Jaxin Annett, Martha Tillson, Megan Dickson, Mary Levi, J. Matthew Webster, Michele Staton
Justice-involved women frequently report maltreatment and intimate relationships characterized by violence and abuse throughout adulthood. The present study aimed to (a) investigate the association between victimization and sexual relationship power (SRP) among justice-involved women with opioid use disorder (OUD) and (b) explore resilience as a potential moderating factor of the association between victimization and SRP. Under the ongoing Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative, justice-involved women (N = 700) were randomly selected from eight jails in Kentucky, screened for OUD, consented to participate, and interviewed by research staff. SRP was examined using the Sexual Relationship Power Scale, a validated instrument with two distinct subscales measuring decision-making dominance (DMD) and relationship control (RC); prior maltreatment was measured using the Global Appraisal of Individual Needs General Victimization Scale, and resilience was assessed using the Brief Resilience Scale. Linear regression was used to examine the association between maltreatment and SRP, with three models constructed to account for SRP, DMD, and RC, controlled for demographic characteristics. Finally, we examined whether the association between victimization and SRP varied as a function of resilience. Significant negative associations between maltreatment and the SRP were observed, ps < .001. Resilience moderated the association between maltreatment and DMD, p = .005; however, resilience did not moderate the associations between maltreatment and SRP, p = .141, or RC, p = .735. These findings highlight the importance of increasing resilience in justice-involved women with OUD to reduce the impact of maltreatment on SRP. Prioritizing resilience may offer significant benefits for preventing and addressing maltreatment.
{"title":"Maltreatment, resilience, and sexual relationship power in a sample of justice-involved women with opioid use disorder","authors":"Jaxin Annett, Martha Tillson, Megan Dickson, Mary Levi, J. Matthew Webster, Michele Staton","doi":"10.1002/jts.23030","DOIUrl":"10.1002/jts.23030","url":null,"abstract":"<p>Justice-involved women frequently report maltreatment and intimate relationships characterized by violence and abuse throughout adulthood. The present study aimed to (a) investigate the association between victimization and sexual relationship power (SRP) among justice-involved women with opioid use disorder (OUD) and (b) explore resilience as a potential moderating factor of the association between victimization and SRP. Under the ongoing Kentucky Justice Community Opioid Innovation Network (JCOIN) cooperative, justice-involved women (<i>N</i> = 700) were randomly selected from eight jails in Kentucky, screened for OUD, consented to participate, and interviewed by research staff. SRP was examined using the Sexual Relationship Power Scale, a validated instrument with two distinct subscales measuring decision-making dominance (DMD) and relationship control (RC); prior maltreatment was measured using the Global Appraisal of Individual Needs General Victimization Scale, and resilience was assessed using the Brief Resilience Scale. Linear regression was used to examine the association between maltreatment and SRP, with three models constructed to account for SRP, DMD, and RC, controlled for demographic characteristics. Finally, we examined whether the association between victimization and SRP varied as a function of resilience. Significant negative associations between maltreatment and the SRP were observed, <i>p</i>s < .001. Resilience moderated the association between maltreatment and DMD, <i>p = </i>.005; however, resilience did not moderate the associations between maltreatment and SRP, <i>p =</i> .141, or RC, <i>p =</i> .735. These findings highlight the importance of increasing resilience in justice-involved women with OUD to reduce the impact of maltreatment on SRP. Prioritizing resilience may offer significant benefits for preventing and addressing maltreatment.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140194080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Caitlyn O. Hood, Matthew W. Southward, Christal L. Badour, Shannon Sauer-Zavala
BPD Compass is a transdiagnostic psychotherapy that includes cognitive, behavioral, and mindfulness skills targeting the personality dimensions of negative affectivity, disinhibition, and antagonism. Given considerable symptom comorbidity and overlap in etiology between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD), this study investigated whether BPD Compass holds promise as an integrated approach to simultaneously treating co-occurring BPD features and PTSD symptoms. Participants included 84 trauma-exposed adults who participated in a two-phase clinical trial (Phase 1: randomized controlled trial of BPD Compass vs. waitlist [n = 43]; Phase 2: open trial of BPD Compass [n = 41]). Compared to waitlist, BPD Compass led to medium-to-large–sized, significant improvements in BPD features, βs = −.57 −.44, and facets of neuroticism, βs < −.55–−.73, as well as small, nonsignificant improvements in self-reported, β = −.20, and clinician-rated PTSD symptom severity, β = −.19. During treatment, within-person improvements in PTSD symptoms predicted subsequent improvements in BPD features, β = .13, but not vice versa, β = .07. Within-person PTSD symptom reduction also predicted subsequent improvement in all personality dimensions, whereas only within-person improvement in despondence, β = .12, affective dysregulation, β = .11, and dissociative tendencies, β = .12, predicted PTSD symptom reductions. Findings offer preliminary support for the potential of BPD Compass to target BPD features and aspects of neuroticism and agreeableness among trauma-exposed adults. Moreover, PTSD symptom change predicting subsequent improvement in BPD features runs counter to current stage-based treatment models that emphasize BPD feature stabilization before engaging in trauma-focused therapy.
