The Comparison of Experiential Avoidance, [corrected] Mindfulness and Rumination in Trauma-Exposed Individuals With and Without Posttraumatic Stress Disorder (PTSD) in an Iranian Sample

Transdiagnostic factors in symptoms of depression and post-traumatic stress: a systematic review

The current systematic review sought to identify quantitative empirical studies that focused on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination, and their relation with depression and post-traumatic stress disorder (PTSD). The overall research aim was to examine the relationship between these transdiagnostic factors and their relation with depression and PTSD symptoms. The systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines. Out of the 768 articles initially identified, 55 met the inclusion criteria for the current review. The results determined that intolerance of uncertainty is indirectly related to depression and PTSD symptoms, mainly through other factors including emotion dysregulation and rumination. Additionally, emotional dysregulation is a significant predictor of both depression and PTSD symptoms. Rumination is a robust factor related to depression and PTSD symptoms, this relationship was significant in cross-sectional and longitudinal studies. This review provides evidence on the transdiagnostic factors of intolerance of uncertainty, emotional dysregulation and rumination in the relationship with depression and PTSD symptoms.

Fake news during the war in Ukraine: coping strategies and fear of war in the general population of Romania and in aid workers

Introduction

In addition to the health crisis that erupted during the COVID-19 pandemic, the war between Russia and Ukraine is impacting the mental health and wellbeing of the Romanian population in a negative way.

Objectives

This study sets out to investigate the impact that social media consumption and an overload of information related to the armed conflict between Russia and Ukraine is having on the distribution of fake news among Romanians. In addition, it explores the way in which several psychological features, including resilience, general health, perceived stress, coping strategies, and fear of war, change as a function of exposure to traumatic events or interaction with victims of war.

Methods

Participants (N = 633) completed the General Health Questionnaire (GHQ), the CERQ scale with its nine subscales, the Perceived Stress Scale (PSS), and the BRS scale (Brief Resilience Scale), the last of which measures resilience. Information overload, information strain and the likelihood of the person concerned spreading fake news were assessed by adapting items related to these variables.

Findings

Our results suggest that information strain partially moderates the relationship between information overload and the tendency to spread false information. Also, they indicate that information strain partially moderates the relationship between time spent online and the tendency to spread false information. Furthermore, our findings imply that there are differences of high and moderate significance between those who worked with refugees and those who did not as regards fear of war and coping strategies. We found no practical differences between the two groups as regards general health, level of resilience and perceived stress.

Conclusion and recommendations

The importance of discovering the reasons why people share false information is discussed, as is the need to adopt strategies to combat this behavior, including infographics and games designed to teach people how to detect fake news. At the same time, aid workers need to be further supported to maintain a high level of psychological wellbeing.

Rumination Mediates the Relationship Between Childhood Traumas with Cognitive Defusion, Acceptance, and Emotion Regulation: A Qualitative and Quantitative Study

This study examines the intermediary role of rumination in the relationship between childhood traumas in young adults and cognitive defusion, psychological acceptance, and suppression which is one of the emotion regulation strategies. In the quantitative stage of the study formed according to the explanatory sequential design, the intermediary role of rumination by using a structural equation model while in the qualitative stage, the intermediary role of rumination was analyzed through interviews using the interpretive phenomenology design. Personal Information Form, Childhood Trauma Scale, Short Form Ruminative Response Scale, Acceptance and Action Form II, Drexel Defusion Scale, and Emotion Regulation Scale were used in the research. At the end of the research, it was determined that childhood traumas have a negative effect on cognitive defusion and acceptance, while they have a positive effect on suppression. It was seen that rumination has a partial intermediary role in the relationship of childhood traumas with cognitive defusion, acceptance, and suppression. As a result of the qualitative analysis, twelve themes such as "Constantly thinking about the past, not being able to move away from childhood traumas, not being able to forgive their parents, inability to get rid of negative thoughts, living in the past, moving away from a value-driven life, false expression of emotion, suppression of emotions, emotions reflected in behavior, coping with negative emotions and desired emotion regulation" emerged concerning participants' experiences of cognitive defusion, acceptance, and suppression. Although one of the purposes of using AAQ-II in the study was to support discussions about the scale via qualitative results, this was a limitation for the study. Therefore, although a high rate was obtained, it is not possible to infer that childhood traumas and rumination can explain acceptance behaviors. For this, much more quantitative and qualitative studies are needed. Other qualitative research findings are thought to support quantitative research findings.

Maladaptive cognitions and emotion regulation in posttraumatic stress disorder

PURPOSE

The present study investigated the interactions between emotion regulation strategies and cognitive distortions in posttraumatic stress disorder (PTSD). We also examined differences in emotion regulation and cognitive distortions across the trauma spectrum.

