Posttraumatic Stress in Survivors of Childhood Cancer and Mothers: Development and Validation of the Impact of Traumatic Stressors Interview Schedule (ITSIS)

This study presents initial data validating the use of a new instrument, the Impact of Traumatic Stressors Interview Schedule (ITSIS), to assess the occurrence of cancer-related posttraumatic stress in childhood cancer survivors and their mothers. Sixty-six child/adolescent cancer survivors and 64 of their mothers, as well as 130 young adult survivors, completed the ITSIS and other measures of posttraumatic stress and general distress. Five ITSIS factors were identified for the mothers and for the young adult survivors, and three ITSIS factors were identified for the child/adolescent survivors. Factors in all three samples reflected symptoms of posttraumatic distress, concern over medical late effects, communication, and changes in self due to cancer. Only young adult survivors had a factor reflecting a positive engagement with the cancer history. Factors correlated with validation measures in predicted ways. The findings further the conceptualization of posttraumatic stress in pediatric cancer by describing the traumatic experience for survivors and mothers. Comparing factors across samples allows an examination of different influences of cancer within families and over the course of development.     

Spouses' Perceptions of Each Other's Coping Ability with Possible Stressful Life Events and Marital Quality

This study examines the effect ob marital quality of spouses' appreciation of partner's coping ability with possible stressful life events. Results show that while higher appreciation of partner's coping ability contributes to marital quality in wives, only the extent of being threatened by stressful life events and sense of being needed by partner for support when confronting with stressful life events contribute to marital quality in husbands.     

Mothers' Psychological Adjustment Following Disaster Affecting Their Children

The authors investigated the psychological adjustment of 37 British women whose adolescent children survived the cruise ship Jupiter's sinking in 1988, about 6 years previously. They compared these women with a group of widows (N = 18) and a group of women who had suffered no major negative life event (N = 15). Psychological adjustment of the 37 women was assessed with the Schedule for Affective Disorders and Schizophrenia Lifetime Version (SADS-L; R. L. Spitzer & J. Endicott, 1975) and various standard questionnaires. The women whose children had been involved in the disaster were found to have suffered a greater number of incidents of psychological distress in the period since the disaster than the women who had suffered no major negative life events but fewer incidents of psychological distress than the widows. The significance of these findings and clinical implications are discussed.     

Stressful Life Events: A Revision and Update of the Social Readjustment Rating Scale

The widely used and cited Social Readjustment Rating Scale developed by Holmes and Rahe (1967) was comprehensively revised and updated. The new instrument, containing 51 major life events, was administered to a national sample of 5000. Respondents were asked to rate the stressfulness of each life event on a 1–100 scale. Completed surveys were returned by 3122 individuals (62.4%). Responses were analyzed using repeated measures MANOVA and profile analysis. Major results included: (a) statistically and practically significant differences in mean ratings for the 51 life events; (b) five overlapping themes in the top 20 rated life events—death and dying, healthcare, crime and the criminal justice system, financial/economic issues, and family-related issues; and (c) an amazing level of agreement concerning perceived life event stressfulness, regardless of gender, age, or income level.     

大学生压力性生活事件与网络游戏成瘾的关系:一个有调节的中介模型

为探究大学生压力性生活事件与网络游戏成瘾的关系以及基本心理需要满足、领悟社会支持在二者关系中的作用,采用大学生网络游戏成瘾量表、青少年生活事件量表、中文版基本心理需要问卷和领悟社会支持量表,对617名大学生进行调查.结果发现,压力性生活事件与网络游戏成瘾显著正相关.基本心理需要满足在压力性生活事件与网络游戏成瘾之间起部...     

Life Stress and Major Depression

ABSTRACT— People have long believed that adversity and stress contribute to emotional problems in general and to depression in particular. A considerable body of research has supported this intuition, documenting a consistent association between major stressful life events and the onset of clinical depression. However, most individuals under stress do not become depressed, sometimes depression develops without prior stress, and distinguishing psychological distress from major depression can be diagnostically challenging. In varying forms and degrees, life stress may play multiple roles in relation to major depression. In this article, we outline the opportunities and obstacles associated with conceptualizing depression from a life-stress perspective and discuss the implications for future research.     

