Event centrality prospectively predicts PTSD symptoms

Background: Recent evidence suggests that event centrality has a prominent association with post-traumatic stress disorder (PTSD) symptoms. However, evidence for this notion thus far has been mostly correlational. We report two studies that prospectively examined the relationship between event centrality and PTSD symptoms. Study 1 Methods: Participants (N?=?1438) reported their most stressful event (“prior event”), along with event centrality, PTSD symptoms, and neuroticism. At Time 2 participants reported their most stressful event since Time 1 (“critical event”), along with measures of event centrality and PTSD symptoms. Study 1 Results: Event centrality for the critical event predicted PTSD symptoms, after controlling for event centrality and PTSD symptoms of the prior event and neuroticism. Study 2 Methods: In the second study (N?=?161) we examined changes in event centrality and PTSD symptoms over a month. Study 2 Results: Using a cross-lagged panel design, results revealed event centrality at Time 1 significantly predicted PTSD symptoms at Time 2, but the reverse was not significant. Conclusions: In two studies, a prospective association between event centrality and PTSD symptoms, but not the reverse, emerged. This evidence implicates event centrality in the pathogenesis and/or maintenance of PTSD symptoms.     

Perceptions of stressful life events as turning points are associated with self-rated health and psychological distress

Abstract

We test the hypothesis that changes in physical and psychological health are associated with construals of stressful life events. At two points in time, approximately 10 years apart, participants (n=1038) rated their physical health and psychological distress. At the second assessment, participants also reported their most stressful life event since the first assessment and indicated whether they considered the event a turning point and/or lesson learned. Lower self-ratings of health and higher ratings of psychological distress, controlling for baseline health and distress, and relevant demographic factors, were associated with perceiving the stressful life event as a turning point, particularly a negative turning point. The two health measures were primarily unrelated to lessons learned. How individuals construe the most stressful events in their lives are associated with changes in self-rated health and distress.     

Re-appraising stress appraisals: The underlying properties of stress in sport

ObjectivesThe purpose of this study is to investigate the underlying properties of athletes’ stressful appraisals. According to Lazarus and Folkman [(1984). Stress, appraisal and coping. New York: Springer] all meaningful situations that are appraised as stressful will include one of eight properties. These properties are: novelty, predictability, event uncertainty, imminence, duration, temporal uncertainty, ambiguity and timing in relation to the life cycle.DesignThis study aimed to examine whether these underlying properties are relevant to the sporting context and if any further properties exist within this context using a qualitative interview approach.MethodsSixteen national level trampolinists took part in interviews which focused on their most stressful competitive experience.ResultsFollowing deductive content analysis all properties were found to have relevance to a sporting domain. Two further properties of Self and Other Comparison and Inadequate Preparation were also revealed which were proposed to be specific to a sporting context.ConclusionsSuggestions are made concerning future research to extend this line of inquiry and our understanding of stress appraisals.     

Enhancing attributional style as a resiliency factor in depressogenic stress generation

Abstract

There is a growing body of evidence that suggests depression and cognitive vulnerabilities to depression may lead individuals to generate stressful events. However, there has been no study to date that has directly examined factors that may lead individuals to be less likely to generate stressful events. The present study examines whether an enhancing attributional style, the tendency to make global and stable inferences following occurrence of a positive event, functions as a resiliency factor in stress generation. One hundred and sixty-seven female students completed measures of depression symptoms and attributional style at baseline and occurrence of life events since baseline at a four-week follow-up. Results indicated that an enhancing attributional style predicted decreased levels of stressful events over the following four weeks, even when controlling for depression symptoms. The findings of this study suggest that there may be resiliency factors that can help protect individuals from the generation of stressful events.     

Age-related differences in physical activity and depressive symptoms among 10−19-year-old adolescents: A population based study

ObjectivesThe aim of this study was to examine age- and gender-related patterns of PA and depressive symptoms among students through their adolescent years.DesignData from three population-based surveys were analysed to determine levels of moderate- to vigorous-intensity PA (MVPA), participation in organized sports and depressive symptoms among 10−19-year-old adolescents.MethodQuestionnaires assessing PA and depressive symptoms were administered to 32 860 students in compulsory and upper-secondary schools in Iceland.ResultsAs age increased, depressive symptoms increased and PA decreased with over half of the adolescents in upper-secondary schools not achieving recommended daily PA. There were gender differences in PA and depressive symptoms with girls being less active and reporting higher levels of depressive symptoms than boys. MVPA was associated with lower levels of depressive symptoms among both genders while organized sports had more impact on depressive symptoms among girls.ConclusionsTo our knowledge, this study is the first to simultaneously examine patterns of PA and depressive symptoms among students through their adolescent years. Our findings show that the decrease in PA and increase in depressive symptoms is most pronounced around the transition from compulsory to upper-secondary school, or around the age of 15–16. Thus the findings provide important information about when to tailor public health efforts to reduce the burden of depressive symptoms among adolescents, for example by employing PA interventions.     