METHODS

The study was conducted in France between December 2019 and August 2020 and was approved by the university ethics committee. We recruited 180 participants aged over 18, with 3 groups of 60 each: (1) patients diagnosed with PTSD, (2) trauma-exposed without PTSD, (3) no history of trauma. Exclusion criteria were a history of neurological or mental disorders, psychoactive substance abuse, and a history of physical injury that could affect outcomes. All participants completed the Life Events Checklist‑5 (LEC-5), Post-traumatic Check List‑5 (PCL-5), Dissociative Experiences Scale (DES), Cognitive Emotion Regulation Questionnaire (CERQ), and Cognitive Distortions scale for Adults (EDC-A). Correlation analysis was performed to observe the relationship between PTSD severity and cognitive functioning. Correlations between cognitive distortions and maladaptive emotion regulation strategies were calculated for the PTSD group. A moderation analysis of the whole sample was conducted to examine the relationship between cognitive distortions, emotion regulation strategies, and PTSD.

RESULTS

Participants with PTSD scored significantly higher on the PCL‑5 and for dissociation than the other groups. PCL‑5 scores were positively correlated with maladaptive emotion regulation strategies and acceptance. They were also correlated with positive and negative dichotomous reasoning and negative minimization. Analysis of the PTSD group revealed correlations between maladaptive emotion regulation strategies and negative cognitive distortions. The moderation analysis revealed the cognitive distortions explaining the relationship between emotion regulation strategies and trauma exposure overall, and how they exacerbate emotional problems in PTSD.

CONCLUSION

The study provides indications for management of PTSD patients. Inclusion of an intermediate group of individuals exposed to trauma without PTSD revealed differences in the observed alterations. It would be interesting to extend the cross-sectional observation design to study traumatic events that may cause a specific type of disorder.

The Role of Anxiety and Depression in the Emotion Regulation Strategies of People Suffering from Post-Traumatic Stress Disorder

Researchers have explored the links between cognitive emotion regulation, impaired cognitive functioning, and anxiety-depression, including the link to anxiety and depression levels. However, very few studies have examined these dimensions in clinical populations with post-traumatic stress disorder (PTSD). A sample of 183 participants was divided into three groups: 59 trauma-exposed with PTSD, 61 trauma-exposed without PTSD, and 63 non-trauma-exposed non-PTSD (controls). All participants were assessed on the following dimensions: PTSD (PCL-5), cognitive emotion regulation (CERQ), anxiety and depression (HADS). Results indicate a specific profile of emotion regulation associated with PTSD. Compared to other groups, participants with PTSD showed more difficulty managing their emotions, with more rumination, self-blame, and catastrophizing. Moreover, these difficulties were also correlated with levels of anxiety and depression, that is, participants with PTSD who had higher anxiety and depression scores used more maladaptive strategies. The PTSD group used significantly more maladaptive cognitive emotion regulation strategies than the other groups, with distinct profiles related to anxiety and depressive symptomatology.

The Moderating Role of Resilience on Mindfulness, Experiential Avoidance, and Posttraumatic Stress Disorder (PTSD) Symptoms of College Student Veterans: A Cross-Sectional Study

The purpose of the study was to investigate the moderating effect of resilience on the relationship between mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptom severity. A cross-sectional study design was used on a sample of 133 college student military veterans. We found a direct effect of mindfulness on PTSD and a significant mediating effect of experiential avoidance on the relationship between mindfulness and PTSD. Resilience also had a significant moderating effect on the relationship between mindfulness and PTSD. This study provides preliminary evidence on the usefulness of integrating resilience development in mindfulness-based interventions for trauma-related disorders.

Group-based Compassion-focused Therapy on Experiential Avoidance, Meaning-in-life, and Sense of Coherence in Female Survivors of Intimate Partner Violence with PTSD: A Randomized Controlled Trial

The current study was carried out to investigate the effects of compassion-focused therapy (CFT) on experiential avoidance, meaning-in-life, and sense of coherence (SoC) in women suffering from post-traumatic stress disorder (PTSD) due to the intimate partner violence (IPV).42 women suffering from PTSD due to the IPV exposure were randomized to the two groups of experimental and control (21 per group). All participants completed the questionnaires of experiential avoidance, meaning-in-life, and SoC as pre-test measures. The experimental group received eight sessions of CFT, while the controls did not receive any treatment. After that, all subjects responded to the questionnaires of experiential avoidance, meaning-in-life, and SoC as the post-test measures. Data were analyzed using one-way repeated measures MANOVA.Subjects of the experimental group indicated a greater reduction in post-test scores of experiential avoidance, and a significant rise in the level of meaning-in-life and its subscales including the presence of meaning-in-life and search for meaning-in-life when compared to the controls. Nevertheless, there was no change in the level of SoC as a function of CFT.Applying CFT can result in reducing experiential avoidance and raising the meaning of life in women with PTSD due to IPV exposure. CFT is highly recommended to strengthen the well-being of patients with PTSD and reduce the PTSD symptoms.

