appearance, form, and duration of startle potentiation depended on the distinguishing features of the context and the nature of the interoceptive stressor. Rats given cholinesterase inhibitors (PB and NB), but not IL-1beta or exposed to an exteroceptive stressor, exhibited exaggerated ASRs in a novel context distinguished by visual cues. Treatment with either PB or IL-1beta led to potentiated ASRs in the presence of odors congruent with those experiences during exposure to the stressor. Startle potentiation by odor was still apparent 2 weeks after treatment. For contexts differentiated by visual stimuli, cholinomimetics transiently alter reactivity within novel contexts. In the case of contexts differentiated by odors, learning is apparent at least 2 weeks after acute treatment of cholinomimetics and IL-1beta . Contextual learning and changes in reactivity consequent to mild interoceptive stressors such as PB may play a role in the development of nonspecific symptoms typical of unexplained illnesses, such as Gulf War Illness. KOC

Shipherd, J.C. Veterans seeking treatment for posttraumatic stress disorder: what about comorbid chronic pain? / J.C. Shipherd...[et al.] In: Journal of rehabilitation research and development = ISSN 0748-7711: vol. 44 (2007), issue 2, page 153-166. PTSD Veteranen Chronische pijn Comorbiditeit Behandeling Our primary aim was to document the rate of comorbidity of physician-diagnosed chronic pain conditions in veterans who were seeking treatment for posttraumatic stress disorder (PTSD). Chronic pain diagnoses (e.g., chronic low-back pain and osteoarthritis) were examined with retrospective chart review. Of the patients with PTSD, 66% had chronic pain diagnoses at pretreatment. These findings are consistent with previous studies that documented the high comorbidity of chronic pain and PTSD using samples of pain patients. Our secondary aim was to examine pain ratings before, during, and after PTSD treatment. Using data that were a part of clinical practice, we found that patients with more pain before treatment reported reductions in pain over the course of PTSD treatment and in the 4 months following treatment. While our results must be interpreted cautiously because of multiple confounding factors and the absence of experimental manipulation, they highlight the importance of PTSD and pain comorbidity. KOC

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Shriver, T.E. Managing the uncertainties of Gulf War illness: the challenges of living with contested illness / T.E. Shriver and D.D. Waskul In: Symbolic Interaction = ISSN 0195-6086: vol. 29 (2006), issue 4, page 465-486. Onverklaarde lichamelijke klachten (OLK) Golfoorlogsyndroom Veteranen Hulpzoekgedrag Interviews Based on observation and in-depth interviews with fifty-five respondents, we provide a detailed analysis of the Gulf War illness experience. All chronically ill people experience troublesome physical symptoms, but most reasonably expect to receive medical answers and treatment, in addition to the support of family, friends, employers, and coworkers. This research addresses a circumstance where neither sick people nor the medical establishment has clear answers to the basic etiology and treatment of illness. Consequently, many veterans endure doubt, threats to their credibility, and intensified stigma. The resulting ambiguity and stigma initiate efforts to redefine and renegotiate the illness experience. Drawing heavily from the thick descriptions provided by Gulf War veterans and their spouses, we document assaults on the physical body, emotional stability, social status, and selfhood, as well as negative effects on social relations. We also examine how institutional barriers influence the contested illness experience. KOC

Shriver, T.E. Women's work: women's involvement in the Gulf War Illness movement / T.E. Shriver, A.C. Miller and S. Cable In: Sociological Quarterly = ISSN 0038-0253: vol. 44 (2003), issue 4, page 639-658. Golfoorlogsyndroom Golfoorlog-veteranen Lotgenotencontact Vrouwen Interviews Sociologie We use in-depth interviews, participant observation, and document analysis to examine women's involvement in the Gulf War Illness movement. We find that women's cumulative grievances of health concerns, financial hardships, and emotional problems opened them to movement recruitment as they surfed the Internet for information and support. The movement's division of labor was influenced not by gender but by health status. Women used the Internet to provide medical information and emotional support to geographically dispersed veterans. Activism transformed women activists by endowing them with a sense of empowerment and a somewhat broadened concern for social justice. Although their transformations disposed the women to become active on related issues, it did not extend to concerns about gender discrimination. We suggest that the next research step is to investigate gender differences in movement processes by surveying activists across a variety of movements to test propositions and to identify the characteristics of other social contexts that structurally instigate a departure from traditional gender roles. KOC

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Sillanpaa, M.C. Minnesota Multiphasic Personality Inventory-2 validity patterns: An elucidation of gulf war syndrome / M.C. Sillanpaa, L.M. Agar and B.N. Axelrod In: Military Medicine = ISSN 0026-4075: vol. 164 (1999), issue 1, page 261-263. Golfoorlogsyndroom Golfoorlog-veteranen Diagnostiek Minnesota Multiphasic Personality Inventory-2 (MMPI-2) Evaluated the potential effects of psychological distress on physical symptoms observed in 48 Persian Gulf War veterans (aged 21-56 yrs) using a neuropsychological evaluation that included personality assessment. Cluster analysis of the validity scales resulted in a solution with 2 viable subgroups. Members of cluster 1 had significantly higher scores on 5 MMPI-2 clinical scales, a measure of trait anxiety, and a number of subjective complaints, including lower scores on a task of attention. Neuropsychological functioning did not otherwise differ between the groups. Contributions of personality style in coping with physical and mental health stressors were indicated. Experience of distress appeared to be attributable to individual differences rather than factors that have been associated with the elusive Gulf War syndrome. It is suggested that Persian Gulf War veterans' emotional reactions to clinical laboratory findings, perceptions of exposure risks, war experience, and stress may represent a variation of posttraumatic stress disorder (PTSD). KOC

