Cultural differences in levels of autonomous orientation in autobiographical remembering in posttraumatic stress disorder

This study investigated cultural differences in levels of autonomous orientation (the tendency to express autonomy and self‐determination) in autobiographical remembering in those with and without posttraumatic stress disorder (PTSD). Trauma survivors with PTSD and without PTSD from individualistic and collectivistic cultures (N = 101) provided self‐defining, everyday and trauma autobiographical memories. Memories were coded for levels of autonomous orientation and interdependence. It was found trauma survivors from individualistic cultures with PTSD had lower levels of autonomous orientation in their autobiographical remembering than trauma survivors from individualistic cultures without PTSD. In contrast, trauma survivors from collectivistic cultures with PTSD had higher levels of autonomous orientation in their autobiographical remembering than trauma survivors from collectivistic cultures without PTSD. The results suggest the cultural distinction in self‐impacts on the relationship between the nature of autobiographical remembering and posttraumatic psychological adjustment. Copyright © 2010 John Wiley & Sons, Ltd.     

Is John Henryism a resilience factor in women experiencing intimate partner violence?

Background: Research suggests that posttraumatic stress disorder (PTSD) and depression are two common mental health problems in intimate partner violence (IPV) survivors. Research has found that while Black women consistently report higher rates of victimization than White women, they also report less severe PTSD and depressive symptoms, suggesting that Black IPV survivors might be more resilient to PTSD and depression than are White survivors. Design: We implemented a correlational study with 81 Black and 100 White female survivors of IPV to determine if John Henryism (JH; i.e., a predisposed active coping mechanism) contributes to the resilience observed in Black IPV survivors. Methods: Participants completed the John Henryism Active Coping Scale, Center for Epidemiological Studies Depression Scale, Davidson Trauma Scale, and the Abusive Behavior Inventory. Results: Results demonstrated that White woman endorsed more severe depressive symptoms as compared to Black women. Severity of PTSD symptoms and JH was not significantly different between races. JH did not moderate the relationship between race and depression; however, for PTSD, JH was found to be protective of PTSD in White women, while demonstrating little impact on Black women. Conclusions: The implications of these findings are discussed in terms of the minority stress model.     

The effects of torture‐related stressors on long‐term complex post‐traumatic symptoms in South Korean torture survivors

This study explored whether perceived distress from specific stressors during and after torture explain long‐term complex post‐traumatic symptoms of South Korean torture survivors. We conducted a cross‐sectional survey of survivors who had been tortured by the homeland regime from the 1970s to the 2000s. Data from 206 survivors were gathered by key informants using target sampling and snowballing techniques. Project staff designed scales to encompass the specific types of stressors related to torture techniques used in Korea. Frequencies and distress ratings of exposure to torture, post‐torture psychosocial stressors and physical damage related to torture were gathered. Psychological symptoms were assessed by the Impact of Event Scale‐Revised‐Korean version and subscales of the Symptom Checklist 90‐Revised‐Korean version. Perceived distress from torture stressors was mainly divided into factors representing physical, psychological and deprivation torture by adapting a principal axis factor analysis. Hierarchical regression analyses showed that distress from psychological torture explained post‐traumatic stress disorder (PTSD) and that distress from deprivation explained PTSD and anxiety after controlling for demographic variables, psychological preparedness, time span since torture and distress from trauma other than torture. Among post‐torture stressors, distress from physical damage related to torture and social exclusion were strong indicators of complex symptoms.     

Posttraumatic Stress and Depression Reactions Among Survivors of the Istanbul November 2003 Terrorist Attacks

This study investigated posttraumatic stress and depression reactions among survivors of the Istanbul November 2003 terrorist bombings that destroyed synagogues, an HSBC bank, and the British General Consulate. One hundred and forty-nine survivors completed a questionnaire measuring exposure, current posttraumatic stress, and depression responses 6 months after the blasts. This study showed that the prevalence rate of posttraumatic stress disorder (PTSD) among survivors was 35.6%?and the rate of depression was 23.5%. PTSD was strongly predicted by perceived life threat, whereas depression was strongly predicted by death of a close friend. Overall, female survivors were found to be more vulnerable to developing posttraumatic stress as well as depression after the terrorist bombings.     