{"title":"BPD Compass: Using a dimensional model of psychopathology to treat co-occurring borderline personality disorder and posttraumatic stress symptoms","authors":"Caitlyn O. Hood, Matthew W. Southward, Christal L. Badour, Shannon Sauer-Zavala","doi":"10.1002/jts.23024","DOIUrl":"10.1002/jts.23024","url":null,"abstract":"<p>BPD Compass is a transdiagnostic psychotherapy that includes cognitive, behavioral, and mindfulness skills targeting the personality dimensions of negative affectivity, disinhibition, and antagonism. Given considerable symptom comorbidity and overlap in etiology between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD), this study investigated whether BPD Compass holds promise as an integrated approach to simultaneously treating co-occurring BPD features and PTSD symptoms. Participants included 84 trauma-exposed adults who participated in a two-phase clinical trial (Phase 1: randomized controlled trial of BPD Compass vs. waitlist [<i>n</i> = 43]; Phase 2: open trial of BPD Compass [<i>n =</i> 41]). Compared to waitlist, BPD Compass led to medium-to-large–sized, significant improvements in BPD features, βs = −.57 −.44, and facets of neuroticism, βs < −.55–−.73, as well as small, nonsignificant improvements in self-reported, β = −.20, and clinician-rated PTSD symptom severity, β = −.19. During treatment, within-person improvements in PTSD symptoms predicted subsequent improvements in BPD features, β = .13, but not vice versa, β = .07. Within-person PTSD symptom reduction also predicted subsequent improvement in all personality dimensions, whereas only within-person improvement in despondence, β = .12, affective dysregulation, β = .11, and dissociative tendencies, β = .12, predicted PTSD symptom reductions. Findings offer preliminary support for the potential of BPD Compass to target BPD features and aspects of neuroticism and agreeableness among trauma-exposed adults. Moreover, PTSD symptom change predicting subsequent improvement in BPD features runs counter to current stage-based treatment models that emphasize BPD feature stabilization before engaging in trauma-focused therapy.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140158389","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
On October 7, 2023 (10/7), Hamas militants brutally attacked Israeli towns and villages surrounding the Gaza Strip, resulting in the killing of more than 1100 people, most of whom were civilians slaughtered in their own homes. The killings occurred under highly traumatic circumstances, including shooting, the burning of homes, hunting down people who attempted to escape, and severe sexual assault. Thus, many Israelis today experience a unique mix of both posttraumatic and severe grief reactions. Traumatic grief (TG) is often defined as a condition that results from the death of a significant other and includes symptoms similar to posttraumatic stress disorder (PTSD) that are specifically related to the deceased, such as intrusive thoughts and memories about the deceased and hypervigilance expressed by constantly looking for them or cues associated with them. However, whereas definitions, phenomenological descriptions, and clinical illustrations of PTSD are abundant and widely validated, TG has yet to receive formal diagnostic status. In this paper, we aim to reexamine TG in the context of post-10/7 Israel. We argue that TG is a critical concept for clinicians working in Israel and other conflict-exposed areas of the world today, as it accurately captures the painful mix of grief- and trauma-related symptoms. We also suggest potential explanations for the lack of acknowledgment of TG as a formal diagnosis and discuss the possible role of historical events in the formation of new, relevant psychiatric diagnoses.
