Traumatology[JOURNAL]
Sun
200 papers
Making Meaning of Disaster Experience in Highly Trauma-exposed Survivors of the Oklahoma City Bombing.
Lee MH, Raitt J, Hong BA … +7 more , Diduck A, Nguyen AMTT, Villareal A, Moden M, Turner B, North CS, Pollio DE
Traumatology (Tallahass Fla) · 2022 Jun · PMID 36035619 · Full text
Survivors of disasters can be expected to form meaningful perspectives on their experiences that shape their trajectories of recovery; thus, these perspectives are important to study. If humans are naturally compelled to...
Survivors of disasters can be expected to form meaningful perspectives on their experiences that shape their trajectories of recovery; thus, these perspectives are important to study. If humans are naturally compelled to create meaning from traumatic experiences, the creation of meaning should be evident in survivors' discussion of the effects of the disaster in their lives. Therefore, the purpose of this study of highly trauma-exposed disaster survivors was to identify meaningful aspects or outcomes of their disaster experiences in their perspectives. This study examined a random sample (N=182) of survivors of the Oklahoma City bombing six months after the disaster using open-ended questions. Text responses (N=650) were compiled, themes identified by multiple coders, responses coded into the themes, interrater reliability established, and the themes were then interpreted. Six themes were identified and grouped into three general categories: personal aspirations (reprioritizing life and altruism and self-improvement), connection with others (a freestanding category/theme), and making meaning (appreciation for life, religion and spirituality, and contemplating life, death, and humanity), which contained the majority of the responses. The findings from this study affirm the human need to make meaning from the experience of a traumatic disaster and suggest the potential relevance to survivors' recovery of therapies based on the creation of meaning and the promotion of positive growth.
Changes in Psychosocial Resources as Predictors of Posttraumatic Growth: A Longitudinal Study of Low-Income, Female Hurricane Katrina Survivors.
Manove EE, Poon CYS, Rhodes JE … +1 more , Lowe SR
Traumatology (Tallahass Fla) · 2021 Dec · PMID 35356133 · Full text
This study examined how well the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) corresponds with self-reported pre- to posttrauma changes in related constructs, including sense of purpose in life, religi...
This study examined how well the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) corresponds with self-reported pre- to posttrauma changes in related constructs, including sense of purpose in life, religiosity, and social support. Participants were 328 low-income mothers (85.2% non-Hispanic Black) who survived Hurricane Katrina and completed surveys approximately 1 year predisaster (Time 1), 4 years postdisaster (Time 2), and 12 years postdisaster (Time 3). PTG was assessed at Time 2 and Time 3, and related constructs were assessed at all waves. Pre- to postdisaster changes in the following related constructs were significantly associated with the corresponding PTGI subscales: purpose in life with Relating to Others, Personal Strength, and New Possibilities; religiosity with Spiritual Change; and perceived social support with Relating to Others. The results demonstrate a link between a number of self-reported pre- to posttrauma psychological changes measured over time and the PTGI. Replication of these results using measures more closely aligned to the PTGI subscales, among more representative samples and in the aftermath of other traumatic events, is warranted.
Social Goal Orientation Differentially Influences Exposure to Interpersonal and Noninterpersonal Trauma.
Shaw R, Colder CR, Read JP
Traumatology (Tallahass Fla) · 2022 Mar · PMID 38046999 · Full text
Emerging adults are at an increased risk for trauma exposure, both interpersonal and non-interpersonal, which often occurs within a social context. How an individual interacts with this context may heighten or buffer aga...
Emerging adults are at an increased risk for trauma exposure, both interpersonal and non-interpersonal, which often occurs within a social context. How an individual interacts with this context may heighten or buffer against their risk for trauma. Social goal orientation represents individual differences that characterize how an individual navigates their social environment. These orientations fall along the two interacting dimensions, Agency and Communion. In a community sample (N=274; 55% female, average age = 18.9) of young adults, we sought to examine the role that these two types of social goals, both uniquely and in interaction with one another, may play in interpersonal and non-interpersonal trauma risk. Because men and women are at differential risk for trauma, we also examined the impact of gender on these associations. Findings revealed that social goal orientations are linked to trauma exposure in ways that differ depending on the type of trauma, interpersonal or non-interpersonal. Moreover, these processes differed for men and women. Whereas a high Communal Orientation was associated with decreased exposure to all trauma, for both women and men, Agentic Orientation was associated with an increased number of interpersonal and non-interpersonal trauma. For men, agency and communion interacted, suggesting that the extent to which an agentic orientation may be risky or protective for interpersonal trauma depends strongly on communal orientation. These findings provided initial evidence for the role social goal orientation may play as a risk or protective factor for trauma exposure.
