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Forkus SR, Contractor AA, Raudales AM, Weiss NH. The influence of trauma-related shame on the associations between posttraumatic symptoms and impulsivity facets. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2023; 15:576-583. [PMID: 35666935 PMCID: PMC10392103 DOI: 10.1037/tra0001288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The co-occurrence of posttraumatic symptoms (PTS) and impulsivity is associated with higher levels of risky and self-destructive behaviors and consequent safety and health risks. Trauma-related shame (TRS) may influence the association between PTS and impulsivity such that engaging in impulsive behaviors may serve to cope with emotional distress. Alternatively, TRS may motivate a deliberate consideration of behaviors (i.e., less impulsivity) to prevent further cognitive and emotional distress. OBJECTIVE The goal of the current study was to examine the influence of TRS on the associations between PTS and impulsivity facets (lack of premeditation, lack of perseverance, negative urgency, positive urgency, sensation seeking). METHOD Data were collected from 506 community individuals who endorsed lifetime sexual trauma (Mage = 34.56, 54.3% women, 78.7% White). RESULTS Findings indicated that TRS moderated associations between PTS and impulsivity facets of lack of perseverance, b = -.001, SE = .0003; t = -2.68, p = .008, 95% confidence interval [-.001, -.0002], and premeditation, b = -.001, SE = .0003; t = -3.70, p < .001, [-.002, -.001]; these associations were significant at low, but not high, levels of TRS. CONCLUSIONS Findings suggest that in the context of PTS, TRS may reduce certain forms of impulsivity, potentially as a means to self-protect against further cognitive and emotional distress. Findings have important implications for understanding how individuals regulate and respond to shame in the context of PTS. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Peck KR, Nighbor TD, Price M. Examining associations between impulsivity, opioid use disorder, and posttraumatic stress disorder: The additive relation between disorders. Exp Clin Psychopharmacol 2022; 30:486-493. [PMID: 34291989 PMCID: PMC8782919 DOI: 10.1037/pha0000507] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Impulsivity is a key feature of opioid use disorder (OUD) and other psychiatric conditions, including posttraumatic stress disorder (PTSD). The relationship between disorders and impulsivity may be additive, such that individuals with multiple disorders exhibit greater impulsivity than those with a single disorder. However, the association between impulsivity, OUD, and PTSD is unclear. Accordingly, this study compared individuals with concurrent OUD and PTSD (OUD + PTSD; n = 55), OUD without PTSD (OUD-PTSD; n = 34), PTSD without OUD (n = 32), and healthy controls (HCs; n = 55) on the Short Urgency, Premeditation, Perseverance, Sensation Seeking, Positive Urgency Impulsive Behavior Scale (SUPPS-P), and the 27-item Monetary Choice Questionnaire (MCQ). With respect to the SUPPS-P, the OUD + PTSD, OUD-PTSD, and PTSD without OUD groups reported more impulsivity on the negative urgency, positive urgency, and lack of premeditation subscales compared to HCs (ps < .001). The OUD + PTSD group also reported greater negative urgency compared to the OUD-PTSD group (p = .001) and HCs (p < .001), but not the PTSD without OUD group (p = .07). Furthermore, participants with OUD + PTSD exhibited greater discounting of delayed rewards on the MCQ than those in the PTSD without OUD group and HCs (p's < .001). However, no significant differences were observed between the two OUD groups (p = .86). These results support impulsivity as a mechanism underlying both OUD and PTSD. Future research should examine whether interventions targeting impulsivity, emotion regulation, and delay discounting are associated with meaningful improvements in functioning among individuals with OUD and PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Kelly R. Peck
- Vermont Center on Behavior and Health, University of Vermont
- Department of Psychiatry, University of Vermont
- Department of Psychological Science, University of Vermont
| | | | - Matthew Price
- Department of Psychological Science, University of Vermont
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Wooldridge JS, Herbert MS, Dochat C, Afari N. Understanding relationships between posttraumatic stress disorder symptoms, binge-eating symptoms, and obesity-related quality of life: the role of experiential avoidance. Eat Disord 2021; 29:260-275. [PMID: 33459212 PMCID: PMC8285449 DOI: 10.1080/10640266.2020.1868062] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Obesity, binge-eating symptoms, and PTSD symptoms commonly co-occur. Avoidance, a key feature of PTSD and proposed mechanism of binge-eating, is one potential mechanism for explaining this clinical overlap. The purpose of the current study was to: 1) examine the associations between PTSD symptoms (PTSD Checklist-Civilian; PCL-C) and measures of bingeeating symptoms (Binge Eating Scale; BES) and obesity-related quality of life (Obesity Related Well-Being Questionnaire-97; ORWELL-97) in a sample of veterans with overweight or obesity (N = 89), and 2) determine whether experiential avoidance (The Acceptance and Action Questionnaire-II; AAQ-II) explains the relationship between PTSD symptoms and binge-eating symptoms, and PTSD symptoms and obesity-related quality of life, respectively. Scores on the PCL-C, BES, ORWELL-97, and AAQ-II were all significantly correlated. Linear regression analyses indicated that higher PCL-C scores were related to higher scores on the BES and ORWELL-97 after controlling for potentially confounding factors (BMI and race). Effect sizes were in the medium-large range. Further, AAQ-II mediated the relationship between PCL-C and ORWELL-97, but did not mediate the relationship between PCL-C and BES. These findings suggest that experiential avoidance should be considered in interventions addressing co-occurring PTSD, binge-eating, and poor obesity-related well-being. Longitudinal research is needed to better understand directionality of these relationships and changes over time.
