Journal of traumatic stress最新文献

Byrow, Y., Nickerson, A., Specker, P., Bryant, R., O'Donnell, M., McMahon, T., Mau, V., & Liddell, B. (2024). The impact of age-related differences in emotion dysregulation on refugee mental health and social outcomes. Journal of Traumatic Stress, 37(6), 1035–1046. https://doi.org/10.1002/jts.23088

In the Abstract, the text “Additionally, higher levels of trauma exposure may negatively impact social engagement” was incorrect and should have been removed. In Paragraph 3 of the “Discussion” section, the text, “Higher degrees of PTE exposure, more postmigration stressors, higher levels of emotion dysregulation, and older age are all important factors that may negatively impact social engagement in the resettlement environment” was incorrect. This should have read, “More exposure to postmigration stressors, higher levels of emotion dysregulation, and older age are all important factors that may negatively impact social engagement in the resettlement environment.”

We apologize for this error.

Trauma impacts a vast percentage of the global population, with women disproportionally affected by trauma-related disorders—a disparity not explained by exposure alone. Identifying mechanisms associated with this inequity is critical to advancing preventative and responsive treatment. Blunted cortisol reactivity to psychosocial stress represents one possible mechanism, though the influence of sex and specific dimensions of trauma on this condition are underinvestigated. This study examined the roles of sex, developmental timing of trauma, trauma subtype, and subjective trauma impact on cortisol reactivity. Adults (N = 59, n = 37 female) participated in the Trier Social Stress Test, completed trauma measures, and provided salivary cortisol samples. Multiple regression analyses were performed to investigate correlates of blunted cortisol reactivity in the full sample and in sex-disaggregated data to account for unique endocrinological milieus. Women who endorsed childhood trauma demonstrated blunted cortisol reactivity, B = −8.72, p = .004, f ² = .39; notably, this association held only when participants endorsed the childhood traumatic event as their most stressful lifetime event. Considering the lack of clarity regarding the conditions under which blunted cortisol reactivity develops, these findings provide insight into factors that may confer risk for these psychophysiological changes. The observed salience of sex-disaggregated analysis has important implications for future research. Despite decades of study, the pathways linking trauma, cortisol dysregulation, and pathology remain elusive; accounting for sex differences may contribute to resolving this quandary. Unraveling these mechanisms could inform prospective risk assessment, prevention efforts, and focused clinical trials.

Child maltreatment (CM) is associated with social problems, such as loneliness and isolation. One factor that might contribute to these problems is the tendency for individuals who have experienced CM to interpret neutral facial expressions as negative (i.e., negativity bias). Previous research has shown that mental representations of an attachment figure (AF) can lead to positive evaluations of neutral stimuli. We assessed whether such representations can also counteract negativity bias among individuals who experienced CM. Adults (N = 159) with and without a CM history completed a facial emotion recognition task. Prior to that, 53 participants with a CM history imagined an AF, and the rest (n = 49), as well as controls with no CM history (n = 57), imagined a neutral person. Participants in the AF group, d = 0.36, p < .001, but not the two other groups, demonstrated increased self-reported security in response to the imagination task. However, imagining an AF did not lead to stronger vagal responses to the imagination task than imagining a neutral person nor did it counteract negativity bias; compared to controls, individuals who experienced CM interpreted neutral expressions more often as contempt, βs .46–.48; ps = .016–.019, regardless of whether they imagined an AF or a neutral person. Thus, imagining an AF may be a helpful intervention to increase momentary feelings of security in individuals with a CM history. However, alternative—possibly body-oriented—interventions and their potential to reduce socially relevant alterations (e.g., negativity bias) on a behavioral level should be explored.