Negative life events and symptoms of depression and anxiety: stress causation and/or stress generation

Background and Objectives: Stressful life events are known to contribute to development of depression; however, it is possible this link is bidirectional. The present study examined whether such stress generation effects are greater than the effects of stressful life events on depression, and whether stress generation is also evident with anxiety. Design: Participants were two large age cohorts (N = 732 aged 44 years; N = 705 aged 63 years) from the West of Scotland Twenty-07 study. Methods: Stressful life events, depression, and anxiety symptoms were measured twice five years apart. Cross-lagged panel analysis examined the mutual influences of stressful life events on depression and on anxiety over time. Results: Life events predicted later depressive symptomatology (p = .01), but the depression predicting life events relationship was less strong (p = .06), whereas earlier anxiety predicted life events five years later (p = .001). There was evidence of sex differences in the extent to which life events predicted later anxiety. Conclusions: This study provides evidence of stress causation for depression and weaker evidence for stress generation. In contrast, there was strong evidence of stress generation for anxiety but weaker evidence for stress causation, and that differed for men and women.     

Meaning in life and violations of beliefs and goals: reciprocal relations among individuals with congestive heart failure

Background and objectives: In the context of highly stressful experiences, violations of beliefs and goals and meaning in life may have a reciprocal relationship over time. More violations may lead to lowered meaning, whereas higher meaning may lead to lowered violations. The present study examines this relationship among congestive heart failure (CHF) patients.

Design: A cross-lagged panel design was used.

Methods: CHF patients (N?=?142) reported twice, six months apart, on their meaning in life and the extent to which CHF violates their beliefs and goals.

Results: Overall, results were consistent with a reciprocal relationship, showing that greater goal violations led to negative subsequent changes in meaning, whereas greater meaning led to favorable subsequent changes in violations of beliefs and goals.

Conclusions: Meaning in life and violations may contribute to one another, and therefore, in understanding the adjustment process, it is important to consider their interrelationship. The results are also broadly informative regarding the experience of meaning, showing that disruption of beliefs and goals may undermine meaning.     

Randomized controlled trial evaluating the effectiveness of a web-based stress management program among community college students

Background and Objectives: This study evaluated the effectiveness of a web-based stress management program among community college students that focused on increasing perceived control over stressful events. Design: Students (N = 257) were randomly assigned to a Present Control Intervention or a Stress-information only comparison group. Methods: Primary outcomes were perceived stress and stress symptoms; secondary outcomes were depression and anxiety. Self-report measures were completed online at preintervention, postintervention, and three-week follow-up. Intervention effects were estimated using linear mixed models. Seventy-five percent of the sample (n = 194) completed the pretest and comprised the intent-to-treat sample. Results: Participants in the intervention group reported significant increases in present control, and significant decreases in all four primary and secondary outcome measures from baseline to postintervention and follow-up. Within-group effect sizes were small to medium at postintervention (mean d = –.34) and follow-up (mean d = –.49). The mean between-group effect size on the four outcome measures was d = .35 at postintervention but d = .12 at follow-up, due to unexpected decreases in distress in the comparison group. Conclusions: Our online program is a cost-effective mental health program for college students. Limitations and future direction are discussed.     

Family support,family stress,and suicidal ideation in a combat-exposed sample of Operation Enduring Freedom/Operation Iraqi Freedom veterans

Background and Objectives: Deployment-related risk factors for suicidal ideation among Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans have received a great deal of attention. Studies show that mental health symptoms mediate the association between most deployment stressors and suicidal ideation; however, family-related factors during deployment are largely unexplored. We examined posttraumatic stress disorder (PTSD) and depression symptoms as mediators of the associations between deployment family support and stress and post-deployment suicidal ideation in combat-exposed OEF/OIF veterans. Design: National cross-sectional mail survey. Methods: 1046 veterans responded to the survey. The sample for this study was 978 veterans who experienced combat. Regression-based path analyses were conducted. Results: Family support and stress had direct associations with suicidal ideation. When PTSD and depression symptoms were examined as mediators of these associations, results revealed significant indirect paths through these symptoms. Conclusions: This study contributes to the literature on suicidal ideation risk factors among OEF/OIF veterans. Deployment family support and family stress are associated with suicidal ideation; however these associations occur primarily through mental health symptomatology, consistent with findings observed for other deployment factors. This research supports ongoing efforts to treat mental health symptomatology as a means of suicide prevention.     