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Affiliation(s)
- Jennalee S Wooldridge
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
| | - Matthew S Herbert
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
| | - Cara Dochat
- San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, California, San Diego, USA
| | - Niloofar Afari
- VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA.,Center of Excellence for Stress and Mental Health (CESAMH), San Diego, California, USA
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Halvorson MA, Pedersen SL, Feil MC, Lengua LJ, Molina BS, King KM. Impulsive States and Impulsive Traits: A Study of the Multilevel Structure and Validity of a Multifaceted Measure of Impulsive States. Assessment 2021; 28:796-812. [PMID: 32680433 PMCID: PMC7854826 DOI: 10.1177/1073191120939161] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Emerging evidence suggests impulsive states may be reliably measured in the moment using ecological momentary assessment (EMA); however, research has not investigated whether the multi-factor structure of impulsive traits also characterizes impulsive states. In two independent samples spanning adolescence through young adulthood (n = 211, n = 222), we adapted global self-report measures of impulsive traits to EMA and conducted multilevel confirmatory factor analyses to characterize the within- and between-person factor structure of five impulsive traits (negative urgency, planning, persistence, sensation seeking, and positive urgency). Across both studies, factor models with one factor for each UPPS-P facet fit the data well at both levels, though some latent factors were highly correlated. Aggregated impulsive states, especially negative urgency, predicted oppositional defiant disorder symptoms, emotional problems, alcohol problems, and attention deficit hyperactivity disorder symptoms. Our results suggest that EMA measures can capture a range of impulsive states that mirrors the heterogeneity seen in the trait literature.
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Affiliation(s)
| | - Sarah L. Pedersen
- University of Pittsburgh, Department of Psychology
- University of Pittsburgh, Department of Psychiatry
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5
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Stanley IH, Marx BP, Keane TM, Vujanovic AA. PTSD symptoms among trauma-exposed adults admitted to inpatient psychiatry for suicide-related concerns. J Psychiatr Res 2021; 133:60-66. [PMID: 33310501 PMCID: PMC7856162 DOI: 10.1016/j.jpsychires.2020.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/18/2020] [Accepted: 12/01/2020] [Indexed: 11/15/2022]
Abstract
Individuals admitted to inpatient psychiatry for suicide-related concerns are at increased risk of suicide post-discharge, necessitating an understanding of factors, such as posttraumatic stress disorder (PTSD), that are associated with suicide-related hospitalizations. In this study, we examined if individuals admitted for suicide-related concerns were more likely than those admitted for other reasons to have elevated PTSD symptoms or a probable PTSD diagnosis. We also examined the moderating role of impulsivity. Participants were 188 trauma-exposed adult psychiatric inpatients (M [SD]age = 33.6 y [11.7 y], 63.3% male, 46.3% white). We used the Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, Beck Scale for Suicide Ideation, and Barratt Impulsiveness Scale-11 to assess trauma exposure, PTSD symptoms, suicidal ideation severity, and impulsivity, respectively. We controlled for trauma load, number of psychiatric diagnoses, and comorbid depressive and substance use disorders. Patients admitted for suicide-related concerns (55.3%; n = 104), compared with those admitted for other reasons (44.7%; n = 84), had more severe PTSD symptoms, corresponding to medium-to-large effect sizes; associations were stronger at higher levels of impulsivity. Additionally, patients admitted for suicide-related concerns were nearly four times more likely than their counterparts to screen positive for a provisional PTSD diagnosis. Among the subset of individuals admitted for suicide-related concerns, greater PTSD symptoms were associated with more severe suicidal ideation. In sum, PTSD symptoms are elevated among psychiatric inpatients admitted for suicide-related concerns, and among this subgroup, greater PTSD symptom severity covaries with suicidal ideation severity. Screening for and treating PTSD, and attending to cooccurring impulsivity, in psychiatric inpatients may reduce suicide risk.
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Affiliation(s)
- Ian H Stanley
- Department of Psychiatry, Boston University School of Medicine, USA; National Center for PTSD, VA Boston Healthcare System, USA.
| | - Brian P Marx
- Department of Psychiatry, Boston University School of Medicine, USA; National Center for PTSD, VA Boston Healthcare System, USA
| | - Terence M Keane
- Department of Psychiatry, Boston University School of Medicine, USA; National Center for PTSD, VA Boston Healthcare System, USA
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Bjork JM, Reisweber J, Burchett JR, Plonski PE, Konova AB, Lopez-Guzman S, Dismuke-Greer CE. Impulsivity and Medical Care Utilization in Veterans Treated for Substance Use Disorder. Subst Use Misuse 2021; 56:1741-1751. [PMID: 34328052 DOI: 10.1080/10826084.2021.1949603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Impulsivity has been defined by acting rashly during positive mood states (positive urgency; PU) or negative mood states (negative urgency; NU) and by excessive de-valuation of deferred rewards. These behaviors reflect a "live in the now" mentality that is not only characteristic of many individuals with severe substance use disorder (SUD) but also impedes medical treatment compliance and could result in repeated hospitalizations or other poor health outcomes. Purpose/objectives: We sought preliminary evidence that impulsivity may relate to adverse health outcomes in the veteran population. Impulsivity measured in 90 veterans receiving inpatient or outpatient SUD care at a Veterans Affairs Medical Center was related to histories of inpatient/residential care costs, based on VA Health Economics Resource Center data. Results: We found that positive urgency, lack of persistence and lack of premeditation, but not sensation-seeking or preference for immediate or risky rewards, were significantly higher in veterans with a history of one or more admissions for VA-based inpatient or residential health care that either included (n = 30) or did not include (n = 29) an admission for SUD care. Among veterans with a history of inpatient/residential care for SUD, NU and PU, but not decision-making behavior, correlated with SUD care-related costs. Conclusions/Importance: In veterans receiving SUD care, questionnaire-assessed trait impulsivity (but not decision-making) related to greater care utilization within the VA system. This suggests that veterans with high impulsivity are at greater risk for adverse health outcomes, such that expansion of cognitive interventions to reduce impulsivity may improve their health.