An Examination of Posttraumatic Stress Symptoms among Maltreated Multiracial Youth

Symptoms of posttraumatic stress disorder (PTSD) are common among maltreated youth removed from their homes. These symptoms might be particularly evident in multiracial youth, although little research exists on this vulnerable population. A model whereby depression, dissociation, and posttraumatic cognition symptoms contributed to symptoms of PTSD met goodness-of-fit criteria in 160 maltreated multiracial adolescents. Enhanced model fit was found for females and for adolescents 11 to 13 years old. Analyses further revealed that the best predictors of PTSD symptoms were negative cognitions about the world and anhedonia. The findings are discussed within the context of existing theoretical models of PTSD. The results further highlight the importance of ethnically and racially sensitive approaches to assessment and treatment of youth with PTSD symptoms.     

Relationships Between Social Support, Social Coping and Life Events in the Relapse of Schizophrenic Patients

The vulnerability-stress model for schizophrenia posits that relapses are at least partly determined by interacting triggering and protecting psychosocial factors. This study examined social support and general coping style in 42 consecutively admitted DSM:III schizophrenic patients, who were followed prospectively for up to four years. In a second part of the study, a subgroup of the patients were interviewed using the Life Event and Difficulty Schedule 9 months after discharge or at relapse. Patients contented with low social integration had a higher relapse rate over four years than patients lacking of social provisions, but wanting more. We found an excess of life events three weeks before relapse compared to events reported in the non-relapsing group. Suggesting a buffering effect of social factors, time between life event and relapse was significantly extended among patients with a high availability of attachment and a coping strategy characterised of active support seeking.     

Posttraumatic Stress Symptoms of Chinese Rural Children and Adolescents Surviving the 2008 Wenchuan Earthquake Assessed Using CRIES

Posttraumatic stress symptoms in Chinese rural children and adolescents were examined after the May 2008 Wenchuan earthquake. Analysis showed that three factors were identified, namely, avoidance, intrusion, and arousal, resembling those in the studies with Western samples. Gender differences in posttraumatic stress symptoms were not significant. Moderate negative correlation coefficients between posttraumatic stress symptom scores and mental health scores were found, indicating that the more severe the posttraumatic stress symptoms, the worse the person's mental health.     

Partners’ Attributions for Service Members’ Symptoms of Combat-Related Posttraumatic Stress Disorder

The association of service members’ combat-related PTSD with partners’ distress is weaker when spouses/partners believe that service members experienced more traumatic events during deployment. Also, when simultaneously examining partners’ perceptions of all PTSD symptoms, perceptions of reexperiencing symptoms (the symptoms most obviously connected to traumatic events) are significantly negatively related to distress in partners. These findings are consistent with the notion that partners may be less distressed if they make external, rather than internal, attributions for service members’ symptoms. The present study explicitly tests this possibility. Civilian wives of active duty service members completed measures regarding their own marital satisfaction, their perceptions of service members’ combat exposure during deployments, their perceptions of service members’ symptoms of PTSD, and their attributions for those symptoms. External attributions were significantly positively associated with perceptions of combat exposure (r_p = .31) and reexperiencing symptoms (β = .33) and significantly negatively associated with perceptions of numbing/withdrawal symptoms (r_p = –.22). In contrast, internal attributions were significantly negatively associated with perceptions of reexperiencing symptoms (β = –.18) and significantly positively associated with perceptions of numbing/withdrawal symptoms (β = .46). Internal attributions significantly moderated the negative association of PTSD symptoms with marital satisfaction, such that the association strengthened as internal attributions increased. These findings are the first explicit support for an attributional understanding of distress in partners of combat veterans. Interventions that alter partners’ attributions may improve marital functioning.     

The Relationship between Traumatic Life Events and Hoarding Symptoms: A Multi-Method Approach

Hoarding Disorder is characterized by difficulties with discarding and frequently excessively acquiring possessions, resulting in substantial clutter. Previous research has implicated trauma in the development of hoarding, but no study to date has examined the relationship between trauma and hoarding using hypothetical hoarding paradigms. This study investigated the association between traumatic events and both self-report and hypothetical indices of hoarding symptoms. We predicted that frequency of trauma would be associated with greater hoarding symptoms (across self-report and hypothetical indices). Undergraduate students (N = 80) completed self-report measures of hoarding symptoms and trauma, and hypothetical measures of acquiring and saving tendencies. As expected, more frequent trauma, and physical/sexual trauma in particular, was associated with greater acquiring tendencies. However, frequency of trauma was not significantly correlated with saving tendencies or self-reported hoarding symptoms. Future research should replicate these findings using longitudinal designs to confirm whether trauma actually serves as a risk factor for hoarding. Replication in a clinical sample is needed to better understand the implications of these results for intervention.     