Appraisals of dependent stressor controllability and severity are associated with depression and anxiety symptoms in youth

Background and objectives: Stress is well established as a strong risk factor for internalizing psychopathology. Learned helplessness research demonstrates that perceived controllability of stressors affects internalizing symptoms. Furthermore, subjective perceived stress is associated with psychopathology. However, most recent research has focused on measuring the frequency and expert-rated severity of stressful life events despite evidence for the importance of stress perceptions. The present study brings together past and current literatures to investigate the importance of perceived severity and controllability of recent life events in the association between stressors and internalizing symptoms.

Design and methods: We used a revised version of the Adolescent Life Events Questionnaire (ALEQ) that asked participants (ages 13–22, N?=?328) to rate the frequency of 65 stressful events typical to youth, as well as the perceived stressfulness and control they felt over each event. Events were categorized prior to analysis as dependent (self-generated), independent (fateful) or neither.

Results: Controllability and severity appraisals were associated with depression and anxiety symptoms, controlling for stressor frequency (which also predicted symptoms), for dependent but not independent stressors.

Conclusions: These results highlight the importance of controllability and severity appraisals as potential risk factors for internalizing disorders, exposing a potential target for therapy.     

Self-efficacy moderates the relationship between stress appraisal and quality of life among rescue workers

Abstract

Rescue workers are frequently exposed to highly stressful situations during their everyday work activity. Stress and coping theory emphasizes the interaction between primary and secondary appraisal in determining coping responses to stressful events and quality of life. According to Social Cognitive Theory, stress reactions depend on self-appraisal of coping capabilities.

The present study investigated whether self-efficacy moderates the relationship between stress appraisal and professional quality of life. A self-administered questionnaire was submitted to a sample of 451 Italian rescue workers (firefighters, paramedics, and medical technicians), including the Professional Quality of Life Scale, which measures three dimensions of emergency workers' quality of working life: compassion fatigue, burnout, and compassion satisfaction. Multiple regression analyses indicated that the relationship between stress appraisal and professional quality of life was significant only among rescue workers with low levels of self-efficacy but not among those with higher levels of self-efficacy. These results confirmed the expectations based on Social Cognitive Theory that self-efficacy buffers the impact of perceived stressful encounters on professional quality of life. Results suggest the usefulness of interventions aimed at increasing rescue workers' psychosocial skills.     

Protective effect of supportive family relationships and the influence of stressful life events on adolescent adjustment

Abstract

The purpose of this study was to determine the association between the occurrence of stressful life events and internalizing and externalizing problems, and to analyze longitudinally buffering effects of supportive family relationships. To this end, 100 Spanish adolescents were studied twice, when they were in mid-adolescence (15–16 years) and two years later. They completed questionnaires regarding stressful life events, family relationships, and adolescent adjustment. Results showed that high quality parent-adolescent relationships protected boys and girls against the negative consequences of stressful life events on externalizing, but not internalizing, symptoms. The adolescents who enjoyed good relationships with their parents in mid-adolescence did not increase their externalizing problems in late adolescence as consequence of the occurrence of stressful events. However, these stressors did lead to an increase in the number of externalizing problems when the family relationships were of a middle or low quality. These results highlight the important role that supportive family relationships play in the behavioral adjustment of adolescents, protecting them against some negative consequences of stressful life events, and suggest the relevance of supporting parents through resources such as parent education in order to help them to improve their relationships with their adolescents.     

Posttraumatic stress and depression: potential pathways to disease burden among heart failure patients

Background and Objectives: Posttraumatic stress disorder (PTSD) and Major Depressive Disorder (MDD) are associated with high disease burden. Pathways by which PTSD and MDD contribute to disease burden are not understood. Design: Path analysis was used to examine pathways between PTSD symptoms, MDD symptoms, and disease burden among 251 low-income heart failure patients. Methods: In Model 1, we explored the independent relationship between PTSD and MDD symptoms on disease burden. In Model 2, we examined the association of PTSD symptoms and disease burden on MDD symptoms. We also examined indirect associations of PTSD symptoms on MDD symptoms, mediated by disease burden, and of PTSD symptoms on disease burden mediated by MDD symptoms. Results: Disease burden correlated with PTSD symptoms (r = .41; p < .001) and MDD symptoms (r = .43; p < .001) symptoms. Both models fit the data well and displayed comparable fit. MDD symptoms did not mediate the association of PTSD symptoms with disease burden. Disease burden did mediate the relationship between PTSD symptoms and MDD symptoms. Conclusions: Results support the importance of detection of PTSD in individuals with disease. Results also provide preliminary models for testing longitudinal data in future studies.     