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Affiliation(s)
- James M Bjork
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Jarrod Reisweber
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Jason R Burchett
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Paul E Plonski
- Hunter Holmes McGuire Veterans Affairs Medical Center, McGuire Research Institute, Richmond, Virginia, USA
| | - Anna B Konova
- Department of Psychiatry, University Behavioral Health Care, and the Brain Health Institute, Rutgers University-New Brunswick, Piscataway, NJ, USA
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Elman I, Upadhyay J, Lowen S, Karunakaran K, Albanese M, Borsook D. Mechanisms Underlying Unconscious Processing and Their Alterations in Post-traumatic Stress Disorder: Neuroimaging of Zero Monetary Outcomes Contextually Framed as "No Losses" vs. "No Gains". Front Neurosci 2020; 14:604867. [PMID: 33390889 PMCID: PMC7772193 DOI: 10.3389/fnins.2020.604867] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/24/2020] [Indexed: 11/26/2022] Open
Abstract
Although unconscious processing is a key element of mental operation, its neural correlates have not been established. Also, clinical observations suggest that unconscious processing may be involved in the pathophysiology of post-traumatic stress disorder (PTSD), but the neurobiological mechanisms underlying such impairments remain unknown. The purpose of the present study was to examine putative mechanisms underlying unconscious processing by healthy participants and to determine whether these mechanisms may be altered in PTSD patients. Twenty patients with PTSD and 27 healthy individuals were administered a validated wheel of fortune-type gambling task during functional magnetic resonance imaging (fMRI). Unconscious processing was elicited using unconscious contextual framing of the zero monetary outcomes as "no loss," "no gain" or as "neutral." Brief passive visual processing of the "no loss" vs. "no gain" contrast by healthy participants yielded bilateral frontal-, temporal- and insular cortices and striatal activations. Between-group comparison revealed smaller activity in the left anterior prefrontal-, left dorsolateral prefrontal-, right temporal- and right insular cortices and in bilateral striatum in PTSD patients with the left dorsolateral prefrontal cortex activity been more pronounced in those with greater PTSD severity. These observations implicate frontal-, temporal-, and insular cortices along with the striatum in the putative mechanisms underlying unconscious processing of the monetary outcomes. Additionally, our results support the hypothesis that PTSD is associated with primary cortical and subcortical alterations involved in the above processes and that these alterations may be related to some aspects of PTSD symptomatology.
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Affiliation(s)
- Igor Elman
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - Jaymin Upadhyay
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, United States
| | | | - Keerthana Karunakaran
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Mark Albanese
- Cambridge Health Alliance, Harvard Medical School, Cambridge, MA, United States
| | - David Borsook
- Center for Pain and the Brain, Department of Anesthesiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, United States
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Patock-Peckham JA, Belton DA, D'Ardenne K, Tein JY, Bauman DC, Infurna FJ, Sanabria F, Curtis J, Morgan-Lopez AA, McClure SM. Dimensions of childhood trauma and their direct and indirect links to PTSD, impaired control over drinking, and alcohol-related-problems. Addict Behav Rep 2020; 12:100304. [PMID: 33364313 PMCID: PMC7752722 DOI: 10.1016/j.abrep.2020.100304] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/06/2020] [Accepted: 09/17/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Post-Traumatic Stress Disorder (PTSD) develops after experiencing events that evoke fear, helplessness, or horror. The Hyperarousablity Hypothesis suggests that those with PTSD may drink more to dampen physiological reactivity. We examined the direct and indirect relationships between childhood trauma (e.g., physical-neglect, emotional-abuse, physical-abuse, sexual-abuse) versus an emotionally-supportive-family on PTSD, impaired control over drinking (IC), alcohol-use, and alcohol-related-problems. IC reflects consuming more alcohol than one originally intended. METHODS We fit a multiple-group SEM to data on 835 participants. Mediational analyses were conducted by using the (K = 20,000) bootstrap technique with confidence intervals. RESULTS Physical-neglect was directly linked to more IC among both genders. Emotional abuse was also found to be directly linked to more PTSD among both genders. Furthermore, PTSD was directly linked to more impaired control over alcohol use (IC) among both genders. Mediational analyses showed that physical-neglect was indirectly linked to more alcohol-related-problems through increased IC. Having an emotionally supportive family was directly linked to fewer PTSD symptoms among women. For both genders, emotional abuse was indirectly linked to more alcohol-related-problems through more PTSD symptoms, impaired control over alcohol use difficulties, and in turn, more alcohol-use. Sexual abuse was indirectly linked to increased alcohol-related- problems through increased PTSD symptoms and more IC, and in turn, more alcohol-use among men. CONCLUSIONS Recalled childhood trauma (sexual and emotional abuse) may contribute to PTSD symptoms and dysregulated drinking. In conclusion, our data suggest that reducing PTSD symptoms may assist individuals in regaining control over their drinking.