Validation of a Tibetan translation of the Hopkins Symptom Checklist 25 and the Harvard Trauma Questionnaire

This study sought to translate and validate the Hopkins Symptom Checklist-25 (HSCL) and the Harvard Trauma Questionnaire (HTQ) in a Tibetan population. Translated questionnaires were administered to 57 Tibetan survivors of torture/human rights abuses living in the United States and receiving services in a torture treatment program. Participants were evaluated to determine if they met criteria for major depressive episode, generalized anxiety disorder, or posttraumatic stress disorder (PTSD). Coefficient alpha for the HSCL Anxiety subscale (.89), Depression subscale (.92), and the HTQ (.89) were high. Diagnostic accuracy using receiver operating characteristic curve analysis generated good classification accuracy for anxiety (.89), depression (.92), and PTSD (.83). However, although sensitivity and specificity for HSCL subscales were quite high, the HTQ generated low sensitivity (.33), partly because of a low rate of PTSD. Results support the reliability and validity of the HSCL but suggest further study of the HTQ with this population is required.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

Phase-based Emotionally Focused Couple Therapy for Adults With Complex Posttraumatic Stress Disorder

Complex posttraumatic stress disorder (complex PTSD) presents unique challenges to treatment beyond that of posttraumatic stress disorder (PTSD). The expert consensus best practice for treatment of complex PTSD is a phase-based or sequenced approach that has typically been offered in individual or group therapy modalities. Emotionally focused couple therapy (EFCT) shows promise as a couple-based treatment for PTSD, but the standard protocol may inadequately incorporate best practice guidelines of phase-based treatment for complex PTSD. Integration of phase-based treatment of complex PTSD within an EFCT format is proposed, giving direction to EFCT providers on incorporating best practice guidelines into their work with survivors.     

Exposure therapy for PTSD delivered to veterans via telehealth: predictors of treatment completion and outcome and comparison to treatment delivered in person

Recent research has focused on the effectiveness of evidence-based psychotherapy delivered via telehealth services. Unfortunately to date, the majority of studies employ very small samples and limited predictor and moderator variables. To address these concerns and further replicate and extend the literature on telehealth, the present study investigated the effectiveness of 12-session exposure therapy delivered either via telehealth (n = 62) or in person (n = 27) in veterans with posttraumatic stress disorder (PTSD). Findings demonstrated that although older veterans and Vietnam veterans were more likely to complete the telehealth treatment, telehealth findings were not influenced by patient age, sex, race, combat theater, or disability status. Exposure therapy delivered via telehealth was effective in reducing the symptoms of PTSD, anxiety, depression, stress, and general impairment with large effect sizes. Interestingly, exposure therapy via telehealth was less effective than exposure therapy delivered in person; however, lack of random assignment to condition limits conclusions of differential effectiveness. Overall, these findings support the utility of telehealth services to provide effective, evidence-based psychotherapies.     

Trauma in Resettled Iraqi Refugees: Differences between Those Seeking Psychological Treatment and Those Not Seeking Psychological Treatment

Psychological distress experienced by resettling refugees has been well documented, with posttraumatic stress disorder (PTSD) and depression being prevalent outcomes. This study examined psychological and physiological measures of trauma exposure in 2 groups of Iraqi refugees resettled in Australia, those seeking psychological treatment (n = 25) versus those not seeking treatment (n = 22). Data from a group of healthy sex- and age-matched controls (n = 32) were collected to facilitate norm comparisons for physiological arousal. Continuous recording of electrocardiogram data examined resting heart rate (HR). Refugees seeking treatment had significantly higher levels of PTSD symptomology and depression levels compared to non-treatment-seeking refugees; however, there was no difference in the number of trauma events endorsed. Finally, resting HR was significantly higher in both refugee groups compared with healthy controls; however, there was no difference between the refugee groups. Clinical consideration of this excessive trauma exposure and elevated autonomic arousal is warranted.     