Affective Lability Moderates the Associations between Negative and Positive Urgency and Posttraumatic Stress.
Jones AC, Lim S, Hood CO … +2 more , Brake CA, Badour CL
Traumatology (Tallahass Fla) · 2021 Sep · PMID 37346924 · Full text
Urgency and affective lability are two vulnerabilities that have been linked to posttraumatic stress disorder (PTSD). Urgency refers to rash action when experiencing intense positive or negative affect, whereas affective...
Urgency and affective lability are two vulnerabilities that have been linked to posttraumatic stress disorder (PTSD). Urgency refers to rash action when experiencing intense positive or negative affect, whereas affective lability is the tendency to shift rapidly between emotion states. Although individuals high in urgency and affective lability may be more likely to engage in behaviors often exhibited by individuals with PTSD (e.g., substance use, risky behaviors), the extent to which urgency and affective lability interact to impact PTSD symptoms has yet to be examined. The current study hypothesized that the association between urgency (negative and positive) and PTSD symptoms would be stronger among those reporting elevated affective lability. Participants included 232 trauma-exposed college students who completed a series of questionnaires. Among individuals low in affective lability, both positive and negative urgency were positively associated with PTSD symptoms. Contrary to hypotheses, among those high in affective lability, positive and negative urgency were not associated with PTSD symptoms. Models with dimensions of affective lability were also examined. Findings suggest that the association between urgency and PTSD symptoms may only emerge among individuals who do not already possess the vulnerability associated with higher affective lability.
Pre- to Posttreatment Changes in Trauma-Cued Negative Emotion Mediate Improvement in Posttraumatic Stress Disorder, Depression, and Impulsivity.
McGuire AP, Anderson LM, Frankfurt SB … +1 more , Connolly KM
Traumatology (Tallahass Fla) · 2020 Dec · PMID 34335112 · Full text
Posttraumatic stress disorder (PTSD) is characterized by strong negative emotions, often in response to trauma cues or reminders. Subsequent emotion regulation strategies impact the maintenance of PTSD symptoms and other...
Posttraumatic stress disorder (PTSD) is characterized by strong negative emotions, often in response to trauma cues or reminders. Subsequent emotion regulation strategies impact the maintenance of PTSD symptoms and other trauma-related outcomes (depression, substance use). This study aimed to examine a range of trauma-cued emotions to enhance our understanding of changes following treatment and their potential role in improving relevant outcomes. Participants included 67 veterans diagnosed with PTSD and a substance use disorder who completed a dual diagnosis residential program that used cognitive processing therapy. At pre- and posttreatment, we measured 8 negative emotions following a trauma recall and PTSD symptoms, depressive symptoms, and negative urgency (impulsivity following negative emotions) as treatment outcomes. We used -tests to assess changes at posttreatment and a within-subjects mediational analysis to test whether changes in trauma-cued emotions mediated treatment outcomes. Participants reported moderate, significant decreases for 5 emotions at posttreatment: anger at self, disgust at self, fear, guilt, and sadness ( ≥ 0.50), whereas nonsignificant changes were found for anger at others, disgust at others, and shame. Mediation analyses indicated greater reductions in trauma-cued sadness had a significant indirect effect on improvement in PTSD symptoms, depressive symptoms, and negative urgency. Reductions in disgust at self and fear also demonstrated a significant indirect effect on depressive symptom improvement. In this dual diagnosis program, veterans reported a significant reduction in some, but not all, trauma-cued emotions, and improvements in only select emotions accounted for a significant portion of improvement in relevant treatment outcomes.
