Anxiety Disorders: Miller L

Miller L. · · Int J Emerg Ment Health. · Pubmed #18546756 No free full text.

Abstract: Like siblings separated at birth, military psychology and police psychology have each independently addressed the cognitive, perceptual, emotional, and behavioral aspects of men and women performing extreme service in defense of their neighborhood or their country. This article reviews the major areas of commonality in the work of military and police psychologists in the areas of crisis intervention and stress management, and provides practical strategies for handling these operational and clinical challenges. The article makes specific recommendations for how police and military psychologists can cross-contribute to each other's fields for the overall enhanced provision of services to the men and women who wear uniforms of all kinds.

Miller L. · · Int J Emerg Ment Health. · Pubmed #17523372 No free full text.

Abstract: A line-of-duty death (LODD) strikingly brings home the risk and vulnerability of all law enforcement officers and affects the officer's peers, the entire department, the wider police community, and the officer's family. This article will place LODD in the context of general bereavement psychology, as well as describe some of its unique features. A variety of supportive and psychotherapeutic measures will be offered for helping peer and family survivors cope with this type of tragedy. This is one important area where police psychologists and community mental health clinicians can be of tremendous service in applying their specialized training in trauma therapy and grief counseling to the special needs of law enforcement and emergency services.

Miller L. · · Am J Psychother. · Pubmed #15106396 No free full text.

Abstract: Terrorist attacks combine features of criminal assaults, disasters, and acts of war. Accordingly, much of our clinical knowledge in treating this relatively new kind of traumatic event is adapted from experiences in treating victims of criminal assault, homicidal bereavement, natural and man-made disasters, war and political violence, workplace homicide, and school shootings. This paper reviews the pertinent literature on these types of trauma and combines this information with the author's own experience in treating direct and indirect victims and survivors of recent terrorist attacks. The paper describes the psychological syndromes resulting from terrorism and discusses individual and family modalities for treating victims and survivors of terrorism.

Freeman JB, Garcia AM, Fucci C, Karitani M, Miller L, Leonard HL. · Child and Family Psychiatry, Rhode Island Hospital, Providence, Rhode Island 02903, USA. · J Child Adolesc Psychopharmacol. · Pubmed #12880502 No free full text.

Abstract: Despite a meaningful common core of symptoms observed across the life span, there are particularly unique features of early-onset (prepubertal) obsessive-compulsive disorder (OCD) that make consideration of early presentation different from adolescent or adult onset and that may have important implications for treatment. This article will first review the unique features of early-onset OCD, focusing particular attention to the developmental and familial context of these children's symptoms. The literature on behavioral family interventions for other childhood disorders, specifically anxiety, as well as that on family processes (e.g., parent-child interactions) in families of children with OCD will be reviewed. The pediatric OCD cognitive-behavioral therapy (CBT) literature (CBT alone and CBT plus medication) will also be reviewed, focusing on current evidence-based treatment guidelines. Finally, a model of family-based treatment for young children with OCD and some preliminary pilot data will be presented.

Miller L. · No affiliation provided · NeuroRehabilitation. · Pubmed #11568469 No free full text.

Abstract: When patients present with syndromes we mistrust or misunderstand, clinician are often quick to make a determination of malingering. However, the use of malingering as a default diagnosis neglects a variety of clinical possibilities that may be relevant for treatment and forensic disposition. In neuropsychology, the growing use of a malingering diagnosis has recently been fueled by the increasingly adversarial nature of forensic brain injury litigation in which the goal is often less to provide an objective evaluation of cognition and personality as to brand all personal injury claimants as manipulative frauds. Less maliciously, but still disturbing, neuropsychologists whose knowledge base and clinical experience involves mainly the administration and scoring of psychometric tests may ignorantly, if innocently, overlook alternative diagnoses and syndromes that their education and training have ill-prepared them to recognize. And some patients do indeed malinger, and it is important to identify them, if only to spare legitimately injured claimants from being tarred with the same brush. This paper describes some of the syndromes that may present in clinical and forensic practice with brain-injured patients. It is to be considered a first step toward a practice model of neuropsychology that encourages the role of knowledge and clinical judgement in guiding the meaningful clinical interpretation of tests and measures.

Miller L. · No affiliation provided · Int J Emerg Ment Health. · Pubmed #11232381 No free full text.

Abstract: Critical Incident Stress Debriefing (CISD) was originally developed as a short-term, group-format, preventive mental health intervention for traumatized law enforcement and emergency services personnel. The debriefing model has since been applied to a variety of clinical groups and crisis situations, correspondingly undergoing modifications in its structure and process. This review describes the CISD approach and explores some of the new directions being taken by practitioners of this intervention strategy. In addition, this review addresses some of the recent critiques of the CISD model, and makes recommendations for optimal utilization of this clinical tool with those populations most likely to benefit from it.