Posttraumatic Stress,Depression, and Insomnia Among U.S. Air Force Pararescuemen

Few studies have examined rates of mental health problems among special duty military personnel, who often have frequent deployments and high exposure to operational stressors and trauma. The current study examined the severity and rates of positive screening for posttraumatic stress, depression, and insomnia among 194 U.S. Air Force pararescuemen (PJs) in the active duty (AD) and National Guard/Reserve (NG/R) components. Overall estimated rates were 11.6% for probable posttraumatic stress disorder (PTSD), 1.6% for probable depression, and 16.1% for clinical insomnia. PJs in the NG/R reported significantly more severe posttraumatic stress symptoms (F(1, 162) = 10.031, p = .002, partial η² = .058) and were approximately twice as likely to screen positive for probable PTSD (8.5% vs. 19.1%; χ²[1] = 3.679, p = .055). No differences in the rate or severity of depression or insomnia symptoms were found. Rates of positive screens are comparable to or lower than previously published rates among military personnel.     

Associations of depression,anxiety and PTSD with neurological disability and cognitive impairment in survivors of moyamoya disease

Depression, anxiety and posttraumatic stress disorder (PTSD) are common complications of cerebrovascular diseases. However, they were seldom explored in Moyamoya Disease (MMD) survivors. In this study, we measured the prevalence of depression, anxiety and PTSD in MMD survivors. We evaluated the association of mental disorders with neurological disability and cognitive impairment, and further find out the independent protective and risk factors of neurological disability and cognitive impairment. In MMD survivors, the prevalence of these three mental disorders is high, 46.7% for depression, 50% for anxiety and 47.5% for PTSD. Anxiety and PTSD were significantly associated with more severe neurological disability (p = 0.039 and < 0.001); depression and anxiety were significantly associated with greater cognitive deficiency (p = 0.004 and 0.002). We further found PTSD was the only risk factor associated with neurological disability, and the corresponding odds ratio (OR) and 95% confidence interval (CI) was 81.74 (9.91–674.17); depression and anxiety were risk factors associated with cognitive impairment, and the corresponding OR and 95%CI were 2.73 (1.10–6.81) and 3.37 (1.29–8.78). Therefore, these three mental disorders were associated with more severe neurological disability and greater cognitive deficiency in MMD survivors.     

The association between dopamine D4 receptor exon III polymorphism and intensity of PTSD symptoms among flood survivors

Abstract

Thanks to the development of molecular genetics methods it is now possible to look for the genes which may contribute to posttraumatic stress disorder (PTSD). Polymorphism located in exon III of dopamine receptor type 4 (DRD4) gene was related to maladaptive stress responses as well as temperament traits related to PTSD. This study analyzed the association between the variable number tandem repeat (VNTR) DRD4 exon III polymorphism and intensity of PTSD symptoms in 107 (57 women and 50 men) survivors of a flood aged 14–62. Intensity of PTSD symptoms was measured using PTSD-F and PTSD-C questionnaires. Multivariate analysis of covariance (MANCOVA) was conducted to test the main and interactive effects of genotype and level of trauma exposure. Participants with at least one copy of the DRD4 long allele (seven or eight repetitions) had more intense PTSD symptoms on the Avoidance/Numbing scale (Cohen's f = .22) and the Total Scale (Cohen's f = .2) of the PTSD-F than participants who did not have these alleles in genotype. The results must be treated with caution, however, due to methodological restrictions and they need to be replicated on a larger sample.     

The Relationship Between Childhood Trauma,Combat Exposure,and Posttraumatic Stress Disorder in Male Veterans

The current study investigated the effects of combat exposure, childhood trauma, and depression on posttraumatic stress disorder (PTSD) severity. Participants were 299 male veterans from the Korean War, World War II, Vietnam, and the first Gulf War who were being screened for admission to the PTSD unit. Participants were assessed with the Clinician-Administered PTSD Scale (CAPS), Combat Exposure Scale (CES), Hamilton Depression Rating Scale (HAMD), Childhood Trauma Questionnaire (CTQ), and Mississippi Scale for PTSD (MPTSD). Results of multiple regression analyses indicated that, as expected, combat exposure and depression were significant predictors of PTSD severity. When examined with combat exposure, childhood trauma has a complex relationship to PTSD severity. Examination of the interaction between the CES and CTQ suggests that when levels of combat are low and childhood trauma levels are high, the CTQ is related to higher levels of PTSD severity on the CAPS, regardless of depression. Treatment implications are discussed.     