Solomon, Z. The contribution of stressful life events throughout the life cycle to combat-induced psychopathology / Z. Solomon...[et al.] In: Journal of Traumatic Stress = ISSN 0894-9867: vol. 21 (2008), issue 3, page 318-325. PTSD Levensgebeurtenissen Veteranen Israël Diagnostiek This study examines the contribution of prewar life events, war exposure, and postwar life events to combat-induced psychopathology among 425 Israeli War veterans from the Lebanon War. Data was collected at two time points (1983 and 2002). The sample included veterans with and without combat stress reaction (CSR). Battle intensity and subjective experience of risk in war were associated with CSR. Negative childhood life events, CSR, PTSD in 1983 and postwar negative life events were associated with PTSD in 2002. Furthermore, a path analysis revealed that CSR mediated the relation between battle intensity and PTSD in 2002. Our findings suggest that stressful life events throughout the life cycle contribute significantly to veterans' posttraumatic symptomatology, above and beyond combat exposure. KOC

Spaulding, D.J. Gulf War Syndrome: are campus health officials prepared to cope with Persian Gulf veterans? / D.J. Spaulding In: College Student Journal = ISSN 0146-3934: vol. 31 (1997), issue 3, page 317-322. Golfoorlogsyndroom Golfoorlog-veteranen Hulpverleners 134

Beleid The Department of Defense is undergoing a large reduction-in-force because of the closure of the Cold War. This downsizing, or drawdown as they term it within the defense establishment, is resulting in and will result in an increase in college enrollment as many of these former soldiers, sailors, airmen, marines, coast guardsmen and women head for the college campus. Many of these former military personnel are veterans of the Gulf War. While the evidence is still not fully conclusive, many of these potential students claim to suffer from a mysterious illness termed Gulf War Syndrome (GWS). Are campus health officials, medical and psychological, prepared to treat these veterans? The authors surveyed 98 campus health officials to determine whether student-veterans with GWS can expect and obtain the health care necessary to enable them to complete their higher education. About one-half indicated that clinic personnel were not familiar with symptoms of GWS. The remaining institutions indicated "familiar." None indicated "extremely familiar." It is concluded that universities and colleges seem ill-prepared to treat and refer students who complain or may yet report symptoms associated with GWS. Recommendations are offered. KOC

Spiegel, D. Post-traumatic stress disorder: medicine or politics (not both) / D. Spiegel and E. Vermetten In: Lancet = ISSN 0140-6736: vol. 369 (2007), issue 9556, page 992. PTSD Maatschappij Beleid KOC

Stein, D.J. Post-traumatic stress disorder: medicine and politics / D.J. Stein...[et al.] In: Lancet = ISSN 0140-6736: vol. 369 (2007), issue 9556, page 139-144. PTSD Maatschappij Beleid Overzichtsartikel Regrettably, exposure to trauma is common worldwide, and can have serious adverse psychological results. The introduction of the notion of post-traumatic stress disorder has led to increasing medicalisation of the problem. This awareness has helped popular acceptance of the reality of post-traumatic psychiatric sequelae, which has boosted research into the pathogenesis of the disorder, leading to improved pharmacological and psychological management. The subjective experience of trauma and subsequent expression of symptoms vary considerably over space and time, and we emphasise that not all psychological distress or psychiatric disorders after trauma should be termed posttraumatic stress disorder. There are limits to the medicalisation of distress and there is value in focusing on adaptive coping during and after traumas. Striking a balance between a focus on heroism and resilience versus victimhood and pathological change is a crucial and constant issue after trauma for both clinicians and society. In this review we discuss the advantages and disadvantages of medicalising trauma response, using examples from South Africa, the Armed Services, and post-disaster, to draw attention to our argument. KOC

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Stein, H.H. Combat veterans: impressions of an analytic observer in a non-analytic setting / H.H. Stein In: The journal of the American Academy of Psychoanalysis and Dynamic Psychiatry = ISSN 1546-0371: vol. 35 (2008), issue 4, page 575-589. Psychotrauma Veteranen Psychoanalyse The hallmark presentation of combat trauma-nightmares, waking hallucinations, intrusive traumatic memories, and extreme affective reactions to environmental triggers-may best be conceptualized as part of an adaptive mechanism intended to protect the individual against a repetition of trauma. Combat veterans continuously must cope with the extreme affects that combat induced. Fear, rage, guilt, and grief predominate. Their mental and emotional life is complicated by a conscience split between war zone and civilian morality and by the special group dynamics of combat. Optimal clinical understanding of combatrelated trauma, whether in a psychoanalytic or general mental health setting, requires an awareness of the interaction of the personal dynamics of each individual with the specific characteristics of their combat situation. KOC

Stein, P.K. Sex effects on heart rate variability in fibromyalgia and Gulf War illness / P.K. Stein...[et al.] In: Arthritis & Rheumatism: Arthritis Care & Research = ISSN 0004-3591: vol. 51 (2004), issue 5, page 700-708. Fibromyalgie Golfoorlogsyndroom Sekseverschillen Diagnostiek Objective: To investigate autonomic abnormalities in male and female fibromyalgia (FM) and Gulf War illness (GWI) patients by comparing heart rate variability (HRV) with that of age- and sex-matched healthy controls. Methods: Subjects included 26 (19 women, 7 men) with FM, 11 (6 men, 5 women) with GWI, and 36 (18 men, 18 women) healthy controls. HRV was determined from Holter recordings obtained in the Clinical Research Center. Analysis of variance compared 24-hour, daytime, and nighttime HRV by sex within groups and by group within sex. Results: In women with FM or GWI, HRV was significantly lower than in men with FM or GWI. HRV was similar in male and female controls. When HRV was compared by group within sex, HRV was significantly decreased in women with FM or GWI and no significant differences were seen for men with these conditions. Conclusion: Decreased HRV in FM and GWI appears to be sex dependent. Results suggest that different mechanisms may be operative in symptom expression in men and women with this spectrum of illness. KOC

