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Toutountzidis D, Gale TM, Irvine K, Sharma S, Laws KR. Childhood trauma and schizotypy in non-clinical samples: A systematic review and meta-analysis. PLoS One 2022; 17:e0270494. [PMID: 35767584 PMCID: PMC9242513 DOI: 10.1371/journal.pone.0270494] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 06/10/2022] [Indexed: 01/14/2023] Open
Abstract
The association of early life adversities and psychosis symptoms is well documented in clinical populations; however, whether this relationship also extends into subclinical psychosis remains unclear. In particular, are early life adversities associated with increased levels of schizotypal personality traits in non-clinical samples? We conducted a systematic review and meta-analysis of associations between early life adversities and psychometrically defined schizotypal traits in non-clinical samples. The review followed PRISMA guidelines. The search using PubMed, Web of Science and EBSCO databases identified 1,609 articles in total. Twenty-five studies (N = 15,253 participants) met eligibility criteria for the review. An assessment of study quality showed that fewer than half of all studies were rated as methodologically robust. Meta-analyses showed that all forms of childhood abuse (emotional, physical and sexual) and neglect (emotional and physical) were significantly associated with psychometric schizotypy. The association of schizotypy traits with childhood emotional abuse (r = .33: 95%CI .30 to .37) was significantly larger than for all other form of abuse or neglect. Meta-regression analyses showed that the physical abuse-schizotypy relationship was stronger in samples with more women participants; and the sexual abuse-schizotypy relationship was stronger in younger samples. The current review identifies a dose-response relationship between all forms of abuse/neglect and schizotypy scores in non-clinical samples; however, a stronger association emerged for emotional abuse. More research is required to address the relationship of trauma types and specific symptom types. Future research should also address the under-representation of men.
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Affiliation(s)
- Diamantis Toutountzidis
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- * E-mail:
| | - Tim M. Gale
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
- Research and Development Department, Hertfordshire Partnership NHS Foundation Trust, Hatfield, United Kingdom
| | - Karen Irvine
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Shivani Sharma
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
| | - Keith R. Laws
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, United Kingdom
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2
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Lu W, Yanos PT, Waynor W, Jia Y, Siriram A, Leong A, Gill K, Mueser KT. Psychometric properties of post-traumatic stress disorder (PTSD) checklist for DSM-5 in persons with serious mental illness. Eur J Psychotraumatol 2022; 13:2038924. [PMID: 35251532 PMCID: PMC8890571 DOI: 10.1080/20008198.2022.2038924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND PCL-5 is a self-report measure consisting of 20 items that are used to assess the symptoms of Post-Traumatic Stress Disorder (PTSD) according to the DSM-5. OBJECTIVE This study evaluated the factor structure of the Post-Traumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) in people with serious mental illness. METHOD The sample in Study 1 included 536 participants with serious mental illness who were receiving supported employment services through community mental health agencies or supported housing programmes. Confirmatory factor analysis assessed the fit of six different models of PTSD. RESULTS Results indicated that Armour's Hybrid 7-factor model composed of re-experiencing, avoidance, dysphoria, dysphoric arousal, anxious arousal, negative affect, anhedonia, and externalizing behaviours demonstrated the best fit. Study 2 found support for convergent validity for PCL-5 among 132 participants who met criteria for PTSD. CONCLUSION Findings provide support for the psychometric properties of the PCL-5 and the conceptualization of the 7-factor hybrid model and the 4-factor DSM-5 model of PTSD among persons living with serious mental illness.
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Affiliation(s)
- Weili Lu
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
| | | | - William Waynor
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
| | - Yuane Jia
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
| | - Amanda Siriram
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
| | - Alyssa Leong
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
| | - Kenneth Gill
- Department of Psychiatric Rehabilitation and Counseling Professions, Rutgers University, Piscataway, NJ, USA
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3
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Gulati NK, Blayney JA, Jaffe AE, Kaysen D, Stappenbeck CA. A formative evaluation of a web-based intervention for women with a sexual assault history and heavy alcohol use. Psychol Trauma 2021; 13:825-834. [PMID: 33630636 DOI: 10.1037/tra0000917] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Sexual assault (SA) among college women is widespread and is associated with negative consequences including heavy drinking. However, women with SA histories are rarely the target of alcohol interventions, and existing alcohol interventions do not address the distal factors that contribute to heavy drinking in this group, such as emotion regulation and distress tolerance. The goal of this study was to evaluate a newly developed web-based alcohol intervention targeting college women with SA histories. METHOD Heavy-drinking college women with SA histories (N = 21) reviewed a series of brief web-based alcohol reduction and regulatory (i.e., emotion regulation, distress tolerance) skill modules and provided feedback on each module. RESULTS Directed content analysis of open-ended survey responses resulted in three themes: intervention content (i.e., what was said in the intervention), intervention delivery (i.e., the look and feel of the intervention), and areas for improvement (i.e., how to enhance the intervention). Quantitative ratings indicated that participants found skill modules moderately relevant and engaging, and qualitative themes and subthemes highlighted important areas for improvement. CONCLUSIONS Incorporating user feedback early in the intervention development process provides critical information for content and delivery modifications that may enhance the target population's engagement and satisfaction with the final product. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | - Jessica A Blayney
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Anna E Jaffe
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, Stanford University
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4
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Zhao Q, Sun X, Xie F, Chen B, Wang L, Hu L, Dai Q. Impact of COVID-19 on psychological wellbeing. Int J Clin Health Psychol 2021; 21:100252. [PMID: 34429728 PMCID: PMC8350012 DOI: 10.1016/j.ijchp.2021.100252] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/11/2021] [Indexed: 11/16/2022] Open
Abstract
This cross-sectional study aims to record post-traumatic stress (PTS) and post-traumatic growth (PTG) of the general population of China during the first wave of COVID-19 spread. Method: An online survey was distributed in China during February and March 2020 to record the general population's PTS (using the Post-traumatic Stress Disorder Checklist-Civilian Version, PCL-C) and PTG (using the Post-traumatic Growth Inventory, PTGI) due to COVID-19. Confirmatory Factor Analyses (CFAs) and a Two-Part Model (TPM) of regression analysis were conducted. Results: In total, 29,118 Chinese participants completed the survey (54.20% were in their 20s, 68% were males, and 60.30% had a university education). CFA results illustrated that bifactor models described the Chinese psychometric traits of PTS and PTG over the default models. Results of TPM suggested that female, low-educated, and middle-aged individuals were more vulnerable to PTS. Remarkably, mutual and positive correlations between the PTS and the PTG, though small in statistics, were observed through regression analyses. Conclusions: The current results presented new best-fit structural models, potential predictors, and valuable baseline information on the PTS and the PTG of the Chinese population in the context of COVID-19.
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Affiliation(s)
- Qing Zhao
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Nursing Psychology, Army Medical University, Chongqing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiaoxiao Sun
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Fei Xie
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Beijing Chen
- Department of Nursing Psychology, Army Medical University, Chongqing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Hu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China.,Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Qin Dai
- Department of Nursing Psychology, Army Medical University, Chongqing, China.,Institute for Brain and Psychological Sciences, Sichuan Normal University, Chengdu, China
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5
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Hetzel-Riggin MD, Landers K, Hinton S, Heukeshoven H. Caught by Connections: The Mediating Roles of Social and Community Support after Interpersonal Violence. Community Ment Health J 2021; 57:1052-1064. [PMID: 33125635 DOI: 10.1007/s10597-020-00732-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022]
Abstract
The purpose of the present study was to examine the potential mediating roles of different sources of social support and sense of community on the relationship between interpersonal violence and mental health outcomes, negative posttraumatic cognitions, and posttraumatic growth. Participants (n = 459) completed an online survey. Interpersonal violence had a significant, direct effect on all posttraumatic outcomes. Support from significant others mediated the relationship between interpersonal violence and posttraumatic stress. Both support from family and a negative sense of community mediated the relationship between interpersonal violence and posttraumatic cognitions, while social support from friends and family and a positive sense of community mediated the relationship between interpersonal violence and posttraumatic growth. The results suggest that posttraumatic distress and growth may be impacted by different connection sources.
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Affiliation(s)
| | - Kameron Landers
- School of Humanities and Social Sciences, Penn State Behrend, Erie, PA, USA
| | - Sinara Hinton
- School of Humanities and Social Sciences, Penn State Behrend, Erie, PA, USA
| | - Hannah Heukeshoven
- School of Humanities and Social Sciences, Penn State Behrend, Erie, PA, USA
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6
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Kimbrel NA, Beckham JC, Calhoun PS, DeBeer BB, Keane TM, Lee DJ, Marx BP, Meyer EC, Morissette SB, Elbogen EB. Development and validation of the Durham Risk Score for estimating suicide attempt risk: A prospective cohort analysis. PLoS Med 2021; 18:e1003713. [PMID: 34351894 PMCID: PMC8341885 DOI: 10.1371/journal.pmed.1003713] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/23/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Worldwide, nearly 800,000 individuals die by suicide each year; however, longitudinal prediction of suicide attempts remains a major challenge within the field of psychiatry. The objective of the present research was to develop and evaluate an evidence-based suicide attempt risk checklist [i.e., the Durham Risk Score (DRS)] to aid clinicians in the identification of individuals at risk for attempting suicide in the future. METHODS AND FINDINGS Three prospective cohort studies, including a population-based study from the United States [i.e., the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) study] as well as 2 smaller US veteran cohorts [i.e., the Assessing and Reducing Post-Deployment Violence Risk (REHAB) and the Veterans After-Discharge Longitudinal Registry (VALOR) studies], were used to develop and validate the DRS. From a total sample size of 35,654 participants, 17,630 participants were selected to develop the checklist, whereas the remaining participants (N = 18,024) were used to validate it. The main outcome measure was future suicide attempts (i.e., actual suicide attempts that occurred after the baseline assessment during the 1- to 3-year follow-up period). Measure development began with a review of the extant literature to identify potential variables that had substantial empirical support as longitudinal predictors of suicide attempts and deaths. Next, receiver operating characteristic (ROC) curve analysis was utilized to identify variables from the literature review that uniquely contributed to the longitudinal prediction of suicide attempts in the development cohorts. We observed that the DRS was a robust prospective predictor of future suicide attempts in both the combined development (area under the curve [AUC] = 0.91) and validation (AUC = 0.92) cohorts. A concentration of risk analysis found that across all 35,654 participants, 82% of prospective suicide attempts occurred among individuals in the top 15% of DRS scores, whereas 27% occurred in the top 1%. The DRS also performed well among important subgroups, including women (AUC = 0.91), men (AUC = 0.93), Black (AUC = 0.92), White (AUC = 0.93), Hispanic (AUC = 0.89), veterans (AUC = 0.91), lower-income individuals (AUC = 0.90), younger adults (AUC = 0.88), and lesbian, gay, bisexual, transgender, and queer or questioning (LGBTQ) individuals (AUC = 0.88). The primary limitation of the present study was its its reliance on secondary data analyses to develop and validate the risk score. CONCLUSIONS In this study, we observed that the DRS was a strong predictor of future suicide attempts in both the combined development (AUC = 0.91) and validation (AUC = 0.92) cohorts. It also demonstrated good utility in many important subgroups, including women, men, Black, White, Hispanic, veterans, lower-income individuals, younger adults, and LGBTQ individuals. We further observed that 82% of prospective suicide attempts occurred among individuals in the top 15% of DRS scores, whereas 27% occurred in the top 1%. Taken together, these findings suggest that the DRS represents a significant advancement in suicide risk prediction over traditional clinical assessment approaches. While more work is needed to independently validate the DRS in prospective studies and to identify the optimal methods to assess the constructs used to calculate the score, our findings suggest that the DRS is a promising new tool that has the potential to significantly enhance clinicians' ability to identify individuals at risk for attempting suicide in the future.