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Affiliation(s)
| | - Daniel A. Belton
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | | | - Jenn-Yun Tein
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - Dylan C. Bauman
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - Frank J. Infurna
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - Federico Sanabria
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | - John Curtis
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
| | | | - Samuel M. McClure
- Arizona State University, Department of Psychology, Tempe, AZ, 85287, USA
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Impulsivity as a multifactorial construct and its relationship to PTSD severity and threat sensitivity. Psychiatry Res 2020; 293:113468. [PMID: 32977054 PMCID: PMC8370776 DOI: 10.1016/j.psychres.2020.113468] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Accepted: 09/15/2020] [Indexed: 02/02/2023]
Abstract
Changes to the DSM-5's conceptualization of posttraumatic stress disorder (PTSD) highlight the importance of impulsivity within the context of PTSD-related arousal dysregulation. While the relationship between PTSD and threat sensitivity is well defined, how they relate to impulsivity remains understudied. We examined the relationship between PTSD symptom severity, threat sensitivity, and impulsivity. 124 participants completed the PTSD Checklist (PCL-C) and the Barratt Impulsiveness Scale 11th ed (BIS-11). BIS-11 items were separated to define cognitive and behavioral impulsivity subdomains. A trauma-exposed subsample of 39 participants were also exposed to no, ambiguous, and high threat conditions in a threat-enhanced acoustic startle paradigm with psychophysiological response as the outcome variable. PTSD severity was significantly associated with greater overall impulsivity and behavioral impulsivity. Greater overall impulsivity and both cognitive and behavioral impulsivity subdomains were significantly associated with psychophysiological magnitudes across threat conditions in the traumatized subsample. Our results suggest PTSD severity may linked to behavioral impulsivity and both cognitive and behavioral impulsivity are associated with threat sensitivity and hyperarousal. Assessing impulsivity within the context of PTSD, particularly in terms of its cognitive and behavioral subdomains, may provide important, clinically relevant information.
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Jin L, Dolan M, Contractor A, Weiss NH, Dranger P. Relations between Emotional Expressivity Dimensions and DSM-5 PTSD Symptom Clusters in a Trauma-Exposed Community Sample. BEHAVIOUR CHANGE 2020; 37:116-129. [PMID: 33776199 PMCID: PMC7995860 DOI: 10.1017/bec.2020.7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractBackground and Objective. A growing body of literature indicates a significant contribution and role of positive and negative emotions (specifically expressivity) in post-traumatic stress disorder's (PTSD) symptomatology. The current study examined the facet-level relationships between emotional expressivity and PTSD. Specifically, we investigated which emotional expressivity dimension (impulse strength, negative emotional expressivity, and positive emotional expressivity) most strongly related to DSM-5 PTSD symptom clusters severity (intrusions, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity). Methods. The sample of 123 trauma-exposed participants seeking mental health treatment completed the PTSD Checklist for DSM-5 (PCL-5) and the Berkeley Expressivity Questionnaire (BEQ). Results. Results of multivariate multiple regression analysis indicated that only intensity of emotion and difficulty in controlling such emotions (i.e., impulse strength) was strongly related to all four PTSD symptom clusters. The valence of emotional expressivity (positive or negative) was not related to any of the PTSD symptom clusters. Conclusions. Study findings highlight the role of emotional expressivity, specifically impulse strength, in PTSD's symptomatology and may inform guidelines for emotion-focused clinical work for trauma-exposed individuals with PTSD symptoms.
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Affiliation(s)
- Ling Jin
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Megan Dolan
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Ateka Contractor
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Paula Dranger
- Counseling Services, Valparaiso University, Valparaiso, IN, USA
- Choices Counseling Services, Valparaiso, IN
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Rababah JA, Al-Hammouri MM, Drew BL. The impact of health literacy on college students' psychological disturbances and quality of life: a structural equation modeling analysis. Health Qual Life Outcomes 2020; 18:292. [PMID: 32867807 PMCID: PMC7457482 DOI: 10.1186/s12955-020-01541-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 08/24/2020] [Indexed: 11/10/2022] Open
Abstract
Background The literature regarding the effect of health literacy on college students’ psychological health and quality of life is scarce. The purpose of conducting this cross-sectional study was to examine the effect of health literacy on certain psychological disturbances (perceived stress, depressive symptoms, and impulsivity) and quality of life of college students. Methods A cross-sectional quantitative design was utilized in this study. A total of 310 four-year college students participated in this study. The students completed a demographics questionnaire as well as already established and validated measures of health literacy, perceived stress, depressive symptoms, impulsivity, and quality of life. Structural equation modeling was performed to analyze the data to explore the effect of health literacy on the psychological disturbances and quality of life. Results The results showed that health literacy has a negative effect on three psychological disturbances commonly experienced by college students; perceived stress, depressive symptoms, and impulsivity. In addition, the effect of health literacy on the quality of life was positive. Conclusion The proposed conceptual model was supported. College students’ counseling staff could use the findings to better address students’ needs pertinent to psychological health and quality of life. Future research is warranted to develop a more comprehensive model that explains the role of health literacy in determining college students’ psychological health and quality of life.
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Affiliation(s)
- Jehad A Rababah
- Adult Health Nursing Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan.
| | - Mohammed M Al-Hammouri
- Community and Mental Health Department, Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan
| | - Barbara L Drew
- College of Nursing, Kent State University, Kent, OH, USA
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12
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Kim JH, Choi JY. Influence of childhood trauma and post-traumatic stress symptoms on impulsivity: focusing on differences according to the dimensions of impulsivity. Eur J Psychotraumatol 2020; 11:1796276. [PMID: 33029332 PMCID: PMC7473132 DOI: 10.1080/20008198.2020.1796276] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Impulsivity, a trait and multidimensional construct, is associated with a wide range of impulsive behaviours. Although it is well documented that childhood trauma (CT) affects impulsivity, few studies examine whether its effects depend on particular dimensions of impulsivity and the role post-traumatic stress symptoms play in the relationship between childhood trauma and different dimensions of impulsivity. OBJECTIVE This research aims to explore the relationships between CT, PTSD, and impulsivity in a heterogeneous clinical sample. We also sought to examine whether the influence of CT on impulsivity differs across the dimensions of impulsivity. METHOD We investigated the relationships between CT, symptoms of post-traumatic stress disorder (PTSD), and five dimensions of impulsivity using a sample of 162 non-psychotic psychiatric patients without neurocognitive diagnoses. Participants completed the Childhood Trauma Questionnaire (CTQ), Impact of Event Scale - Revised (IES), and the UPPS-P Impulsive Behaviour Scale (UPPS-P). RESULTS The results of structural equation modelling showed that CT is associated with PTSD symptoms, in addition to four of the five dimensions of impulsivity in the UPPS-P:positive urgency, negative urgency, lack of premeditation, and lack of perseverance. The indirect effect of CT through PTSD symptoms was significant only for the two types of urgency. CONCLUSIONS The results of this study suggest that interventions that aim to alleviate impulsive behaviour derived from high urgency should pay particular attention to the presence of CT and PTSD symptoms.