{"title":"A unique combination of horror and longing: Traumatic grief in post–October 7, 2023, Israel","authors":"Ilanit Hasson-Ohayon, Danny Horesh","doi":"10.1002/jts.23026","DOIUrl":"10.1002/jts.23026","url":null,"abstract":"<p>On October 7, 2023 (10/7), Hamas militants brutally attacked Israeli towns and villages surrounding the Gaza Strip, resulting in the killing of more than 1100 people, most of whom were civilians slaughtered in their own homes. The killings occurred under highly traumatic circumstances, including shooting, the burning of homes, hunting down people who attempted to escape, and severe sexual assault. Thus, many Israelis today experience a unique mix of both posttraumatic and severe grief reactions. Traumatic grief (TG) is often defined as a condition that results from the death of a significant other and includes symptoms similar to posttraumatic stress disorder (PTSD) that are specifically related to the deceased, such as intrusive thoughts and memories about the deceased and hypervigilance expressed by constantly looking for them or cues associated with them. However, whereas definitions, phenomenological descriptions, and clinical illustrations of PTSD are abundant and widely validated, TG has yet to receive formal diagnostic status. In this paper, we aim to reexamine TG in the context of post-10/7 Israel. We argue that TG is a critical concept for clinicians working in Israel and other conflict-exposed areas of the world today, as it accurately captures the painful mix of grief- and trauma-related symptoms. We also suggest potential explanations for the lack of acknowledgment of TG as a formal diagnosis and discuss the possible role of historical events in the formation of new, relevant psychiatric diagnoses.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jts.23026","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140131834","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joselyn R. Sarabia, Elinam Dellor, Bridget Freisthler, Katherine Kieninger
Critical incident stress debriefing (CISD) is a commonly utilized intervention in the fire service that aims to minimize psychological harm and adverse mental health outcomes after a potentially traumatic incident. This study aimed to explore firefighter preferences regarding CISD and alternative post–critical incident interventions in relation to firefighter coping self-efficacy (FFCSE) and trauma coping self-efficacy (CSE-T). Firefighters (N = 241) completed an online survey and provided complete data. Most participants were White (n = 203, 84.2%), non-Hispanic (n = 221, 91.7%) men (94.2%; n = 227). CISD was the most preferred intervention among firefighters (n = 113, 46.9%) as compared to informal peer support (n = 31, 12.9%), formal one-on-one counseling (n = 29, 12.0%), and no intervention (n = 68, 28.2%). Firefighters who preferred CISD had statistically significant lower levels of FFCSE, R2= .033–.044, ps = .012–.030, and CSE-T, R2= .035–.061 ps = .017–.024, compared to those who preferred no intervention. Firefighters who preferred formal one-on-one counseling had statistically significantly lower levels of FFCSE, R2= .033–.044, ps = .003–.011, and CSE-T, R2= .035–0.061, p < .001–p = .002, compared to those who preferred no intervention. The findings from this study may guide future research to increase knowledge on firefighter intervention preferences and the association between preference and coping self-efficacy.
{"title":"Exploring the association between post–critical incident intervention preferences and self-reported coping self-efficacy among firefighters","authors":"Joselyn R. Sarabia, Elinam Dellor, Bridget Freisthler, Katherine Kieninger","doi":"10.1002/jts.23029","DOIUrl":"10.1002/jts.23029","url":null,"abstract":"<p>Critical incident stress debriefing (CISD) is a commonly utilized intervention in the fire service that aims to minimize psychological harm and adverse mental health outcomes after a potentially traumatic incident. This study aimed to explore firefighter preferences regarding CISD and alternative post–critical incident interventions in relation to firefighter coping self-efficacy (FFCSE) and trauma coping self-efficacy (CSE-T). Firefighters (<i>N</i> = 241) completed an online survey and provided complete data. Most participants were White (<i>n</i> = 203, 84.2%), non-Hispanic (<i>n</i> = 221, 91.7%) men (94.2%; <i>n</i> = 227). CISD was the most preferred intervention among firefighters (<i>n</i> = 113, 46.9%) as compared to informal peer support (<i>n</i> = 31, 12.9%), formal one-on-one counseling (<i>n</i> = 29, 12.0%), and no intervention (<i>n</i> = 68, 28.2%). Firefighters who preferred CISD had statistically significant lower levels of FFCSE, <i>R</i><sup>2</sup> <i>=</i> .033–.044, <i>p</i>s = .012–.030, and CSE-T, <i>R</i><sup>2</sup> <i>=</i> .035–.061 <i>p</i>s = .017–.024, compared to those who preferred no intervention. Firefighters who preferred formal one-on-one counseling had statistically significantly lower levels of FFCSE, <i>R</i><sup>2</sup> <i>=</i> .033–.044, <i>p</i>s = .003–.011, and CSE-T, <i>R</i><sup>2</sup> <i>=</i> .035–0.061, <i>p</i> < .001–<i>p</i> = .002, compared to those who preferred no intervention. The findings from this study may guide future research to increase knowledge on firefighter intervention preferences and the association between preference and coping self-efficacy.