Homicide Survivorship and Suicidality Among Adolescents.
Bamwine PM, Jones K, Chugani C … +2 more , Miller E, Culyba A
Traumatology (Tallahass Fla) · 2020 Jun · PMID 34305479 · Full text
Homicide survivorship is linked to depression and trauma symptoms among adolescents, but little is known about associations with suicidality and how these associations intersect with other childhood adversities. This stu...
Homicide survivorship is linked to depression and trauma symptoms among adolescents, but little is known about associations with suicidality and how these associations intersect with other childhood adversities. This study examined the prevalence of homicide survivorship and associations with suicidality and childhood aversities among a population-based sample of youth using the Healthy Allegheny Teen Survey, a county-wide representative survey of 1,609 youth aged 14 to 19 in Allegheny County, Pennsylvania. Logistic regression models examined associations between homicide survivorship and suicidality, adjusting for (a) demographics and (b) demographics and childhood adversities. In all, 13% of youth were homicide survivors. Black youth experienced a disproportionate burden of traumatic loss. Homicide survivorship was associated with suicide attempts and childhood adversities. Closer attention to the impact of homicide survivorship on youth, mental health sequelae, and co-occurrent childhood adversities may guide interventions to recognize and support youth following traumatic loss.
How Mental Health Professionals Can Address Disparities in the Context of the COVID-19 Pandemic.
Loeb TB, Ebor MT, Smith-Clapham AM … +7 more , Chin D, Novacek DM, Hampton-Anderson JN, Norwood-Scott E, Hamilton AB, Brown AF, Wyatt GE
Traumatology (Tallahass Fla) · 2021 Mar · PMID 34025223 · Full text
The Coronavirus 2019 (COVID-19) pandemic is an unparalleled crisis, yet also a unique opportunity for mental health professionals to address and prioritize mental and physical health disparities that disproportionately i...
The Coronavirus 2019 (COVID-19) pandemic is an unparalleled crisis, yet also a unique opportunity for mental health professionals to address and prioritize mental and physical health disparities that disproportionately impact marginalized populations. Black, Indigenous, and People of Color (BIPOC) have long experienced structural racism and oppression, resulting in disproportionately high rates of trauma, poverty, and chronic diseases that span generations and are associated with increased COVID-19 morbidity and mortality rates. The current pandemic, with the potential of conferring new trauma exposure, interacts with and exacerbates existing disparities. To assist mental health professionals in offering more comprehensive services and programs for those who have minimal resources and the most profound barriers to care, four critical areas are highlighted as being historically problematic and essential to address: (a) recognizing psychology's role in institutionalizing disparities; (b) examining race/ethnicity as a critical variable; (c) proactively tackling growing mental health problems amidst the COVID-19 crisis; and (d) understanding the importance of incorporating historical trauma and discrimination in research and practice. Recommendations are provided to promote equity at the structural (e.g., nationwide, federal), professional (e.g., the mental health professions), and individual (e.g., practitioners, researchers) levels.
Distress Tolerance Interacts with Peritraumatic Emotions to Predict Posttraumatic Stress Symptoms Following Sexual Victimization.
Hood CO, Jones AC, Flores J … +2 more , Badour CL, Feldner MT
Traumatology (Tallahass Fla) · 2020 Dec · PMID 33776596 · Full text
The intensity of peritraumatic emotions occurring at the time of, and in the hours or days immediately following, a traumatic event prospectively predicts posttraumatic stress symptom severity. However, less is known abo...
The intensity of peritraumatic emotions occurring at the time of, and in the hours or days immediately following, a traumatic event prospectively predicts posttraumatic stress symptom severity. However, less is known about how the perception of one's ability to tolerate distressing emotions affects the relation between peritraumatic emotions and posttraumatic stress symptoms. Therefore, the current study investigated how perceived distress tolerance affects the association between peritraumatic emotional intensity and symptoms of posttraumatic stress. Participants included 72 adult women with a history of sexual victimization. Ratings of peritraumatic emotions (e.g., fear, anger, sadness, guilt, and shame), perceived distress tolerance, and posttraumatic stress symptoms were examined. All analyses controlled for general negative affect. Significant interactions emerged for overall peritraumatic emotional intensity, and specifically for peritraumatic anger, sadness, and shame. The associations between these peritraumatic emotions and posttraumatic stress symptoms were stronger for individuals with lower perceived ability to tolerate distress. Our results suggest that peritraumatic emotional experiences may be particularly relevant to understanding the development and maintenance of posttraumatic stress symptoms among individuals who have difficulty tolerating intense negative emotional states. Future research should examine whether perceived distress tolerance might serve as a potential target for posttraumatic stress prevention efforts.