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Affiliation(s)
- Ji Hye Kim
- Department of Psychiatry, Sanggye Paik Hospital, Inje University, Seoul, South Korea
| | - Ji Young Choi
- Department of Child Studies, Inha University, Incheon, South Korea
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Stairs DJ, Chacho NM, Wunsch C, Pipitone L, Dravid SM. Environmental enrichment increases cue-dependent freezing and behavioral despair but decreases anxiety-like behavior in rats. Pharmacol Biochem Behav 2020; 196:172979. [PMID: 32593789 DOI: 10.1016/j.pbb.2020.172979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 06/17/2020] [Accepted: 06/24/2020] [Indexed: 10/24/2022]
Abstract
While post-traumatic stress disorder (PTSD) can develop after exposure to severe traumatic events, data have shown that individuals with high sensation-seeking personality traits are less prone to developing PTSD. The current study used the rodent environmental enrichment preclinical model of sensation-seeking to determine if similar sensation seeking effects in animal models of PTSD-like behaviors were found. The study also attempted to determine whether environmental enrichment altered the effects of midazolam on these PTSD-like behaviors. Male Sprague-Dawley rats were received at postnatal day (PND) 21 and placed into either an enriched (EC), isolated (IC), or social (SC) condition. Beginning on PND 51, the animals underwent 3 fear conditioning trials where a tone was paired with a 2 s 0.7 mA footshock. Twenty-four hours later, rats were given 15-min i.p. pretreatments of 0, 0.5, or 1.5 mg/kg midazolam, before being placed into fear conditioning chambers for a test of expression of conditioned fear response in a novel context. Following fear conditioning, rodents were also tested in the elevated plus maze (EPM) and the forced swim task (FST) following pretreatments of midazolam. Results from fear conditioning indicated IC rats showed a significant decrease in freezing during acquisition compared to EC and SC rats. Also, during expression, IC rats had lower freezing following saline injections and 0.5 mg/kg midazolam but were equal in time freezing to EC and SC rats following 1.5 mg/kg midazolam. In the EPM there were no effects of midazolam and IC rats showed decreased time spent in the open arms compared to EC and SC rats. In FST, IC rats spent less time immobile and more time swimming compared to EC and SC rats. Overall, results suggest that the rodent environmental enrichment model of sensation-seeking seems to parallel the effects of sensation-seeking on likelihood of PTSD symptoms seen in humans.
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Affiliation(s)
- Dustin J Stairs
- Creighton University Department of Psychological Science, United States of America.
| | - Nicole M Chacho
- Creighton University Department of Psychological Science, United States of America
| | - Connor Wunsch
- Creighton University Department of Psychological Science, United States of America
| | - Lauren Pipitone
- Creighton University Department of Psychological Science, United States of America
| | - Shashank M Dravid
- Creighton University Department of Pharmacology and Neuroscience, United States of America
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14
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Piggott VM, Lloyd SC, Perrine SA, Conti AC. Chronic Intermittent Ethanol Exposure Increases Ethanol Consumption Following Traumatic Stress Exposure in Mice. Front Behav Neurosci 2020; 14:114. [PMID: 32694985 PMCID: PMC7338656 DOI: 10.3389/fnbeh.2020.00114] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/08/2020] [Indexed: 01/15/2023] Open
Abstract
Individuals with post-traumatic stress disorder (PTSD) often use alcohol to cope with their distress. This aberrant use of alcohol often develops into alcohol use disorder (AUD) leading to high rates of PTSD-AUD co-occurrence. Individuals with comorbid PTSD-AUD have more intense alcohol cravings and increased relapse rates during withdrawal than those with AUD alone. Also, individuals with PTSD or AUD alone often show similar psychological behaviors, such as impulsivity and anhedonia. Extensive clinical studies on the behavioral effects of PTSD-AUD comorbidity, namely alcohol use, have been performed. However, these effects have not been well studied or mechanistically explored in animal models. Therefore, the present study evaluated the effects of traumatic stress comorbid with alcohol exposures on ethanol intake, impulsivity, and anhedonia in mice. Adult male C57Bl/6 mice were first exposed to either mouse single-prolonged stress (mSPS), an animal model that has been validated for characteristics akin to PTSD symptoms, or control conditions. Baseline two-bottle choice ethanol consumption and preference tests were conducted after a 7-day isolation period, as part of the mSPS exposure. Next, mice were exposed to air or chronic intermittent ethanol (CIE), a vapor-induced ethanol dependence and withdrawal model, for 4 weeks. Two-bottle choice ethanol drinking was used to measure dependence-induced ethanol consumption and preference during periods intervening CIE cycles. The novelty suppressed feeding (NSF) test was used to evaluate impulsivity and anhedonia behaviors 48 h after mSPS and/or repeated CIE exposure. Results showed that, compared to control conditions, mSPS did not affect baseline ethanol consumption and preference. However, mSPS-CIE mice increased Post-CIE ethanol consumption compared to Control-Air mice. Mice exposed to mSPS had a shorter latency to feed during the NSF, whereas CIE-exposed mice consumed less palatable food reward in their home cage after the NSF. These results demonstrate that mice exposed to both mSPS and CIE are more vulnerable to ethanol withdrawal effects, and those exposed to mSPS have increased impulsivity, while CIE exposure increases anhedonia. Future studies to examine the relationship between behavioral outcomes and the molecular mechanisms in the brain after PTSD-AUD are warranted.