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jts.23029","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mayumi O. Gianoli, Andrew W. Meisler, Rebecca Gordon
Studies have raised concerns about possible inequities in the U.S. Department of Veterans Affairs (VA)’s awards of disability for posttraumatic stress disorder (PTSD) to women. However, the diagnoses and opinions made by disability examiners have not been studied. A sample of 270 initial PTSD examination reports and corresponding VA decisions were studied. Compared to men, women veterans were as likely to be diagnosed with a service-related mental disorder, χ2(1, N = 270) = 2.31, p = .129, odds ratio (OR) = 1.79, 95% CI [0.84, 3.80], and be granted service-connection, χ2(1, N = 270) = 0.49, p = .483, OR = 1.28, 95% CI [0.65, 2.51]. Women veterans were considered to have more psychiatric symptoms, Z = −2.05, p = .041, r = .16, and more psychiatric impairment, Z = −2.48, p = .013, r = .20, but the percentage of disability awarded by the VA did not differ, χ2(1, N = 270) = 0.49, p = .483; OR = 1.28, 95% CI [0.65, 2.51]. Secondary analyses implicate the role of military sexual trauma and premilitary trauma in explaining sex differences in symptoms and impairment. The findings indicate that neither opinions by examiners nor corresponding decisions by the VA regarding service connection reflect a negative bias toward women veterans. Results indicate that unbiased examinations lead to equitable VA claims decisions for women veterans. Future studies of the VA PTSD disability program nationally, including examination procedures and VA policies and implementation, will promote equity for women veterans in the PTSD claims process.
研究表明,美国退伍军人事务部(VA)在向妇女发放创伤后应激障碍(PTSD)残疾赔偿金时可能存在不公平现象,这引起了人们的关注。然而,我们尚未对伤残鉴定人员的诊断和意见进行研究。我们对 270 份创伤后应激障碍初步检查报告和退伍军人事务部的相应决定进行了抽样研究。与男性退伍军人相比,女性退伍军人被诊断出患有与服役相关的精神障碍的几率为 χ2 (1, N = 270) = 2.31, p = .129, 赔率比 (OR) = 1.79, 95% CI [0.84, 3.80],被授予服役关系的几率为 χ2 (1, N = 270) = 0.49, p = .483, OR = 1.28, 95% CI [0.65, 2.51]。女性退伍军人被认为具有更多的精神症状(Z = -2.05,p = .041,r = .16)和更多的精神损伤(Z = -2.48,p = .013,r = .20),但退伍军人事务部授予的残疾百分比没有差异(χ2 (1, N = 270) = 0.49,p = .483;OR = 1.28,95% CI [0.65,2.51])。二次分析显示,军队性创伤和入伍前创伤在解释症状和损伤的性别差异方面发挥了作用。研究结果表明,无论是检查人员的意见还是退伍军人事务部关于服役关系的相应决定,都没有反映出对女性退伍军人的负面偏见。结果表明,无偏见的检查会导致退伍军人事务部为女性退伍军人做出公平的索赔决定。未来在全国范围内对退伍军人事务部创伤后应激障碍残疾计划的研究,包括检查程序和退伍军人事务部的政策和实施,将促进女性退伍军人在创伤后应激障碍索赔过程中的公平。
{"title":"Examining bias in the award of Veterans Affairs (VA) disability benefits for posttraumatic stress disorder in women veterans: Analysis of evaluation reports and VA decisions","authors":"Mayumi O. Gianoli, Andrew W. Meisler, Rebecca Gordon","doi":"10.1002/jts.23034","DOIUrl":"10.1002/jts.23034","url":null,"abstract":"<p>Studies have raised concerns about possible inequities in the U.S. Department of Veterans Affairs (VA)’s awards of disability for posttraumatic stress disorder (PTSD) to women. However, the diagnoses and opinions made by disability examiners have not been studied. A sample of 270 initial PTSD examination reports and corresponding VA decisions were studied. Compared to men, women veterans were as likely to be diagnosed with a service-related mental disorder, χ<sup>2</sup>(1, <i>N</i> = 270) = 2.31, <i>p</i> = .129, odds ratio (<i>OR</i>) = 1.79, 95% CI [0.84, 3.80], and be granted service-connection, χ<sup>2</sup>(1, <i>N</i> = 270) = 0.49, <i>p</i> = .483, <i>OR</i> = 1.28, 95% CI [0.65, 2.51]. Women veterans were considered to have more psychiatric symptoms, <i>Z</i> = −2.05, <i>p</i> = .041, <i>r</i> = .16, and more psychiatric impairment, <i>Z</i> = −2.48, <i>p</i> = .013, <i>r</i> = .20, but the percentage of disability awarded by the VA did not differ, χ<sup>2</sup>(1, <i>N</i> = 270) = 0.49, <i>p</i> = .483; <i>OR</i> = 1.28, 95% CI [0.65, 2.51]. Secondary analyses implicate the role of military sexual trauma and premilitary trauma in explaining sex differences in symptoms and impairment. The findings indicate that neither opinions by examiners nor corresponding decisions by the VA regarding service connection reflect a negative bias toward women veterans. Results indicate that unbiased examinations lead to equitable VA claims decisions for women veterans. Future studies of the VA PTSD disability program nationally, including examination procedures and VA policies and implementation, will promote equity for women veterans in the PTSD claims process.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140094334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Debra Kaminer, Duane Booysen, Kate Ellis, Christian Haag Kristensen, Anushka R. Patel, Katy Robjant, Srishti Sardana