Direct and Mediating Effects of an Anxiety Sensitivity Intervention on Posttraumatic Stress Disorder Symptoms in Trauma-Exposed Individuals

Anxiety sensitivity (AS), or fear of anxious arousal, is a higher-order cognitive risk-factor for posttraumatic stress disorder (PTSD) composed of lower-order physical, cognitive, and social concerns regarding anxiety symptoms. Brief and effective interventions have been developed targeting AS and its constituent components. However, there is limited evidence as to whether an intervention aimed at targeting AS would result in reductions in PTS symptoms and whether the effects on PTS symptoms would be mediated by reductions in AS. Furthermore, there is no evidence whether these mediation effects would be because of the global or more specific components of AS. The direct and indirect effects of an AS intervention on PTS symptoms were examined in a sample of 82 trauma-exposed individuals (M age = 18.84 years, SD = 1.50) selected based on elevated AS levels (i.e., 1 SD above the mean) and assigned to either a treatment (n = 40) or an active control (n = 42) condition. Results indicated that the intervention led to reductions in Month 1 PTS symptoms, controlling for baseline PTS symptoms. Furthermore, this effect was mediated by changes in global AS and AS social concerns, occurring from intervention to Week 1. These findings provide an initial support for an AS intervention in amelioration of PTS symptoms and demonstrate that it is primarily reductions in the higher-order component of AS contributing to PTS symptom reduction.     

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.     

A Cross-Lagged Panel Approach to Understanding Social Support and Chronic Posttraumatic Stress Disorder Symptoms in Veterans: Assessment Modality Matters

Although there is a strong and consistent association between social support and posttraumatic stress disorder (PTSD), the directionality of this association has been debated, with some research indicating that social support protects against PTSD symptoms, whereas other research suggests that PTSD symptoms erode social support. The majority of studies in the literature have been cross-sectional, rendering directionality impossible to determine. Cross-lagged panel models overcome many previous limitations; however, findings from the few studies employing these designs have been mixed, possibly due to methodological differences including self-report versus clinician-administered assessment. The current study used a cross-lagged panel structural equation model to explore the relationship between social support and chronic PTSD symptoms over a 1-year period in a sample of 264 Iraq and Afghanistan veterans assessed several years after trauma exposure. Approximately a third of the sample met criteria for PTSD at the baseline assessment, with veterans’ trauma occurring an average of 6 years prior to baseline. Two separate models were run, with one using PTSD symptoms assessed via self-report and the other using clinician-assessed PTSD symptoms. Excellent model fit was found for both models. Results indicated that the relationship between social support and PTSD symptoms was affected by assessment modality. Whereas the self-report model indicated a bidirectional relationship between social support and PTSD symptoms over time, the clinician-assessed model indicated only that baseline PTSD symptoms predicted social support 1 year later. Results highlight that assessment modality is one factor that likely impacts disparate findings across previous studies. Theoretical and clinical implications of these findings are discussed, with suggestions for the growing body of literature utilizing these designs to dismantle this complex association.     

Use of the Personality Assessment Inventory in Assessment of Posttraumatic Stress Disorder in Women

This study investigated the utility of the Personality Assessment Inventory (PAI) for the assessment of posttraumatic stress disorder (PTSD). Participants were 55 community-residing adult women who were administered a comprehensive battery that included the PAI and the Clinician-Administered PTSD Scale (CAPS). Participants were classified as either PTSD or non-PTSD based on the CAPS, and PAI profiles were compared between the two groups. Significant group differences were found for seven PAI clinical scales (Anxiety, Depression, Anxiety-Related Disorders, Somatic Complaints, Paranoia, Borderline Features, and Schizophrenia), one validity scale (Negative Impression), and two treatment scales (Nonsupport and Treatment Rejection). When all PAI scales and component subscales are considered, the largest group differences were found for the physiological subscale of the Depression scale (DEP-P) and the Traumatic Stress subscale of the Anxiety-Related Disorders scale (ARD-T). ARD-T and DEP-P also demonstrated excellent diagnostic utility. Finally, correlations between PAI scales and four CAPS symptom clusters provided additional validity evidence, in particular supporting a distinction between effortful avoidance and numbing. Taken together, these results support the use of the PAI in the assessment of PTSD.This study was the basis of a Masters thesis for Meghan McDevitt-Murphy. Portions of this study were presented at the annual meeting of the Association for Advancement of Behavior Therapy, November 2000.     

