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

Objective: This theoretical review proposes a three-phase process model of posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG).

Method: By combining trauma-related theories, emotional regulation theories, social support theories, and empirical study findings to elucidate the mechanisms underlying PTSD and PTG, we then propose our model.

Results: The proposed model highlights the dynamic characteristics of the PTSD and PTG developmental processes as well as their coexistence and places equal emphasis on the roles of cognitive and emotional activities and social support in three distinct dynamic phases of PTSD and PTG. It emphasizes that PTSD and PTG share similar prerequisites but that these two outcomes later diverge and ultimately manifest via three distinct phases. The specific roles of cognitive regulation, emotional regulation, and social support, and the potential theoretical and practical implications of this model, are discussed.

Conclusions: This integrative and dynamic process model has the potential to advance scientific understanding of the mechanisms underlying PTSD and PTG. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The present study aimed to examine the profile patterns of co-occurring posttraumatic stress disorder (PTSD), cognitive emotion regulation (CER), and disorganized attachment in traumatized adolescents. It also aimed to examine whether these adolescents with different profiles would differ in posttraumatic growth (PTG) and comorbid psychiatric symptoms after controlling for academic stress and egocentrism.

Method: Nine hundred and forty-nine (N = 949) adolescents were recruited from two secondary schools in China. They completed measures on PTSD, comorbid psychiatric symptoms, PTG, CER, disorganized attachment, and covariates of egocentrism and academic stress.

Results: Latent profile analysis identified a four-class model as the optimal solution: low trauma group (Class 1), adaptive copers (Class 2), moderate trauma group (Class 3), and high trauma group (Class 4). After controlling for demographics and levels of egocentrism and academic stress, Class 4 had more severe comorbid psychiatric symptoms than the other three classes. Class 3 had higher levels of comorbid psychiatric symptoms than Class 2 and Class 1, while these latter two were comparable in comorbid psychiatric symptoms. Conversely, Class 4 students had lower levels of PTG than individuals in the other three classes. Class 3 had similar levels of PTG to Class 1, and these two classes reported lower levels of PTG than Class 2.

Conclusions: Chinese adolescents may experience both negative and positive changes after stressful events. The extent of these psychological outcomes could vary depending on the adolescents' previous trauma experiences, emotion regulation, and attachment qualities. Implications for clinical practice were discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The COVID-19 pandemic is a significant stressor, potentially putting the well-being of the general population at risk. However, a significant proportion of the population exhibits resilience, raising questions regarding psychological constructs that could contribute to resilient coping. Studies indicate that flexibility, defined as the ability to adapt to changing contextual demands by employing various emotional, cognitive, and behavioral strategies, may significantly contribute to coping with long-term stressors such as COVID-19.

Method: Cognitive and coping flexibility domains and longitudinal trajectories of anxiety and depression were assessed at three-time points across 13 months in 571 Israelis.

Results: Analyses revealed four different trajectories for anxiety: resilient (66%), chronic (22%), emerging (7%), and improving (6%), and two trajectories for depression: resilient (87%) and chronic (13%). Individuals in the chronic trajectory group (for both anxiety and depression) exhibited lower cognitive flexibility and coping flexibility levels than individuals in the resilient trajectory group. Across time, anxiety and depression were linked to clinically significant posttraumatic stress disorder-like symptoms.

Conclusions: Low cognitive and coping flexibility are linked to the probability of experiencing chronic mental health problems, making them a potential target for prevention and treatment. (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 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).

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: 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: 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).

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: 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).