Research has established the importance of posttrauma appraisals to the development of posttraumatic stress symptoms (PTSS) across a variety of trauma types, populations, and developmental periods. Considering this large body of evidence, there is a notable lack of research on posttrauma appraisals in older adulthood. As rates of elder abuse and maltreatment grow, rates of PTSS are also expected to rise, signaling an urgent need to pinpoint the factors associated with the development and maintenance of PTSS during this unique developmental period. This study extends previous research by exploring whether alienation appraisals were positively associated with PTSS when controlling for other factors known to predict PTSS, including fear appraisals, social support, and cumulative maltreatment. In a convenience sample of community-dwelling older adults (N = 99), multiple linear regression revealed that alienation appraisals were significantly associated with PTSS, β = .34, p = .002, after controlling for cumulative maltreatment (before and after 60 years of age), financial exploitation, fear appraisals, and social support, R² = .51. Our findings suggest that consistent with research from earlier developmental periods, alienation appraisals are significantly associated with PTSS in older adults even when accounting for other factors, such as social support, that are known to be particularly important in old age. Implications, limitations, and future directions are discussed.

This qualitative study aimed to identify service needs and barriers and facilitators to treatment among violently injured patients and their caregivers (e.g., parent, partner) to improve access to and quality of care. Participants included 14 violently injured patients admitted to a Level 1 trauma center (M_age = 28 years, 92.8% Black, 92.8% male) and eight of their caregivers (M_age = 44 years, 100.0% Black, 100.0% female). Semistructured interviews were audio-recorded, transcribed, and deidentified. A team of three coders analyzed the data using thematic analysis. Results indicated that desired in-hospital services included social and emotional support, financial support, and support for caregivers. Desired postdischarge services included financial support and services to promote physical and emotional recovery. Patients often mentioned needing mental health services for their caregivers, whereas caregivers frequently discussed the need for financial assistance and services to support patients’ physical recovery after discharge. Common facilitators for engaging in mental health treatment included support from hospital staff, family, and friends in navigating mental health service systems. Reported barriers to engaging in mental health services were a lack of readiness and limited resources. The findings highlight the critical need to integrate comprehensive care programs within trauma centers to support violently injured patients and their caregivers, reduce barriers to postinjury mental health care, and enhance access to mental health treatment.

Nearly half of women in the United States experience intimate partner violence (IPV) in their lifetime, which is linked to deleterious sequelae related to health outcomes. To better understand these dynamic processes, the current study used secondary data from a 30-day experience sampling methods (ESM) study to examine associations among IPV experiences, posttraumatic stress symptoms (PTSS), alcohol use, and emotion dysregulation. Participants were women over 18 years of age who experienced physical or sexual victimization in the past 6 months. Group iterative multiple model estimation (GIMME) was used to generate idiographic networks for each individual, followed by unsupervised subgroup classification to examine patterns of results across people. The results indicated great heterogeneity among networks. No overall group-level paths emerged, but seven small subgroups emerged, and 30.6% of the sample did not fit into any subgroup. All networks had significant autoregressions, suggesting that associations between IPV, PTSS, emotion dysregulation, and alcohol use are variable and highly specific to the individual. Notably, across findings, most associations emerged at the contemporaneous level, with few lagged effects. The complexity of the findings suggests that substantial heterogeneity exists in the dynamic associations among these processes. Personally tailored approaches may be more effective than one-size-fits-all approaches for assessing and intervening on IPV and related mental health concerns.

Male sexual trauma survivors are understudied compared to their female counterparts despite having a high risk for mental health difficulties. This study aimed to use structural equation modeling to examine the unique influences of sociocultural factors, specifically masculinity facets and negative social reactions upon disclosing sexual trauma, on internalizing symptoms among male sexual trauma survivors. We hypothesized that self-reliance, emotional control, and negative social reactions would directly predict internalizing symptoms related to posttraumatic stress disorder, depression, and generalized anxiety and that indirect effects through self-blame would also be significant. We also performed exploratory analyses to examine other facets of masculinity and their associations with internalizing symptoms. Prolific was used to recruit a final sample of 205 cisgender men who experienced sexual trauma. Results indicated that, as predicted, self-blame, negative social reactions to trauma disclosure, and self-reliance were significantly associated with worse internalizing symptoms, βs = .23–.41, p < .001-p = .002; however, contrary to our hypotheses, no direct effects were observed for emotional control. As hypothesized, indirect effects were found such that self-blame partially explained associations between internalizing symptoms and both self-reliance and negative social reactions to sexual trauma disclosure, βs = .05–.06; ps = .021–035. Exploratory analyses of other facets of masculinity revealed that power over women, β = -.31, p = .016, was associated with lower internalizing symptoms, and winning was associated with higher internalizing symptoms, β = .21, p = .015. The findings from this study can be used to inform therapeutic interventions for this vulnerable, understudied population.