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Affiliation(s)
- Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, United States of America
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Patrick S. Calhoun
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, United States of America
- VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
| | - Bryann B. DeBeer
- Rocky Mountain Mental Illness Research, Education, and Clinical Center, Denver, Colorado, United States of America
| | - Terence M. Keane
- National Center for PTSD, Boston, Massachusetts, United States of America
- VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Daniel J. Lee
- National Center for PTSD, Boston, Massachusetts, United States of America
- VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Brian P. Marx
- National Center for PTSD, Boston, Massachusetts, United States of America
- VA Boston Healthcare System, Boston, Massachusetts, United States of America
- Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Eric C. Meyer
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Sandra B. Morissette
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Eric B. Elbogen
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, United States of America
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, United States of America
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina, United States of America
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7
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Dong GC, Li M. Potential Traumatic Events through the Life Cycle in an Immigrant Population. Geriatrics (Basel) 2021; 6:geriatrics6020039. [PMID: 33917656 PMCID: PMC8167569 DOI: 10.3390/geriatrics6020039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/30/2021] [Accepted: 03/30/2021] [Indexed: 12/05/2022] Open
Abstract
Existing studies on traumatic events focused on children, while it has been understudied in older adults. This study aims to examine prevalence, frequency, and severity of life events in older Chinese Americans. The data were drawn from the Population Study of Chinese Elderly (PINE) in 2017–2019. Twenty life events were evaluated, including natural disasters, personal traumatic events, and historical events. Among 3125 participants, the mean age was 75.33 (standard deviation (SD) = 8.22) with 61.06% female. Cultural Revolution (73.27%) has the highest prevalence. A total of 1819 (58.39%) participants reported typhoon and experienced multiple times. Falsely accused of crime was reported as the most severe event. Women were more likely to report family-related life events. Those with higher education were more likely to report personal traumatic events. This study is among the first to profile life events in older Chinese Americans. Age cohorts, gender roles, and socioeconomic status shape individuals’ exposure to life events. This study could help identify which vulnerable groups have high risks of exposure to traumatic events.
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Affiliation(s)
- Gabriella C. Dong
- Princeton High School, Princeton, NJ 08540, USA
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA;
- Correspondence:
| | - Mengting Li
- Institute for Health, Health Care Policy and Aging Research, Rutgers, The State University of New Jersey, New Brunswick, NJ 08901, USA;
- School of Nursing, Rutgers, The State University of New Jersey, Newark, NJ 07102, USA
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Perizzolo Pointet VC, Moser DA, Vital M, Rusconi Serpa S, Todorov A, Schechter DS. Violence Exposure Is Associated With Atypical Appraisal of Threat Among Women: An EEG Study. Front Psychol 2021; 11:576852. [PMID: 33510667 PMCID: PMC7835125 DOI: 10.3389/fpsyg.2020.576852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 11/23/2020] [Indexed: 11/13/2022] Open
Abstract
Introduction The present study investigates the association of lifetime interpersonal violence (IPV) exposure, related posttraumatic stress disorder (IPV-PTSD), and appraisal of the degree of threat posed by facial avatars. Methods We recorded self-rated responses and high-density electroencephalography (HD-EEG) among women, 16 of whom with lifetime IPV-PTSD and 14 with no PTSD, during a face-evaluation task that displayed male face avatars varying in their degree of threat as rated along dimensions of dominance and trustworthiness. Results The study found a significant association between lifetime IPV exposure, under-estimation of dominance, and over-estimation of trustworthiness. Characterization of EEG microstates supported that lifetime IPV-PTSD modulates emotional appraisal, specifically in encoding and decoding processing associated with N170 and LPP evoked potentials. EEG source localization demonstrated an overactivation of the limbic system, in particular the parahippocampal gyrus, in response to non-threatening avatars. Additionally, dysfunctional involvement of attention-related processing anterior prefrontal cortex (aPFC) was found in response to relatively trustworthy avatars in IPV-PTSD individuals compared with non-PTSD controls. Discussion This study showed that IPV exposure and related PTSD modulate individuals' evaluation of facial characteristics suggesting threat. Atypical processing of these avatar characteristics was marked by group differences in brain regions linked to facial processing, emotion regulation, and memory.
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Affiliation(s)
| | - Dominik Andrea Moser
- University Service of Child and Adolescent Psychiatry, Lausanne University Medical Center, Lausanne, Switzerland.,Institute of Psychology, University of Bern, Bern, Switzerland
| | - Marylène Vital
- Department of Child and Adolescent Psychiatry, University of Geneva Hospitals, Geneva, Switzerland
| | - Sandra Rusconi Serpa
- Department of Psychology, Faculty of Psychology and Educational Science, University of Geneva, Geneva, Switzerland
| | - Alexander Todorov
- Department of Psychology, Princeton University, Princeton, NJ, United States
| | - Daniel Scott Schechter
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland.,University Service of Child and Adolescent Psychiatry, Lausanne University Medical Center, Lausanne, Switzerland.,Department of Child and Adolescent Psychiatry, New York University Langone School of Medicine, New York, NY, United States
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Abstract
BACKGROUND Alcohol use/misuse is a costly public health problem, particularly among college students in the United States. Alcohol use tends to increase during adolescence and peaks in the early/mid-20s; however, there is significant heterogeneity among alcohol use during the college years. Several studies applying a mixture modeling framework to extract latent profiles of alcohol consumption have been conducted. However, none to our knowledge has included only those exposed to trauma, a group known to be at risk for alcohol misuse. The aim of this longitudinal study (n = 1,186) was to identify profiles of alcohol consumption and their associations with demographic and trauma-related constructs. METHOD Data were collected from a larger study of college students attending a large public university. Participants in the current study were, on average, 18.46 years old at study entry, primarily female (69.6%), and of diverse racial/ethnic backgrounds (e.g., 48.8% White, 20.4% Black, 16.8% Asian). RESULTS Results suggest evidence for four latent profiles. These classes include an initially high increasing, an initially high decreasing, an initially low decreasing, and an initially low increasing, the last of which had not been found. Using analyses of variance, profile membership was associated with number of traumas, probable posttraumatic stress disorder, broad drinking motives, and trauma-specific drinking-to-cope motives. CONCLUSIONS Results suggest that drinking motives and trauma-related factors are important correlates of these latent alcohol profiles. Work clarifying the longitudinal interrelations between profile membership and these factors is needed to help inform more effective prevention and intervention efforts.
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10
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Morey RA, Garrett ME, Stevens JS, Clarke EK, Haswell CC, van Rooij SJ, Fani N, Lori A, Mirecc Workgroup VMA, Kimbrel NA, Dennis MF, Marx CE, Beckham JC, McCarthy G, Hauser MA, Ashley-Koch AE. Genetic predictors of hippocampal subfield volume in PTSD cases and trauma-exposed controls. Eur J Psychotraumatol 2020; 11:1785994. [PMID: 33029326 PMCID: PMC7473168 DOI: 10.1080/20008198.2020.1785994] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 06/02/2020] [Indexed: 12/12/2022] Open
Abstract
Behavioural, structural, and functional neuroimaging have implicated the hippocampus as a critical brain region in posttraumatic stress disorder (PTSD) pathogenesis. Recent work in a normative, primarily European, sample identified 15 unique genetic loci contributing to structural variability in six hippocampal subfield volumes. We explored the relevance of these loci in two samples (Mental Illness Research Education and Clinical Centre [MIRECC] and Grady; n = 290) of trauma-exposed individuals enriched for PTSD and of diverse ancestry. Four of the previous loci demonstrated nominal evidence of replication in the MIRECC dataset, primarily within non-Hispanic whites (NHW). One locus replicated in the Grady cohort, which was composed exclusively of non-Hispanic blacks (NHB). Our data supported genetic interactions with diagnosis of lifetime PTSD and genetic interactions with childhood trauma in the MIRECC sample, but not the Grady sample. Given the racial, diagnostic, and trauma-exposure differences with the original genome-wide association study (GWAS) report, we conducted a full GWAS in the MIRECC and Grady datasets. Interactions between genetic variants and lifetime PTSD or childhood trauma were interrogated for single nucleotide polymorphisms (SNPs) with evidence of main effects. Genetic associations surpassed false discovery rate (FDR)-correction within hippocampal subfields in fimbria, subiculum, cornu ammonis-1 (CA1), and hippocampal amygdala transition area (HATA). One association was replicated in the Grady cohort (rs12880795 in TUNAR with left (L)-HATA volume). The most significant association in the MIRECC dataset was between rs6906714 in LINC02571 and right (R)-fimbria volume (p = 5.99×10-8, q = 0.0056). Interestingly, the effect of rs6906714 on R-fimbria volume increased with exposure to childhood trauma (gene*environment [G*E] interaction p = 0.022). These preliminary results argue for G*E interactions between genetic loci with PTSD and childhood trauma on hippocampal phenotypes. Our results underscore the need for larger neuroimaging-genetic studies in PTSD, trauma, and ancestrally diverse populations.
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Affiliation(s)
- Rajendra A. Morey
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Melanie E. Garrett
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Jennifer S. Stevens
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Emily K. Clarke
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Courtney C. Haswell
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, USA
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Negar Fani
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Adriana Lori
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Nathan A. Kimbrel
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
| | - Michelle F. Dennis
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
| | - Christine E. Marx
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Jean C. Beckham
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
| | | | - Michael A. Hauser
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
| | - Allison E. Ashley-Koch
- VA Mid-Atlantic Mental Illness Research Education and Clinical Center, Durham VAMC, Durham, NC, USA
- Duke Molecular Physiology Institute, Duke University Medical Center, Durham, NC, USA
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11
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Davis A, Pala AN, Nguyen N, Robbins RN, Joska J, Gouse H, Mellins CA, Myer L, Henry M, Leu CS, Remien RH. Sociodemographic and psychosocial predictors of longitudinal antiretroviral therapy (ART) adherence among first-time ART initiators in Cape Town, South Africa. AIDS Care 2020; 33:1394-1403. [PMID: 32698680 DOI: 10.1080/09540121.2020.1798336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
First-time antiretroviral therapy (ART) initiators may be more vulnerable to poor ART adherence because they may be coping with a new HIV diagnosis, facing logistical challenges to accessing and adhering to ART for the first time, and have not yet developed support networks or the skills to support long-term adherence. We recruited 324 participants in two HIV clinics near Cape Town, South Africa. Sociodemographic/psychosocial factors were measured at baseline and self-reported adherence at the 6 month follow-up. We conducted multivariable regression to determine which baseline factors were associated with 6-month adherence. A better patient-clinic relationship score (OR: 1.08 [95% CI: 1.05-1.11]) was associated with higher adherence. A drug use problem (0.51 [0.29-0.87]), higher social isolation (0.93 [0.87-0.99]), and greater number of years living with HIV before initiating ART (0.92 [0.86-1.00]) were associated with adherence levels below 90%. Patient-clinic relationships and social support are key psycho-social factors in early adherence behavior. Reducing drug use problems through targeted screening and early intervention may improve ART adherence.
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Affiliation(s)
- Alissa Davis
- School of Social Work, Columbia University, New York, NY, USA
| | | | - Nadia Nguyen
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Reuben N Robbins
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - John Joska
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Hetta Gouse
- HIV Mental Health Research Unit, Division of Neuropsychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Claude A Mellins
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Landon Myer
- School of Public Health & Family Medicine, University of Cape Town, Cape Town, South Africa
| | - Michelle Henry
- Numeracy Centre, Centre for Higher Education Development, University of Cape Town, Cape Town, South Africa
| | - Cheng Shiun Leu
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
| | - Robert H Remien
- HIV Center for Clinical and Behavioral Studies, Columbia University and New York State Psychiatric Institute, New York, NY, USA
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12
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Curtis ME, Ryan-Gonzalez C, Blessing A, Lara-Ruiz J, Mohammed Z, Osman A. The Trauma and Suicide Potential Index-5: Psychometric Evaluation in College Samples. Arch Suicide Res 2020; 24:450-466. [PMID: 31349762 PMCID: PMC7023984 DOI: 10.1080/13811118.2019.1645067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
We provide a brief description of the development of the Trauma and Suicide Potential Index-5 (TSPI-5) and report on the psychometric properties of scores from the new instrument. The TSPI-5 is designed to assess an individual's desire to attempt suicide due to experiencing a trauma. We examined the structure of the instrument in two independent undergraduate samples. Study 1 (N = 415) examined the structure of the TSPI-5 using exploratory structural equation modeling. Study 2 (N = 538) reexamined the instrument structure using the same modeling strategy and also examined other validity estimates. Study 1 demonstrated an adequate fit to the sample data (χ2 [1, N = 415] = 215.99, p < .001, comparative fit index (CFI ) = .969, Tucker-Lewis non-normed fit index (TLI) = .939, root mean squared error of approximation (RMSEA) = .319 [90% confidence interval (CI) = .283, .356], p < .001) and suggested evidence for unidimensionality. Study 2 confirmed the unidimensionality of the TSPI-5 as shown by acceptable fit estimates to the sample data, χ2 (5, N = 538) = 80.45, p < .001, CFI = .996, TLI = .99, RMSEA = .17 (90% CI = .140, .200), p < .001. Scale reliability estimates for the TSPI-5 were good in Study 1 (omega = .94) and Study 2 (omega = .96). The TSPI-5 is a brief unidimensional instrument and its scores demonstrated good reliability and validity for assessing suicide-related behaviors due to experiencing a trauma in undergraduate samples.