Stetler, C.B. An organizational framework and strategic implementation for system-level change to enhance research-based practice: QUERI Series / C.B. Stetler...[et al.] In: Implementation science = ISSN 1748-5908: vol. 3 (2008), issue 1 (may), page 30. Evidence-based medicine Veteranen 136

Hulpverlening U.S. Veterans Health Administration (VA) BACKGROUND: The continuing gap between available evidence and current practice in health care reinforces the need for more effective solutions, in particular related to organizational context. Considerable advances have been made within the U.S. Veterans Health Administration (VA) in systematically implementing evidence into practice. These advances have been achieved through a system-level program focused on collaboration and partnerships among policy makers, clinicians, and researchers. The Quality Enhancement Research Initiative (QUERI) was created to generate research-driven initiatives that directly enhance health care quality within the VA and, simultaneously, contribute to the field of implementation science. This paradigm-shifting effort provided a natural laboratory for exploring organizational change processes. This article describes the underlying change framework and implementation strategy used to operationalize QUERI. Strategic approach to organizational change QUERI used an evidence-based organizational framework focused on three contextual elements: 1) cultural norms and values, in this case related to the role of health services researchers in evidence-based quality improvement; 2) capacity, in this case among researchers and key partners to engage in implementation research; 3) and supportive infrastructures to reinforce expectations for change and to sustain new behaviors as part of the norm. As part of a QUERI Series in Implementation Science, this article describes the framework's application in an innovative integration of health services research, policy, and clinical care delivery. CONCLUSION: QUERI's experience and success provide a case study in organizational change. It demonstrates that progress requires a strategic, systems-based effort. QUERI's evidence-based initiative involved a deliberate cultural shift, requiring ongoing commitment in multiple forms and at multiple levels. VA's commitment to QUERI came in the form of visionary leadership, targeted allocation of resources, infrastructure refinements, innovative peer review and study methods, and direct involvement of key stakeholders. Stakeholders included both those providing and managing clinical care, as well as those producing relevant evidence within the health care system. The organizational framework and related implementation interventions used to achieve contextual change resulted in engaged investigators and enhanced uptake of research knowledge. QUERI's approach and progress provide working hypotheses for others pursuing similar system-wide efforts to routinely achieve evidence-based care. KOC

Storzbach, D. Psychological differences between veterans with and without Gulf War unexplained symptoms / D. Storzbach...[et al.] In: Psychosomatic Medicine = ISSN 0033-3174: vol. 62 (2000), issue 5, page 726-735. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom Assessed measures of psychological and neurobehavioral functioning to determine their association with unexplained symptoms in Gulf War veterans. Persistent symptoms with no medical explanation associated with service in the Persian Gulf (e.g., fatigue, muscle pain, and memory deficits) that began during or after the war qualified respondents as cases. The 241 veterans (mean age 34.3 yrs) with unexplained symptoms were classified as case Ss, and the 113 veterans without symptoms were classified as control Ss. All veterans completed a battery of computerized assessment tests consisting of 12

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psychosocial and 6 neurobehavioral tests. Case Ss differed substantially and consistently from control Ss on diverse psychological tests in the direction of increased distress and psychiatric symptoms. Case Ss had small but statistically significant deficits relative to control Ss on some neurobehavioral tests of memory, attention, and response speed. The results revealed that Gulf War veterans who report symptoms associated with that conflict differed on multiple psychological measures in the direction of increased distress and performed more poorly on neurobehavioral measures when compared with control Ss who did not report symptoms. KOC

Sullivan, G. Translating clinical training into practice in complex mental health systems: toward opening the 'Black Box' of implementation / G. Sullivan, D. Blevins and M.R. Kauth In: Implementation science = ISSN 1748-5908: (2008) (jun), page 33. Trainingen Hulpverleners Veteranen ABSTRACT: BACKGROUND: Implementing clinical training in a complex health care system is challenging. This report describes two successive trainings programs in one Veterans Affairs healthcare network and the lessons we drew from their success and failures. The first training experience led us to appreciate the value of careful implementation planning while the second suggested that use of an external facilitator might be an especially effective implementation component. We also describe a third training intervention in which we expect to more rigorously test our hypothesis regarding the value of external facilitation. RESULTS: Our experiences appear to be consonant with the implementation model proposed by Fixsen. In this paper we offer a modified version of the Fixsen model with separate components related to training and implementation. CONCLUSION: This report further reinforces what others have noted, namely that educational interventions intended to change clinical practice should employ a multilevel approach if patients are to truly benefit from new skills gained by clinicians. We utilize an implementation research model to illustrate how the aims of the second intervention were realized and sustained over the 12-month follow-up period, and to suggest directions for future implementation research. The present report attests to the validity of, and contributes to, the emerging literature on implementation research. KOC

Swoboda, D.A. The social construction of contested illness legitimacy: a grounded theory analysis / D.A. Swoboda In: Qualitative Research in Psychology = ISSN 1478-0887: vol. 3 (2006), issue 3, page 233-251. Onverklaarde lichamelijke klachten (OLK) Golfoorlogsyndroom Veteranen Hulpzoekgedrag Interviews This study examines the social influences that shape how individuals come to believe they have a contested illness and the explanations of illness legitimacy that result. Chronic fatigue syndrome, multiple chemical sensitivities, and Gulf War syndrome have all been identified as contested illnesses because their etiology, diagnosis, and prevalence are