Choosing Assessment Instruments for Posttraumatic Stress Disorder Screening and Outcome Research

Effect‐size results from Erford et al.'s ( 2016 ) meta‐analysis for the treatment of posttraumatic stress disorder (PTSD) were used to compare 6 instruments' usefulness in measuring counseling treatment outcomes. Effect‐size comparisons indicated equivalent overall effect sizes using the Clinician‐Administered PTSD Scale, the Impact of Event Scale–Revised, the Posttraumatic Stress Diagnostic Scale, the PTSD Checklist, and the Structured Interview for PTSD. The Mississippi Scale for Combat‐Related PTSD yielded significantly more conservative (i.e., lower) effect‐size comparisons.     

Emotion regulation mediates the effects of temperament traits and posttraumatic stress disorder symptoms on affect in motor vehicle accident survivors

ObjectivesThe aim of the present study was to investigate the associations among temperament traits postulated by the Regulative Theory of Temperament (RTT), posttraumatic stress disorder symptoms (PTSD symptoms), emotion regulation strategies, and affect in the 280 motor vehicle survivors (MVA).MethodsTemperament was measured with the Formal Characteristics of Behaviour–Temperament Inventory (FCB-TI), the level of posttraumatic stress disorder symptoms was assessed by the PTSD Clinical Inventory (PTSD-C), emotion regulation was tested with the Polish adaptation of the Inventory of Cognitive Affect Regulation Strategies (ICARUS), and affect was evaluated by the Polish version of the Positive and Negative Affect Scale (PANAS).ResultsGreater emotional reactivity was associated with grater negative affect (also by maladaptive regulation) and lower positive affect whereas greater activity was linked to grater positive affect (also via adaptive regulation). Furthermore, greater PTSD symptoms were related to greater negative affect (also through maladaptive regulation) and lower positive affect. However, PTSD symptoms were not linked to adaptive regulation strategies.ConclusionThe findings significantly extends our current knowledge on the associations among temperament traits, PTSD symptoms, emotion regulation strategies, and affect in the motor vehicle survivors.     

Brain-derived neurotrophic factor Val66met polymorphism and plasma levels in road traffic accident survivors

Background: Alterations in brain-derived neurotrophic factor (BDNF) expression and release may play a role in the pathogenesis of post-traumatic stress disorder (PTSD). Design: This study evaluated road traffic accident (RTA) survivors to determine whether PTSD and trauma-related factors were associated with plasma BDNF levels and BDNF Val66Met carrier status following RTA exposure. Methods: One hundred and twenty-three RTA survivors (mean age 33.2 years, SD?=?10.6 years; 56.9% male) were assessed 10 (SD?=?4.9) days after RTA exposure. Acute stress disorder (ASD), as assessed with the Acute Stress Disorder Scale, was present in 50 (42.0%) of the participants. Plasma BDNF levels were measured with enzyme-linked immunosorbent assay and BDNF Val66Met genotyping was performed. PTSD, as assessed with the Clinician-Administered PTSD Scale, was present in 10 (10.8%) participants at 6 months follow-up. Results: Neither BDNF Val66Met genotype nor plasma BDNF was significantly associated with the presence or severity of ASD or PTSD. Plasma BDNF levels were, however, significantly correlated with the lifetime number of trauma exposures. Conclusions: In RTA survivors, plasma BDNF levels increased with increasing number of prior trauma exposures. Plasma BDNF may, therefore, be a marker of trauma load.     