The psychological and economic toll of the COVID-19 pandemic on Latina mothers in primarily low-income essential worker families.
Hibel LC, Boyer CJ, Buhler-Wassmann AC … +1 more , Shaw BJ
Traumatology (Tallahass Fla) · 2021 Mar · PMID 37383674 · Full text
INTRODUCTION: The COVID-19 pandemic will have widespread health, economic, and psychological consequences. Reports indicate the Latino community is particularly vulnerable to the economic and health risks of this pandemi...
INTRODUCTION: The COVID-19 pandemic will have widespread health, economic, and psychological consequences. Reports indicate the Latino community is particularly vulnerable to the economic and health risks of this pandemic as a consequence of systemic oppression. Latina mothers, in particular, are navigating the pandemic from their racialized, gendered, and classed positions while caring for children and families. These factors are likely to have a significant psychological toll. METHOD: The sample consisted of 70 Latina mothers. The majority of the families (72%) contained at least one employed adult, of which 91.7% were essential workers. Factors associated with stress, depressive symptoms, and anxiety symptoms during the initial March 20 - June 1, 2020 California "shelter in place" mandate were assessed via phone survey using validated measures and Likert-scale items created for the study. Receipt of the federal stimulus check on stress, depressive symptoms, and anxiety symptoms was also assessed. RESULTS: Due to the pandemic, 52.7% of the mothers reported being forced to engage in economic cutbacks. Mothers' experiences of stress during the outbreak stem from worries about themselves contracting the virus and making economic cutbacks. Economic cutbacks were also associated with greater reports of depressive and anxiety symptoms. Receiving the stimulus payment did not reduce economic cutbacks, contract worries, stress, or depressive and anxiety symptoms. CONCLUSION: Findings highlight the pandemic's immediate economic toll on Latino families. Further, these economic implications seem to be having downstream effects on mothers' psychological well-being, that were not alleviated by the stimulus payment.
How Right Now? Supporting Mental Health and Resilience Amid COVID-19.
Burke-Garcia A, Johnson-Turbes A, Mitchell EW … +10 more , Verlenden JMV, Puddy R, Mercado MC, Nelson P, Rabinowitz L, Xia K, Wagstaff L, Feng M, Caicedo L, Tolbert E
Traumatology (Tallahass Fla) · 2021 · PMID 35360002
The How Right Now communication initiative (HRN) was developed to facilitate resilience amid the COVID-19 pandemic in the United States. HRN was designed as a conduit for promoting mental health and addressing feelings o...
The How Right Now communication initiative (HRN) was developed to facilitate resilience amid the COVID-19 pandemic in the United States. HRN was designed as a conduit for promoting mental health and addressing feelings of grief, worry, and stress experienced during this time. This article provides an overview of the rapid, mixed-method, culturally responsive formative research process undertaken to inform the development of HRN. Specifically, it describes how HRN's disproportionately affected audiences (adults aged 65 and older and their caregivers, adults with preexisting physical and mental health conditions, adults experiencing violence, and adults experiencing economic distress) describe and discuss emotional resilience, what they need to be resilient, and what factors contribute to the perceptions of their ability to "bounce back" from the conditions caused by the COVID-19 pandemic. Data collection methods included an environmental scan ( ≥ 700 publications), social listening ( ≥ 1 million social media posts), partner needs-assessment calls ( = 16), partner-convened listening sessions with community members ( = 29), online focus groups ( = 58), and a national probability survey ( = 731), all in English and Spanish. Results revealed that HRN's audiences have diverse perceptions of what constitutes resilience. However, common factors were identified across populations to support resilience amid the COVID-19 pandemic, including informal and formal social support and access to services to meet basic needs, including food and housing resources. Stress, anxiety, depression, and experience with stigma and discrimination were also linked to resilience. Understanding the perspectives and experiences of disproportionately affected populations is vital to identifying supports and services, including the engagement of community stakeholders.