Recurrence of Posttraumatic Stress Disorder in Late Life: A Cognitive Aging Perspective

Clinical experience with older adults shows that many will experience PTSD symptoms in older adulthood because of trauma exposure early in life. Some of these patients struggled with PTSD in the distant past and remained symptomfree for decades only to have a recurrence of PTSD in late life. This paper outlines a cognitive aging explanation for the recurrence of PTSD. It is proposed that the age-related decreases in attention make the intrusion of trauma-related memories more likely. The increase in intrusive memories, combined with age-related decreases in working memory, explicit memory, and prospective memory, increases the subjective distress associated with the memories and results in a recurrence of PTSD.     

创伤后应激障碍的双重表征理论及其进展

创伤后应激障碍(PTSD)的双重表征理论认为创伤引起了可回忆的言语记忆和可回忆的情境记忆两类记忆。这两类记忆能够解释PTSD,比如再现创伤和情绪加工。创伤的情绪加工可能合出现成功完成、慢性加工和过早抑制加工三个结果。最后本文讨论了该理论在研究设计、临床实践和解释实验数据方面的应用。     

Childhood Sexual Assault,Quality of Life,and Psychiatric Comorbidity in Veterans With Military and Civilian Sexual Trauma

Veterans with military sexual trauma (MST) are at risk for a variety of psychiatric conditions, including posttraumatic stress disorder (PTSD) and depression. Survivors of MST are also likely to experience diminished quality of life (QoL). Individuals with higher lifetime incidence of sexual trauma may also be at increased risk for poorer outcomes in QoL and psychiatric symptomatology. The differences in psychological sequelae among those who have experienced sexual trauma as children, and those whose sexual trauma exposure is limited to adulthood are relatively understudied. The majority of sexual trauma literature has focused primarily on civilian trauma, and comparatively few studies have specifically examined psychosocial sequelae (e.g., QoL) in veterans with MST. This study examined how childhood sexual abuse (CSA) affects overall QoL as well as severity of PTSD and depressive symptoms. Veterans who reported CSA had significantly greater depression symptom severity than veterans who did not. No significant differences in PTSD symptom severity or QoL were found between veterans who did and did not report CSA. Results highlight the need for further examination of the relationship between CSA and depression in veterans with MST-related PTSD who also report CSA.     

Emotion Regulation of Events Central to Identity and Their Relationship With Concurrent and Prospective Depressive Symptoms

Dispositional emotion regulation is related to the severity and maintenance of depressive symptoms. However, whether emotion regulation specific to an event highly central for an individual’s identity is predictive of depressive symptoms has not been examined. Nonclinical participants (N = 220) reported the extent to which they employed a selection of emotion regulation strategies when recalling low- and high-centrality events. Dispositional emotion regulation and depressive symptoms were also assessed. A 7-week follow-up was conducted. High-centrality events were associated with more emotion regulation efforts. Greater brooding and expressive suppression in relation to high-centrality memories predicted concurrent depressive symptoms after controlling for event valence and dispostional emotion regulation. Effects were absent for low-centrality memories. Emotion regulation in response to high-centrality memories did not predict depressive symptoms at follow-up beyond baseline depressive symptoms. Overall, the findings showed that maladaptive emotion regulation in response to memories of high-centrality events is important for explaining depressive symptomatology.     

Karamojong Adolescents in Tororo,Uganda: Life Events,Adjustment Problems,and Protective Factors

The Karamojong people of Uganda are marginalized and likely to have difficult lives. Research is needed to understand Karamojong children’s challenges, adjustment, and resiliency to help guide interventions and policies to improve their lives. Thus, 18 Karamojong 10–16-year-olds (10 girls; M?=?13.33 years; SD?=?1.81) were recruited from a nongovernmental organization in Tororo District, Uganda, and interviewed about their life events, coping strategies, social support, and hope. Adolescents also were verbally administered questionnaires about their life events and adjustment problems. Participants reported many negative life events (M?=?9.28 of 16). The number of negative life events was positively correlated with internalizing, but not with externalizing, problems. Participants described a variety of coping strategies. Most participants received emotional or instrumental social support, and were hopeful about their futures. Hardships were often alcohol- or poverty-related events, whereas hope was often centered on education.