An examination of the roles of trauma exposure and posttraumatic stress disorder on emotion regulation strategies of Operation Iraqi Freedom,Operation Enduring Freedom,and Operation New Dawn veterans

Theories of posttraumatic stress disorder (PTSD) implicate emotional processes, including difficulties utilizing adaptive emotion regulation strategies, as critical to the etiology and maintenance of PTSD. Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (OIF/OEF/OND) veterans report high levels of combat exposure and PTSD. We aimed to extend findings suggesting that emotion regulation difficulties are a function of PTSD, rather than combat trauma exposure or common comorbidities, to OIF/OEF/OND veterans, in order to inform models of PTSD risk and recovery that can be applied to returning veterans. We tested differences in emotion regulation, measured with the Difficulties in Emotion Regulation Scale and Emotion Regulation Questionnaire, among trauma-exposed veterans with (n = 24) or without PTSD (n = 22) and healthy civilian comparison participants (n = 27) using multivariate analyses of covariance, adjusting for major depressive disorder, anxiety disorders, and demographic variables (age, sex, and ethnicity). Veterans with PTSD reported more use of expressive suppression and more difficulties with emotion regulation than veterans without PTSD and healthy comparison participants. Groups did not differ on cognitive reappraisal. Findings suggest the key role of PTSD above and beyond trauma exposure, depression, and anxiety in specific aspects of emotion dysregulation among OIF/OEF/OND veterans. Interventions that help veterans expand and diversify their emotion regulation skills may serve as helpful adjunctive treatments for PTSD among OIF/OEF/OND veterans.     

Breast Cancer as Trauma: Posttraumatic Stress and Posttraumatic Growth

Diagnosis and treatment of cancer has been associated with both posttraumatic stress disorder (PTSD) symptoms and posttraumatic growth (PTG). This cross-sectional study sought to assess the frequency, common predictors, and interrelationships of PTSD symptoms and PTG in breast cancer survivors (n = 65). In this sample, symptoms of PTSD and reports of PTG were common and were not significantly related to one another. Greater social constraints on talking about breast cancer and perception of cancer as a traumatic stressor were associated with greater PTSD symptomatology. Younger age and perception of cancer as a traumatic stressor were associated with greater PTG. Findings suggest the central role of subjective appraisal in adjustment to cancer. Psychosocial interventions should be sensitive to the potential for PTG, both in treatment design and in assessment of outcomes.     

The Relationship Between Posttraumatic Stress Symptoms and Suicide Ideation Among Child Survivors Following the Wenchuan Earthquake

The association between posttraumatic stress disorder (PTSD) symptoms and suicide ideation was examined in a sample of 2,298 child survivors of the Wenchuan earthquake. Results indicated that intrusion, avoidance, hyperarousal symptom clusters, and PTSD total score were significantly associated with suicide ideation. Except for intrusion, other measures of PTSD remained as statistically significant correlates of suicide ideation even after controlling for age, gender, direct exposure, indirect exposure, and depression. Furthermore, results showed that PTSD symptoms had an indirect influence on suicide ideation that was mediated by depression. The findings suggest that avoidance and hyperarousal symptom clusters of PTSD may be two important indicators of suicide ideation among child survivors of the Wenchuan earthquake. Implications of the results for intervention and prevention of suicide behavior are discussed.     

Daily Posttraumatic Stress Disorder Symptom Accommodation and Relationship Functioning in Military Couples

Romantic partners’ accommodation of trauma survivors’ posttraumatic stress disorder (PTSD) symptoms (e.g., taking on tasks, survivors avoid participating in social withdrawal) is associated with lower relationship satisfaction for both partners and survivors. Little is known about associations of partner accommodation with other aspects of relationship functioning, like intimacy. Sixty‐four male military veterans with at least subclinical PTSD and their partners participated in a 2‐week daily diary study. Veterans completed nightly measures of PTSD symptoms, while female partners completed nightly measures of accommodating behaviors performed that day. Both partners reported feelings of intimacy each night. Multilevel models revealed that accommodation was significantly, negatively associated with feelings of intimacy, with stronger effects for partners (t = ?8.70) than for veterans (t = ?5.40), and stronger effects when veterans had lower (t = ?7.43) rather than higher (t = ?5.20) levels of daily PTSD symptoms. Therapists should consider accommodating behaviors as a potential impediment to relationship intimacy, particularly when veterans have less severe symptoms of PTSD. Accommodating behaviors are an ideal treatment target in behavioral couple therapies.