210 research outputs found
Factor analysis of posttraumatic stress disorder symptoms using data pooled from two venlafaxine extended-release clinical trials
No full textBACKGROUND: Confirmatory factor analysis (CFA) of Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) (DSM-IV) three-factor posttraumatic stress disorder (PTSD) diagnostic criteria was conducted to determine fit for this patient population. An exploratory factor analysis (EFA) of alternate symptom structures was planned to identify symptoms that cluster in this population. The response of symptom factors to treatment with venlafaxine extended release (ER) was explored.METHODS: Baseline 17-item Clinician-Administered PTSD Scale (CAPS-SX17) data were pooled from patients enrolled in two double-blind, randomized, placebo-controlled trials. The CFA was conducted using maximum likelihood and weighted, least-squares factor extraction methods. The EFA was performed using a polychoric correlation covariance matrix and Pearson correlation matrix.RESULTS: Data from a pooled population of 685 patients (venlafaxine ER: n = 339; placebo: n = 346) were analyzed. CFA rejected the DSM-IV three-factor structure. The EFA identified a different three-factor structure as the best fit: factor 1 included reexperiencing symptoms, factor 2 included symptoms of altered mood and cognition, whereas factor 3 comprised avoidance and arousal symptoms. All DSM-IV symptom factors and all factors in the identified three-factor model responded positively to venlafaxine ER treatment.CONCLUSIONS: Data are consistent with literature failing to confirm the three-factor structure of DSM-IV PTSD, and they support the DSM-5 inclusion of a symptom cluster addressing altered mood and cognition in PTSD. The efficacy of venlafaxine ER in reducing a range of symptom clusters in PTSD is consistent with its multiple mechanisms of action.<br/
Onset of activity and time to response on individual CAPS-SX17 items in patients treated for posttraumatic stress disorder with venlafaxine XR: A pooled analysis
No full textThis pooled analysis of data from two randomized, placebo-controlled trials of venlafaxine extended release (ER) assessed onset of activity and time to response on the 17 symptoms of post-traumatic stress disorder (PTSD) listed in DSM-IV and measured by the 17-item Clinician-Administered PTSD Scale (CAPS-SX17). The intent-to-treat (ITT) population comprised 687 patients (placebo, n=347; venlafaxine ER, n=340). Significant (p<0.05) separation between venlafaxine ER and placebo was observed on most CAPS-SX17 items, with earliest onset of activity and response (week 2) on items 5 (physiological reactivity on exposure to cues) and 14 (irritability or anger outbursts), and (week 4) items 1 (intrusive recollections) and 4 (psychological distress at exposure to cues). Onset of activity and response occurred later (generally, weeks 6-8) on items 9 (diminished interest/participation in activities), 10 (detachment or estrangement), 11 (restricted range of affect), 12 (sense of foreshortened future), all associated with numbing, 15 (difficulty concentrating), 16 (hypervigilance), 17 (exaggerated startle response), associated with hyperarousal, and 6 (avoidance of thoughts/feelings or conversations). Significant differences between venlafaxine ER and placebo were largely absent throughout the treatment period and at the primary week-12 end-point for items 2 (distressing dreams), 7 (avoidance of activities, places or people), 8 (inability to recall important aspect of trauma) and 13 (difficulty falling/staying asleep). These results indicate that symptoms of physiological reactivity and psychological distress in response to cues, and irritability/anger outbursts show early and robust improvement with venlafaxine ER treatment, while symptoms of numbing and hyperarousal take longer. The early and persistent effect of venlafaxine ER over placebo on anger/irritability is noteworthy in view of the clinical significance of these symptoms in PTSD.<br/
Symptoms of post-traumatic stress disorder: examination of factor structure in two separate clinical trials
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Anxiety Disorders in Late Life
No full textAnxiety disorders in later life are some of the most significant mental health problems affecting older adults. Prevalence estimates of anxiety disorders in late life vary considerably based on multiple methodological issues. Current diagnostic criteria may not adequately capture the nature and experience of anxiety in older people, particularly those in ethnic and racial minority groups. This article reviews late-life anxiety disorders. Pharmacologic and psychotherapy approaches to treat late-life anxiety are reviewed, including a summary of current innovations in clinical care across settings, treatment models, and treatment delivery.</p
Verkeerswaterbouwkunde b.o.
No full textVaartuigen, vaarwegen, vaarweggebruikers, prognoses van het scheepvaartverkeer, begrippen capaciteit en weerstand, dimensionering van schutsluizen, capaciteit en weerstand van schutsluizen.Hydraulic EngineeringCivil Engineering and Geoscience
Waterbouwkundige kunstwerken b.o. (tunnels)
No full textSoorten oeververbindingen, afweging van keuzes, lengteprofiel van een tunnel, dwarsprofiel van een tunnel, uitvoering van het gezonken deel, enige constructieve aspecten.Hydraulic EngineeringCivil Engineering and Geoscience
Waterbouwkundige kunstwerken B.O.: Voorlopig dicaat
No full textCivil Engineering and GeosciencesHydraulic Engineerin
General B.O. Smith with four unidentified men.
No full texthttps://egrove.olemiss.edu/cfclayton/1058/thumbnail.jp
Aspecten van zandtransport in open waterlopen
No full textCollege "Materiaaltransport B.O.", sedimenttransport in rivieren.Hydraulic EngineeringCivil Engineering and Geoscience
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