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Affiliation(s)
- Megan E Curtis
- University of Texas at San Antonio, San Antonio, Texas, USA.,University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | | | | | - Jose Lara-Ruiz
- University of Texas at San Antonio, San Antonio, Texas, USA.,University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
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13
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Hawn SE, Aggen SH, Cusack SE, Dick D, Amstadter AB. Examination of a novel measure of trauma-related drinking to cope. J Clin Psychol 2020; 76:1938-1964. [PMID: 32478444 DOI: 10.1002/jclp.22972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 03/19/2020] [Accepted: 04/25/2020] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The present study sought to fill a gap in the current literature by developing a concise self-report questionnaire assessing drinking motives specific to coping with symptoms of posttraumatic stress disorder (PTSD). This new four-item questionnaire is called the Trauma Related Drinking questionnaire (TRD). METHOD Using structural equation modeling, the latent structure of the TRD items and how they relate to other variables of interest were explored among a sample of 1,896 college undergraduates from a large public university. RESULTS Broadly, we found evidence to suggest that TRD is a more specific measure of drinking to cope motives compared to the commonly used Drinking Motives Questionnaire coping subscale. Additionally, findings demonstrate support for the external validation of TRD, both with regard to PTSD and alcohol consumption and related problems. CONCLUSIONS Results support the use of TRD in future self-medication research and as a clinically useful screening tool.
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Affiliation(s)
- Sage E Hawn
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Steven H Aggen
- Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | - Shannon E Cusack
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia.,Department of Psychology, Virginia Commonwealth University, Richmond, Virginia
| | | | - Danielle Dick
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia.,Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, Virginia
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14
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Cowell W, Colicino E, Lee AG, Enlow MB, Flom JD, Berin C, Wright RO, Wright RJ. Data-driven discovery of mid-pregnancy immune markers associated with maternal lifetime stress: results from an urban pre-birth cohort. Stress 2020; 23:349-358. [PMID: 31664889 PMCID: PMC7210067 DOI: 10.1080/10253890.2019.1686612] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Changes to the maternal inflammatory milieu may be a mechanism through which maternal psychosocial stress is transmitted to the fetus. Research investigating a limited number of immune markers may miss important signals. We take a proteomics approach to investigate maternal lifetime stress and 92 biomarkers of immune system status. Participants were enrolled in an urban, dual-site (Boston, n = 301 and New York City, n = 110) pregnancy cohort. We measured maternal lifetime history of stress and trauma using the validated Life Stressor Checklist-Revised (LSC-R). We measured a panel of 92 immune-related proteins in mid-pregnancy serum using proximity extension assay technology. We leveraged the dual-site study design to perform variable selection and inference within the cohort. First, we used LASSO to select immune markers related to maternal stress among Boston mothers. Then, we performed OLS regression to examine associations between maternal stress and LASSO-selected proteins among New York City mothers. LASSO regression selected 19 immune proteins with non-null coefficients (CCL11, CCL23, CD244, CST5, CXCL1, CXCL5, CXCL10, CX3CL1, FGF-23, IL-5, IL-7, IL-10, IL-17C, MCP-2, MMP-1, SLAMF1, ST1A1, TNF-β, and TWEAK). Of these, only the chemotactic cytokine CX3CL1 (i.e. fractalkine) was significantly associated with maternal stress among the validation sample (percent change in LSC-R score per 1% increase in relative fractalkine expression: 0.74, 95% confidence interval: 0.19, 1.28). Expanding research suggests fractalkine plays an important role in many aspects of pregnancy and fetal development and is stress-sensitive. We found that maternal lifetime history of stress and trauma was significantly associated with elevated serum fractalkine levels during pregnancy.
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Affiliation(s)
- Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alison G. Lee
- Division of Pulmonary, Critical Care and Sleep Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Julie D. Flom
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cecilia Berin
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Pediatrics, Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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15
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Hill SB, Wolff JD, Bigony CE, Winternitz SR, Ressler KJ, Kaufman ML, Lebois LAM. Dissociative subtype of posttraumatic stress disorder in women in partial and residential levels of psychiatric care. J Trauma Dissociation 2020; 21:305-318. [PMID: 31607239 PMCID: PMC7138694 DOI: 10.1080/15299732.2019.1678214] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The dissociative subtype of posttraumatic stress disorder (PTSD) is estimated to characterize about 12-30% of those with PTSD. Some research links this subtype with increased severity of PTSD symptoms compared to samples with "classic" PTSD. However, prevalence and severity rates reported in the literature have varied. One possible explanation for these discrepancies could be related to where the populations were sampled. Therefore, we investigated whether these differences are still observed when holding level of care constant. We collected data from 104 women at a partial and residential psychiatric hospital program focused on trauma-related disorders. Participants completed self-report questionnaires assessing trauma exposure, symptoms and provisional diagnosis of PTSD, trauma-related thoughts and beliefs, and feelings of shame. All participants reported a history of childhood and/or adulthood trauma exposure. Eighty-eight (85%) met criteria for PTSD, and of those, seventy-three (83%) met criteria for the dissociative subtype as assessed by the Dissociative Subtype of PTSD Scale. A series of independent t-tests revealed no significant differences between the "classic" and dissociative PTSD groups with respect to lifetime or childhood trauma exposure, posttraumatic cognitions, shame, or overall PTSD severity. Our results suggest that samples with classic PTSD and the dissociative subtype may not differ in some types of symptom severity when holding level of care constant. Importantly, however, we found at partial/residential level of care the majority of patients with PTSD were dissociative. Given the elevated prevalence rate in this sample, these findings support the need to assess dissociative symptoms, particularly in more acute psychiatric settings.
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Affiliation(s)
- Sarah B Hill
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
| | - Jonathan D Wolff
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA
| | - Cara E Bigony
- Department of Counseling Psychology, Fordham University, New York, New York, USA
| | - Sherry R Winternitz
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Kerry J Ressler
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Milissa L Kaufman
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Lauren A M Lebois
- Division of Depression and Anxiety Disorders, McLean Hospital, Belmont, Massachusetts, USA.,Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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16
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Newins AR, Glenn JJ, Wilson LC, Wilson SM, Kimbrel NA, Beckham JC, Calhoun PS. Psychological outcomes following sexual assault: Differences by sexual assault setting. Psychol Serv 2020; 18:504-511. [PMID: 32271049 DOI: 10.1037/ser0000426] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sexual assault is associated with increased psychological distress. It is possible that military sexual assault (MSA) is associated with heightened psychological distress compared to adult sexual assault that occurs pre- or postmilitary service due to the nature of the military setting. Veterans and service members (N = 3,114; 19.6% women) who participated in the Post-Deployment Mental Health Study completed self-report measures of sexual assault history, symptoms of posttraumatic stress disorder (PTSD), symptoms of depression, hazardous alcohol use, drug use, and suicidal ideation. Women who reported a history of MSA endorsed higher levels of all types of psychological distress than women who did not experience adult sexual assault. Women who reported a history of MSA also endorsed higher levels of PTSD and depression symptoms than women who experienced pre- or postmilitary adult sexual assault. Men who reported a history of adult sexual assault, regardless of setting, reported higher levels of PTSD and depression symptoms than individuals who did not experience adult sexual assault. MSA was associated with higher psychological distress than pre- or postmilitary adult sexual assault among women. Among men, distress associated with MSA was comparable to sexual assault outside the military. Women may face unique challenges when they experience sexual assault in the military, and men may face additional stigma (compared to women) when they experience sexual assault, regardless of setting. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
| | | | | | - Sarah M Wilson
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)
| | - Nathan A Kimbrel
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)
| | - Jean C Beckham
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)
| | - Patrick S Calhoun
- VA Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC)
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17
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Owais S, Faltyn M, Johnson AVD, Gabel C, Downey B, Kates N, Van Lieshout RJ. The Perinatal Mental Health of Indigenous Women: A Systematic Review and Meta-Analysis. Can J Psychiatry 2020; 65:149-163. [PMID: 31601125 PMCID: PMC7019461 DOI: 10.1177/0706743719877029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Although Indigenous women are exposed to high rates of risk factors for perinatal mental health problems, the magnitude of their risk is not known. This lack of data impedes the development of appropriate screening and treatment protocols, as well as the proper allocation of resources for Indigenous women. The objective of this systematic review and meta-analysis was to compare rates of perinatal mental health problems among Indigenous and non-Indigenous women. METHODS We searched Medline, EMBASE, PsycINFO, CINAHL, and Web of Science from their inceptions until February 2019. Studies were included if they assessed mental health in Indigenous women during pregnancy and/or up to 12 months postpartum. RESULTS Twenty-six articles met study inclusion criteria and 21 were eligible for meta-analysis. Indigenous identity was associated with higher odds of mental health problems (odds ratio [OR] 1.62; 95% confidence interval [CI], 1.25 to 2.11). Odds were higher still when analyses were restricted to problems of greater severity (OR 1.95; 95% CI, 1.21 to 3.16) and young Indigenous women (OR 1.86; 95% CI, 1.51 to 2.28). CONCLUSION Indigenous women are at increased risk of mental health problems during the perinatal period, particularly depression, anxiety, and substance misuse. However, resiliency among Indigenous women, cultural teachings, and methodological issues may be affecting estimates. Future research should utilize more representative samples, adapt and validate diagnostic and symptom measures for Indigenous groups, and engage Indigenous actors, leaders, and related allies to help improve the accuracy of estimates, as well as the well-being of Indigenous mothers, their families, and future generations. TRIAL REGISTRATION PROSPERO-CRD42018108638.
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Affiliation(s)
- Sawayra Owais
- MD/PhD Program, McMaster University, Hamilton, Ontario, Canada
| | - Mateusz Faltyn
- Arts & Science Undergraduate Program, McMaster University, Hamilton, Ontario, Canada
| | - Ashley V D Johnson
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Chelsea Gabel
- Department of Health, Aging & Society, McMaster University, Hamilton, Ontario, Canada
| | - Bernice Downey
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,School of Nursing, McMaster University, Hamilton, Ontario, Canada
| | - Nick Kates
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada.,Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ryan J Van Lieshout
- MD/PhD Program, McMaster University, Hamilton, Ontario, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
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18
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Paltell KC, Smith RL, Kansky J, Cox CM, Amstadter AB, Dick D, The Spit For Science Working Group, Salvatore JE, Berenz EC. Posttraumatic stress disorder symptoms, relationship quality, and risky alcohol use among trauma-exposed students. Addict Behav 2020; 102:106216. [PMID: 31838368 DOI: 10.1016/j.addbeh.2019.106216] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Revised: 11/04/2019] [Accepted: 11/06/2019] [Indexed: 11/22/2022]
Abstract
Individuals with posttraumatic stress disorder (PTSD) are at increased risk for alcohol use disorder (AUD), in part due to the use of alcohol as a coping strategy. High quality romantic relationships can buffer individuals against risk for psychopathology; however, no studies have evaluated romantic relationship quality in risk for PTSD-AUD in non-clinical samples. The current study examined the main and interactive effects of PTSD symptoms and romantic relationship quality on alcohol consumption (i.e., past 30-day alcohol use quantity, frequency, and binge frequency) and alcohol-related consequences in a sample of 101 college students (78.2% women) with a history of interpersonal trauma (i.e., physical/sexual assault, excluding intimate partner violence) who reported being in a romantic relationship. Relationship quality significantly moderated the association between PTSD symptom severity and alcohol use quantity (B = -0.972, p = .016) and alcohol-related consequences (B = -0.973, p = .009), such that greater PTSD symptoms were associated with greater alcohol use quantity and consequences among those low, but not high, in relationship quality. The interaction between PTSD symptom severity and relationship quality in relation to binge drinking was marginally significant (B = -0.762, p = .063), and relationship quality did not significantly moderate the association between PTSD symptom severity and alcohol use frequency. The main effect of PTSD symptom severity was significantly associated with alcohol-related consequences, but no other alcohol outcomes; the main effect of relationship quality was not associated with alcohol use outcomes or consequences. High quality romantic relationships may serve as a buffer for young adults at risk for alcohol problems.