Intolerance of uncertainty predicts analogue posttraumatic stress following adverse life events

ABSTRACT

BACKGROUND AND OBJECTIVES: There is evidence that intolerance of uncertainty (IU) is associated with elevated post-traumatic stress (PTS) symptoms. There is a scarcity of research examining whether IU is prospectively related to PTS following exposure to negative life events. Using data from a Dutch student-sample, we examined the degree to which IU predicts post-traumatic stress symptoms associated with negative stressful life events (analogue posttraumatic stress (PTS)).

DESIGN: This was a prospective survey-study.

METHODS: A group of 193 undergraduate students completed self-report measures of Inhibitory IU, Prospective IU, and anxiety sensitivity (at Time 1, T1). One year later (at T2), participants rated adverse life-events experienced between T1 and T2, and completed a questionnaire tapping PTS associated with the most distressing event experienced in this time-frame. We hypothesized that pre-event Inhibitory IU and—to a lesser extent—Prospective IU would predict analogue PTS, after covarying for anxiety sensitivity.

RESULTS: As predicted, pre-event Inhibitory IU predicted post-event analogue PTS, even when controlling for anxiety sensitivity. With respect to distinct analogue PTS clusters, Inhibitory IU predicted PTS avoidance and PTS hyperarousal, but was unrelated to PTS reexperiencing.

CONCLUSIONS: This study confirm that IU, particularly Inhibitory IU, may convey risk for elevated PTS following adverse life events.     

Hardiness and mental health during naval deployment: The relation is mediated by social processes and not by self-regulatory processes

IntroductionThe aim of the present study was to investigate the mediating effects of cohesion and self-efficacy on the relation between hardiness and symptoms of anxiety and depression during naval international operations.Objective and methodIt was hypothesized that an indirect effect of both cohesion and operational self-efficacy would emerge even when controlling for pre-deployment measures of symptoms.ResultsThe results revealed a strong indirect effect of cohesion on the relationship between hardiness and scores on Hopkins Symptom Checklist – 25 items. The effect was evident for the total score and the dimensions of anxiety as well as depression. No effect was found for operational self-efficacy.ConclusionIt was concluded that the social process of cohesion outperforms the self-regulatory process of operational self-efficacy as a mediator between hardiness and mental health. Greater focus on developing crew cohesion may thus be important for maintaining mental health under stressful conditions.     

Associations between childhood adversity and daily suppression and avoidance in response to stress in adulthood: can neurobiological sensitivity help explain this relationship?

Background and objectives: Although it has been postulated that psychological responses to stress in adulthood are grounded in childhood experiences in the family environment, evidence has been inconsistent. This study tested whether two putative measures of neurobiological sensitivity (vagal flexibility and attentional capacity) moderated the relation between women’s reported exposure to a risky childhood environment and current engagement in suppressive or avoidant coping in response to daily stress.

Design and methods: Adult women (N?=?158) recruited for a study of stress, coping, and aging reported on early adversity (EA) in their childhood family environment and completed a week-long daily diary in which they described their most stressful event of the day and indicated the degree to which they used suppression or avoidance in response to that event. In addition, women completed a visual tracking task during which heart rate variability and attentional capacity were assessed.

Results: Multilevel mixed modeling analyses revealed that greater EA predicted greater suppression and avoidance only among women with higher attentional capacity. Similarly, greater EA predicted greater use of suppression, but only among women with greater vagal flexibility.

Conclusion: Childhood adversity may predispose individuals with high neurobiological sensitivity to a lifetime of maladaptive coping.     

Role of event centrality and emotion regulation in posttraumatic stress disorder symptoms among internally displaced persons

Background: Event centrality and emotion regulation in relation to posttraumatic stress disorder (PTSD) have been documented in various global samples especially in Western cultures; but internally displaced persons (IDPs) still constitute an underrepresented population in psychotraumatology literature. This study tested the roles of event centrality and emotion regulation strategies (cognitive reappraisal and expressive suppression) in PTSD symptoms among IDPs in Nigeria.

Design: The multi-group cross-sectional design was adopted.

Methods: Tiv language versions of the Centrality of Events Scale, Emotion Regulation Questionnaire, and Harvard Trauma Questionnaire were completed by 859 IDPs in two camps located in Benue State, North-central region of Nigeria.