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controversial. Narratives from in-depth interviews with 22 individuals who identified themselves as having these illnesses were analysed using a grounded theory approach. Findings indicate that claiming medical legitimacy for a contested illness involves a difficult and protracted process in which sufferers develop social representations of the etiology, diagnostic criteria, trajectory, and treatment of their illnesses. Study results shed light on the role of sufferers in the social construction of the medical and cultural legitimacy of emerging illnesses. KOC

Tan, E.C.T.H. Twee medische specialisten op missie in Uruzgan / E.C.T.H. Tan en M. Bussink In: Nederlands Militair Geneeskundig Tijdschrift = ISSN 0369-4844: vol. 61 (2008), issue 4, page 117-120. Medisch personeel Militairen Uruzgan Persoonlijke ervaringen Gedurende de periode 3 juni t/m 1 augustus 2007 waren de auteurs, samen met twee OKassistenten en een anesthesiemedewerker uit Nijmegen, twee IC-verpleegkundigen uit Den Haag, een radiodiagnostisch laborant uit Utrecht en een analist uit Leiden, als medisch specialistisch team werkzaam in het ziekenhuis van Kamp Holland. De medische teams bieden waar nodig medisch specialistische zorg aan zowel Nederlandse militairen, leden van de coalitietroepen, milities van de Afghan National Police of de Afghan National Army, leden van de Opposing Military Forces (Talibanstrijders) en Afghaanse burgers. KOC

Tantau, C. Commentary on VanDeusen Lukas et al's "Implementation of a clinical innovation": improving implementation strategies for clinical innovations / C. Tantau In: The Journal of ambulatory care management = ISSN 0148-9917: vol. 31 (2008), issue 2, page 109-110. Gezondheidszorg Veteranen Innovaties Beleid The ability to successfully implement clinical innovation is a significant and critical challenge for all healthcare organizations. The Department of Veterans Affairs has provided insight into isolating those factors that are most strongly associated with successful implementation. Using their experience with spreading advanced clinic access to multiple clinics at multiple sites, they were able to study key components of successful implementation in a variety of settings. Advanced clinic access is a complex set of principles that require widespread involvement and support. The goal of advanced clinic access is to dramatically reduce waits and delays for appointments. In using this particular example to study, the VA provided a rigorous case study. KOC

Tate, S.R. Health problems of substance-dependent veterans with and those without trauma history / S.R. Tate...[et al.]

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In: Journal of substance abuse treatment = ISSN 0740-5472: vol. 33 (2007), issue 1, page 25-35. PTSD Gezondheid Drugsmisbruik Veteranen Vergelijkend onderzoek Substance use disorders (SUDs) and posttraumatic stress disorder (PTSD) are associated with an increased risk for health problems. We examined whether trauma history and PTSD were related to physical health in patients with an SUD. We compared health stressors, health service utilization, and self-rated health status in three groups of male veterans receiving SUD treatment: (1) no trauma exposure (SUD-only group), n = 55; (2) with PTSD (SUD-PTSD group), n = 32; and (3) trauma exposure without PTSD (SUD-trauma group), n = 34. The veterans were assessed quarterly for 1 year. Groups differed in their likelihood of experiencing chronic health stressors at all time points. The SUD-only group consistently had the lowest rates of chronic health stressors, the SUDPTSD group had the highest rates, and the SUD-trauma group fell in between. In contrast, groups did not differ in rates of acute health problems. Chronic health stressors appear to be associated with trauma exposure and psychologic response to the trauma. Substance use disorder interventions may benefit from incorporation of primary care services. KOC

Tiersky, L.A. Functional status and mood in Persian Gulf veterans with unexplained fatiguing illness / L.A. Tiersky...[et al.] In: Military Psychology = ISSN 0899-5605: vol. 12 (2000), issue 4, page 233-248. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom In this investigation, the effects of unexplained fatiguing illness and psychiatric disturbance on functional status and quality of life in Gulf War veterans (GWVs) was examined. 29 GWVs with unexplained fatigue (K. Fukuda et al., 1994) and an Axis I psychiatric diagnosis (mean age 34.8 yrs), 19 GWVs with fatigue and no Axis I psychiatric disorder (mean age 35.5 yrs), and 45 healthy GWVs (mean age 34.1 yrs) were evaluated. Measures included the SF-36, the Profile of Mood States, the Multi-Dimensional Fatigue Inventory, and a symptom severity scale. GWVs with unexplained fatigue suffered from significant functional decline and decreased well-being in all spheres, relative to healthy GWVs. Veterans with comorbid psychiatric illnesses demonstrated the most impaired functioning on measures of life quality that emphasized psychological well-being, but they did not demonstrate reduced physical functioning relative to other fatigued veterans. Thus, reduced physical functioning and well-being in GWVs cannot be attributed to psychiatric disturbance but seems to result from unexplained fatiguing illness. KOC

Toomey, R. Invited commentary: how healthy is the "healthy warrior"? / R. Toomey In: American journal of epidemiology = ISSN 0002-9262: vol. 167 (2008), issue 11, page 1277-1280. Gezondheid