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19
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Edwards MJ, Aybek S. Gender, Abuse, and Functional Movement Disorders: From His-story to the Future. Mov Disord Clin Pract 2020; 7:167-168. [PMID: 32071933 PMCID: PMC7011849 DOI: 10.1002/mdc3.12887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Accepted: 11/18/2019] [Indexed: 11/08/2022] Open
Affiliation(s)
- Mark J. Edwards
- Neuroscience Research CentreInstitute of Molecular and Clinical Sciences, St George's University of LondonCranmer TerraceLondonUnited Kingdom
| | - Selma Aybek
- Clinical Neurosciences, Bern University and Neurology DepartmentUniversity Hospital InselpitalBernSwitzerland
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20
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Hahm HC, Zhou L, Lee C, Maru M, Petersen JM, Kolaczyk ED. Feasibility, preliminary efficacy, and safety of a randomized clinical trial for Asian Women's Action for Resilience and Empowerment (AWARE) intervention. Am J Orthopsychiatry 2019; 89:462-474. [PMID: 31305114 DOI: 10.1037/ort0000383] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
To our knowledge, Asian Women's Action for Resilience and Empowerment (AWARE) is the first gender- and culture-specific and trauma-informed group psychotherapy intervention designed for Asian-American young women with histories of interpersonal violence and trauma and/or Post-Traumatic Stress Disorder (PTSD) diagnosis. We employed a 2-arm randomized controlled trial. Sixty-three women who met clinical criteria for trauma were randomized to the intervention (n = 32) or waitlist control (n = 31) group. We documented retention rates, preliminary efficacy for sexual risk behaviors and depressive symptoms (overall and stratified by PTSD at baseline), and safety in terms of suicidality at baseline, postintervention, and 3-month follow-up. AWARE demonstrated high retention rates, in that 87.50% of those enrolled in the program completed at least 6 out of the 8 sessions. Although there were no differences overall for sexual risk behaviors or depressive symptoms, among women with PTSD, significant reductions in depressive symptoms were observed in treatment compared to control, with an effect size of .84. Suicidal ideation and intent were reduced in both the treatment and control groups, with no attempts during the trial. AWARE is uniquely tailored to serve a pressing clinical need. These results support its feasibility and safety. A large-scale trial targeted at women with PTSD is recommended to further explore the efficacy of AWARE. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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21
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Elbogen EB, Wagner HR, Brancu M, Kimbrel NA, Naylor JC, Swinkels CM, Fairbank JA. Psychosocial Risk Factors and Other Than Honorable Military Discharge: Providing Healthcare to Previously Ineligible Veterans. Mil Med 2019; 183:e532-e538. [PMID: 29547949 DOI: 10.1093/milmed/usx128] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Revised: 11/09/2017] [Indexed: 11/14/2022] Open
Abstract
INTRODUCTION In response to a strong focus on suicide prevention for all veterans, the Department of Veterans Affairs (VA) recently revised policy to provide emergency mental healthcare for veterans who received Other Than Honorable (OTH) discharges from the military. This current study takes a preliminary step toward identifying demographic, historic, military, clinical, and social characteristics of veterans with OTH discharges. MATERIALS AND METHODS N = 1,172 Iraq/Afghanistan-era veterans were evaluated between 2005 and 2016 in the multi-site VA Mid-Atlantic Mental Illness, Research, Education and Clinical Center (MIRECC) Study of Post-Deployment Mental Health (PDMH Study). RESULTS Veterans with OTH discharges constituted 2.7% of our sample, approximating the estimated rate in the overall U.S. veteran population. Compared to veterans discharged under honorable conditions, veterans with OTH discharges were more likely to be younger and have greater odds of reporting family history of drug abuse and depression. Further, veterans with OTH discharges reported a lower level of social support and were more likely to be single, endorse more sleep problems, score higher on measures of drug misuse, have a history of incarceration, and meet diagnostic criteria for major depressive disorder. A subsequent matching analysis provided further evidence of the association between OTH discharge and two risk factors: drug misuse and incarceration. CONCLUSION These findings elucidate potential factors associated with veterans with OTH discharges, particularly substance abuse and criminal justice involvement. Results also indicate higher incidence of risk factors that often accompany suicidal ideation and should be a highlighted component of healthcare delivery to this vulnerable cohort of veterans.
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Affiliation(s)
- Eric B Elbogen
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - H Ryan Wagner
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Mira Brancu
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Nathan A Kimbrel
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Jennifer C Naylor
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | - Cindy M Swinkels
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
| | | | - John A Fairbank
- Veterans Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center (MIRECC), 508 Fulton Street, Durham VA Medical Center, Durham, VA.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC
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22
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Morey RA, Davis SL, Haswell CC, Naylor JC, Kilts JD, Szabo ST, Shampine LJ, Parke GJ, Sun D, Swanson CA, Wagner HR, Marx CE. Widespread Cortical Thickness Is Associated With Neuroactive Steroid Levels. Front Neurosci 2019; 13:1118. [PMID: 31798395 PMCID: PMC6862925 DOI: 10.3389/fnins.2019.01118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 10/03/2019] [Indexed: 12/15/2022] Open
Abstract
Background Neuroactive steroids are endogenous molecules with regenerative and neuroprotective actions. Both cortical thickness and many neuroactive steroid levels decline with age and are decreased in several neuropsychiatric disorders. However, a systematic examination of the relationship between serum neuroactive steroid levels and in vivo measures of cortical thickness in humans is lacking. Methods Peripheral serum levels of seven neuroactive steroids were assayed in United States military veterans. All (n = 143) subsequently underwent high-resolution structural MRI, followed by parcellelation of the cortical surface into 148 anatomically defined regions. Regression modeling was applied to test the association between neuroactive steroid levels and hemispheric total gray matter volume as well as region-specific cortical thickness. False discovery rate (FDR) correction was used to control for Type 1 error from multiple testing. Results Neuroactive steroid levels of allopregnanolone and pregnenolone were positively correlated with gray matter thickness in multiple regions of cingulate, parietal, and occipital association cortices (r = 0.20–0.47; p < 0.05; FDR-corrected). Conclusion Positive associations between serum neuroactive steroid levels and gray matter cortical thickness are found in multiple brain regions. If these results are confirmed, neuroactive steroid levels and cortical thickness may help in monitoring the clinical response in future intervention studies of neuroregenerative therapies.
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Affiliation(s)
- Rajendra A Morey
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.,Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | - Sarah L Davis
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Courtney C Haswell
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Jennifer C Naylor
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Jason D Kilts
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Steven T Szabo
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Larry J Shampine
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Gillian J Parke
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Delin Sun
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | - Chelsea A Swanson
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | - Henry R Wagner
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.,Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | | | - Christine E Marx
- Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham VA Medical Center, U.S. Department of Veteran Affairs, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
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He Q, Veldkamp BP, Glas CAW, van den Berg SM. Combining Text Mining of Long Constructed Responses and Item-Based Measures: A Hybrid Test Design to Screen for Posttraumatic Stress Disorder (PTSD). Front Psychol 2019; 10:2358. [PMID: 31695647 PMCID: PMC6817621 DOI: 10.3389/fpsyg.2019.02358] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 10/03/2019] [Indexed: 11/13/2022] Open
Abstract
This article introduces a new hybrid intake procedure developed for posttraumatic stress disorder (PTSD) screening, which combines an automated textual assessment of respondents’ self-narratives and item-based measures that are administered consequently. Text mining technique and item response modeling were used to analyze long constructed response (i.e., self-narratives) and responses to standardized questionnaires (i.e., multiple choices), respectively. The whole procedure is combined in a Bayesian framework where the textual assessment functions as prior information for the estimation of the PTSD latent trait. The purpose of this study is twofold: first, to investigate whether the combination model of textual analysis and item-based scaling could enhance the classification accuracy of PTSD, and second, to examine whether the standard error of estimates could be reduced through the use of the narrative as a sort of routing test. With the sample at hand, the combination model resulted in a reduction in the misclassification rate, as well as a decrease of standard error of latent trait estimation. These findings highlight the benefits of combining textual assessment and item-based measures in a psychiatric screening process. We conclude that the hybrid test design is a promising approach to increase test efficiency and is expected to be applicable in a broader scope of educational and psychological measurement in the future.
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Affiliation(s)
- Qiwei He
- Educational Testing Service, Princeton, NJ, United States
| | - Bernard P Veldkamp
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Cees A W Glas
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
| | - Stéphanie M van den Berg
- Department of Research Methodology, Measurement and Data Analysis, Faculty of Behavioural, Management and Social Sciences, University of Twente, Enschede, Netherlands
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24
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Fitzpatrick S, Dworkin ER, Zimmerman L, Javorka M, Kaysen D. Stressors and Drinking in Sexual Minority Women: The Mediating Role of Emotion Dysregulation. Psychol Sex Orientat Gend Divers 2019; 7:46-54. [PMID: 32596411 DOI: 10.1037/sgd0000351] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Sexual minority women are at elevated risk for exposure to stressors (both traumatic and discriminatory) and have higher rates of alcohol consumption and problems. The psychological mediation framework (Hatzenbuehler, 2009) suggests that both general (e.g., traumatic events to which minorities and nonminorities may be exposed) and minority-group-specific (e.g., discrimination) stressors contribute to psychopathology through mediators such as emotion dysregulation. Guided by this framework, the present study longitudinally examined the relationship between stressors and problematic drinking outcomes (i.e., binge drinking and alcohol-related problems), as mediated by emotion dysregulation, in sexual minority women (SMW). It addressed two research questions: (1) whether stressors longitudinally predict problematic drinking outcomes in SMW, as mediated by emotion dysregulation, and (2) for which specific forms of stressor (i.e., traumatic events and/or discrimination) this mediational relationship is present. Young adult women (N = 1057) who identified as lesbian or bisexual completed annual measures of daily heterosexism, traumas, and drinking outcomes for four years, and completed a measure of emotion dysregulation during the third year of data collection. We found an indirect relationship between discrimination and problematic drinking outcomes via emotion dysregulation. These findings are consistent with the psychological mediation framework (Hatzenbuehler, 2009) and suggest that SMW group-specific processes such as discrimination may be especially important in conferring risk for problem drinking via emotion dysregulation. Clinicians are advised to assess unique stressors faced by SMW and their potential contribution to problematic drinking outcomes, and to target emotion dysregulation in alcohol treatments.
