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

Objective: The COVID-19 pandemic has elicited wide-scale general psychological distress; however, longitudinal investigations are required to identify the critical resources that support individuals' adaptation to this type of unique situation over time. Hardiness, a cognitive trait that facilitates adaptation in the context of adversity and possible posttraumatic growth, may be particularly influential on mental health recovery during health disasters when other resources are not available or effective.

Method: We tested the hypothesis that greater psychological hardiness prior to the pandemic would predict lower traumatic stress symptoms (TSSs) and loneliness early into the pandemic and decreases in TSSs and loneliness between early 2020 and late 2021. Predominantly ethnic minority (77% Latina/o/x or Asian American) female young adults (N = 80; M_age = 25 years; 88% female) attending a minority-serving public university completed a measure of hardiness in January 2020 as well as measures of pandemic-related TSSs and loneliness in April 2020, October 2020, and December 2021.

Results: Latent growth curve analyses indicated that hardiness was associated with lower initial loneliness as well as decreases in TSSs and loneliness over time.

Conclusions: Consistent with previous research on adaptation to other potentially traumatic stressors, the current findings suggest that psychological hardiness may play a critical protective role during a global health disaster, both in terms of initial distress and changes in distress over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objectives: Cognitive processing therapy (CPT) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD); however, little is known about how interrelationships between PTSD symptoms change over the course of treatment. The current study examined baseline, midtreatment, and posttreatment PTSD symptom networks during CPT for PTSD.

Method: Adults with PTSD (n = 107) received 12 sessions of CPT as part of a randomized trial. Self-reported PTSD symptoms were assessed at pretreatment, midtreatment, and posttreatment, and network analysis was used to examine the interrelationships between symptoms at these three timepoints. Linear regression was conducted to examine whether any baseline symptoms or midpoint symptoms predicted overall treatment change.

Results: In the baseline PTSD network, feelings of detachment and feeling upset at reminders of the trauma were central to the symptom network. These symptoms were no longer central at midtreatment, possibly suggesting that CPT quickly reduces the importance of these symptoms. These findings were consistent with regression results that, after accounting for multiple comparisons, high baseline scores of feeling upset at trauma reminders predicted later treatment change. At the conclusion of treatment, strong negative emotions were the most central symptom and may be most important in maintaining or lowering other PTSD symptoms at the conclusion of treatment.

Conclusions: Though replication is necessary, these findings offer insights into identifying which symptoms may be most predictive of treatment outcomes and the course by which CPT reduces PTSD symptoms. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The COVID-19 outbreak has led to an increase in posttraumatic stress symptoms (PTSSs; Prout et al., 2020) for some individuals, whereas others appeared to be more resilient. It remains relatively unclear what characterizes these potentially different response trajectories ( Chen & Bonanno, 2020). This study sought to (a) assess individuals' PTSS levels at the start of the pandemic and at two subsequent timepoints 3 and 6 months later, (b) identify different trajectories of PTSSs over time, and (c) describe which individual characteristics influenced the likelihood of each of these different trajectories to occur.

Method: A community sample (n = 317) responded to an online survey during the first weeks of the pandemic, 3 and 6 months later.

Results: Among those who reported acute levels of PTSSs, latent class growth analyses identified three different resilience trajectories-resilient (low baseline PTSSs and a slight decrease over time), chronic (severe PTSSs at baseline and no change over time), and recovered (severe PTSSs at baseline but a sharp improvement over time). Baseline childhood adversity, depression, anxiety, defensive functioning, and somatization predicted trajectories. Demographics (age, gender, preexisting chronic illness) and COVID-related factors (knowing someone diagnosed with or who died of COVID-19) were unrelated to trajectories.

Conclusions: Results suggest that although high PTSS levels decreased over time on average, heterogenous change trajectories can be identified based on baseline psychological characteristics. This implies that mental health, including past and present experiences, as well as adaptational mechanisms may shape individuals' experiences with pandemic-related ongoing stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The general aim of this study was to examine the psychological variables associated with post-traumatic stress disorder (PTSD) symptomatology, focusing on perceived stress, worry, as well as mature, neurotic, and immature defenses. Therefore, the differences in the study variables based on the levels of posttraumatic stress were explored, and a moderated mediation model was tested, controlling for gender and SARS-CoV-2 infection as covariates.