Exploring the relationships between resilience, mindfulness, and experiential avoidance after the use of a mindfulness- and acceptance-based mobile app for posttraumatic stress disorder

PURPOSE

This study used a mindfulness- and acceptance-based mobile app to examine the relationships between resilience, mindfulness, experiential avoidance, and posttraumatic stress disorder (PTSD) symptoms.

DESIGN AND METHODS

A quasi-experimental pre-posttest, single-group study design was used. A total of 23 college student veterans used the app for 4 weeks. Outcomes of resilience, mindfulness, experiential avoidance, and PTSD were measured at three time-points (baseline, end of Week 2, and end of Week 4).

FINDINGS

All outcomes significantly improved at postintervention. Improvements in resilience and PTSD significantly correlated with improvement in mindfulness.

PRACTICE IMPLICATIONS

Mindfulness- and acceptance-based mobile apps can be safely used by individuals with PTSD as a complementary approach to enhance resilient coping with PTSD.

Social Media Exposure and College Students' Mental Health During the Outbreak of COVID-19: The Mediating Role of Rumination and the Moderating Role of Mindfulness

In response to reports of people experiencing varying levels of anxiety and depression during the outbreak of COVID-19, researchers have argued that exposure to related information on social media is a salient contributing factor. Based on the integrated model of ruminative response style and the diathesis-stress model, it has been suggested that incorporating rumination and mindfulness may elucidate the potential mechanism underlying the aforementioned association. This study aimed to examine the mediating role of rumination and the moderating role of mindfulness in the association between social media exposure (SME) to COVID-19 information and psychological distress. The results from online questionnaire responses of 439 college students from two universities in Wuhan, Hubei Province, showed that rumination mediated the association between SME and psychological distress. Furthermore, mindfulness was revealed as a protective factor that buffered the adverse effect of SME on psychological distress through rumination. These findings advance a better understanding of the formation process of psychological symptoms during the COVID-19 pandemic and provide insights regarding effective interventions for adverse mental health consequences in college students.

Rumination in posttraumatic stress disorder: A systematic review

Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.

Testing the acceptability and initial efficacy of a smartphone-app mindfulness intervention for college student veterans with PTSD

This single-arm, pre-post feasibility study evaluated the acceptability and initial efficacy of a mindfulness smartphone-app intervention intended to promote resilience and improve posttraumatic stress disorder (PTSD) symptoms among college student military veterans. The app contained mindfulness exercises and meditations based on the acceptance and commitment therapy. Twenty-three student veterans used the app for four weeks. The results showed high levels of perceived satisfaction and usability of the app. Significant changes in resilience, mindfulness, PTSD, experiential avoidance, and rumination were observed. Future research is needed to test the intervention in a randomized controlled trial.

Less Mindful, More Struggle and Growth: Mindfulness, Posttraumatic Stress Symptoms, and Posttraumatic Growth of Breast Cancer Survivors

Treatment of posttraumatic stress symptoms (PTSSs) and facilitation of posttraumatic growth (PTG) are two encouraging areas of research, yet little is understood about the relationships between dispositional mindfulness, PTSSs, and PTG. The aim of the present study was to investigate whether PTSSs is correlated with PTG among breast cancer patients in China and explore the role of mindfulness in this relationship. A sample of 202 Chinese breast cancer patients voluntarily participated in the study by completing a set of questionnaires. The results revealed that PTSSs were significantly positively correlated with PTG. Structural equation modeling showed that mindfulness did not moderate but mediated the relation between PTSSs and PTG. These findings indicate that breast cancer patients with higher mindfulness may recover from PTSSs through a different process. Posttraumatic growth may not be the only positive indicator of posttraumatic individuals.

The Role of Mindfulness in Reducing the Adverse Effects of Childhood Stress and Trauma

Research suggests that many children are exposed to adverse experiences in childhood. Such adverse childhood exposures may result in stress and trauma, which are associated with increased morbidity and mortality into adulthood. In general populations and trauma-exposed adults, mindfulness interventions have demonstrated reduced depression and anxiety, reduced trauma-related symptoms, enhanced coping and mood, and improved quality of life. Studies in children and youth also demonstrate that mindfulness interventions improve mental, behavioral, and physical outcomes. Taken together, this research suggests that high-quality, structured mindfulness instruction may mitigate the negative effects of stress and trauma related to adverse childhood exposures, improving short- and long-term outcomes, and potentially reducing poor health outcomes in adulthood. Future work is needed to optimize implementation of youth-based mindfulness programs and to study long-term outcomes into adulthood.