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Militairen Mariniers Irak Operation Enduring Freedom Epidemiologie In this issue of the Journal, Larson et al. (Am J Epidemiol 2008;167:1269-1276) report incidence rates of 11.8% for any mental disorder and 1.6% for post-traumatic stress disorder among US Marines deployed during Operation Iraqi Freedom and Operation Enduring Freedom. Various methodological reasons can help explain why these rates are lower than those found in previous wars. One primary reason is varying methods of diagnosis. Other reasons include differences in percentages of active-duty personnel, windows of observation, and methods of calculating rates. In addition, comorbidity for some mental disorders and specific risks for developing certain disorders complicate interpretation of rates. Nevertheless, Larson et al. document evidence for the "healthy warrior" effect-namely that deployed Marines have fewer mental disorders than nondeployed Navy and Marine Corps personnel, with the exception of stress disorders. Suggestions are made for directions of future research into this effect. KOC

Tussenbroek, B. van Beleven en verwerken van oorlog: Deh Rawod juli-december 2007, door de ogen van de psycholoog / B. van Tussenbroek In: Carré = ISSN 0165-7437: vol. 31 (2008), issue 5, page 14-17. Nazorg Militairen Afghanistan Persoonlijke ervaringen Hulpverleners Hoe reageer je op een plotselinge omslag van wederopbouw naar vechten? Je kwam toch om op te bouwen? Hoe leer je van teleurstellingen, oplossingen en succes? Hoe ga je om met de voortdurende dreiging? Waar vind je kracht als je nauwelijks kan rusten? Een ervaringsverhaal uit Deh Rawod, de laatste maanden van 2007, geeft antwoorden. KOC

Utter, G.H. Microchimerism decades after transfusion among combat-injured US veterans from the Vietnam, Korean, and World War II conflicts / G.H. Utter...[et al.] In: Transfusion = ISSN 0041-1132: (2008) (may). Bloedtransfusies Militairen Tweede Wereldoorlog Korea Vietnam Diagnostiek BACKGROUND: Blood transfusion after traumatic injury can result in microchimerism (MC) of donor white cells (WBCs) in the recipient as late as 2 to 3 years postinjury, the longest prospective follow-up to date. The purpose of this study was to determine how long transfusion-associated MC lasts after traumatic injury. STUDY DESIGN AND METHODS: A group of US combat veterans who received transfusions who responded to a recruitment notice was retrospectively evaluated. Their blood was sampled, and MC was

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assessed by quantitative allele-specific polymerase chain reaction detection of differences at the HLA-DR locus or a panel of insertion-deletion polymorphism loci. Results of veterans were compared to those from an age- and gender-matched blood donor control group, from whom WBCs were retrieved from leukoreduction filters. RESULTS: Among 163 combat veterans who received transfusion and 150 control subjects who did not receive transfusions, 16 (9.8%) of the veterans and 1 (0.7%) control subject had evidence of MC (relative risk, 14.7; 95% confidence interval, 2.0-110). The veterans with MC included 3 who served in WWII (7% of subjects from that conflict), 5 in Korea (18%), and 6 in Vietnam (7%). CONCLUSIONS: Transfusion for combat-related injury can result in MC that lasts for 60 years, suggesting that it may involve permanent engraftment. MC is rare among male blood donors who did not receive transfusions, who are probably representative of individuals who have not had postnatal allogeneic exposures. KOC

Verret, C. Reproductive health and pregnancy outcomes among French gulf war veterans / C. Verret...[et al.] In: BMC public health = ISSN 1471-2458: vol. 8 (2008), issue 1, page 141. Golfoorlogsyndroom Golfoorlog-veteranen Geboorteafwijkingen Frankrijk ABSTRACT: BACKGROUND: Since 1993, many studies on the health of Persian Gulf War veterans (PGWVs) have been undertaken. Some authors have concluded that an association exists between Gulf War service and reported infertility or miscarriage, but that effects on PGWV's children were limited. The present study's objective was to describe the reproductive outcome and health of offspring of French Gulf War veterans. METHODS: The French Study on the Persian Gulf War (PGW) and its Health Consequences is an exhaustive cross-sectional study on all French PGWVs conducted from 2002 to 2004. Data were collected by postal self-administered questionnaire. A casecontrol study nested in this cohort was conducted to evaluate the link between PGWrelated exposures and fathering a child with a birth defect. RESULTS: In the present study, 9% of the 5,666 Gulf veterans who participated reported fertility disorders, and 12% of male veterans reported at least one miscarriage among their partners after the PGW. Overall, 4.2% of fathers reported at least one child with a birth defect conceived after the mission. No PGW-related exposure was associated with any birth defect in children fathered after the PGW mission. Concerning the reported health of children born after the PGW, 1.0% of children presented a pre-term delivery and 2.7% a birth defect. The main birth defects reported were musculoskeletal malformations (0.5%) and urinary system malformations (0.3%). Birth defect incidence in PGWV children conceived after the mission was similar to birth defect incidence described by the Paris Registry of Congenital Malformations, except for Down syndrome (PGWV children incidence was lower than Registry incidence.) CONCLUSIONS: This study did not highlight a high frequency of fertility disorders or miscarriage among French PGW veterans. We found no evidence for a link between paternal exposure during the Gulf War and increased risk of birth defects among French PGWV children. KOC

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Vogt, D.S. Validation of scales from the Deployment Risk and Resilience Inventory in a sample of Operation Iraqi Freedom veterans / D.S. Vogt...[et al.] In: Assessment = ISSN 1073-1911: (2008) (apr). Deployment Risk and Resilience Inventory (DRRI) Validaties Veteranen Irak The Deployment Risk and Resilience Inventory (DRRI) is a suite of scales that can be used to assess deployment-related factors implicated in the health and well-being of military veterans. Although initial evidence for the reliability and validity of DRRI scales based on Gulf War veteran samples is encouraging, evidence with respect to a more contemporary cohort of Operation Iraqi Freedom (OIF) veterans is not available. Therefore, the primary goal of the present study was to validate scales from the DRRI in a large sample of OIF army personnel diversified in occupational and demographic characteristics. In general, results supported the use of these DRRI scales in this population. Internal consistency reliability estimates were quite strong. Additionally, support was obtained for criterion-related validity, as demonstrated by associations with mental and physical health measures, and discriminative validity, as demonstrated by differences between key military subgroups. KOC