The Impact of Job Loss on Posttraumatic Stress Disorder Among Asian Americans: 11-12 Years After the World Trade Center Attack.
Huang D, Wang X, Kung W
Traumatology (Tallahass Fla) · 2020 Mar · PMID 32922216 · Full text
Adversities following disasters are associated with the delayed onset and persistence of post-traumatic stress disorder (PTSD). In the wake of the World Trade Center attack, a sizeable group of Asian Americans being dire...
Adversities following disasters are associated with the delayed onset and persistence of post-traumatic stress disorder (PTSD). In the wake of the World Trade Center attack, a sizeable group of Asian Americans being directly exposed to the disaster had endured job loss during the decade afterwards. Yet, no studies to date have examined the relationship between job loss and long-term PTSD in this group. This study examined the 10-11-year prevalence of probable PTSD (≥ PCL score of 44) among Asian (n=1,712) and Caucasian American (n=25,011) participants of the World Trade Center Health Registry who had completed three waves of survey studies (2003-04, 2006-08, 2011-12). Logistic regression was used to model the relationship between job loss since the disaster and probable PTSD for the two racial groups separately while controlling for sociodemographics, disaster exposure, post-disaster traumatic/stressful events exposure, lower respiratory symptoms, PTSD history since 911, and mental health service use. The long-term prevalence of probable PTSD was 15.1% for Asian Americans and 14.4% for Caucasian Americans, with no significant difference. For both groups, having job loss since 911 was a significant risk factor for probable PTSD (Asian Americans: AOR=1.80; 95% CI=1.19, 2.71; Caucasian Americans: AOR=1.73; 95% CI=1.56, 1.93). While job loss was an important risk factor, employment opportunities were more restricted for Asian Americans given the cultural and language limitations. Current findings highlight the importance of improving employment as part of post-disaster assistance.
Rumination as a Mediator of the Associations Between Moral Injury and Mental Health Problems in Combat-Wounded Veterans.
Bravo AJ, Kelley ML, Mason R … +3 more , Ehlke S, Vinci C, Redman Ret LJC
Traumatology (Tallahass Fla) · 2020 Mar · PMID 32863781 · Full text
Moral injury is hypothesized to develop from witnessing or engaging in events that violate one's beliefs about themselves and has been shown to be associated with negative mental health symptoms. Although there has been...
Moral injury is hypothesized to develop from witnessing or engaging in events that violate one's beliefs about themselves and has been shown to be associated with negative mental health symptoms. Although there has been an increase in research examining moral injury among military veterans, mechanisms that link moral injury to mental health outcomes are not well understood. The present study examined rumination subcomponents (problem-focused thoughts, counterfactual thinking, repetitive thoughts, and anticipatory thoughts) as possible mediators of the associations between moral injury (both self-directed and other-directed symptoms) and negative mental health symptoms (i.e., depression, anxiety, suicidality, sleep disturbance, memory problems, and posttraumatic stress disorder symptoms). Participants were 189 combat wounded veterans (180 men; Mean age = 43.14 years) who had experienced one or more deployments (defined as 90 days or more). Nearly all participants reported a service-connected disability ( = 176, 93.1%), with the average participant reporting a 90% total VA disability ranking, and most participants had received a purple heart ( = 163, 86.2%). Within our comprehensive mediation model, we found eight significant mediation effects with the most consistent mediator being problem-focused thoughts. Specifically, both self-directed and other- directed moral injury were associated with increased problem-focused thoughts, which in turn was associated with higher reported symptoms of depression, anxiety, and posttraumatic stress disorder. Taken together, rumination, and in particular, problem-focused thoughts, is relevant to understand the increased vulnerability of military veterans to exhibit poor mental health outcomes when experiencing moral injury.
Racial differences in posttraumatic stress disorder symptoms among African American and Caucasian male veterans.