In low- and middle-income countries (LMICs), the mental health consequences of trauma exposure pose a substantial personal, societal, and economic burden. Yet, the significant need for evidence-based mental health treatment remains largely unmet. To unlock the potential for mental health care for trauma survivors in lower-resource contexts, it is critical to map treatment barriers and identify strategies to improve access to evidence-based, culturally appropriate, and scalable interventions. This review, based on an International Society for Traumatic Stress (ISTSS) briefing paper, describes the treatment gap facing adults with traumatic stress in LMICs and identifies the barriers that contribute to this gap. We then highlight strategies for enhancing access to effective treatments for these populations, including task-sharing, the use of culturally adapted and multiproblem interventions, and digital tools to scale access to appropriate care. Finally, we offer recommendations for policymakers, researchers, and service providers to guide an agenda for action to close the treatment gap for trauma survivors in LMICs.
{"title":"Improving access to evidence-based interventions for trauma-exposed adults in low- and middle-income countries","authors":"Debra Kaminer, Duane Booysen, Kate Ellis, Christian Haag Kristensen, Anushka R. Patel, Katy Robjant, Srishti Sardana","doi":"10.1002/jts.23031","DOIUrl":"10.1002/jts.23031","url":null,"abstract":"<p>In low- and middle-income countries (LMICs), the mental health consequences of trauma exposure pose a substantial personal, societal, and economic burden. Yet, the significant need for evidence-based mental health treatment remains largely unmet. To unlock the potential for mental health care for trauma survivors in lower-resource contexts, it is critical to map treatment barriers and identify strategies to improve access to evidence-based, culturally appropriate, and scalable interventions. This review, based on an International Society for Traumatic Stress (ISTSS) briefing paper, describes the treatment gap facing adults with traumatic stress in LMICs and identifies the barriers that contribute to this gap. We then highlight strategies for enhancing access to effective treatments for these populations, including task-sharing, the use of culturally adapted and multiproblem interventions, and digital tools to scale access to appropriate care. Finally, we offer recommendations for policymakers, researchers, and service providers to guide an agenda for action to close the treatment gap for trauma survivors in LMICs.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":2.4,"publicationDate":"2024-03-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140065332","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Accumulating evidence suggests that trauma exposure is positively associated with future engagement in risky behavior, such as substance misuse, aggression, risky sex, and self-harm. However, the psychological factors driving this association and their relevance across gender groups require further clarification. In a community sample of 375 adults with a high rate of trauma exposure (age range: 18–55 years, M = 32.98 years, SD = 10.64; 76.3% assaultive trauma exposure), we examined whether emotional reactivity linked lifetime assaultive trauma exposure with past–month risky behavior. We also explored whether this model differed for cisgender women (n = 178, 47.6%) and men (n = 197, 52.5%). As hypothesized, assaultive trauma was positively related to emotional reactivity, β = .20, SE = 0.03, t(369) = 3.65, p < .001, which, in turn, partially accounted for the association between assaultive trauma and past-month risky behavior, indirect effect: β = .03, SE = 0.01, 95% bootstrapped CI [0.01, 0.06]. Gender moderated this association such that assaultive trauma was indirectly associated with risky behavior via emotional reactivity for women but not for men, index moderation: B = -0.03, SE = 0.02, 95% bootstrapped CI [-0.07, -0.01]. Cross-sectional results suggest that emotional reactivity may be a proximal target for clinical intervention to aid in the reduction of risky behavior among women.