Method: A sample of 1,864 Italian participants completed the Impact of event scale-revised (IES-R), the 10-Item Perceived Stress Scale (PSS-10), the Penn State Worry Questionnaire (PSWQ), and the 40-Item Defense Style Questionnaire (DSQ-40).

Results: 41% (n = 764) of participants showed scores indicative of a probable presence of PTSD. They reported significantly higher levels of perceived stress, worry, neurotic and immature defenses than participants with lower PTSD symptomatology. Perceived stress was significantly associated with PTSD symptomatology, both directly and indirectly through the mediation of worry. Furthermore, neurotic and immature defenses were significant moderators in some relationships of this model.

Conclusions: Such data can provide useful indications to elaborate tailored interventions and specific prevention activities for PTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Both theoretical and empirical studies suggest that negative cognitive biases significantly influence the onset and persistence of posttraumatic stress disorder (PTSD) symptoms. However, the interplay among these cognitive biases and their conjoint contribution to the long-term trajectory of posttraumatic stress symptoms remains underexplored. This study delves into the interplay among attention, appraisal, and memory biases within a provisional PTSD population and evaluates the predictive effects of two integrative models (weakest link, additive approach) on posttraumatic stress symptoms reported 2 months later.

Method: Sixty Chinese participants (M_age = 20.17, SD_age = 2.11) with provisional PTSD undertook the scrambled sentences test (appraisal bias) with their eye movements recorded (attention bias) and then the free recall task (memory bias). Posttraumatic stress symptom was assessed at baseline and 2-month follow-up.

Results: Selective attention bias toward negative words was positively associated with the negative appraisal of scrambled sentences, which subsequently showed a strong association with negative memory bias. Regarding the progression of posttraumatic stress symptoms, the additive approach was found to be a more reliable predictor of self-reported posttraumatic stress symptoms at 2 months than the weak link approach.

Conclusions: This study provides initial evidence supporting the combined cognitive biases hypothesis in provisional PTSD. It also underscores potential avenues to enhance cognitive bias modification techniques. Replication of these findings in broader clinical samples is essential. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Belsky's parenting model provides insight into the relationship between parental psychological status and parenting behaviors. However, little is known about the unique associations of posttraumatic stress disorder (PTSD) symptoms with specific parenting behaviors. This study aimed to assess the associations of PTSD symptoms and three types of parenting behaviors (rejection, emotional warmth, and overprotection) with marital satisfaction, and to examine gender differences in these associations.

Method: Self-report questionnaires were used to survey 4,570 parents 3 months after Typhoon Lekima in China.

Results: The results showed that intrusion and avoidance symptoms had positively indirect associations with emotional warmth and negatively indirect associations with rejection and overprotection via marital satisfaction. However, negative cognitive and emotional alterations (NCEA) and hyperarousal symptoms had opposite relationships with three types of parenting behavior. A gender-moderated mediation relationship was found in the associations of PTSD symptoms and parenting behaviors via marital satisfaction. Marital satisfaction played a mediating role in the relationships between four PTSD symptom clusters and three types of parenting behavior in mothers, whereas in fathers, marital satisfaction mediated only the relationships of NCEA and hyperarousal symptoms with three types of parenting behavior.

Conclusions: Marital satisfaction mediated the associations between four distinct PTSD symptom clusters and three types of parenting behavior, and a gender difference was found to be in these indirect relationships. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Healthcare professionals are highly susceptible to adverse psychological outcomes amid the COVID-19 pandemic due to their job duties. As the largest part of the healthcare workforce, growing attention has been paid to nurses' adjustments to the pandemic. Despite the distress, recent studies found that nurses could still experience positive changes (i.e., adversarial growth, AG) during the pandemic. Research on the general populations has indicated that individuals' stress responses, coping resources, and coping strategies are associated with their AG during the pandemic. This study examined how sociodemographic characteristics, secondary traumatic and posttraumatic stress, coping resources, and coping strategies were associated with AG among nurses in Hong Kong amid the fifth wave (i.e., the most disastrous wave) of the COVID-19 pandemic.

Method: Recruited through local nursing associations between May 24 and June 13, 2022, 209 nurses in Hong Kong completed an online questionnaire measuring the abovementioned variables.

Results: Hierarchical regression results found that those affiliating with a religion, having participated in mental health-related workshops, higher levels of secondary traumatic stress (STS), social support, job satisfaction, plus more frequent emotional processing were associated with higher AG (βs ranging from 0.15 to 0.31, ps < .01).