Miller L. · No affiliation provided · Ment Health Today. · Pubmed #19266657 No free full text.

This publication has no abstract.

Miller L. · · Int J Emerg Ment Health. · Pubmed #18788346 No free full text.

Abstract: For law enforcement and emergency services professionals, stress and resilience are not academic topics or luxuries; they are essential to the physical and mental health, as well as to optimum job functioning. This article traces the history of the stress and resilience concepts in psychology, the military, and law enforcement, outlines the major risk and protective factors for traumatic stress responses, and presents a general psychophysiological model of stress and coping. The article next applies these concepts to the proactive fostering of mental toughness and resilience, using lessons learned from sports psychology and the mental conditioning literature. It then describes psychological debriefing, mental health counseling, and psychotherapeutic strategies for facilitating resilient recovery from critical incidents and traumatic events. Although directed mainly to law enforcement, the principles set out in this article may be productively applied to emergency medicine, public safety, military, and civilian trauma counseling settings.

Miller L. · Independent Practice, Boca Raton, Florida, USA. · Int J Emerg Ment Health. · Pubmed #17131770 No free full text.

Abstract: Psychologists who work with law enforcement agencies may be called upon to respond to an officer-involved shooting (OIS). These need not be the most traumatic critical incidents in policing, but when they are, the reasons usually involve a mix of incident characteristics, officer response styles, and departmental handling. This article describes some of the psychological reactions experienced by officers during and following an OIS and provides a model of administrative, legal, mental health, and peer support services for officers in need. Finally, the article discusses several key roles that the police psychologist can play in the process of managing an OIS.

Coffey SF, Gudmundsdottir B, Beck JG, Palyo SA, Miller L. · Department of Psychiatry and Human Behavior, The University of Mississippi Medical Center, 2500 North State Street, Jackson, 39216, USA. · J Trauma Stress. · Pubmed #16568464 links to  free full text

Abstract: The current study compares the total scores of two potential posttraumatic stress disorder (PTSD) screening tools, the Impact of Event Scale (IES) and the PTSD Symptom Scale, Self-Report (PSS-SR), to the Clinician-Administered PTSD Scale (CAPS) in a large sample of motor vehicle accident (MVA) survivors (N = 229, of whom 43% met criteria for PTSD). For the IES using a cutoff score of 27, sensitivity was .91, specificity was .72, and overall correct classification was .80. For the PSS-SR using a cutoff score of 14, sensitivity was .91, specificity was .62, and overall correct classification was .74. Compared to those in studies of other trauma populations, the identified IES cutoff score is somewhat lower for this population of MVA survivors and the identified PSS-SR cutoff score is consistent with previous findings. These data support the use of the IES and the PSS-SR as PTSD screening tools in MVA samples.

Larson MJ, Miller L, Becker M, Richardson E, Kammerer N, Thom J, Gampel J, Savage A. · New England Research Institutes Inc, Watertown, MA 02472, USA. · J Behav Health Serv Res. · Pubmed #15834263 No free full text.

Abstract: This article documents the physical health burdens of participants in a large, federally funded cross-site study of specialized services for women with histories of trauma (physical or sexual abuse) and co-occurring substance abuse and mental health disorders. Nearly half of the 2729 women in the study (48%) reported serious physical illnesses that frequently limited their daily life activities or required them to use special equipment. Nearly half (46%) rated their health status as only fair or poor. Given the prevalence of physical illnesses in this population, behavioral service providers should discuss with clients their overall health and how it might hinder their participation in treatment for trauma, substance abuse, and mental illness, and policymakers should consider this need when designing behavioral health requirements, setting reimbursement rates, and allocating funds.

Gudmundsdottir B, Beck JG, Coffey SF, Miller L, Palyo SA. · Department of Psychology, University at Buffalo, The State University of New York, Buffalo, New York 14260, USA. · Depress Anxiety. · Pubmed #15580574 No free full text.

Abstract: We examined the respective contributions of depression, anxiety, and post-trauma symptoms, as these factors reduce quality of life (QOL) in 111 individuals who had experienced a serious motor vehicle accident. Correlations and structural equation modeling were used to evaluate whether the severity of posttraumatic stress disorder symptoms influences QOL directly, and whether depression and anxiety mediated this relationship. Results indicated that post trauma symptomatology has a negative effect on QOL, which is mediated by depression and anxiety.