{"title":"Emotional reactivity linking assaultive trauma and risky behavior: Evidence of differences between cisgender women and men","authors":"Anna Stumps, Nadia Bounoua, Naomi Sadeh","doi":"10.1002/jts.23028","DOIUrl":"10.1002/jts.23028","url":null,"abstract":"<p>Accumulating evidence suggests that trauma exposure is positively associated with future engagement in risky behavior, such as substance misuse, aggression, risky sex, and self-harm. However, the psychological factors driving this association and their relevance across gender groups require further clarification. In a community sample of 375 adults with a high rate of trauma exposure (age range: 18–55 years, <i>M =</i> 32.98 years, <i>SD</i> = 10.64; 76.3% assaultive trauma exposure), we examined whether emotional reactivity linked lifetime assaultive trauma exposure with past–month risky behavior. We also explored whether this model differed for cisgender women (<i>n</i> = 178, 47.6%) and men (<i>n =</i> 197, 52.5%). As hypothesized, assaultive trauma was positively related to emotional reactivity, β = .20, <i>SE</i> = 0.03, <i>t</i>(369) = 3.65, <i>p</i> < .001, which, in turn, partially accounted for the association between assaultive trauma and past-month risky behavior, indirect effect: β = .03, <i>SE</i> = 0.01, 95% bootstrapped CI [0.01, 0.06]. Gender moderated this association such that assaultive trauma was indirectly associated with risky behavior via emotional reactivity for women but not for men, index moderation: <i>B</i> = -0.03, <i>SE</i> = 0.02, 95% bootstrapped CI [-0.07, -0.01]. Cross-sectional results suggest that emotional reactivity may be a proximal target for clinical intervention to aid in the reduction of risky behavior among women.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140059702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Joel G. Sprunger, Jeffrey M. Girard, Kathleen M. Chard
Dimensional conceptualizations of psychopathology hold promise for understanding the high rates of comorbidity with posttraumatic stress disorder (PTSD). Linking PTSD symptoms to transdiagnostic dimensions of psychopathology may enable researchers and clinicians to understand the patterns and breadth of behavioral sequelae following traumatic experiences that may be shared with other psychiatric disorders. To explore this premise, we recruited a trauma-exposed online community sample (N = 462) and measured dimensional transdiagnostic traits of psychopathology using parceled facets derived from the Personality Inventory for DSM-5 Faceted–Short Form. PTSD symptom factors were measured using the PTSD Checklist for DSM-5 and derived using confirmatory factor analysis according to the seven-factor hybrid model (i.e., Intrusions, Avoidance, Negative Affect, Anhedonia, Externalizing Behaviors, Anxious Arousal, And Dysphoric Arousal). We observed hypothesized associations between PTSD factors and transdiagnostic traits indicating that some transdiagnostic dimensions were associated with nearly all PTSD symptom factors (e.g., emotional lability: rmean = .35), whereas others showed more unique relationships (e.g., hostility–Externalizing Behavior: r = .60; hostility with other PTSD factors: rs = .12–.31). All PTSD factors were correlated with traits beyond those that would appear to be construct-relevant, suggesting the possibility of indirect associations that should be explicated in future research. The results indicate the breadth of trait-like consequences associated with PTSD symptom exacerbation, with implications for case conceptualization and treatment planning. Although PTSD is not a personality disorder, the findings indicate that increased PTSD factor severity is moderately associated with different patterns of trait-like disruptions in many areas of functioning.