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Affiliation(s)
| | - Emily R Dworkin
- Department of Psychiatry and Behavioral Sciences, University of Washington
| | - Lindsey Zimmerman
- Department of Psychiatry and Behavioral Sciences, University of Washington
- National Center for PTSD, VA Palo Alto Health Care System
| | | | - Debra Kaysen
- Department of Psychiatry and Behavioral Sciences, University of Washington
- Present Address: Department of Psychiatry and Behavioral Sciences, Stanford University
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25
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Jenzer T, Meisel SN, Blayney JA, Colder CR, Read JP. Reciprocal processes in trauma and coping: Bidirectional effects over a four-year period. Psychol Trauma 2019; 12:207-218. [PMID: 31414867 DOI: 10.1037/tra0000500] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Both trauma exposure and coping are strong predictors of mental health outcomes. There is evidence that trauma and coping are linked, with cross-sectional work suggesting that individuals with more trauma exposure show poorer coping ability (i.e., more avoidance coping, less approach coping). To date, no study has examined the temporal directionality of this association, a question with important clinical implications. METHOD Using a longitudinal data set over 4 years of college (N = 787), we examined bidirectional associations between trauma exposure and 3 coping styles (approach, avoidance, social support seeking). Our data analytic approach allowed us to examine both within-person and between-person effects, to better determine how change occurs at the individual level. Coping was assessed using the Brief Cope (Carver, 1997), and trauma exposure was assessed using the Traumatic Life Experiences Questionnaire (Kubany et al., 2000). Gender, baseline posttraumatic stress disorder symptoms, and precollege trauma were included as statistical control variables. RESULTS The between-person effects were consistent with the cross-sectional literature. Interestingly, rather than an increase in avoidance coping and trauma exposure over time, the within-person findings suggested an adaptive cycle over time, in which increased trauma exposure marginally predicted an increase in approach coping (B = .05, p = .07), and approach coping predicted decreased trauma exposure (B = -.07, p = .04). CONCLUSIONS Our study sheds new light on how coping and stressful events may impact one another across time. Findings suggest that a focus on approach-based coping skills may be an important direction for prevention efforts. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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26
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Gibbons MBC, Gallop R, Thompson D, Gaines A, Rieger A, Crits-Christoph P. Predictors of treatment attendance in cognitive and dynamic therapies for major depressive disorder delivered in a community mental health setting. J Consult Clin Psychol 2019; 87:745-755. [PMID: 31204838 DOI: 10.1037/ccp0000414] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Our goal was to evaluate treatment attendance patterns, including both treatment completion and premature termination from treatment, for 2 evidence-based psychotherapies for major depressive disorder (MDD) delivered in a community mental health setting. We explored rates of premature termination across the course of treatment as well as the factors that predicted and moderated premature termination and treatment completion. METHOD This investigation included 237 patients with MDD who participated in a noninferiority trial comparing short-term dynamic psychotherapy (DT) to cognitive therapy (CT). Patients in both conditions were offered 16 sessions of treatment and had up to 5 months to complete treatment. All patients completed an extensive self-report battery at treatment baseline as well as measures of the therapeutic alliance and opinions about treatment following Session 2. RESULTS Premature termination from both treatments was high with 27% of patients discontinuing treatment very early after only an intake session or a single treatment session. Patients in CT were significantly more likely to terminate treatment prematurely, χ²(3) = 14.35, p = .002. Baseline physical health functioning, subthreshold psychotic symptoms, Session 2 ratings of agreement on tasks, and Session 2 ratings of treatment sensibility all independently predicted premature termination of services. Trauma history significantly moderated very early termination of treatment, χ²(3) = 10.26, p = .017, with patients with high trauma histories more likely to complete DT but terminate prematurely from CT. CONCLUSIONS Very early termination from services was higher in CT compared with DT. Including techniques to improve engagement in both therapies and matching patients to treatment based on predictors/moderators may be effective ways to optimize treatment engagement. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Abstract
Experiences of humiliation, unjust hurt caused by another or anger naturally, elicit the desire to seek revenge and fantasies of revenge. The current study examined the associations between a history of traumatic events and feelings of injustice and levels of desire for revenge-seeking and fantasies of revenge. Specifically, it tested whether feelings of injustice mediated the associations between the number of past traumatic events and the desire for revenge or revenge fantasies. Based on recent studies showing that retaliatory violence is gendered, sex differences in levels of feelings of injustice, desire for revenge, and the presence of revenge fantasies were explored, as well whether participants' sex conditioned the mediation models. The results showed positive associations between feelings of injustice and the desire for revenge and revenge fantasies. The mediation model indicated that feelings of injustice mediated the associations between the number of previous traumatic events and the desire for revenge or revenge fantasies. Men had higher levels of revenge fantasies than women, whereas women tended to perceive revenge as pointless. A sex effect was found for the mediation model, which revealed significant regressed models for women but not for men. The clinical implications are discussed.
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Affiliation(s)
- Limor Goldner
- The Emili Sagol Creative Arts Therapies Research Center, University of Haifa, Haifa, Israel
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28
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Flanagan JC, Joseph JE, Nietert PJ, Back SE, McCrady BS. Design of a randomized controlled trial examining the efficacy of oxytocin to enhance alcohol behavioral couple therapy. Contemp Clin Trials 2019; 82:1-8. [PMID: 31063869 DOI: 10.1016/j.cct.2019.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/20/2019] [Accepted: 05/02/2019] [Indexed: 12/15/2022]
Abstract
Combining pharmacological interventions with evidence-based behavioral interventions may help optimize treatment outcomes for alcohol use disorder (AUD). While several effective behavioral interventions for AUD have been developed, the vast majority target individual patients, despite evidence that behavioral interventions for couples have the ability to outperform individual treatments for AUD. Alcohol Behavioral Couples Therapy (ABCT) is an evidence-based behavioral intervention for couples that has been shown to significantly reduce AUD severity as well as improve relationship functioning. Accumulating evidence suggests that the neuropeptide oxytocin has the ability to reduce alcohol craving and consumption, symptoms of tolerance and withdrawal, and ameliorate neurobiological deficits associated with AUD. Furthermore, oxytocin has demonstrated the ability to increase prosocial behavior and cognition, and restore sensitivity to natural rewards such as interpersonal relationships. No study to date has examined the ability of oxytocin to enhance ABCT. Thus, the primary objective of this Phase II study is to examine the effects of oxytocin versus placebo in combination with ABCT in reducing AUD severity and improving relationship functioning. We also will utilize neuroimaging techniques before and after treatment to investigate the underlying pathophysiology of AUD among couples and identify prognostic indicators of treatment outcome. The findings from this study might provide critical new information to help inform clinical practice and accelerate research on the pharmacological treatment of AUD.
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Salminen LE, Morey RA, Riedel BC, Jahanshad N, Dennis EL, Thompson PM. Adaptive Identification of Cortical and Subcortical Imaging Markers of Early Life Stress and Posttraumatic Stress Disorder. J Neuroimaging 2019; 29:335-343. [PMID: 30714246 PMCID: PMC6571150 DOI: 10.1111/jon.12600] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 01/13/2019] [Accepted: 01/16/2019] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Posttraumatic stress disorder (PTSD) is a heterogeneous condition associated with a range of brain imaging abnormalities. Early life stress (ELS) contributes to this heterogeneity, but we do not know how a history of ELS influences traditionally defined brain signatures of PTSD. Here, we used a novel machine learning method - evolving partitions to improve classification (EPIC) - to identify shared and unique structural neuroimaging markers of ELS and PTSD in 97 combat-exposed military veterans. METHODS We used EPIC with repeated cross-validation (CV) to determine how combinations of cortical thickness, surface area, and subcortical brain volumes could contribute to classification of PTSD (n = 40) versus controls (n = 57), and classification of ELS within the PTSD (ELS+ n = 16; ELS- n = 24) and control groups (ELS+ n = 16; ELS- n = 41). Additional inputs included intracranial volume, age, sex, adult trauma, and depression. RESULTS On average, EPIC classified PTSD with 69% accuracy (SD = 5%), and ELS with 64% accuracy in the PTSD group (SD = 10%), and 62% accuracy in controls (SD = 6%). EPIC selected unique sets of individual features that classified each group with 75-85% accuracy in post hoc analyses; combinations of regions marginally improved classification from the individual atlas-defined brain regions. Across analyses, surface area in the right posterior cingulate was the only variable that was repeatedly selected as an important feature for classification of PTSD and ELS. CONCLUSIONS EPIC revealed unique patterns of features that distinguished PTSD and ELS in this sample of combat-exposed military veterans, which may represent distinct biotypes of stress-related neuropathology.
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Affiliation(s)
- Lauren E Salminen
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
| | - Rajendra A Morey
- Durham VA Medical Center, Durham, NC
- Duke University Medical Center, Durham, NC
| | - Brandalyn C Riedel
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN
| | - Neda Jahanshad
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
| | - Emily L Dennis
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
- Psychiatry Neuroimaging Laboratory, Harvard Medical School, Boston, MA
- Stanford Neurodevelopment, Affect, and Psychopathology Laboratory, Stanford, CA
| | - Paul M Thompson
- Imaging Genetics Center of the Mark and Mary Stevens Institute for Neuroimaging & Informatics, Keck School of Medicine, University of Southern California, Marina del Rey, CA
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30
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Japuntich SJ, Lee LO, Pineles SL, Gregor K, Joos CM, Patton SC, Krishnan-Sarin S, Rasmusson AM. Contingency management and cognitive behavioral therapy for trauma-exposed smokers with and without posttraumatic stress disorder. Addict Behav 2019; 90:136-142. [PMID: 30391774 DOI: 10.1016/j.addbeh.2018.10.042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Revised: 09/25/2018] [Accepted: 10/28/2018] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) are more likely to smoke and less successful in quit attempts than individuals without psychopathology. Contingency management (CM) techniques (i.e., incentives for abstinence) have demonstrable efficacy for smoking cessation in some populations with psychopathology, but have not been well tested in PTSD. This pilot study examined the feasibility of CM plus brief cognitive behavioral therapy (CBT) in promoting smoking cessation among trauma-exposed individuals with and without PTSD. METHODS Fifty trauma-exposed smokers (18 with PTSD) were asked to abstain from tobacco and nicotine replacement therapy for one month. During week one of cessation, CBT was provided daily and increasing CM stipends were paid for each continuous day of biochemically-verified abstinence; CM stipends were withheld in response to smoking lapses and reset to the initial payment level upon abstinence resumption. CBT and fixed payments for study visits were provided during the subsequent three weeks. RESULTS Of the 50 eligible participants who attended at least one pre-quit visit (49% female, 35% current PTSD), 43 (86%) attended the first post-quit study visit, 32 (64%) completed the first week of CM/CBT treatment, and 26 (52%) completed the study. Post-quit seven-day point prevalence abstinence rates for participants with and without PTSD, respectively, were similar: 39% vs. 38% (1 week), 33% vs. 28% (2 weeks), 22% vs. 19% (3 weeks), and 22% vs. 13% (4 weeks). CONCLUSIONS Use of CM + CBT to support tobacco abstinence is a promising intervention for trauma-exposed smokers with and without PTSD.
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Rosen MI, Becker WC, Black AC, Martino S, Edens EL, Kerns RD. Brief Counseling for Veterans with Musculoskeletal Disorder, Risky Substance Use, and Service Connection Claims. Pain Med 2019; 20:528-542. [PMID: 29800338 PMCID: PMC6387983 DOI: 10.1093/pm/pny071] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE High proportions of post-9/11 veterans have musculoskeletal disorders (MSDs), but engaging them in care early in their course of illness has been challenging. The service connection application is an ideal point of contact for referring veterans to early interventions for their conditions. DESIGN Among MSD claimants who reported risky substance use, we pilot-tested a counseling intervention targeting pain and risky substance use called Screening Brief Intervention and Referral to Treatment-Pain Module (SBIRT-PM). Veterans were randomly assigned in a 2:1:1 ratio to SBIRT-PM, Pain Module counseling only, or treatment as usual (TAU). METHODS Participants assigned to either counseling arm were offered a single meeting with a study therapist with two follow-up telephone calls as needed. Participants completed outcome assessments at four and 12 weeks after randomization. RESULTS Of 257 veterans evaluated, 101 reported risky substance use and were randomized. Counseling was attended by 75% of veterans offered it and was well received. VA pain-related services were used by 51% of participants in either of the pain-focused conditions but only by 27% in TAU (P < 0.04). Starting with average pain severity ratings of 5.1/10 at baseline, only minimal changes in mean pain severity were noted regardless of condition. Self-reported risky substance use was significantly lower over time in the SBIRT-PM condition relative to the two other conditions (P < 0.02). At week 12, proportions of veterans reporting risky substance use were 0.39, 0.69, and 0.71 for the SBIRT-PM, Pain Module counseling, and TAU conditions, respectively. CONCLUSIONS SBIRT-PM shows promise as a way to engage veterans in pain treatment and reduce substance use.
