Psychological trauma : theory, research, practice and policy最新文献

Objective: Suicide is a leading cause of adolescent death demonstrating an increasing trend in the United States for more than a decade. Recently, the U.S. Surgeon General issued an advisory about the negative impact of social media on adolescent mental health. Results from prior research on digital engagement among adolescents have been inconsistent. The purpose of this research is to investigate trends in adolescent technology use prior to death by suicide using National Violent Death Reporting System (NVDRS) data.

Method: All 3,597 case records for adolescent deaths by suicide occurring during 2017-2019 were screened for mention of technology use. Qualitative content analysis methods were used to develop a codebook of nine technology use categories. Descriptive parameters were compiled, and cross tabulations by age, sex, use, and contextual factors were compiled.

Results: A final sample of 1,107 incidents included an identified role of technology use. Most completed suicides involved males, and the most common use of technology was to communicate intent to die by suicide on social media, identified in approximately 50% of identified incidents across demographic categories. Unavailability of technology due to punishment or malfunction preceded death by suicide in 23% of cases.

Conclusion: Results of national survey data suggest adolescent females experience poorer mental health than males although adolescent males in the United States died by suicide at more than twice the rate of females. Suicide following technology restriction supports prior research suggesting the potential for technology addiction among adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Military sexual trauma (MST), childhood trauma, and combat trauma are prevalent among U.S. military personnel. Cumulative trauma exposure may hinder posttraumatic growth, a positive psychological change following traumatic events, while social support can facilitate this growth. Understanding the influence of these traumas and social support on longitudinal posttraumatic growth is crucial.

Method: We assessed 1,230 veterans at 6, 9, 12, 18, and 24 months postinitial survey. Latent class analysis identified trauma experience classes, and latent growth models examined posttraumatic growth trajectories, incorporating social support as a time-varying covariate.

Results: The latent class analysis revealed four classes: high trauma exposure, moderate childhood trauma-moderate combat trauma, high MST-moderate combat trauma, and combat trauma only. Veterans in the combat-only class reported significant posttraumatic growth. The moderate childhood trauma-moderate combat class exhibited consistently low growth. Veterans in the high MST-moderate combat class showed slightly higher initial growth but no significant change over time. The high trauma exposure class experienced a significant decline in growth.

Conclusions: Social support significantly predicted posttraumatic growth, with varying impacts across trauma classes. Interventions could be vital for survivors of MST, childhood trauma, or compounded traumas to enhance posttraumatic growth among military veterans. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The goal of this study was to (a) examine the association between childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms and possible risk factors of previous trauma, individual characteristics (neuroticism, anxiety sensitivity, and resilience), type of birth, and birth satisfaction and (b) explore whether birth satisfaction moderates any association between individual characteristics and CB-PTSD symptoms.

Method: This was a longitudinal questionnaire study during pregnancy and postpartum. Pregnant women (N = 396) were recruited from antenatal clinics and completed questionnaires during mid-late pregnancy (Time 1) and 6-12 weeks after childbirth (Time 2). Time 1 questionnaires measured anxiety sensitivity (Anxiety Sensitivity Index), neuroticism (International Personality Item Pool-50, Neuroticism subscale), resilience (Brief Resilience Scale), and trauma history. Time 2 questionnaires measured birth satisfaction and CB-PTSD (Birth-Related and General Symptoms subscales).

Results: Regression analysis showed that previous sexual trauma, higher levels of neuroticism, and lower levels of birth satisfaction predicted higher levels of CB-PTSD symptoms. Anxiety sensitivity and resilience were not significant predictors of CB-PTSD. Additionally, birth satisfaction moderated the relationship between higher neuroticism and higher levels of CB-PTSD (total and general symptoms) and between lower resilience and higher CB-PTSD general symptoms. Effects were stronger when low birth satisfaction was reported.

Conclusions: Individual characteristics and birth satisfaction interact in the development of posttraumatic stress disorder following childbirth, with previous traumatic experiences playing an additional role. These findings can inform screening and care pathways for women at greater risk. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Research on factors that predict compassion satisfaction and compassion fatigue of teachers is limited. This study aimed to evaluate predictors of compassion fatigue (as defined by burnout and secondary traumatic stress) and compassion satisfaction of Australian teachers.