Conclusions: Nurses did report AG during the fifth wave of the COVID-19 pandemic in Hong Kong. To promote AG among those nurses, future interventions should enhance nurses' understanding about the potential impact of STS on their well-being, solicit their interpersonal and work-related coping resources, plus facilitate their use of effective coping strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Existing literature has yielded mixed results regarding the relationships between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG). The recent network analysis provided opportunities to investigate the associations between PTSS and PTG on a more fine-grained level. Previous cross-sectional network analyses were unable to address the directionality of the temporal relationships between components of PTSS and PTG. Therefore, the current study aimed to model cross-lagged network of components of PTSS and PTG with longitudinal data to unveil the direction of their relationships.

Method: A sample of 202 adolescents (M_age = 14.36, 38% boys) who survived the Yancheng tornado were assessed with the Child PTSD Symptom Scale (CPSS) and Posttraumatic Growth Inventory (PTGI) at 9, 12, and 18 months following the tornado. Two cross-lagged panel networks were examined to model the temporal associations between components of PTSS and PTG.

Results: The T1-T2 Network was much denser than the T2-T3 Network. The majority of cross-cluster edges were directed from PTSS to PTG. Interestingly, two major components of PTSS, Avoidance and Intrusion shared vastly different relationships with PTG. While Intrusion positively predicted components of PTG, Avoidance exhibited negative predictive value on PTG.

Conclusions: The study highlighted the differential relationships that Intrusion and Avoidance shared with the PTG components, suggesting that interventions could benefit from mitigating avoidance and incorporating intrusion into positive change. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Although irritability, anger, and aggression are diagnostic symptoms of posttraumatic stress disorder (PTSD), their clinical significance and associations with psychopathology remain unclear.

Method: In a sample of community adults with probable PTSD (n = 151), we measured irritability, physical aggression, verbal aggression, anger, and hostility with the Brief Irritability Test and the Brief Aggression Questionnaire. Participants' psychopathology, including depression, attention deficit and hyperactivity disorder (ADHD), psychotic-like experiences, insomnia, as well as suicidal behaviors were also assessed.

Results: Correlation analysis showed that irritability and anger were modestly related to all PTSD dimensions; physical aggression was related to avoidance, negative alterations in cognitions and mood (NACM), and hyperarousal; hostility was related to reexperiencing, NACM, and hyperarousal; while verbal aggression was not significantly related to any PTSD dimensions. After adjustment for trauma exposure and PTSD symptoms, irritability was associated with almost all psychopathology and suicidal behaviors, however, anger, hostility, and aggression were sparsely related to some psychopathology or suicidal behaviors. Particularly, anger was only related to ADHD and insomnia. Latent profile analysis based on PTSD, irritability, anger, hostility, and aggression indicated two discrete subgroups: the high severity group (33.8%) and the low severity group (66.2%), with high severity group reporting higher rates of comorbidity and suicidal behaviors.

Conclusions: The findings support irritability, aggression, anger, and hostility as separate constructs; moreover, irritability, anger, and aggression should be independently measured in PTSD. Our findings also suggest the significance of irritability as a separate hallmark of PTSD and the need to incorporate PTSD dimensions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Dual-tasking studies show that emotionality and vividness of aversive memory decrease by engaging in a working memory task and simultaneous recall of that memory. Adding positive valence to a dual task might be a promising innovation in the amelioration of lab-induced memory. However, studies aiming to translate these findings into autobiographical memory of a posttraumatic stress disorder (PTSD) population find conflicting results or show methodological flaws. The current study assesses the benefit of adding positive valence to a dual-tasking procedure in PTSD patients.

Method: In a cross-over design PTSD patients (N = 33) recalled their traumatic memory and received the following three conditions in randomized order: rating positive pictures + exposure, rating neutral pictures + exposure, and exposure only. Each of the three conditions consisted of four sets of 1 min. In the first cycle, participants were exposed to each condition in a randomized order, which was then repeated in a second cycle. Before and after each condition, emotionality and vividness were rated on a visual analog scale (VAS), resulting in seven measurement timepoints in total.

Results: Firstly, repeated measures ANOVAs showed a time effect: memories were less emotional and vivid after our summed (three) interventions. Secondly, repeated measures ANCOVAs indicated no evidence for differences between the conditions.

Conclusions: We did not find evidence for a benefit of adding positive valence to a dual-task procedure in PTSD patients. (PsycInfo Database Record (c) 2024 APA, all rights reserved).