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Affiliation(s)
- Marc I Rosen
- Department of Psychiatry, Yale University, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - William C Becker
- VA Connecticut Healthcare System, West Haven, Connecticut
- Section of Internal Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Anne C Black
- Department of Psychiatry, Yale University, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Steve Martino
- Department of Psychiatry, Yale University, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Ellen L Edens
- Department of Psychiatry, Yale University, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
| | - Robert D Kerns
- Department of Psychiatry, Yale University, New Haven, Connecticut
- VA Connecticut Healthcare System, West Haven, Connecticut
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Franz HM, Corbo V, Fonda JR, Levin LK, Milberg WP, McGlinchey RE. The impact of interpersonal early life trauma on cardio-metabolic health in post-9/11 veterans. Health Psychol 2019; 38:113-121. [PMID: 30652910 DOI: 10.1037/hea0000706] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE This study examined the impact of early life trauma (ELT) on cardio-metabolic health in veterans from post-9/11 conflicts who experience significant stress from deployment and reintegration. METHOD Three hundred thirty-seven veterans from the Translational Research Center for Traumatic Brain Injury and Stress Disorders study underwent physiological assessments, including blood pressure and waist circumference. Fasting blood samples were collected to measure metabolic syndrome (MetS; cholesterol/triglycerides/glucose). ELT history was determined using the Traumatic Life Events Questionnaire. Posttraumatic stress disorder (PTSD) symptoms were assessed using the Clinician-Administered PTSD Scale. Logistic regression models examined the association of ELT and MetS diagnostic criteria while controlling for confounders. RESULTS The adjusted logistic regression showed a significant relationship between interpersonal ELT (IP ELT) and risk of MetS, with IP ELT having an approximately 3-fold increase in the risk of cardio- metabolic syndrome compared with those with no trauma (odds ratio [OR] = 3.06, p < .05). IP ELT was associated with over a 2-fold increased risk of elevated triglycerides compared with those with no trauma (OR = 2.06, p < .05). PTSD symptoms also explained in part the IP-ELT/MetS relationship. Veterans with any ELT were significantly more likely to meet for a current diagnosis of PTSD. CONCLUSIONS Our findings suggest that veterans with IP ELT are more likely to meet MetS and PTSD diagnostic criteria than veterans without IP ELT. This is concerning considering the young age of the sample and stresses the importance of an integrated and holistic approach in the assessment of physical and mental health in returning veterans. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Affiliation(s)
- Hannah M Franz
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System
| | - Vincent Corbo
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System
| | - Jennifer R Fonda
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System
| | - Laura K Levin
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System
| | - William P Milberg
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System
| | - Regina E McGlinchey
- Translational Research Center for TBI and Stress Disorders (TRACTS), VA Boston Healthcare System
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Price CJ, Crowell SE, Pike KC, Cheng SC, Puzia M, Thompson EA. Psychological and Autonomic Correlates of Emotion Dysregulation among Women in Substance Use Disorder Treatment. Subst Use Misuse 2019; 54:110-119. [PMID: 30273086 PMCID: PMC6379107 DOI: 10.1080/10826084.2018.1508297] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Emotion regulation is increasingly recognized as important for the prevention and treatment of substance use disorder (SUD). However, there is an identified lack of physiological indexes of emotion dysregulation in SUD treatment studies, critically needed to better understand the link between emotion regulation capacity (measured physiologically) and self-report health outcomes among individuals in SUD treatment. OBJECTIVE To examine the association between respiratory sinus arrhythmia (RSA) and self-report health outcomes among women in SUD treatment. METHODS This is a cross-sectional study based on baseline data from 217 women enrolled in a randomized control trial to study a mind-body intervention as an adjunct to SUD treatment. All participants were enrolled in community-based outpatient treatment. Participants were administered questionnaires to examine sample characteristics, mental health symptoms, and interoceptive awareness and mindfulness skills. RSA data was gathered as an index of emotion dysregulation. Descriptive statistics, bivariate correlations, and regression were used in the analyses. RESULTS Findings highlight the extensive trauma histories, low SES, and the high symptoms of distress in this sample. RSA was only significantly correlated with interoceptive awareness after controlling for age and BMI. Measures of symptomatic distress and mindfulness were not correlated with RSA. Conclusions/Importance: Results provide the first evidence of RSA as an index of interoceptive awareness in this population. The inclusion of biomarkers such as RSA in SUD clinical studies may help identify individuals that are in need of targeted treatments that include interoceptive awareness training focused on improving emotion regulation.
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Affiliation(s)
- Cynthia J Price
- a Department of Biobehavioral Nursing and Health Informatics , University of Washington , Seattle , Washington , USA
| | - Sheila E Crowell
- b Department of Psychology , University of Utah , Salt Lake City , Utah, USA
| | - Kenneth C Pike
- c Department of Psychosocial and Community Health Nursing , University of Washington , Seattle , Washington , USA
| | - Sunny Chieh Cheng
- d Nursing and Healthcare Leadership , University of Washington , Tacoma , Washington, USA
| | - Megan Puzia
- b Department of Psychology , University of Utah , Salt Lake City , Utah, USA
| | - Elaine Adams Thompson
- c Department of Psychosocial and Community Health Nursing , University of Washington , Seattle , Washington , USA
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Berenz EC, McNett S, Rappaport LM, Vujanovic AA, Viana AG, Dick D, Amstadter AB. Age of alcohol use initiation and psychiatric symptoms among young adult trauma survivors. Addict Behav 2019; 88:150-156. [PMID: 30195854 DOI: 10.1016/j.addbeh.2018.08.022] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/20/2018] [Accepted: 08/21/2018] [Indexed: 11/29/2022]
Abstract
Alcohol use disorder (AUD) evidences high rates of comorbidity with a range of psychiatric disorders, particularly within high-risk populations, such as individuals exposed to physical or sexual violence. Increasing efforts are focused on understanding the role of early alcohol use (e.g., during adolescence) on emotional and psychiatric functioning over time, as well as sex differences in these associations. The aim of the current study was to evaluate patterns of association between age of initiation of regular alcohol use and posttraumatic stress disorder (PTSD), anxiety, and depressive symptoms as a function of sex. Participants were 269 college students with a history of interpersonal trauma and alcohol use who completed a battery of questionnaires regarding alcohol use and emotional health. Neither bivariate correlations nor results from structural equation models covarying for key factors showed a relationship between age of alcohol use initiation and current psychiatric symptoms among men (n = 63). Results of a structural equation model supported an association between earlier age of alcohol use initiation and greater levels of current PTSD (β = -0.14), anxiety (β = -0.15), and depression symptoms (β = -0.16) in the female sub-sample (n = 202), after controlling for covariates, as well as intercorrelations among criterion variables. Statistical support for sex as a moderator of these associations was not detected. The current study provides preliminary evidence for potential sex differences in the role of early alcohol use in the development of psychiatric symptoms and highlights the need for systematic longitudinal research.
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Affiliation(s)
- Erin C Berenz
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA.
| | - Sage McNett
- Department of Psychology, University of Illinois at Chicago, Chicago, IL, USA
| | - Lance M Rappaport
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Andres G Viana
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Danielle Dick
- Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA; Department of Human and Molecular Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA; Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
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Sheerin CM, Amstadter AB, Kurtz ED, Bountress KE, Stratton KJ, McDonald SD, Mid-Atlantic Va Mirecc Workgroup. The association of resilience on psychiatric, substance use, and physical health outcomes in combat trauma-exposed military service members and veterans. Eur J Psychotraumatol 2019; 10:1625700. [PMID: 31263518 PMCID: PMC6598486 DOI: 10.1080/20008198.2019.1625700] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Revised: 04/23/2019] [Accepted: 05/20/2019] [Indexed: 11/17/2022] Open
Abstract
Objective: Although Combat exposure is associated with a range of psychiatric outcomes, many veterans do not develop psychopathology. Resilience is a multifaceted construct associated with reduced risk of distress and psychopathology; however, few studies have examined the relationship of resilience with a broader spectrum of health outcomes following combat exposure. It also remains important to determine the association of resilience above and beyond other documented risk and protective factors. Method: In a sample of combat-exposed veterans (N = 1,046) deployed to Iraq and Afghanistan, we examined a quantitative method for exploring relative psychological resilience (discrepancy-based psychiatric resilience; DBPR) and tested the hypothesis that resilience would be associated with reduced risk for psychiatric diagnosis count, substance use, and physical health outcomes, above and beyond other known correlates (e.g. combat exposure, social support). Results: In the final model, results suggested an inverse association of discrepancy-based psychiatric resilience with current psychiatric diagnosis count (β = -0.57, p < .001), alcohol use (β = -0.16, p < .001), drug use (β = -0.13, p < .001), and physical health concerns (β = -0.42, p < .001) after accounting for other relevant risk and protective factors. Conclusions: Results extend the nomological net of this quantitative resilience construct to include other relevant health outcomes, and demonstrate that resilience may have more of a buffering relationship with psychiatric and physical health concerns compared to substance use outcomes.
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Affiliation(s)
- Christina M Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Erin D Kurtz
- Psychology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Kaitlin E Bountress
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelcey J Stratton
- Resiliency and Well-Being Services, University of Michigan, Ann Arbor, MI, USA
| | - Scott D McDonald
- Psychology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Mid-Atlantic Va Mirecc Workgroup
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Psychology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA.,Resiliency and Well-Being Services, University of Michigan, Ann Arbor, MI, USA.,Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
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Benight CC, Shoji K, Yeager CM, Weisman P, Boult TE. Predicting Change in Posttraumatic Distress Through Change in Coping Self-Efficacy After Using the My Trauma Recovery eHealth Intervention: Laboratory Investigation. JMIR Ment Health 2018; 5:e10309. [PMID: 30497992 PMCID: PMC6293247 DOI: 10.2196/10309] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Revised: 07/19/2018] [Accepted: 09/20/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Technology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors. OBJECTIVE This study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS. METHODS A total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module. RESULTS PTSS significantly declined from T1 to T9 (F1,90=23.63, P<.001, η2p=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F8,83=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=-.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent. CONCLUSIONS The findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.
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Affiliation(s)
- Charles C Benight
- Department of Psychology, University of Colorado, Colorado Springs, CO, United States.,Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO, United States
| | - Kotaro Shoji
- Trauma, Health, and Hazards Center, University of Colorado, Colorado Springs, CO, United States
| | - Carolyn M Yeager
- Department of Psychology, University of Colorado, Colorado Springs, CO, United States
| | - Pamela Weisman
- Department of Psychology, University of Colorado, Colorado Springs, CO, United States
| | - Terrance E Boult
- Department of Computer Science, University of Colorado, Colorado Springs, CO, United States
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Maru M, Saraiya T, Lee CS, Meghani O, Hien D, Hahm HC. The Relationship Between Intimate Partner Violence and Suicidal Ideation among Young Chinese, Korean, and Vietnamese American Women. Women Ther 2018; 41:339-355. [PMID: 30467448 DOI: 10.1080/02703149.2018.1430381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
High depression and suicide rates are critical problems that have a significant impact on the lives of young Asian American women. Intimate partner violence (IPV) has been identified as a predictor of suicidality in general female samples, but no research study has examined the relationship between IPV and suicidality in a sample of 1.5 and second-generation Chinese, Korean, and Vietnamese American women. We used data collected from 173 women (aged 18-35 years) who were screened for eligibility to participate in the development and efficacy study of Asian American Women's Action for Resilience and Empowerment (AWARE). We measured the prevalence of (a) IPV, (b) lifetime suicidal ideation/intent, and (c) childhood abuse and tested the association between IPV and lifetime suicidal ideation/intent among study participants who completed the clinical screening assessments. The results indicated that seven out of 10 women in our sample experienced lifetime suicidal ideation/intent, psychological aggression was the most commonly reported form of IPV during the last six months, followed by sexual coercion, and history of physical and/or sexual partner violence had the most robust association with lifetime suicidal ideation/intent after controlling for demographic factors and childhood abuse. Our study suggests that suicide prevention and intervention programs for young 1.5 and second-generation Asian American women should not only address experiences of childhood abuse, but also incorporate culturally adapted behavioral health approaches to identify and target physical and sexual partner violence. Furthermore, any such programs need to integrate a systemic approach in addressing IPV within the context of various marginalized experiences of Asian American women.
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Affiliation(s)
- Mihoko Maru
- Boston University School of Social Work, Boston, Massachusetts
| | - Tanya Saraiya
- Gordon F. Derner School of Psychology, Adelphi University, Garden City, New York
| | - Christina S Lee
- Boston University School of Social Work, Boston, Massachusetts
| | - Ozair Meghani
- Boston University School of Social Work, Boston, Massachusetts
| | - Denise Hien
- Graduate School of Applied and Professional Psychology, Rutgers University, Piscataway, New Jersey
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Glackin E, Forbes D, Heberle A, Carter A, Gray SAO. Caregiver Self-Reports and Reporting of Their Preschoolers' Trauma Exposure: Discordance Across Assessment Methods. ACTA ACUST UNITED AC 2018; 25:172-180. [PMID: 31507351 DOI: 10.1037/trm0000179] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Nearly half of preschool-aged children from low-income families in the United States have been exposed to potentially traumatic events (PTEs), yet few are identified or receive trauma-focused mental health care. Given the critical need to accurately and efficiently identify PTE-exposed individuals, the current study examined discordant caregiver self-reporting of PTE exposure and caregiver reporting of child PTE exposure across two assessment methods: checklist and interview. Research has demonstrated significant cross-method discrepancies among adults reporting stressful life experiences, but examinations of caregiver reporting for their young children have not been conducted. Further, given their possible impact on reporting patterns, caregiver and child characteristics were examined in relation to discordant caregiver reporting by trauma type. Participants were 64 low-income, racially and ethnically diverse caregivers and their preschool-aged children from a Northeastern US city. Caregivers reported self and child PTE exposure via checklist and semi-structured interview. Cross-method discordance for caregiver and child exposure by trauma type ranged from 10.9% to 46.9% (Cohen's kappa =.06-.70). Caregiver race and education were associated with discordant reporting, as were caregiver and child psychopathology. Lower levels of caregiver psychopathology were associated with discordant caregiver reporting of their own exposure, whereas higher levels were associated with discordant caregiver reporting of child exposure. Discordant caregiver reporting of PTE exposure varies by assessment format and trauma type and is differentially related to caregiver demographics and caregiver and child psychopathology. Associations between assessment methods, individual characteristics, and reporting should be considered when assessing PTE exposure to support service engagement and targeted treatment.