Wahab, M.A. Elevated chromosome translocation frequencies in New Zealand nuclear test veterans / M.A. Wahab...[et al.] In: Cytogenetic and genome research = ISSN 1424-8581: vol. 121 (2008), issue 2, page 79-87. Nucleaire tests Straling Veteranen Nieuw Zeeland In 1957/58 the British Government conducted a series of nuclear tests in the mid-Pacific codenamed Operation Grapple, which involved several naval vessels from Britain and New Zealand. Two New Zealand frigates with 551 personnel onboard were stationed at various distances between 20 and 150 nautical miles from ground zero. In the present study we applied the cytomolecular technique mFISH (multicolour fluorescent in situ hybridisation) to investigate a potential link between chromosome abnormalities and possible past radiation exposure in New Zealand nuclear test veterans who participated in Operation Grapple. Compared to age matched controls, the veterans showed significantly higher (P < 0.0001) frequencies of chromosomal abnormalities (275 translocations and 12 dicentrics in 9,360 cells vs. 96 translocations and 1 dicentric in 9,548 cells in the controls), in addition to a significant excess of CCRs (complex chromosomal rearrangements) in the veterans. A Kolmogorov-Smirnoff test showed that the distributions of translocations for the two groups were significantly different. KOC

Watson, P.B. Post-traumatic stress disorder symptoms in the files of Australian servicemen hospitalized in 1942-1952/ P.B. Watson and B. Daniels In: Australasian psychiatry = ISSN 1039-8562: vol. 16 (2008), issue 1, page 13-17. 143

PTSD Veteranen Tweede Wereldoorlog Australië OBJECTIVE: To investigate post-traumatic stress disorder (PTSD) symptomatology in servicemen hospitalized 1942-1952. METHOD: Hospital files of servicemen (n = 590) were studied and PTSD symptoms in groups, based on service experience, were compared. RESULTS: Based on their hospital files, 19% of servicemen were classified as having partial PTSD. No full cases of PTSD were identified, due primarily to the small number of recorded avoidance symptoms and the limited information in relation to the stressor criterion. Prisoners of war had the highest reported avoidance and lowest intrusive symptoms compared with other combatants. CONCLUSIONS: PTSD symptoms may have been common during and after World War II. At that time avoidance was not considered a symptom of disorder. Intrusive and arousal symptoms may be the core symptoms of PTSD and avoidance symptoms need to be reconsidered. KOC

Westermeyer, J. Reliability of sleep log data versus actigraphy in veterans with sleep disturbance and PTSD / J. Westermeyer...[et al.] In: Journal of anxiety disorders = ISSN 0887-6185: vol. 21 (2007), issue 7, page 966-975. Slaapstoornissen PTSD Veteranen The goal of the study was to assess inter-rater reliability of the daily sleep log (a selfrating) with actigraphy (an objective measure of sleep based on activity) in veterans with Posttraumatic Stress Disorder (PTSD). This analysis focused on time asleep and number of awakenings during bedtime. Study participants consisted of 21 veterans with a lifetime diagnosis of Posttraumatic Stress Disorder and current sleep disturbance symptoms. Data collection included study participants' daily charting of sleep logs and actigraphy (utilizing study participants' activity level). Data analysis included the following: (1) interrater reliability for the tabulation of self-reported sleep logs by two trained raters using 99 nights of sleep from 10 cases; (2) comparison of sleep log data versus actigraphic findings for sleep time during 241 bedtimes; (3) comparison of sleep log data versus actigraphic findings for awakenings during 241 bedtimes. Findings showed that the two raters had intraclass correlation scores of .801 for time spent asleep and .602 for time spent in bedacceptable scores for tabulation of the sleep logs. Comparison of patients' sleep logs versus actigraphy for 241 nights showed that 10 out of 21 study participants had acceptable intraclass correlations of 0.4 or above for duration of sleep. However, sleep logs and actigraphic data on number of sleep awakenings showed poor intraclass correlation, with only 1 subject having an intraclass correlation greater than .30. In conclusion, these data strongly suggest that sleep logs do not reproduce actigraphic records in patients with PTSD even though the sleep logs were reliably quantified. Sleep logs especially under-count awakenings in PTSD patients with sleep complaints. KOC

Williams Jr., J.W. Serving the health needs of our military and veterans / J.W. Williams Jr. In: North Carolina medical journal = ISSN 0029-2559: vol. 69 (2008), issue 1, page 23-26. Veteranen

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Wind Wardell, D. Commentary on "a spiritually based group intervention for combat veterans with posttraumatic stress disorder: feasability study" / D. Wind Wardell In: Journal of holistic nursing = ISSN 0898-0101: vol. 26 (2008), issue 2, page 117-118. PTSD Veteranen Behandeling Groepstherapie Spiritualiteit KOC