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Affiliation(s)
- Veronica M Piggott
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI, United States.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Scott C Lloyd
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI, United States.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Shane A Perrine
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI, United States.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
| | - Alana C Conti
- Research & Development Service, John D. Dingell VA Medical Center, Detroit, MI, United States.,Department of Neurosurgery, Wayne State University School of Medicine, Detroit, MI, United States.,Department of Psychiatry and Behavioral Neurosciences, Wayne State University School of Medicine, Detroit, MI, United States
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15
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Grubbs JB, Chapman H. Predicting Gambling Situations: The Roles of Impulsivity, Substance Use, and Post-Traumatic Stress. SUBSTANCE ABUSE-RESEARCH AND TREATMENT 2019; 13:1178221819852641. [PMID: 31258327 PMCID: PMC6591666 DOI: 10.1177/1178221819852641] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Accepted: 05/02/2019] [Indexed: 12/04/2022]
Abstract
Gambling disorder and symptoms of post-traumatic stress are highly comorbid.
Numerous studies suggest that the presence of one (either disordered gambling or
post-traumatic stress) substantially increases the odds of later developing the
other. However, little is known about the etiological links between these two
domains or the nuances of the comorbidity. Past research has suggested that
symptoms of post-traumatic stress might be related to unique motivations for and
beliefs about gambling. The present work sought to examine whether or not
symptoms of post-traumatic stress might also be related to specific situational
vulnerabilities to gambling behaviors. Using a large cross-sectional sample of
Internet-using adults in the United States who were primarily recreational
gamblers (N = 743; 46% men, Mage = 36.0, SD = 11.1),
as well as an inpatient sample of US Armed Forces veterans seeking treatment for
gambling disorder (N = 332, 80% men, Mage = 53.5,
SD = 11.5), the present work tested whether or not symptoms of post-traumatic
stress were uniquely related to a variety of gambling situations. Results in
both samples revealed that even when controlling for potentially confounding
variables (eg, substance use and trait impulsivity), symptoms of post-traumatic
stress were uniquely related to gambling in response to negative affect,
gambling in response to social pressure, and gambling due to a need for
excitement. These findings are consistent with recent work suggesting that
individuals with post-traumatic stress symptoms are more likely to engage in
gambling behaviors for unique reasons that differ from gamblers without such
symptoms.
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Affiliation(s)
- Joshua B Grubbs
- Department of Psychology, Bowling Green State University, Bowling Green, OH, USA
| | - Heather Chapman
- Gambling Treatment Program, Louis Stokes Cleveland VA Medical Center, Cleveland, OH, USA
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16
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Squillace Louhau M, Picón-Janeiro J, Mazzei N, Villar A, Azzollini S. Neuropsychological Profiles of Three Subtypes of Impulsivity in the General Population: A Young Adults Study. Int J Psychol Res (Medellin) 2019; 12:28-40. [PMID: 32612785 PMCID: PMC7110171 DOI: 10.21500/20112084.3648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The impulsivity construct has been investigated in the psychological literature as both a personality factor and a manifestation of the cognitive functioning of individuals. In addition, an increasing number of studies have shown that impulsivity is not a unitary concept and that it must be conceived of as several subtypes. We investigated whether a self-report test of three types of impulsivity could be a good predictor of cognitive functioning in healthy individuals. The sample was composed of 230 subjects (65% women) with a mean age of 28.4 years (SD = 13.6 years) from the general population of the Autonomous City of Buenos Aires, Argentina. The sample was evaluated using the Questionnaire on Compulsive Urgency, Sensation Seeking, and Impulsive Improvidence (CUBI-18; Squillace Louhau, & Picón Janerio, 2019), which measures three impulsivity subtypes. A battery of neuropsychological tests was administered to measure not only executive-attentional functioning, verbal and non-verbal fluency, and speed of processing, but also strategies in the decision-making process. The results showed a differential profile of the three subtypes of impulsivity. Compulsive Urgency was associated with greater executive- attentional difficulties, Impulsive Improvidence with lower fluency in processing nonverbal information, and Sensation Seeking with better general cognitive performance and risk-taking during decision-making.