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Affiliation(s)
- Erin Glackin
- Department of Psychology, Tulane University, New Orleans, Louisiana
| | - Danielle Forbes
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | - Amy Heberle
- Department of Psychology, Clark University, Worcester, Massachusetts
| | - Alice Carter
- Department of Psychology, University of Massachusetts, Boston, Massachusetts
| | - Sarah A O Gray
- Department of Psychology, Tulane University, New Orleans, Louisiana
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Price CJ, Thompson EA, Crowell SE, Pike K, Cheng SC, Parent S, Hooven C. Immediate effects of interoceptive awareness training through Mindful Awareness in Body-oriented Therapy (MABT) for women in substance use disorder treatment. Subst Abus 2018; 40:102-115. [PMID: 29949455 DOI: 10.1080/08897077.2018.1488335] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: Sensory information gained through interoceptive awareness may play an important role in affective behavior and successful inhibition of drug use. This study examined the immediate pre-post effects of the mind-body intervention Mindful Awareness in Body-oriented Therapy (MABT) as an adjunct to women's substance use disorder (SUD) treatment. MABT teaches interoceptive awareness skills to promote self-care and emotion regulation. Methods: Women in intensive outpatient treatment (IOP) for chemical dependency (N = 217) at 3 community clinics in the Pacific Northwest of the United States were recruited and randomly assigned to one of 3 study conditions: MABT + treatment as usual (TAU), women's health education (WHE) +TAU (active control condition), and TAU only. At baseline and 3 months post-intervention, assessments were made of interoceptive awareness skills and mindfulness, emotion regulation (self-report and psychophysiological measures), symptomatic distress (depression and trauma-related symptoms), and substance use (days abstinent) and craving. Changes in outcomes across time were assessed using multilevel mixed-effects linear regression. Results: Findings based on an intent-to-treat approach demonstrated significant improvements in interoceptive awareness and mindfulness skills, emotion dysregulation (self-report and psychophysiology), and days abstinent for women who received MABT compared with the other study groups. Additional analyses based on participants who completed the major components of MABT (at least 75% of the intervention sessions) revealed these same improvements as well as reductions in depressive symptoms and substance craving. Conclusions: Findings that interoceptive training is associated with health outcomes for women in SUD treatment are consistent with emerging neurocognitive models that link interoception to emotion regulation and to related health outcomes, providing knowledge critical to supporting and improving SUD treatment.
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Affiliation(s)
- Cynthia J Price
- a Department of Biobehavioral Nursing and Health Informatics , University of Washington , Seattle , Washington , USA
| | - Elaine A Thompson
- b Department of Psychosocial and Community Health Nursing , University of Washington , Seattle , Washington , USA
| | - Sheila E Crowell
- c Department of Psychology , University of Utah , Salt Lake City , Utah , USA
| | - Kenneth Pike
- b Department of Psychosocial and Community Health Nursing , University of Washington , Seattle , Washington , USA
| | - Sunny C Cheng
- d Nursing and Healthcare Leadership Program , University of Washington , Tacoma , Washington , USA
| | - Sara Parent
- a Department of Biobehavioral Nursing and Health Informatics , University of Washington , Seattle , Washington , USA
| | - Carole Hooven
- b Department of Psychosocial and Community Health Nursing , University of Washington , Seattle , Washington , USA
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Abstract
Spiritual issues are often implicated in trauma, yet little research has examined the specific pathways through which trauma may affect spiritual well-being or relations between spiritual well-being and other aspects of adjustment following trauma. Such information would be helpful in developing psychological interventions for trauma recovery. In a sample of 436 college students who had survived a traumatic experience, a transactional stress and coping perspective were used to examine both predictors of three components of spiritual well-being (faith, meaning, and peace) and relations between spiritual well-being and other aspects of psychological adjustment. Results suggest that different patterns of appraisals and coping predict each component of spiritual well-being and that all three components-particularly those of meaning and peace-are related to psychological adjustment. These results suggest that spiritual well-being is an important posttraumatic outcome warranting future research and clinical attention.
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Affiliation(s)
- Crystal L Park
- a Department of Psychological Sciences , University of Connecticut , Storrs , Connecticut , USA
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41
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Ysseldyk R, McQuaid RJ, McInnis OA, Anisman H, Matheson K. The ties that bind: Ingroup ties are linked with diminished inflammatory immune responses and fewer mental health symptoms through less rumination. PLoS One 2018; 13:e0195237. [PMID: 29684053 PMCID: PMC5912761 DOI: 10.1371/journal.pone.0195237] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Accepted: 02/25/2018] [Indexed: 02/03/2023] Open
Abstract
The present research explored whether components of social identity, namely ingroup ties, affect, and centrality, were differentially linked to mental health and inflammatory immune responses, and whether rumination mediated those relations. Study 1 (N = 138) indicated that stronger ingroup ties were associated with fewer mental health (depressive and post-traumatic stress) symptoms; those relations were mediated by the tendency for individuals with strong ties to rely less on ruminative coping to deal with a stressful life event. Study 2 (N = 54) demonstrated that ingroup ties were negatively associated with depressive symptoms, dispositional rumination, as well as stress-linked inflammatory elements at the physiological level. Consistent associations for centrality and ingroup affect were absent, suggesting that ingroup ties may have unique health benefits.
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Affiliation(s)
- Renate Ysseldyk
- Department of Health Sciences, Carleton University, Ottawa, Ontario, Canada
- * E-mail:
| | - Robyn J. McQuaid
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
- The Royal’s Institute of Mental Health Research, affiliated with the University of Ottawa, Ontario, Canada
| | - Opal A. McInnis
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
| | - Hymie Anisman
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
- The Royal’s Institute of Mental Health Research, affiliated with the University of Ottawa, Ontario, Canada
| | - Kimberly Matheson
- Department of Neuroscience, Carleton University, Ottawa, Ontario, Canada
- The Royal’s Institute of Mental Health Research, affiliated with the University of Ottawa, Ontario, Canada
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Thompson-Hollands J, Litwack SD, Ryabchenko KA, Niles BL, Beck JG, Unger W, Sloan DM. Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type. ACTA ACUST UNITED AC 2018; 22:1-15. [PMID: 29755256 DOI: 10.1037/gdn0000077] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective Examine initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. Method One hundred and seventy-eight male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or non-interpersonal) impacted initial levels of alliance or change in alliance over time. Results Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a non-interpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p > .05), but did not have significantly different initial alliance ratings. Conclusions The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance.
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Affiliation(s)
- Johanna Thompson-Hollands
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
| | - Scott D Litwack
- VA Boston Healthcare System.,Boston University School of Medicine
| | - Karen A Ryabchenko
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
| | - Barbara L Niles
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
| | | | | | - Denise M Sloan
- National Center for PTSD, Behavioral Science Division.,VA Boston Healthcare System.,Boston University School of Medicine
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Sheerin CM, Stratton KJ, Amstadter AB, Education Clinical Center Mirecc Workgroup TVMAMIR, McDonald SD. Exploring resilience models in a sample of combat-exposed military service members and veterans: a comparison and commentary. Eur J Psychotraumatol 2018; 9:1486121. [PMID: 29988781 PMCID: PMC6032017 DOI: 10.1080/20008198.2018.1486121] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Accepted: 05/14/2018] [Indexed: 11/08/2022] Open
Abstract
Background: The term resilience is applied in numerous ways in the mental health field, leading to different perspectives of what constitutes a resilient response and disparate findings regarding its prevalence following trauma. Objective: illustrate the impact of various definitions on our understanding and prevalence of resilience, we compared various resilience definitions (absence of PTSD, absence of current mental health diagnosis, absence of generalized psychological distress, and an alternative trauma load-resilience discrepancy model of the difference between actual and predicted distress given lifetime trauma exposure) within a combat-exposed military personnel and veteran sample. Method: In this combat-trauma exposed sample (N = 849), of which approximately half were treatment seeking, rates of resilience were determined across all models, the kappa statistic was used to determine the concordance and strength of association across models, and t-tests examined the models in relation to a self-reported resilience measure. Results: Prevalence rates were 43.7%, 30.7%, 87.4%, and 50.1% in each of the four models. Concordance analyses identified 25.7% (n = 218) considered resilient by all four models (kappa = .40, p < .001). Correlations between models and self-reported resilience were strong, but did not fully overlap. Conclusions:The discussion highlights theoretical considerations regarding the impact of various definitions and methodologies on resilience classifications, links current findings to a systems-based perspective, and ends with suggestions for future research approaches on resilience.
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Affiliation(s)
- Christina M Sheerin
- Psychology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.,Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Kelcey J Stratton
- Psychology Service, Hunter Holmes McGuire VA Medical Center, Richmond, VA, USA.,Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA.,Department of Psychology, Virginia Commonwealth University, Richmond, VA, USA
| | - Ananda B Amstadter
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Scott D McDonald
- Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
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Carr S, Hardy A, Fornells-Ambrojo M. The Trauma and Life Events (TALE) checklist: development of a tool for improving routine screening in people with psychosis. Eur J Psychotraumatol 2018; 9:1512265. [PMID: 30220986 PMCID: PMC6136359 DOI: 10.1080/20008198.2018.1512265] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Revised: 07/20/2018] [Accepted: 07/26/2018] [Indexed: 10/28/2022] Open
Abstract
Background: Best practice guidelines recommend traumatic events should be assessed in psychosis to support the identification and, when indicated, treatment of post-traumatic stress reactions. However, routine assessment in frontline services is rare, and available tools are not tailored to psychosis. Assessment obstacles include lengthy measures, a focus on single, physically threatening events, and the exclusion of psychosis-related traumas. Objective: To develop and validate a brief trauma screening tool for the identification of clinically significant traumas in people with psychosis. Method: The Trauma and Life Events (TALE) checklist was developed in conjunction with people with lived experience of trauma and psychosis, and specialist clinicians and researchers. The psychometric properties (i.e. test-retest reliability, content validity, construct validity) of the TALE were evaluated in a sample of 39 people with psychosis diagnoses. Results: The TALE displayed moderate psychometric acceptability overall, with excellent reliability and convergent validity for sexual abuse. High rates of psychosis-related trauma and childhood adversity were reported, in particular bullying and emotional neglect. A dose-response relationship between cumulative trauma, post-traumatic stress and psychosis was found. Conclusions: The TALE is the first screening tool specifically designed to meet the needs of routine trauma screening in psychosis services. The psychometric limitations highlight the challenge of developing a measure that is both sufficiently brief to be useful in clinical settings and comprehensive enough to identify all relevant adverse events. Validation of the TALE is now required across the spectrum of psychosis.
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Affiliation(s)
- Sarah Carr
- Department of Clinical, Education and Health Psychology, University College London, London, UK
| | - Amy Hardy
- Department of Psychology, Institute of Psychiatry, King's College London, London, UK.,Psychosis Clinical Academic Group, South London & Maudsley NHS Foundation Trust, London, UK
| | - Miriam Fornells-Ambrojo
- Department of Clinical, Education and Health Psychology, University College London, London, UK
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45
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Abstract
Sleep problems are prevalent among Veterans. Left untreated, such problems may elevate psychological distress and increase risk of subsequent mental health disorders. Psychological resilience may buffer against negative psychological outcomes, yet the relationship between sleep and resilience has not been studied. This study explored poor sleep, resilience, and psychological distress using questionnaires collected as part of the Study of Post-Deployment Mental Health. Participants (N = 1,118) had served in the US military since September 11, 2001, had one or more overseas deployments, and were free from a past-month DSM-defined mental health disorder. Hierarchical linear regression was used to examine the association between poor sleep quality (Pittsburgh Sleep Quality Index total score) and psychological distress (Global Symptom Index; Symptom Checklist-90-R), controlling for demographic and health characteristics. Moderation analyses tested for a potential buffering effect of resilience (Connor-Davidson Resilience Scale). Poor sleeping Veterans had worse physical and psychological health, lower resilience, and endorsed more lifetime traumatic events. Poor sleep was associated with greater psychological distress controlling for health and demographic characteristics. Both resilience factors-adaptability and self-efficacy-had significant buffering effects on the relationship between poor sleep and psychological distress, suggesting that resilience may protect against negative outcomes in poor sleepers. Additional research is warranted to better understand the relationships between sleep, resilience, and psychological distress. Such research may inform pertinent prevention efforts, including interventions that improve sleep, enhance resilience, and protect against incident mental health diagnoses.