Method: Three hundred and two teachers completed an online survey. It was hypothesized that teachers with prior experience with trauma-exposed students, a history of mental illness, and personal trauma history would show higher compassion fatigue. Older teachers, teachers previously exposed to trauma training, and teachers with higher perceived knowledge and confidence to manage student trauma were expected to show higher compassion satisfaction.

Results: Teachers with exposure to student trauma, a personal history of trauma, and a history of mental illness experienced higher compassion fatigue, while older teachers and those with higher perceived knowledge and confidence to deal with student trauma experienced higher compassion satisfaction.

Conclusions: Results indicate that professional development programs should include trauma-informed knowledge and skills for teachers to enhance their well-being when responding to trauma-exposed students. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: This project seeks to clarify the impact of childhood trauma and psychotic-like experiences (PLEs) on working memory (WM) and explore gender differences in these relationships. The effect of childhood trauma on WM performance has yet to be explored in individuals with PLEs, despite consistent associations between trauma, psychosis spectrum symptoms, and WM performance.

Method: In 466 undergraduates, positive PLEs (Prodromal Questionnaire) and trauma (Childhood Trauma Questionnaire) were examined to determine contributions to WM performance on a spatial n-back task. We conducted hierarchical linear regressions on the total sample and stratified by gender to examine the effects of childhood trauma, positive PLEs, and their interaction on WM performance. Supplemental analyses explored attenuated negative and disorganized symptoms.

Results: Controlling for age, there were no significant main effects of positive PLEs, childhood trauma, their interaction, or three-way interaction including gender in predicting WM. After stratifying by gender, childhood trauma was significantly associated with poorer WM in females only. Post hoc analyses revealed that in the full sample, physical neglect predicted WM performance and was a trend for females, while sexual abuse trended toward predicting WM in males. Supplemental analyses of attenuated negative and disorganized symptoms revealed childhood trauma significantly predicted WM in the full sample and females only for negative symptoms.

Conclusions: Females who have experienced childhood trauma may be at greater risk for WM problems, irrespective of co-occurring PLEs, suggesting that cognitive difficulties may be partially attributable to history of trauma. These findings have potential implications for intervention strategies in trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Posttrauma nightmares are recurring nightmares that begin after a traumatic experience. Research has only recently begun to identify variables that predict posttrauma nightmare occurrences. Research has identified presleep arousal-cognitive (PSA-C) and presleep arousal physiological (PSA-PHYS), sleep onset latency (SOL), and sleep-disordered breathing (SDB) as potential predictors of posttrauma nightmares. However, previous research includes methodological limitations, such as a lack of physiological measures and a homogeneous sample. To replicate previous findings and increase generalizability, the current study investigated predictors of nightmare occurrences in a sample of male inpatient veterans with mixed-trauma history.

Method: Participants (n = 15) completed an initial assessment battery and seven consecutive days of pre and postsleep diaries, including measures of posttrauma nightmare triggers and posttrauma nightmare occurrences. Portable objective measurements of sleep and presleep states were used to examine sleep quality and physical arousal.

Results: Analyses revealed that PSA-C and SOL both predicted posttrauma nightmare occurrences and that PSA-PHYS was significantly higher on nights when nightmares occurred.

Conclusion: Results replicate earlier research which posits that PSA and SOL play a role in triggering the occurrence of posttrauma nightmares. It should be noted that the sample was relatively small, warranting cautious interpretation of results. However, when taken together with the findings of the replicated study, results could suggest the plausibility of therapies targeting presleep cognitions, SOL, and presleep arousal in the treatment of posttrauma nightmares. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Previous research with youth has shown that clinicians tend to diagnose and treat posttraumatic stress disorder (PTSD) in trauma-exposed clients, even when clinical presentations indicate that PTSD is not the primary diagnosis. The current study sought to examine this trauma-related diagnostic overshadowing bias in adult cases across different types of trauma exposure.