Clinicians have expressed concerns that symptoms may worsen during evidence-based treatments for posttraumatic stress disorder (PTSD), such as cognitive processing therapy (CPT). The current study examined rates of symptom exacerbation in two samples undergoing massed CPT: veterans (N = 499) and community members (N = 69). The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) was administered throughout treatment in both samples, and exacerbation was calculated based on changes from one assessment point to the next during treatment. Clinically reliable exacerbation, defined as a PCL-5 score increase greater than 8.83 points in consecutive measurements taken throughout treatment, was observed at least once in 27.3% of veterans and 21.7% of community members during treatment. Only 1.4% of veterans and 5.8% of community members reported reliably elevated symptoms from baseline at the end of treatment. The findings suggest low rates of clinically meaningful exacerbation during massed CPT, highlighting its utility across diverse populations and treatment formats. These results can inform clinician-patient discussions, alleviate concerns about worsening symptoms, and assuage clinician concerns about symptom exacerbation during CPT.

There are 43,400,000 refugees worldwide; half are children. To address this global public health crisis, there is a need to integrate refugee youth voices into the study of risk and resilience following forced migration. We aimed to disentangle linguistic elements of refugee youths’ trauma narratives and identify biopsychosocial correlates of traumatic stress. Participants were 68 youth aged 7–17 years who resettled as refugees of Syria (M_age = 12.85) and provided trauma narratives while electrodermal activity (EDA) was recorded. A mixed-methods analytic approach combined narrative data analyzed using the Linguistic Inquiry and Word Count (LIWC) tool with psychophysiology and self-reported anxiety symptoms. In total, 61.8% of participants mentioned violence and loss in pre-resettlement narratives. Post-resettlement narratives frequently described discrimination and bullying in schools and neighborhoods. Exploratory LIWC analyses revealed social references and perception as the top semantic categories in narratives. Two-tailed Spearman correlations indicated a significant association between anxiety severity and social-related language, r = .40, and home-related language, r = .37, ps < .001. We also observed significant associations between social anxiety and space-related language, r = .36, p < .001, and baseline tonic EDA and death-related language frequency, r = -.38, p < .001. Effects did not survive correction for multiple comparisons. The design and preliminary data lay the groundwork for further understanding the qualitative stressors of youth pre- and post-resettlement but require replication in better-powered samples. Understanding the impact of civilian war trauma, forced displacement, and post-resettlement stress can inform intervention development, targeted treatment, and policy.

The aim of this study was to investigate the prevalence of prolonged grief disorder (PGD) in children and adolescents who experienced parental loss in the 2023 Turkey earthquake and to identify factors predicting the development of PGD. The study was designed as a prospective, longitudinal observational study. The final sample consisted of 147 children and adolescents. The Prolonged Grief Assessment–Child Version (PGA-C) was used to assess the severity of prolonged grief and normative grief symptoms. The Revised Child Anxiety and Depression Scale–Child Version was used to assess the severity of major depressive disorder (MDD) symptoms, and the Children's Revised Impact of Event Scale was used to assess the severity of posttraumatic stress disorder (PTSD) symptoms. Data collection took place in two phases: The first phase occurred between June 16, 2023, and July 20, 2023, and the second phase was conducted between November 10, 2023, and November 20, 2023. The PGA-C was utilized in the latter assessment to evaluate the prevalence and severity of PGD. Nine months after the earthquake, 19.7% of participants met the diagnostic criteria for PGD. Multivariate regression analyses showed that the severity of MDD symptoms predicted PGD, OR = 1.14, p = .024, whereas both normative grief, B = 0.35, p = .005, and MDD symptom severity, B = 0.42, p = .028, significantly predicted PGD symptom severity. These findings suggest that early identification and treatment of MDD during bereavement may help mitigate the risk of later PGD development.