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Affiliation(s)
- Jaime M Hughes
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina
| | - Christi S Ulmer
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina.,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - S Nicole Hastings
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina.,Geriatric Research, Education, and Clinical Center, Durham VA Medical Center, Durham, North Carolina.,Department of Medicine and Center for the Study of Aging and Human Development, Duke University, Durham, North Carolina
| | - Jennifer M Gierisch
- Center for Health Services Research in Primary Care, Durham VA Medical Center, Durham, North Carolina.,Department of General Internal Medicine, Duke University, Durham, North Carolina
| | | | - Matthew O Howard
- School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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Elrond AF, Høgh A, Andersen SB. Leadership and post-traumatic stress disorder: are soldiers' perceptions of organizational justice during deployment protective? Eur J Psychotraumatol 2018; 9:1449558. [PMID: 29707168 PMCID: PMC5912440 DOI: 10.1080/20008198.2018.1449558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Accepted: 02/10/2018] [Indexed: 11/29/2022] Open
Abstract
Background: Soldiers' perception of leadership during military deployment has gained research attention as a potentially modifiable factor to buffer against the development of postdeployment post-traumatic stress disorder (PTSD). Within nonmilitary research, the organizational justice (OJ) framework, i.e. distributive justice, procedural justice (PJ) and interactional justice (IJ), has been found to relate to mental health outcomes. Aspects of OJ may, therefore, be protective against PTSD. Objectives: We examined the prospective relationship between aspects of OJ, namely the perceptions of PJ and IJ by subordinate soldiers without leadership obligations in relationship to immediate superiors and PTSD. Method: Participants were soldiers (n = 245) deployed to Helmand Province in Afghanistan in 2009. Logistic regression procedures were used. The primary analysis measured PTSD cases using the Structured Clinical Interview for DSM-IV-TR Axis-I Disorder (SCID) 2½ years after homecoming. PJ/IJ was measured during deployment with a 6-item composite measure ranging from 0 to 12. Supplementary primary analyses were performed with PJ/IJ measured before and immediately after deployment. A secondary PJ/IJ analysis also tested against four postdeployment measures with the Post-Traumatic Stress Disorder Checklist Civilian (PCL-C) dichotomized at screening symptom levels. Results: Higher levels of perceived PJ/IJ for soldiers without leadership obligations during deployment had a prospective relation (OR = 0.86, 95% CI = 0.75-0.98) with PTSD on the SCID 2½ years after homecoming after adjustment for factors including predeployment PTSD symptoms, trauma and combat exposure, and state affectivity. Similar results were found by measuring PJ/IJ before (OR = 0.83, 95% CI = 0.71-0.95) but not immediately after homecoming (OR = 0.97, 95% CI = 0.85-1.11). A relationship with PTSD symptoms at the screening level at the four measurements of PCL-C was found, but only when predeployment PTSD symptoms were not controlled for. Conclusions: These results suggest that PJ/IJ exercised by superiors in relation to military deployments may protect subordinate soldiers against the development of postdeployment PTSD.
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Affiliation(s)
- Andreas F Elrond
- Research and Knowledge Centre, The Danish Veteran Centre, Ringsted, Denmark.,Department of Psychology, University of Copenhagen, København K, Denmark
| | - Annie Høgh
- Department of Psychology, University of Copenhagen, København K, Denmark
| | - Søren B Andersen
- Research and Knowledge Centre, The Danish Veteran Centre, Ringsted, Denmark
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Sun D, Davis SL, Haswell CC, Swanson CA, LaBar KS, Fairbank JA, Morey RA. Brain Structural Covariance Network Topology in Remitted Posttraumatic Stress Disorder. Front Psychiatry 2018; 9:90. [PMID: 29651256 PMCID: PMC5885936 DOI: 10.3389/fpsyt.2018.00090] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2017] [Accepted: 03/05/2018] [Indexed: 01/18/2023] Open
Abstract
Posttraumatic stress disorder (PTSD) is a prevalent, chronic disorder with high psychiatric morbidity; however, a substantial portion of affected individuals experience remission after onset. Alterations in brain network topology derived from cortical thickness correlations are associated with PTSD, but the effects of remitted symptoms on network topology remain essentially unexplored. In this cross-sectional study, US military veterans (N = 317) were partitioned into three diagnostic groups, current PTSD (CURR-PTSD, N = 101), remitted PTSD with lifetime but no current PTSD (REMIT-PTSD, N = 35), and trauma-exposed controls (CONTROL, n = 181). Cortical thickness was assessed for 148 cortical regions (nodes) and suprathreshold interregional partial correlations across subjects constituted connections (edges) in each group. Four centrality measures were compared with characterize between-group differences. The REMIT-PTSD and CONTROL groups showed greater centrality in left frontal pole than the CURR-PTSD group. The REMIT-PTSD group showed greater centrality in right subcallosal gyrus than the other two groups. Both REMIT-PTSD and CURR-PTSD groups showed greater centrality in right superior frontal sulcus than CONTROL group. The centrality in right subcallosal gyrus, left frontal pole, and right superior frontal sulcus may play a role in remission, current symptoms, and PTSD history, respectively. The network centrality changes in critical brain regions and structural networks are associated with remitted PTSD, which typically coincides with enhanced functional behaviors, better emotion regulation, and improved cognitive processing. These brain regions and associated networks may be candidates for developing novel therapies for PTSD. Longitudinal work is needed to characterize vulnerability to chronic PTSD, and resilience to unremitting PTSD.
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Affiliation(s)
- Delin Sun
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | - Sarah L Davis
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | - Courtney C Haswell
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | - Chelsea A Swanson
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States
| | | | - Kevin S LaBar
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States
| | - John A Fairbank
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States
| | - Rajendra A Morey
- Department of Veteran Affairs (VA) Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC, United States.,Duke-UNC Brain Imaging and Analysis Center, Duke University, Durham, NC, United States.,Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, United States
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48
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Ponce de León B, Andersen S, Karstoft KI, Elklit A. Pre-deployment dissociation and personality as risk factors for post-deployment post-traumatic stress disorder in Danish soldiers deployed to Afghanistan. Eur J Psychotraumatol 2018; 9:1443672. [PMID: 29707166 PMCID: PMC5912445 DOI: 10.1080/20008198.2018.1443672] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 02/06/2018] [Indexed: 11/16/2022] Open
Abstract
Objective: This study investigated whether pre-deployment dissociation was associated with previously identified post-traumatic stress disorder (PTSD) symptom trajectories from before to 2.5 years after military deployment. Furthermore, it examined whether the tendency to dissociate, pre-deployment personality factors, conceptualized by the Big Five model, and previous trauma represented independent risk factors for post-deployment PTSD symptoms. Method: This prospective study included the entire team of 743 soldiers from the Danish Contingent of the International Security Assistance Force 7 deployed to Afghanistan in 2009. Data consisted of self-report measures and were collected six times: before deployment; during deployment; and 1-3 weeks, 2 months, 7 months and 2.5 years after homecoming. Results: The findings indicate significant associations between pre-deployment dissociation and six PTSD trajectories (p < 0.001, η2 = 0.120). Based on mean differences in dissociation for the six trajectories, two main groups emerged: a group with high dissociation scores at pre-deployment, which had moderate PTSD symptom levels at pre-deployment and fluctuated over time; and a group with low dissociation scores at pre-deployment, which had low initial PTSD symptom levels and diverged over time. Our study also confirmed previous findings of a positive association between neuroticism and dissociation (r = 0.31, p < 0.001). This suggests that negative emotionality may be a vulnerability that enhances dissociative experiences, although a causal link cannot be concluded from the findings. Finally, pre-deployment dissociation, pre-deployment neuroticism and a history of traumatic events, as independent factors, were significant predictors of post-deployment PTSD (p < 0.001, R2 = 0.158). Conclusions: The study emphasizes the multiplicity of factors involved in the development of PTSD, and group differences in dissociative symptoms support the heterogeneity in PTSD. Further, this study points to specific aspects of personality that may be targeted in a clinical setting and in pre-deployment assessments in the military.
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Affiliation(s)
- Beatriz Ponce de León
- Danish National Centre of Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark.,Psychiatry, Afdeling for Traume- og Torturoverlevere, Region of Southern Denmark,Vejle, Denmark
| | - Søren Andersen
- Research and Knowledge Centre, The Danish Veteran Centre, Ringsted, Denmark
| | | | - Ask Elklit
- Danish National Centre of Psychotraumatology, Department of Psychology, University of Southern Denmark, Odense, Denmark
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Harenski CL, Brook M, Kosson DS, Bustillo JR, Harenski KA, Caldwell MF, Van Rybroek GJ, Koenigs M, Decety J, Thornton DM, Calhoun VD, Kiehl KA. Socio-neuro risk factors for suicidal behavior in criminal offenders with psychotic disorders. Soc Cogn Affect Neurosci 2017; 12:70-80. [PMID: 28065894 PMCID: PMC5390707 DOI: 10.1093/scan/nsw164] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Accepted: 10/31/2016] [Indexed: 12/11/2022] Open
Abstract
Relative to the general population, individuals with psychotic disorders have a higher risk of suicide. Suicide risk is also elevated in criminal offenders. Thus, psychotic-disordered individuals with antisocial tendencies may form an especially high-risk group. We built upon prior risk analyses by examining whether neurobehavioral correlates of social cognition were associated with suicidal behavior in criminal offenders with psychotic disorders. We assessed empathic accuracy and brain structure in four groups: (i) incarcerated offenders with psychotic disorders and past suicide attempts, (ii) incarcerated offenders with psychotic disorders and no suicide attempts, (iii) incarcerated offenders without psychotic disorders and (iv) community non-offenders without psychotic disorders. Established suicide risk variables were examined along with empathic accuracy and gray matter in brain regions implicated in social cognition. Relative to the other groups, offenders with psychotic disorders and suicide attempts had lower empathic accuracy and smaller temporal pole volumes. Empathic accuracy and temporal pole volumes were significantly associated with suicide attempts independent of other risk variables. The results indicate that brain and behavioral correlates of social cognition may add incremental value to models of suicide risk.
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Affiliation(s)
- Carla L Harenski
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | - Michael Brook
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - David S Kosson
- Department of Psychology, Rosalind Franklin University, Chicago, IL
| | - Juan R Bustillo
- Department of Psychiatry, University of New Mexico, Albuquerque, NM
| | - Keith A Harenski
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA
| | | | | | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin - Madison, Madison, WI
| | - Jean Decety
- Departments of Psychology and Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | | | - Vince D Calhoun
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.,Department of Electrical and Computer Engineering, University of New Mexico, Albuquerque, NM
| | - Kent A Kiehl
- The Mind Research Network and Lovelace Biomedical and Environmental Research Institute, Albuquerque, NM, USA.,Department of Psychology, University of New Mexico, Albuquerque, NM
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50
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LaMotte AD, Taft CT, Weatherill RP. Mistrust of others as a mediator of the relationship between trauma exposure and use of partner aggression. Psychol Trauma 2017; 8:535-540. [PMID: 27348070 DOI: 10.1037/tra0000157] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Prior research indicates a connection between the experience of trauma and use of intimate partner aggression (IPA), but little work has focused on core cognitive schemas that can be influenced by trauma. In the current study, we examine the cognitive schema of mistrust in others as a mediator of the relationship between trauma exposure and IPA use. This schema may lead to IPA through distorted social information processing that can escalate relationship conflict. METHOD The sample consisted of 83 heterosexual community couples. All variables were assessed via written questionnaires, and IPA frequency was calculated by incorporating both partners' reports on each member of the couple. RESULTS For males, mistrust significantly mediated the relationships between trauma exposure and both physical and psychological IPA use. For females, mistrust did not mediate the significant relationship between trauma exposure and IPA use. In analyses using the actor-partner interdependence model, both actor and partner mistrust uniquely predicted physical and psychological IPA use. CONCLUSIONS The findings of the study suggest the importance of examining core schemas that may underlie trauma reactions and use of IPA. (PsycINFO Database Record
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Affiliation(s)
- Adam D LaMotte
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System
| | - Casey T Taft
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System
| | - Robin P Weatherill
- Behavioral Science Division, National Center for PTSD, VA Boston Healthcare System
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