Wissel, M.J.M. de Lichamelijk letsel door gevechtshandelingen bij Nederlandse militairen in de jaren 19922007: een retrospectief onderzoek naar militaire revalidatiezorg / M.J.M. de Wissel, A. van der Meer, W.J. Wertheim en P. van der Wurff In: Nederlands Militair Geneeskundig Tijdschrift = ISSN 0369-4844: vol. 61 (2008), issue 4, page 134-138. Gewonden Militairen Nederland Revalidatie Achtergrond en doel: Nederlandse militairen die uitgezonden worden, lopen het risico ernstig gewond te raken door gevechtshandelingen. Een deel van deze gewonde militairen heeft revalidatiezorg nodig en wordt behandeld in het Militair Revalidatie Centrum 'Aardenburg' (MRC) in Doorn. Het doel van dit onderzoek is een beschrijving te geven van deze patiënten en de militaire revalidatiezorg. Methode: Een retrospectieve beschrijvende studie. Door analyse van de gegevens uit de medische dossiers over demografische kenmerken, het type letsel, de lokalisatie van de letsels en de geboden revalidatiezorg. Resultaten: In de periode 1992 tot en met 2007 werden 20 militairen met lichamelijk letsel ten gevolge van gevechtshandelingen behandeld in het MRC. Het betrof 19 mannen en 1 vrouw met een gemiddelde leeftijd bij opname van 27,5 jaar. De militairen raakten gewond tijdens missies in Cambodja (n=3), Ex-Joegoslavië (n=7) en Afghanistan (n=10). De militairen waren werkzaam bij de landmacht (n=16) en de marine (n=4). Penetrerende wonden (80%), fracturen (60%) en amputaties (35%) werden het meest frequent gezien. Letsels aan de onderste extremiteiten kwamen (75%) het meest voor gevolgd door letsels aan de bovenste extremiteiten (40%). Letsels aan de romp kwamen het minst frequent voor (10%). Bij alle patiënten bestond de revalidatiezorg uit een vorm van bewegingstherapie (100%) en bijna alle patiënten kregen ADL training (95%) en psychosociale hulpverlening (85%). Conclusies: 20 militairen met ernstige lichamelijk letsel ten gevolge van gevechtshandelingen ontvingen revalidatiezorg in het MRC. Het betrof een groep jonge, voornamelijk mannelijke militairen van de landmacht met letsels van de extremiteiten. In de meeste gevallen was sprake van wonden, fracturen en amputaties ten gevolg van explosies. Een exponentiële toename van het aantal behandelde gewonde militairen is waarneembaar sinds de missie in Afghanistan.

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Yano, E.M. The role of organizational research in implementing evidence-based practice: QUERI Series / E.M. Yano In: Implementation science = ISSN 1748-5908: vol. 3 (2008), issue 1 (may), page 29. Evidence-based medicine Veteranen Hulpverlening U.S. Veterans Health Administration (VA) ABSTRACT: BACKGROUND: Health care organizations exert significant influence on the manner in which clinicians practice and the processes and outcomes of care that patients experience. A greater understanding of the organizational milieu into which innovations will be introduced, as well as the organizational factors that are likely to foster or hinder the adoption and use of new technologies, care arrangements and quality improvement (QI) strategies are central to the effective implementation of research into practice. Unfortunately, much implementation research seems to not recognize or adequately address the influence and importance of organizations. Using examples from the U.S. Department of Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI), we describe the role of organizational research in advancing the implementation of evidence-based practice into routine care settings. METHODS: Using the six-step QUERI process as a foundation, we present an organizational research framework designed to improve and accelerate the implementation of evidence-based practice into routine care. Specific QUERI-related organizational research applications are reviewed, with discussion of the measures and methods used to apply them. We describe these applications in the context of a continuum of organizational research activities to be conducted before, during and after implementation. RESULTS: Since QUERI's inception, various approaches to organizational research have been employed to foster progress through QUERI's six-step process. We report on how explicit integration of the evaluation of organizational factors into QUERI planning has informed the design of more effective care delivery system interventions and enabled their improved "fit" to individual VA facilities or practices. We examine the value and challenges in conducting organizational research, and briefly describe the contributions of organizational theory and environmental context to the research framework. CONCLUSIONS: Understanding the organizational context of delivering evidence-based practice is a critical adjunct to efforts to systematically improve quality. Given the size and diversity of VA practices, coupled with unique organizational data sources, QUERI is well-positioned to make valuable contributions to the field of implementation science. More explicit accommodation of organizational inquiry into implementation research agendas has helped QUERI researchers to better frame and extend their work as they move toward regional and national spread activities. KOC

Young, A.L. A conflict between science and social concerns: Agent Orange / A.L. Young In: Environmental science and pollution research international = ISSN 0944-1344: vol. 15 (2008), issue 1, page 1-2. Chemische oorlogsvoering Agent Orange KOC

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Zalihic, A. Case-control study: posttraumatic stress disorder and habits of war veterans / A. Zalihic...[et al.] In: Psychiatria Danubina = ISSN 0353-5053: vol. 20 (2008), issue 1, page 75-79. PTSD Drugsgebruik Alcoholgebruik Roken Veteranen Voormalig Joegoslavië Diagnostiek AIM: To correlate habits (abuse of tobacco, alcohol, psychoactive substances and drugs) of war veterans and the frequency of symptoms in persons with PTSD and those without it. METHODS: We have carried out a prospective research (case-control study) over the period between September of 2005 and June 2006. The sample consisted of two groups of examinees: 60 males, war veterans with PTSD and 60 males, war veterans without PTSD. The group of war veterans without PTSD was formed using matching criteria (same age, level of education). Both groups included married males. Research was performed using a questionnaire designed for this study. RESULTS: A higher number of war veterans without PTSD were employed compared to war veterans with PTSD (chi(2)=45.753; df=4; p<0.050). A higher number of war veterans with PTSD used psychoactive substances during the war period compared to war veterans without PTSD (18.3% vs. 3.3%). We have observed that 85% of examinees with PTSD have used anxiolitic drugs in the period of research, compared to only 5% of those without PTSD (chi(2)=77.576; df=1; P<0.050). All examinees with PTSD had some form of sleep disorders comparing to 70% of those without PTSD (chi(2)=50.595; df=3; P<0.050). Analysis of alcohol abuse showed a statisticaly significant difference between the examined groups (chi(2)=9.654; df=2; P=0.008). CONCLUSION: A higher number of war veterans without PTSD had employment in comparison to the group of war veterans with PTSD. A higher number of war veterans with PTSD had some form of sleeping disorder, used psychoactive substances and anxiolitic drugs during the war period, and had alcohol abuse in comparison to the group of war veterans without PTSD. KOC