Coleman JA, Ingram KM, Sheerin CM
Traumatology (Tallahass Fla) · 2019 Dec · PMID 32099537 · Full text
OBJECTIVE: Posttraumatic stress disorder (PTSD) is one of the most prevalent mental health diagnoses for veterans. Previous research as well as the minority stress model and transgenerational trauma theories, suggest tha...
OBJECTIVE: Posttraumatic stress disorder (PTSD) is one of the most prevalent mental health diagnoses for veterans. Previous research as well as the minority stress model and transgenerational trauma theories, suggest that race may be associated with PTSD, particularly in veterans. The current study examined whether there were racial differences in symptomology in a sample of combat veterans with PTSD (global and symptom cluster-specific). METHODS: Data were collected from male veterans who identified as non-Hispanic Caucasian or non-Hispanic African American ( = 413). Participants completed the Posttraumatic Stress Disorder Checklist- Military version (PCL-M). The PCL-M items were split into four symptom clusters to align with the DSM-5: Re-experiencing, Avoidance, Numbing, and Hyperarousal. It was hypothesized that African American veterans would report more severe global PTSD symptoms and higher levels of hypervigilance. RESULTS: Findings indicated global PTSD symptoms and three of the four symptom clusters did not differ, although the symptom cluster of Re-experiencing was found to be higher for African Americans compared to Caucasians. CONCLUSIONS: It may be helpful for researchers to broaden their methods of assessing PTSD symptomology, such as to examine specific PTSD symptom clusters, especially when assessing differences by race.
Personality-Based PTSD Subtypes in Young Adults.
Egerton G, Radomski SA, Read JP
Traumatology (Tallahass Fla) · 2019 Dec · PMID 34177379 · Full text
The symptom presentation of Posttraumatic Stress Disorder (PTSD) varies widely between individuals, which can complicate both diagnosis and treatment. Personality may help to explain this variability, and personality-bas...
The symptom presentation of Posttraumatic Stress Disorder (PTSD) varies widely between individuals, which can complicate both diagnosis and treatment. Personality may help to explain this variability, and personality-based subtypes of PTSD (Externalizing, Internalizing, Simple; Miller et al., 2003) have been identified for this purpose. Yet, empirical tests of these subtypes have been limited, focusing largely on older samples with combat trauma or other homogenous trauma types. Our study examined PTSD subtypes in two samples of young adults with heterogeneous trauma exposure using cluster analyses. We tested for subtype-based heterogeneity in traumatic response (i.e., PTSD symptomatology). Results revealed that, across the two samples, Externalizing (low conscientiousness, moderate neuroticism), Internalizing (low extraversion, moderate neuroticism), and Simple (low neuroticism) personality-based subtypes emerged, consistent with the existing literature. Subtype-based differences in PTSD symptom severity also were observed, with the Simple subtype generally exhibiting less severe PTSD symptomatology than Internalizing and Externalizing subtypes. However, the subtypes did not differ in terms in number or type (interpersonal versus non-interpersonal) of traumatic experiences. Findings support PTSD subtypes and their relevance for post-traumatic response, particularly PTSD severity, in young adults with a variety of trauma types.
Caregiver Self-Reports and Reporting of Their Preschoolers' Trauma Exposure: Discordance Across Assessment Methods.
Glackin E, Forbes D, Heberle A … +2 more , Carter A, Gray SAO
Traumatology (Tallahass Fla) · 2019 Sep · PMID 31507351 · Full text
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 th...
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.
A Preliminary Examination of the Effect of Cognitive Processing Therapy on Sleep Disturbance Among Veterans with Military Sexual Trauma-Related Posttraumatic Stress Disorder.
Holder N, Holliday R, Wiblin J … +1 more , Surís A
Traumatology (Tallahass Fla) · 2019 Dec · PMID 31275080 · Full text
Veterans who have experienced military sexual trauma (MST) report numerous psychosocial difficulties including sleep disturbance and posttraumatic stress disorder (PTSD). Cognitive Processing Therapy (CPT) has been shown...
