College students' intentions to seek help for suicidal ideation: accounting for the help-negation effect

Prior research has identified a negative association between suicidal ideation and help-seeking, a phenomenon called "help-negation." Help-negation has been documented to occur for both professional and nonprofessional sources of help. In this study help-seeking attitudes, stigma concerns, and perceptions of social support were examined as possible mediators of help-negation. Data were collected from a nonclinical sample of college undergraduates at a midwestern university (N = 321). Findings provided partial support for the mediation hypotheses. Help-seeking attitudes and stigma were significant predictors of help-seeking intentions (β = .34 and β = -.17, p < .05, respectively), but did not mediate help-negation for professional sources. Perceptions of social support, on the other hand, fully mediated help-negation for nonprofessional sources (β = .27, p < .05).     

Underlying Circuits of Social Support for Bullied Victims: An Appraisal‐Based Perspective on Supportive Communication and Postbullying Adjustment

This study examined the working mechanisms of social support for victims of bullying. Structural equation modeling analyses based on retrospective survey data (N = 448) revealed that the effects of supportive messages varied distinctively, depending on the content of the messages; emotional and esteem support enhanced, but network support impeded, positive reappraisal (the effects of informational support were not significant). Except for that which was related to network support, discrepancy between desired and received support was associated with less positive appraisal. Finally, positive appraisal was found to enhance victims' postbullying adjustment both behaviorally and psychologically. These findings are discussed in terms of their theoretical and practical implications with reference to the literature on social support and coping of bullied victims.     

Attachment and social support mediate associations between Polyvictimization and psychological distress in early adolescence

The current study assesses associations between multiple experience of traumatic events (polyvictimization), PTSD symptoms (PTSS) and psychiatric symptoms in early adolescence, and explores the mediating roles of attachment orientations and perceived social support in the associations between polyvictimization, PTSS and psychiatric symptoms. In 2001, a representative national sample of 390 Danish eighth-graders (M = 13.95, SD = .37) completed validated self-report questionnaires. Polyvictimization was related to higher PTSS and psychiatric symptoms. Importantly, polyvictimization was significantly linked to high attachment anxiety, which was linked with low perceived social support, which in turn was linked with high PTSS levels and psychiatric symptoms. Polyvictimization might have dire consequences in early adolescence. An individual's high attachment anxiety might be connected with lack of perceived social support, which should be seen as a possible psychological distress mechanism subsequent to exposure to a number of potentially traumatic events.     

Differential Predictors of Transient Stress Versus Posttraumatic Stress Disorder: Evaluating Risk Following Targeted Mass Violence

Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and posttrauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known levels of pretrauma functioning (N = 573). Although the largest proportion of participants evidenced resilience following exposure to the event (46.1%), many reported high rates of PTSS shortly after the shooting (42.1%) and a smaller proportion (11.9%) met criteria for probable PTSD both in the acute and more distal aftermath of the event. While several preshooting factors predicted heightened PTSS after the shooting, prior trauma exposure was the only preshooting variable shown to significantly differentiate between those who experienced transient versus prolonged distress. Among postshooting predictors, individuals reporting greater emotion dysregulation and peritraumatic dissociative experiences were over four times more likely to have elevated PTSS 8 months postshooting compared with those reporting less dysregulation and dissociative experiences. Individuals with less exposure to the shooting, fewer prior traumatic experiences, and greater satisfaction with social support were more likely to recover from acute distress. Overall, results suggest that, while pretrauma factors may differentiate between those who are resilient in the aftermath of a mass shooting and those who experience heightened distress, several event-level and posttrauma coping factors help distinguish between those who eventually recover and those whose PTSD symptoms persist over time.     

Support during birth interacts with prior trauma and birth intervention to predict postnatal post-traumatic stress symptoms

Background: Many women experience childbirth as traumatic and 2% develop post-traumatic stress disorder. This study examined the role of health practitioner support and personal control during birth as predictors of post-traumatic stress (PTS) symptoms, adjusting for vulnerability factors of prior trauma, depression, control beliefs and birth intervention. It also investigated interactions between support, prior trauma and birth intervention and their association with PTS symptoms.

Methods: A prospective longitudinal survey of 138 women recruited from UK NHS maternity clinics. Measures were taken in pregnancy, 3 weeks and 3 months after the birth.

Results: Support and control during birth were not predictive of postnatal PTS symptoms. However, support was predictive of PTS symptoms in a subset of women with prior trauma (β?=??0.41, R ²?=?16%) at both 3-weeks and 3-months postpartum. The interaction of birth intervention and support was associated with PTS symptoms 3 months after birth, the relationship between support and PTS symptoms was stronger in women experiencing more intervention.

Conclusions: Low support from health practitioners is predictive of postnatal PTS symptoms in women who have a history of trauma. Longer term effects of low support on postnatal PTS symptoms are also found in women who had more intervention during birth.     