Method: Mental health professionals (N = 232) reviewed two vignettes describing an adult seeking treatment for either obsessive-compulsive disorder (OCD) symptoms or substance use disorder (SUD) symptoms (target disorders). Each participant was randomly assigned to one vignette in which one client endorsed exposure to trauma (i.e., sexual trauma or physical trauma) and one vignette in which the client reported no trauma exposure. Following each vignette, participants responded to questions related to the diagnosis and treatment of the client.

Results: In both cases, participants were significantly less likely to choose the target diagnosis and treatment and more likely to choose a PTSD diagnosis and trauma treatment when trauma exposure was present in the vignettes. Evidence for the bias was strongest for vignettes that contained sexual trauma compared to vignettes that contained physical trauma. Evidence for the bias was also more consistent in the OCD case compared to the SUD case.

Conclusions: Results indicate evidence for the existence of trauma-related diagnostic overshadowing in adult populations, though the strength of this bias may be dependent on aspects of the trauma and overall clinical presentation. More work is needed to understand factors that may impact the presence of this bias. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This letter discusses the current challenge in classification and treatment of DSM-5-TR prolonged grief disorder. Prolonged grief disorder (PGD) is among the new mental disorders included in the DSM-5-TR section II, a chapter about trauma and stressor-related disorders. By definition, PGD is a maladaptive response to the death of a loved one characterized by a period of at least 12 months of persistent yearning for or preoccupation with the deceased and disabling symptoms such as disbelief about the death, avoidance, emotional numbness, identity disruption, intense emotional pain, loneliness, a sense that life is meaningless, and failure to move forward. This syndrome occurs in 9.8% of bereaved survivors and may be associated with increased risk of medical conditions (e.g., cardiovascular disease, cancer, and immunological dysfunction), substance use disorders (particularly increased tobacco and alcohol use), suicidality, and diminished quality of life. Given that PGD has clinical similarities with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), recent studies have evaluated selective serotonin reuptake inhibitors (SSRIs) in the treatment of this novel DSM-5-TR diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: A growing body of research has emerged to characterize differences in posttraumatic stress disorder (PTSD) symptom presentations in individuals from diverse racial and ethnic groups. However, less research has examined if these observed differences can be attributed to bias within PTSD assessments. Knowledge about potential bias in PTSD assessment is essential for interpreting group differences. If PTSD assessments do not perform similarly across diverse demographic groups, then observed differences may be artificial products of inaccurate measurement, new assessments could be required for individuals from different demographic groups, and we would be unable to accurately detect PTSD treatment effects in patients from diverse groups.

Method: We evaluated PTSD assessment bias through tests of measurement invariance for the semistructured, clinician-administered AUDADIS-5 diagnostic assessment of participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants included those who reported having experienced at least one potentially traumatic event in their lifetime (N = 23,936). Measurement invariance was assessed for participants who identified from several demographic groups (Asian, Native Hawaiian, or Pacific Islander; Hispanic; American Indian/Alaskan Native; and Black) compared to participants who identified as White (non-Hispanic).

Results: Overall, PTSD assessment was largely invariant across groups, while small amounts of measurement invariance were detected that can inform future research and clinical adaptations.

Conclusions: This work validates prior research that relies on a common conceptualization of PTSD, and it provides several paths for future improvement in research and clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: There is emerging evidence that first responders, like military personnel, are at risk for exposure to potentially morally injurious events. However, studies examining expressions of moral injury in first responders are nascent, in large part due to the limited number of measures validated for use in this population. To address this gap, the present study sought to investigate the psychometric properties of the Expressions of Moral Injury Scale-Military Version (EMIS-M) in a sample of first responders.

Method: The psychometric properties of the EMIS-M were investigated in a sample of 228 first responders to determine reliability, convergent validity, discriminative validity, and divergent validity. In addition, confirmatory factor analysis was conducted to test the bifactor model identified in a veteran sample (Currier et al., 2018).

Results: Results yielded an excellent fit for the bifactor model with correlated self-directed and other-directed subscales identified in the EMIS-M development study. In addition, the measure evidenced strong reliability, convergent validity, discriminative validity, and divergent validity.

Conclusions: The findings of the present study suggest that the Expressions of Moral Injury Scale-First Responder Version is a psychometrically sound measure capable of assessing self- and other-directed expressions of moral injury in first responders. The significance of these findings to our understanding of moral injury in first responders and their implications for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).