Veterans who have experienced military sexual trauma (MST) report numerous psychosocial difficulties including sleep disturbance and posttraumatic stress disorder (PTSD). Cognitive Processing Therapy (CPT) has been shown to effectively reduce total PTSD symptoms among veterans with MST-related PTSD; however, sleep disturbance may persist after successful treatment. Sleep disturbance is associated with suicidal self-directed violence, substance use, and poorer physical health. Identification of if and when CPT can sufficiently address sleep disturbance may help to determine when adjunctive interventions may be indicated. The current study described the rate of sleep disturbance in a sample of veterans with MST-related PTSD before and after CPT. In an exploratory analysis, potential baseline predictors (i.e., sociodemographic, PTSD symptoms, trauma-related cognitions, depression, physical health) of change in sleep disturbance following CPT were assessed. A secondary analysis of 72 male and female veterans enrolled in a randomized clinical trial examining the efficacy of CPT for MST-related PTSD was conducted. Most veterans reported clinically significant sleep disturbance at baseline (100%) and post-treatment (89%). A significant relationship between clinically significant change in PTSD symptoms and resolution of sleep disturbance was not identified. Using hierarchical multiple linear regression, potential predictors of change in sleep severity following CPT were assessed; however, no significant predictors were identified in this exploratory analysis. These results are consistent with previous research describing high residual rates of sleep disturbance in veterans with PTSD, despite reductions in overall PTSD symptoms. Future research should focus on identifying effective augmentation strategies for CPT to specifically address sleep disturbance.
Psychometric Properties of a Modified Moral Injury Questionnaire in a Military Population.
Braitman AL, Battles AR, Kelley ML … +4 more , Hamrick HC, Cramer RJ, Ehlke S, Bravo AJ
Traumatology (Tallahass Fla) · 2018 Dec · PMID 30546271 · Full text
Moral injury (MI) results from perpetration of or exposure to distressing events, known as morally injurious events (MIEs), that challenge moral beliefs and values. Due to the type of involvement in recent military confl...
Moral injury (MI) results from perpetration of or exposure to distressing events, known as morally injurious events (MIEs), that challenge moral beliefs and values. Due to the type of involvement in recent military conflicts, many veterans report MIEs that may cause dissonance and, in turn, MI. Although two existing measures assess MIEs, neither currently assesses the defining characteristics of MI (i.e., guilt, shame, difficulty forgiving self and others, and withdrawal). The present study reports the initial psychometric test of a modified version (Robbins, Kelley, Hamrick, Bravo, & White, 2017) of the Moral Injury Questionnaire - Military version (MIQ-M; Currier, Holland, Drescher, & Foy, 2015) in a sample of 328 military personnel (e.g., veterans, National Guard/reservists, active duty members). The MIQ-M was modified to assess both MIEs and the defining characteristics of MI. Exploratory factor analyses suggested a three-factor model of MIEs consisting of , , and The modified MIQ-M factors were correlated with defining characteristics of MI. In addition, each MIE factor and associated defining characteristics of MI were positively correlated with symptoms of posttraumatic stress disorder, depression, and anxiety, as well as substance use. The modified MIQ-M is a reliable measure of MI that is comprised of three subscales that are associated with, but distinct from, mental health outcomes. Although findings are promising, further research evaluating the applicability of the modified MIQ-M in clinical settings is required to establish construct validity of the defining characteristics and secondary manifestations of MI.
Does Deployment-Related Military Sexual Assault Interact with Combat Exposure to Predict Posttraumatic Stress Disorder in Female Veterans?
Gross GM, Cunningham KC, Moore DA … +7 more , Naylor JC, Brancu M, Wagner HR, Elbogen EB, Calhoun PS, VA Mid-Atlantic MIRECC Workgroup, Kimbrel NA
Traumatology (Tallahass Fla) · 2018 · PMID 30202245
The objective of the present research was to expand upon previous findings indicating that military sexual trauma interacts with combat exposure to predict PTSD among female Iraq/Afghanistan-era veterans. Three hundred a...