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Affiliation(s)
- Mario Squillace Louhau
- . Universidad de Buenos Aires, Argentina.Universidad de Buenos AiresUniversidad de Buenos AiresArgentina
- . Instituto de Investigación de la Universidad del Salvador, Argentina.Universidad del SalvadorUniversidad del SalvadorArgentina
- . Pontificia Universidad Católica Argentina.Pontificia Universidad Católica ArgentinaPontificia Universidad CatólicaArgentina
- . Universidad de la Defensa Nacional, FE, Centro de Investigaciones Sociales y Humanas para la Defensa, Argentina.Universidad de la Defensa NacionalArgentina
- . Hospital Universitario Austral, Argentina.Hospital Universitario AustralArgentina
- Corresponding author:
| | - Jimena Picón-Janeiro
- . Universidad de Buenos Aires, Argentina.Universidad de Buenos AiresUniversidad de Buenos AiresArgentina
- . Consejo Nacional de Investigaciones Científicas y Técnicas, Argentina.Consejo Nacional de Investigaciones Científicas y TécnicasConsejo Nacional de Investigaciones Científicas y TécnicasArgentina
| | - Nicolás Mazzei
- . Instituto de Investigación de la Universidad del Salvador, Argentina.Universidad del SalvadorUniversidad del SalvadorArgentina
| | - Alejandra Villar
- . Instituto de Investigación de la Universidad del Salvador, Argentina.Universidad del SalvadorUniversidad del SalvadorArgentina
| | - Susana Azzollini
- . Universidad de Buenos Aires, Argentina.Universidad de Buenos AiresUniversidad de Buenos AiresArgentina
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17
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Ross J, Murphy D, Armour C. A network analysis of DSM-5 posttraumatic stress disorder and functional impairment in UK treatment-seeking veterans. J Anxiety Disord 2018; 57:7-15. [PMID: 29886306 DOI: 10.1016/j.janxdis.2018.05.007] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 05/10/2018] [Accepted: 05/26/2018] [Indexed: 12/21/2022]
Abstract
Network analysis is a relatively new methodology for studying psychological disorders. It focuses on the associations between individual symptoms which are hypothesized to mutually interact with each other. The current study represents the first network analysis conducted with treatment-seeking military veterans in UK. The study aimed to examine the network structure of posttraumatic stress disorder (PTSD) symptoms and four domains of functional impairment by identifying the most central (i.e., important) symptoms of PTSD and by identifying those symptoms of PTSD that are related to functional impairment. Participants were 331 military veterans with probable PTSD. In the first step, a network of PTSD symptoms based on the PTSD Checklist for DSM-5 was estimated. In the second step, functional impairment items were added to the network. The most central symptoms of PTSD were recurrent thoughts, nightmares, negative emotional state, detachment and exaggerated startle response. Functional impairment was related to a number of different PTSD symptoms. Impairments in close relationships were associated primarily with the negative alterations in cognitions and mood symptoms and impairments in home management were associated primarily with the reexperiencing symptoms. The results are discussed in relation to previous PTSD network studies and include implications for clinical practice.
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Affiliation(s)
- Jana Ross
- Psychology Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland, UK.
| | - Dominic Murphy
- Research Department, Combat Stress, Leatherhead, UK; King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK.
| | - Cherie Armour
- Psychology Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland, UK.
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18
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Evren C, Umut G, Bozkurt M, Evren B. Relationship of PTSD With impulsivity Dimensions While Controlling the Effect of Anxiety and Depression in a Sample of Inpatients With Alcohol Use Disorder. J Dual Diagn 2018; 14:40-49. [PMID: 29166213 DOI: 10.1080/15504263.2017.1404665] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The aim of the present study was to evaluate the relationship of posttraumatic stress disorder (PTSD) with impulsivity dimensions while controlling the effect of anxiety and depression in a sample of inpatients with alcohol use disorder (AUD). METHODS Participants were 190 male patients admitted to a specialized center for substance use disorders within a six month period. Participants were evaluated with the State-Trait Anxiety Inventory (STAI), Beck Depression Inventory (BDI), the Short Form Barratt Impulsiveness Scale (BIS-11-SF), the Traumatic Experiences Checklist, and PTSD Checklist-Civilian version. RESULTS Age was lower in the group with PTSD (n = 63, 33.2%) than the group without PTSD (n = 127, 66.8%). Duration of education, marital, and employment status did not differ between the groups. STAI, BDI, and BIS-11-SF scores were higher in the group with PTSD. Trait anxiety, depression, and impulsivity predicted high PTSD risk in a logistic regression model. Same variables predicted the severity of PTSD symptoms in a linear regression. Among dimensions of impulsivity attentional component was the only predictor of PTSD symptoms severity, not motor or nonplanning impulsivity. CONCLUSIONS These findings suggest that the PTSD may be related to impulsivity, particularly attentional impulsivity, even after controlling anxiety and depression among inpatients with AUD.
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Affiliation(s)
- Cuneyt Evren
- a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) , Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Gokhan Umut
- a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) , Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Muge Bozkurt
- a Research, Treatment and Training Center for Alcohol and Substance Dependence (AMATEM) , Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery , Istanbul , Turkey
| | - Bilge Evren
- b Department of Psychiatry , Baltalimani State Hospital for Muskuloskeletal Disorders , Istanbul , Turkey
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19
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Contractor AA, Caldas S, Weiss NH, Armour C. Examination of the heterogeneity in PTSD and impulsivity facets: A latent profile analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2017; 125:1-9. [PMID: 29628542 DOI: 10.1016/j.paid.2017.12.022] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The experience of traumatizing events and resulting posttraumatic stress disorder (PTSD) symptomology relates to a range of impulsive behaviors. While both PTSD and impulsivity are heterogeneous and multidimensional constructs, no research has used person-centered approaches to examine subgroups of individuals based on these response endorsements. Hence, our study examined PTSD-impulsivity typologies and their construct validity in two samples: university students (n = 412) and community participants recruited through Amazon's MTurk (n = 346). Measures included the Stressful Life Events Screening Questionnaire (PTEs), PTSD Checklist for DSM-5 (PTSD severity), UPPS Impulsive Behavior Scale (negative urgency, lack of premeditation, lack of perseverance, sensation seeking). Dimensions of Anger Reaction Scale (anger), and the Patient Health Questionnaire-9 (depression). For both samples, results of latent profile analyses indicated a best-fitting 3-class solution: High, Moderate, and Low PTSD-Negative Urgency. Negative urgency was the most distinguishing impulsivity facet. Anger and depression severity significantly predicted membership in the more severe symptomatology classes. Thus, individuals can be meaningfully categorized into three subgroups based on PTSD and impulsivity item endorsements. We provide some preliminary evidence for a negative urgency subtype of PTSD characterized by greater depression and anger regulation difficulties; and underscore addressing emotional regulation skills for these subgroup members.