Results: Hierarchical multiple linear regression results indicated that event centrality positively predicted PTSD symptoms. Cognitive reappraisal was a negative predictor of PTSD symptoms while expressive suppression was a positive predictor of PTSD symptoms. Bonferroni corrections indicated that expressive suppression was the strongest predictor of total PTSD symptoms, avoidance/numbing symptoms, and hyper-arousal symptoms; but event centrality was the most robust predictor of PTSD intrusion/re-experiencing symptoms.

Conclusion: The findings underscore recent developments in psychotraumatology indicating that the extent to which individual differences impact the development of PTSD is essential in clinical psychology research and practice.     

Time-Varying and Time-Invariant Dimensions in Intolerance of Uncertainty: Specificity in the Prediction of Obsessive-Compulsive Symptoms

Intolerance of uncertainty (IU) is the tendency to respond negatively toward uncertain situations. IU consists of a Prospective factor (desire for predictability) and an Inhibitory factor (uncertainty paralysis) and is central to theoretical approaches to obsessive-compulsive disorder (OCD). However, time-invariant (TI) and time-varying (TV) components of IU and their association with OCD symptoms are not yet understood. The present study examined the association between TI and TV components of IU and OCD symptoms in community adults (N = 1,280) over a 5-month period. Latent variable models were fit to the data to examine the relative impact of TI and TV components of IU on OCD symptoms. As a test of specificity, models examining the association between TI and TV components of IU and depressive symptoms were also examined. The results showed that IU consists of significant TI and TV components, although the TI component accounted for most of the variance (76–84%) and was more strongly associated with OCD and depressive symptoms than the TV component. Furthermore, the TI component of IU was strongly associated with OCD symptoms when controlling for depressive symptoms, and the TI component of IU was strongly associated with depressive symptoms when controlling for OCD symptoms. A consistent pattern was observed for both Prospective and Inhibitory IU factors, with stable TI components demonstrating stronger relations with OCD and depressive symptoms than TV components. These findings have implications for conceptualizing the TI component of IU as a risk for OCD and other emotional disorders.     

Stressful experiences among six certification levels of ice hockey officials

ObjectivesWhile many studies have examined the sources of stress that sports officials encounter, this study represents an exploration into the influence that certification level has on the sources and intensity of ice hockey officials’ experiences of stressful events.MethodsParticipants were 421 officials from six certification levels of Canadian ice hockey. The 15-item Hockey Officials Sources of Stress Inventory (HOSSI) was developed and content validated for this study.ResultsOverall, the intensity of the stressors identified was moderate. The three events consistently among the top five rated stressors across certification level were making a controversial call, difficulty working with a partner official, and confrontation with coaches. Further examination of the subscales of verbal and physical abuse and fear of mistakes by means of a MANCOVA (using age and officiating experience as covariates) showed significant differences to exist among certification level for each subscale, F(10,786)=5.175, p<0.0001 and F(10,786)=7.546, p<0.0001, respectively.ConclusionsResults indicate that officials in the lowest level of the officiating ranks (level 1) experience less stress than the other levels of officiating. Also, levels 1 and 6 officials experience more stress from fear of mistakes than from abusive events. These findings suggest that intervention programs need to be cognisant of the differences in the stressful experiences based upon certification levels.     

Prevalence of anxiety symptoms and disorders in the transgender population: A systematic review of the literature

Introduction: Anxiety disorders are the most common mental illness in the general population, affecting 18% of the population in the United States (12 months prevalence) and 13.6% in Europe (life time prevalence). Several studies have also described high rates of anxiety disorders and symptoms of anxiety among the transgender population. There is, however, a great variation of results (particularly related to gender prevalence), and few studies have described the type of anxiety disorders specific to the transgender population.

Aim: To collect and critically appraise the information from the available studies describing prevalence rates of anxiety disorders and symptoms.

Results: A total of 25 cross-sectional (n = 17) and longitudinal (n = 8) studies were found. Cross-sectional studies described higher prevalence rates of anxiety symptoms in the transgender group than in the cis population. The prevalence of anxiety disorders range from 17% to 68%. The most common anxiety disorders found were specific phobias, social phobias, panic disorders, and obsessive-compulsive disorders. Most of the large studies suggest higher levels of anxiety symptoms and disorders in transgender men compared with transgender women; however, considerable variation in results was found.

Conclusions: The findings identified that there is considerable variation in anxiety disorders and symptoms among transgender people attending transgender health services. These findings are likely to be the result of the tools used, the lack of matching controls, and the lack of homogeneity of the group studied. Overall this review indicates high levels of anxiety symptoms and disorders among transgender people attending gender services, primarily (but not exclusively) before commencement of cross-sex hormone treatment. Anxiety disorders related to social interaction (such as social anxiety) and panic attack appear to be particularly common, however more rigorous studies to confirm those findings are needed.