The objective of the present research was to expand upon previous findings indicating that military sexual trauma interacts with combat exposure to predict PTSD among female Iraq/Afghanistan-era veterans. Three hundred and thirty female veterans completed self-report measures of combat experiences, military sexual assault (MSA) experiences, and PTSD symptoms as well as structured diagnostic interviews for PTSD. A significant strength of the present research was the use of PTSD diagnosis as an outcome measure. Consistent with prior research, both combat exposure and MSA were significant predictors of PTSD symptoms (linear regression) and PTSD diagnoses (logistic regression). Specifically, participants who experienced deployment-related MSA had approximately six times the odds of developing PTSD compared to those who had not experienced deployment-related MSA, over and above the effects of combat exposure. Contrary to expectations, the hypothesized interaction between MSA and combat exposure was not significant in any of the models. The low base rate of MSA may have limited power to find a significant interaction; however, these findings are also consistent with other recent studies that have failed to find support for the hypothesized interaction. Thus, whereas the majority of available evidence indicates that MSA increases risk for PTSD among veterans over and above the effects of combat, there is presently only limited support for the hypothesized MSA x combat interaction. These findings highlight the continued need for prevention and treatment of MSA in order to improve veterans' long-term mental health and well-being.
Interpersonal Sensitivity as Mediator of the Relations Between War Experiences and Mental Illness in War-Affected Youth in Northern Uganda: Findings From the WAYS Study.
Amone-P'Olak K, Elklit A
Traumatology (Tallahass Fla) · 2018 Sep · PMID 30190654 · Full text
The pathways from war experiences to mental health problems are poorly understood. The current study aims to assess the role of interpersonal sensitivity in the relations between war experiences and mental health problem...
The pathways from war experiences to mental health problems are poorly understood. The current study aims to assess the role of interpersonal sensitivity in the relations between war experiences and mental health problems based on data from the ar-ffected outh urvey cohort study. The ar-ffected outh urvey is an ongoing research project of formerly abducted children in Northern Uganda assessing their war experiences and the risk and protective factors in the development of mental health problems. Mediation of the relations between war experiences and mental health problems by interpersonal sensitivity was analyzed using structural equation modeling. War experiences were related to posttraumatic stress disorder through interpersonal sensitivity accounting for 55% of the variance in their relations, to depression/anxiety through interpersonal sensitivity accounting for 89% of the variance in their relations (i.e., near complete mediation), and to psychotic symptoms through interpersonal sensitivity accounting for 53% of the variance in their relations. The direct relation between war experiences, on the one hand, and posttraumatic stress disorder and psychotic symptoms, on the other hand, attenuated but remained statistically significant. For depression/anxiety, the direct relationship ceased to be significant after including interpersonal sensitivity in the model. Interpersonal sensitivity is an important determinant of long-term mental health problems in war-affected youth. Interventions to improve mental health should target youth with high scores on interpersonal sensitivity. Cognitive-behavioral therapy to recognize and change cognitive schemas in youth prone to interpersonal sensitivity is recommended.
PTSD and Problem Drinking in Relation to Seeking Mental Health and Substance Use Treatment Among Sexual Assault Survivors.
Kirkner A, Relyea M, Ullman SE
Traumatology (Tallahass Fla) · 2018 Mar · PMID 29755296 · Full text
This study seeks to understand the effects of the co-occurrence of PTSD and problem drinking on formal help-seeking among sexual assault survivors over time. Data comes from a diverse sample of 1,863 women in a large Mid...
This study seeks to understand the effects of the co-occurrence of PTSD and problem drinking on formal help-seeking among sexual assault survivors over time. Data comes from a diverse sample of 1,863 women in a large Midwestern city who participated in a three-year study on women's experiences with sexual assault. Generalized Estimating Equations (GEE) were used to estimate the parameters of generalized linear models to assess the effects of PTSD and problem drinking on survivor mental health help-seeking and substance use treatment-seeking over time. In our models, having more PTSD, more education, and receiving a reaction of tangible support increased the odds of survivors seeking mental health treatment, which replicates past findings. This is the first study of women sexual assault survivors to find a unique effect of both PTSD and problem drinking on substance use treatment- seeking. The findings suggest survivors with co-occurring PTSD and problem drinking are less likely to seek substance use treatment over time. Future directions are discussed for research on survivors with co-occurring symptoms.
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