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Affiliation(s)
| | - Stephanie Caldas
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Cherie Armour
- Psychology Research Institute, Ulster University, Coleraine, Northern Ireland
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20
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Contractor AA, Weiss NH, Tull MT, Elhai JD. PTSD's relation with problematic smartphone use: Mediating role of impulsivity. COMPUTERS IN HUMAN BEHAVIOR 2017. [DOI: 10.1016/j.chb.2017.05.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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21
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Contractor AA, Weiss NH, Dranger P, Ruggero C, Armour C. PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology. Psychiatry Res 2017; 252:215-222. [PMID: 28285248 PMCID: PMC5472336 DOI: 10.1016/j.psychres.2017.03.008] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2016] [Revised: 02/02/2017] [Accepted: 03/06/2017] [Indexed: 10/20/2022]
Abstract
A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment.
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Affiliation(s)
- Ateka A. Contractor
- Department of Psychology, University of North Texas, Denton, TX, USA,Corresponding author: (A.A. Contractor)
| | - Nicole H. Weiss
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Paula Dranger
- Counseling Services, Valparaiso University, Valparaiso, IN, USA,Choices Counseling Services, Valparaiso, IN
| | - Camilo Ruggero
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Cherie Armour
- Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK
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22
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Brown S, Mitchell TB, Fite PJ, Bortolato M. Impulsivity as a moderator of the associations between child maltreatment types and body mass index. CHILD ABUSE & NEGLECT 2017; 67:137-146. [PMID: 28262605 PMCID: PMC5436933 DOI: 10.1016/j.chiabu.2017.02.029] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2016] [Revised: 12/21/2016] [Accepted: 02/19/2017] [Indexed: 06/03/2023]
Abstract
Child maltreatment has emerged as an important risk factor for adult obesity (Danese & Tan, 2014; Hemmingsson et al., 2014). However, there is a need for research delineating the factors that play a role in this association. Impulsivity has been shown to be associated with both child maltreatment (Brodsky et al., 2001) and body mass index (BMI; Cortese et al., 2008; Thamotharan et al., 2013). Further, given previous research showing that adverse events interact with impulsivity to predict hazardous drinking behaviors (Fox et al., 2010), there is reason to hypothesize that child maltreatment might interact with impulsivity to predict other adverse health outcomes, such as elevated BMI. Accordingly, the current study examined whether impulsivity moderated the association between child maltreatment types (i.e., physical abuse, physical neglect, sexual abuse, emotional abuse, and emotional neglect) and BMI. The sample was comprised of 500 undergraduate students (49.6% male) between the ages of 18 and 25 years. Regression analyses suggested that maltreatment types and impulsivity were not uniquely associated with BMI. However, impulsivity moderated the association between childhood sexual abuse and adult BMI, such that BMI was highest at high levels of both sexual abuse and impulsivity. Impulsivity did not moderate the associations between the other child maltreatment types and BMI. Limitations, future directions, and clinical implications of this research are discussed.
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Affiliation(s)
- Shaquanna Brown
- Clinical Child Psychology Program and Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA.
| | - Tarrah B Mitchell
- Clinical Child Psychology Program and Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA
| | - Paula J Fite
- Clinical Child Psychology Program and Consortium for Translational Research on Aggression and Drug Abuse (ConTRADA), University of Kansas, 2009 Dole Human Development Center, 1000 Sunnyside Avenue, Lawrence, KS 66045, USA
| | - Marco Bortolato
- Department of Pharmacology and Toxicology, College of Pharmacy, University of Utah, 3916 Skaggs Hall, 30 South 2000 East, Salt Lake City, UT 84112, USA; ConTRADA, University of Kansas, USA
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23
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Contractor AA, Frankfurt SB, Weiss NH, Elhai JD. Latent-level relations between DSM-5 PTSD symptom clusters and problematic smartphone use. COMPUTERS IN HUMAN BEHAVIOR 2017; 72:170-177. [PMID: 28993716 DOI: 10.1016/j.chb.2017.02.051] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Common mental health consequences following the experience of potentially traumatic events include Posttraumatic Stress Disorder (PTSD) and addictive behaviors. Problematic smartphone use is a newer manifestation of addictive behaviors. People with anxiety severity (such as PTSD) may be at risk for problematic smartphone use as a means of coping with their symptoms. Unique to our knowledge, we assessed relations between PTSD symptom clusters and problematic smartphone use. Participants (N = 347), recruited through Amazon's Mechanical Turk (MTurk), completed measures of PTSD and smartphone addiction. Results of the Wald tests of parameter constraints indicated that problematic smartphone use was more related to PTSD's negative alterations in cognitions and mood (NACM) than to PTSD's avoidance factor, Wald χ2(1, N = 347) = 12.51, p = 0.0004; and more to PTSD's arousal compared to PTSD's avoidance factor, Wald χ2(1, N = 347) = 14.89, p = 0.0001. Results indicate that problematic smartphone use is most associated with negative affect and arousal among trauma-exposed individuals. Implications include the need to clinically assess problematic smartphone use among trauma-exposed individuals presenting with higher NACM and arousal severity; and targeting NACM and arousal symptoms to mitigate the effects of problematic smartphone use.
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Affiliation(s)
| | - Sheila B Frankfurt
- VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System, Waco, TX, USA.,Texas A&M Health Science Center, College Station, TX, USA
| | - Nicole H Weiss
- Department of Psychiatry, Yale University School of Medicine, West Haven, CT, USA
| | - Jon D Elhai
- Department of Psychology and Psychiatry, University of Toledo, Toledo, OH, USA
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