Coping strategies of former prisoners of war mediate the intergenerational transmission of posttraumatic stress symptoms

Objectives: Certain coping strategies, characterized by emotional coping or disengagement/ avoidance, have been linked to posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS). However, the role of primary trauma victims’ coping strategies in the intergenerational transmission of PTSS is still lacking. This prospective study assessed the mediating role of former prisoners of war’s (ex-POWs) coping strategies in the associations between ex-POWs’ PTSS and their adult offspring’s secondary PTSS in relation to their fathers’ captivity and psychiatric symptomatology.

Design: A correlational, prospective study.

Method: A sample from the 1973 Yom Kippur War composed of 79 Israeli ex-POW father-offspring dyads completed self-report measures. Fathers were assessed in 2001 and 2008, and their adult offspring participated in 2014.

Results: ex-POWs’ problem-focused coping strategies of active coping and planning, as well as disengagement-oriented coping strategies of alcohol and substance use and venting of emotions, were negatively associated with offspring’s PTSS and psychiatric symptomatology. Importantly, ex-POWs’ venting of emotions mediated the link between ex-POWs’ PTSS and their offspring’s secondary PTSS.

Conclusions: Ex-POWs with PTSS might expose their offspring to dysregulated mood, behaviors, and cognitions. Special awareness should be given to the venting of emotions coping style as possible mechanism for the intergenerational transmission of captivity-related PTSS.     

自尊对主观幸福感的影响：有调节的中介效应

采用问卷法调查了1084名高一至大四的学生,探讨了自尊、主观幸福感、自我怀疑及抑郁的关系。结果发现：自尊在自我怀疑与主观幸福感之间起部分中介作用,这一中介作用的实现受到抑郁的调节,即自尊对主观幸福感的影响是有调节的中介效应。     

Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans

Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.     

Main and interactive effects of social support in predicting mental health symptoms in men and women following military stressor exposure

Abstract

Evidence across a multitude of contexts indicates that social support is associated with reduced risk for mental health symptoms. More information is needed on the effectiveness of different sources of support, as well as sex differences in support. Associations between social support from two sources – the military unit and friends and family – and mental health symptoms were examined in a study of 1571 Marine recruits assessed at the beginning and end of a highly stressful 13-week training program. Military social support buffered the stressor exposure–posttraumatic stress symptomatology (PTSS) relationship, whereas the relationship between stressor exposure and PTSS was highest when civilian social support was high. Further inspection of the interactions revealed that military support was most important at high levels of stressor exposure. Sex differences in the relationship between social support and symptoms were found, such that support from military peers was associated with lower levels of PTSS for men, whereas civilian support was associated with lower PTSS for women. While civilian social support was associated with lower levels of depression symptom severity in both women and men, the relationship was stronger for women. Reviewed implications focus on the importance of considering the recipient, source, and context of social support.     

Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis

A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.     

Vicarious Trauma in Social Workers: The Role of Trauma History,Social Support,and Years of Experience

Vicarious trauma, a disruption in schemas and worldview often accompanied by symptoms similar to those of posttraumatic stress disorder, occurs as a result of chronic secondary exposure to traumatic material. The aim of this study was to examine the role of personal trauma history, social support, and experience level in the development of vicarious trauma among licensed social workers in Maryland (N = 160). Results indicated an increase in social support and in experience level of social workers predicted less severe vicarious trauma. In addition, an interaction effect between trauma history and social support trending on significance indicated higher levels of social support might help protect those without a trauma history but not those with a trauma history against vicarious trauma. Research and clinical implications are discussed.     

Attribution style and post-traumatic stress severity in the Central Region of Kenya: Influences of dwelling location

This study investigated the influence of attribution styles as predictors of post-traumatic stress severity (PTSS) by dwelling in Kenya. A non-clinical convenience sample of 354 rural (n = 178) and urban (n = 176) Kenyans from the Central Region of Kenya were participants. They responded to a post-traumatic stress screener, attribution style questionnaire and post-traumatic disorder (PTSD) checklist. A regression analysis showed that the urban dweller (UD) sample was significantly more likely to attribute negative events to internal, specific causes than the rural dweller (RD) sample. Findings suggest social support protections in RD to buffer them from negative self-attributions for PTSS among this Kenyan sample.     

Gender differences in posttraumatic stress symptoms among former prisoners of wars’ adult offspring

Objectives: The lifetime risk for posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS) among primary and secondary female victims is known to be higher than for male. This study assessed gender differences in PTSS among former prisoners of war’s (ex-POWs) adult offspring and the associations with their fathers’ and mothers’ PTSS and the parental bonding with them.

Design: A correlative study.

Methods: A sample of 79 Israeli father–mother-offspring ex-POW triads from the 1973 Yom Kippur War completed self-report measures. Fathers were assessed in 2008, mothers were assessed in 2011 and their adult offspring took part in 2014.

Results: Sons of ex-POWs reported higher levels of PTSS as compared to daughters of ex-POWs. However, fathers’ PTSS was positively related to daughters’ PTSS, but not significantly related to sons’ PTSS. Daughters’ PTSS were also associated with both parents’ lower care and higher overprotection, while sons’ PTSS were associated only with fathers’ lower care and higher overprotection.

Conclusions: Among adult offspring of ex-POWs, sons are at greater risk for psychological distress in the form of PTSS. Nevertheless, the intergenerational transmission of captivity-related PTSS from both fathers and spouses to their offspring is more prominent among daughters of ex-POWs.     