{"title":"Associations between transdiagnostic traits of psychopathology and hybrid posttraumatic stress disorder factors in a trauma-exposed community sample","authors":"Joel G. Sprunger, Jeffrey M. Girard, Kathleen M. Chard","doi":"10.1002/jts.23023","DOIUrl":"10.1002/jts.23023","url":null,"abstract":"<p>Dimensional conceptualizations of psychopathology hold promise for understanding the high rates of comorbidity with posttraumatic stress disorder (PTSD). Linking PTSD symptoms to transdiagnostic dimensions of psychopathology may enable researchers and clinicians to understand the patterns and breadth of behavioral sequelae following traumatic experiences that may be shared with other psychiatric disorders. To explore this premise, we recruited a trauma-exposed online community sample (<i>N</i> = 462) and measured dimensional transdiagnostic traits of psychopathology using parceled facets derived from the Personality Inventory for <i>DSM-5</i> Faceted–Short Form. PTSD symptom factors were measured using the PTSD Checklist for <i>DSM-5</i> and derived using confirmatory factor analysis according to the seven-factor hybrid model (i.e., Intrusions, Avoidance, Negative Affect, Anhedonia, Externalizing Behaviors, Anxious Arousal, And Dysphoric Arousal). We observed hypothesized associations between PTSD factors and transdiagnostic traits indicating that some transdiagnostic dimensions were associated with nearly all PTSD symptom factors (e.g., emotional lability: <i>r</i><sub>mean</sub> = .35), whereas others showed more unique relationships (e.g., hostility–Externalizing Behavior: <i>r</i> = .60; hostility with other PTSD factors: <i>r</i>s = .12–.31). All PTSD factors were correlated with traits beyond those that would appear to be construct-relevant, suggesting the possibility of indirect associations that should be explicated in future research. The results indicate the breadth of trait-like consequences associated with PTSD symptom exacerbation, with implications for case conceptualization and treatment planning. Although PTSD is not a personality disorder, the findings indicate that increased PTSD factor severity is moderately associated with different patterns of trait-like disruptions in many areas of functioning.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jts.23023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996588","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ben Porter, Mary E. Dozier, Amber D. Seelig, Yunnuo Zhu, Michaela S. Patoilo, Edward J. Boyko, Rudolph P. Rull
The current study investigated the associations among probable posttraumatic stress disorder (PTSD), recent Veterans Health Administration (VHA) health care use, and care-seeking for PTSD in U.S. military veterans. Analyses were conducted among 19,691 active duty military personnel enrolled in the Millennium Cohort Study who separated from the military between 2000 and 2012 and were weighted to the 1,130,103 active duty personnel who separated across this time period. VHA utilization was identified from electronic medical records in the year before survey completion, and PTSD care-seeking and PTSD symptoms were assessed through self-report on the 2014–2016 survey; thus, the observation period regarding care-seeking and VHA use encompassed 2013–2016. Veterans with probable PTSD were more likely to use VHA services than those without probable PTSD, aOR = 1.12, 95% CI [1.01, 1.24], although the strongest association with recent VHA use was a depression diagnosis, aOR = 2.47, 95% CI [2.26, 2.70]. Among veterans with probable PTSD, the strongest predictor of care-seeking was recent VHA use compared to community care, aOR = 4.01, 95% CI [3.40, 4.74); reporting a diagnosis of depression was the second strongest predictor of PTSD care-seeking, OR = 2.99, 95% CI [2.53, 3.54]. However, the absolute number of veterans with probable PTSD who were not seeking care was approximately equivalent between veterans using VHA services and those not using VHA services. Additionally, certain groups were identified as being at risk of not seeking care, namely Air Force veterans and veterans with high physical and mental functioning despite substantial PTSD symptoms.