Zavestoski, S. Patient activism and the struggle for diagnosis: Gulf War illnesses and other medically unexplained physical symptoms in the US / S. Zavestoski...[et al.] In: Social Science & Medicine = ISSN 0277-9536: vol. 58 (2004), issue 1, page 161-175. Gezondheid Onverklaarde lichamelijke klachten Golfoorlog-veteranen Golfoorlogsyndroom We examine Gulf War illnesses--which include the fatigue, joint pain, dermatitis, headaches, memory loss, blurred vision, diarrhea, and other symptoms reported by Gulf War veterans--in relation to other medically unexplained physical symptoms such as multiple chemical sensitivity, chronic fatigue syndrome, and fibromyalgia. Our intent is to examine the diagnosis negotiations involved in these mysterious diseases, by showing the different forms of legitimacy involved in such interactions. Factors involved in diagnostic legitimacy are: diagnostic legitimacy in the medical community, lay acceptance of the diagnosis, uncertainty in looking for causes, and social mobilization. We conclude by 147

noting that research may not be able to find any cause for these diseases/conditions; hence, it may be necessary to embrace medical uncertainty, and also to accept patient experience in order to facilitate diagnosis, treatment, and recovery process. Such a change can alter patients' expectations and taken-for-granted assumptions about medicine, and perhaps in turn reduce the frequency with which dissatisfied individuals form illness groups that mobilize to challenge what they see as an unresponsive medical system. KOC

Zinzow, H.M. Sexual assault, mental health, and service use among male and female veterans seen in Veterans Affairs primary care clinics: a multi-site study / H.M. Zinzow...[et al.] In: Psychiatry research = ISSN 0165-1781: vol. 159 (2008), issue 1-2, page 226-236. Seksueel geweld Geestelijke gezondheid Hulpverlening Veteranen This study examined the nature and prevalence of sexual assault (SA), as well as its relationship to psychiatric sequelae and service use, among the veteran population. We performed a secondary data analysis of a cross-sectional dataset consisting of 643 male and 173 female veterans seen in four Veterans Affairs (VA) primary care clinics. Original data were obtained through semi-structured clinic assessments, structured telephone interviews, and medical chart reviews. Analyses included descriptive statistics, chi-square, analysis of variance (ANOVA), and logistic regression. The lifetime prevalence of SA was 38% among women and 6% among men. Of veterans reporting a history of SA, most experienced child sexual abuse and sexual revictimization. SA victims also had a more extensive trauma history and demonstrated greater psychological impairment in comparison to veterans reporting other types of trauma. However, only 25% of male SA survivors and 38% of female SA survivors used mental health services in the past year. These findings suggest that VA primary care clinics may benefit from expanding the current mandated screen for military sexual trauma to include lifetime experiences and trauma-related symptoms, thereby connecting more veterans with needed mental health services. KOC

Tweede generatie / Second generation De De Joodse na-oorlogse generatieproblematiek anno 2007. Rapportage van een onderzoek naar aard en omvang / Drs. A.J. Agsteribbe, Drs. C.M. Kooyman. - Joods Maatschappelijk Werk : Amsterdam, 2007. - 54 p. ; 24 cm Holocaust Joden Tweede generatie Psychosociale problematiek Hulpverlening Joods Maatschappelijk Werk (JMW) s8.1.2 AGS

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Himmler, Katrin Katrin Himmler ; vertaling (uit het Duits) Marion Wilbrink Lezing Vught, 9 december 2007 / Katrin Himmler ; vertaling (uit het Duits) Marion Wilbrink In:Neuengamme Bulletin = ISSN 1574-9746: (2008), issue maart (maart), page 19-28. Duitsland Kinderen van foute ouders Heinrich Himmler Families Geschiedenis Zwijgen Daders Verwerkingsproces Lezing door Katrin Himmler, achternicht van Heinrich Himmler, gehouden op uitnodiging van Kamp Vught. Zij vertelt over haar boek dat zij geschreven heeft over de geschiedenis van haar familie en hoe het is om het zwijgen te doorbreken.

Scheub, Ute Het valse leven : over het Nazi-verleden van mijn vader / Ute Scheub ; uit het Duits vert. door Hans Hom. - Amsterdam : Meulenhoff, cop. 2006. - 302 p. ; 22 cm. - (Meulenhoff editie ; 2168) Vert. van: Das falsche Leben : eine Vatersuche. - München [etc.] : Piper, cop. 2006. - Met lit. opg. ISBN 90-290-7745-X CONTENTS Een Duitse journaliste/schrijfster onderzoekt het naziverleden van haar vader die in 1969 zelfmoord pleegde. Tweede Wereldoorlog Duitsland Nazisme Vaders Schuldgevoelens Zwijgen Tweede generatie Biografieën s8.1.2 SCH

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