本研究调查了美国退伍军人中可能存在的创伤后应激障碍(PTSD)、退伍军人健康管理局(VHA)最近的医疗保健使用情况以及因创伤后应激障碍而寻求护理之间的关联。分析对象是参加千年队列研究(Millennium Cohort Study)的 19,691 名现役军人,他们在 2000 年至 2012 年期间退伍,分析结果经加权后与这一时期退伍的 1,130,103 名现役军人进行比较。退伍军人医疗服务中心的使用情况是通过调查完成前一年的电子病历确定的,而创伤后应激障碍的就医情况和创伤后应激障碍症状是通过 2014-2016 年调查中的自我报告进行评估的;因此,有关就医情况和退伍军人医疗服务中心使用情况的观察期包括 2013-2016 年。有可能患有创伤后应激障碍的退伍军人比没有可能患有创伤后应激障碍的退伍军人更有可能使用退伍军人医疗服务,aOR = 1.12,95% CI [1.01,1.24],但与近期使用退伍军人医疗服务关系最大的是抑郁症诊断,aOR = 2.47,95% CI [2.26,2.70]。在可能患有创伤后应激障碍的退伍军人中,与社区护理相比,最近使用退伍军人医疗服务是寻求护理的最强预测因素,OR = 4.01,95% CI [3.40,4.74];报告抑郁症诊断是寻求创伤后应激障碍护理的第二大预测因素,OR = 2.99,95% CI [2.53,3.54]。然而,在使用退伍军人事务部服务和未使用退伍军人事务部服务的退伍军人中,可能患有创伤后应激障碍但未寻求治疗的退伍军人的绝对人数大致相当。此外,某些群体(即空军退伍军人和尽管有大量创伤后应激障碍症状但身体和心理功能良好的退伍军人)被认为有不寻求治疗的风险。
{"title":"Posttraumatic stress disorder, Veterans Health Administration use, and care-seeking among recent-era U.S. veterans","authors":"Ben Porter, Mary E. Dozier, Amber D. Seelig, Yunnuo Zhu, Michaela S. Patoilo, Edward J. Boyko, Rudolph P. Rull","doi":"10.1002/jts.23019","DOIUrl":"10.1002/jts.23019","url":null,"abstract":"<p>The current study investigated the associations among probable posttraumatic stress disorder (PTSD), recent Veterans Health Administration (VHA) health care use, and care-seeking for PTSD in U.S. military veterans. Analyses were conducted among 19,691 active duty military personnel enrolled in the Millennium Cohort Study who separated from the military between 2000 and 2012 and were weighted to the 1,130,103 active duty personnel who separated across this time period. VHA utilization was identified from electronic medical records in the year before survey completion, and PTSD care-seeking and PTSD symptoms were assessed through self-report on the 2014–2016 survey; thus, the observation period regarding care-seeking and VHA use encompassed 2013–2016. Veterans with probable PTSD were more likely to use VHA services than those without probable PTSD, a<i>OR</i> = 1.12, 95% CI [1.01, 1.24], although the strongest association with recent VHA use was a depression diagnosis, a<i>OR</i> = 2.47, 95% CI [2.26, 2.70]. Among veterans with probable PTSD, the strongest predictor of care-seeking was recent VHA use compared to community care, a<i>OR</i> = 4.01, 95% CI [3.40, 4.74); reporting a diagnosis of depression was the second strongest predictor of PTSD care-seeking, <i>OR</i> = 2.99, 95% CI [2.53, 3.54]. However, the absolute number of veterans with probable PTSD who were not seeking care was approximately equivalent between veterans using VHA services and those not using VHA services. Additionally, certain groups were identified as being at risk of not seeking care, namely Air Force veterans and veterans with high physical and mental functioning despite substantial PTSD symptoms.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bita Ghafoori, Sofia Triliva, Panagiota Chrysikopoulou, Andreas Vavvos
Greek health care workers (HCWs) working with refugee and asylum-seeker populations may be at risk of trauma exposure and related distress. The current study sought to further understand the factors that may promote or hinder psychological adaptation among HCWs working with trauma-exposed refugee populations in Greece. Participants were HCWs (N = 20) who completed semistructured interviews. Thematic analysis procedures identified three main themes: vicarious traumatization, (b) mismatch of expectations, and (c) difficulty coping. Our study findings highlight the need to provide adequate training, supervision, and mental health support for HCWs to prevent mental health issues in this population. Additional studies are necessary to understand the long-term consequences of working with refugee populations and explore ways to assist HCWs with self-care.
{"title":"Psychological adaptation among health care workers who work with trauma-exposed refugees in Greece","authors":"Bita Ghafoori, Sofia Triliva, Panagiota Chrysikopoulou, Andreas Vavvos","doi":"10.1002/jts.23022","DOIUrl":"10.1002/jts.23022","url":null,"abstract":"<p>Greek health care workers (HCWs) working with refugee and asylum-seeker populations may be at risk of trauma exposure and related distress. The current study sought to further understand the factors that may promote or hinder psychological adaptation among HCWs working with trauma-exposed refugee populations in Greece. Participants were HCWs (<i>N</i> = 20) who completed semistructured interviews. Thematic analysis procedures identified three main themes: vicarious traumatization, (b) mismatch of expectations, and (c) difficulty coping. Our study findings highlight the need to provide adequate training, supervision, and mental health support for HCWs to prevent mental health issues in this population. Additional studies are necessary to understand the long-term consequences of working with refugee populations and explore ways to assist HCWs with self-care.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":null,"pages":null},"PeriodicalIF":3.3,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139905948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}