The relationship among genital herpes simplex virus, stress, and social support

Despite widespread popular belief in the activation of recurrent lesions in genital herpes simplex virus (HSV) by psychosocial stress, little empirical evidence supports that contention. This study retrospectively examined the role of stress in activation of HSV lesions as mediated by social support. Participants were 59 volunteers who had self-reported culture-positive genital HSV for at least 10 months. Measures of stress proneness (State-Trait Anxiety Inventory; STAI-Trait), recent stressful events (Schedule of Recent Events; SRE), and subjective appraisal of stress (global self-rating) were administered along with measures of general social support and herpes-specific social support. When retrospective reports of HSV symptoms were examined using a multiple-regression approach, duration of disease and amount of herpes-specific social support were found to be significant moderators of the relation between stress and number of HSV recurrences in the preceding 12 months. When duration of disease was short (less than 4 years), stress (SRE) and number of recurrences were positively associated; when disease duration was longer, there was no relationship. Similarly, at low levels of herpes-specific social support, a positive relation between stress (SRE) and number of recurrences was found. However, at higher levels of herpes-specific social support, no association was found. No relation was found between stress proneness (STAI-Trait) and HSV symptoms. However, subjective appraisal (global rating) of stress in the preceding 12 months was positively and significantly correlated with reported number of recurrences. Results are discussed in terms of their clinical implications.     

Anxiety Sensitivity Prospectively Predicts Posttraumatic Stress Symptoms Following a Campus Shooting

Anxiety sensitivity (AS), the feared consequences of anxious arousal, is known to be related to posttraumatic stress symptoms (PTSS) concurrently and longitudinally. However, no studies have demonstrated whether AS prior to a Criterion A traumatic event predicts later PTSS. The present study evaluated whether preshooting AS predicted PTSS following a campus shooting, as well as whether preshooting AS interacted with shooting exposure to predict PTSS. Participants comprised undergraduates (N = 71) who completed a self-report battery upon enrolling in Introductory Psychology. After a campus shooting later in the semester, they were invited to complete measures of PTSS and level of exposure to the shooting. Preshooting levels of AS significantly predicted PTSS after the shooting. This effect was qualified by a significant AS by shooting exposure interaction, such that those with high AS who were exposed to the shooting reported the greatest levels of PTSS. Though all three of the preshooting physical, cognitive, and social AS subfactors demonstrated main effects significantly predicting postshooting PTSS, only AS physical concerns significantly interacted with shooting exposure. The implications of this study concerning AS as a causal risk factor for PTSD are discussed.     

Temporal Associations Between Posttraumatic Stress Symptoms and Depression in Response to Online Expressive Writing Interventions in a Hispanic Sample

Some expressive writing (EW) interventions targeting posttraumatic stress symptoms (PTSS) may reduce both PTSS and comorbid depression symptoms. The temporal associations between PTSS and depression symptom levels in response to EW interventions are unknown. This study examined the directionality of PTSS and depression symptom levels from baseline to 1-week, 1-month, and 3-month follow-ups of two online EW interventions in a Hispanic sample with diverse trauma experiences. Participants (n = 70) completed either emotion-focused or fact-focused writing for 3 consecutive days online. A manifest autoregressive model with cross-lagged effects and treatment condition was analyzed. All but one first-order autoregressive path were statistically significant, with later PTSS and depression scores significantly predicted by those scores at preceding time points. The cross-lagged effects findings suggest that earlier PTSS levels influenced later depression levels, but earlier depression did not influence later PTSS, demonstrating a unidirectional temporal association. Severe PTSS may hinder EW treatment gains in depression. Superior outcomes for emotion-focused writing relative to fact-focused writing were also found.     

Posttraumatic Stress Symptoms and Stressful Life Events Predict the Long-term Adjustment of Survivors of Childhood Cancer and Their Mothers

Objectives: To examine prospectively the impact of posttraumatic stress symptoms (PTSS) in response to childhood cancer and treatment on general adjustment while accounting for the role of other stressful life events and appraisal of life threat and treatment intensity. Methods: As part of a larger study assessing PTSS, 56 childhood cancer survivors, aged 8 to 18, and 65 mothers completed self-report measures of PTSS and appraisal of the intensity and life threat associated with cancer treatment at time 1 and self-report measures of stressful life events and general adjustment at time 2 (approximately 18 months after time 1). Results: For child survivors and their mothers, posttraumatic stress at time 1 significantly predicted general adjustment at time 2, over and above the significant contribution of lifetime stressful events. The life events variable did not function as a mediator in the association of PTSS and general adjustment. Conclusions: Trauma responses to childhood cancer and its treatment have implications for the long-term adaptation of children and their families. Early signs and symptoms of posttraumatic stress and stressful life experiences require early assessment and intervention.     

Sleep quality and treatment of social anxiety disorder

Background and Objectives: Poor sleep is prevalent among individuals with social anxiety disorder (SAD) and may affect treatment outcome. We examined whether: (1) individuals with SAD differed from healthy controls (HCs) in sleep quality, (2) baseline sleep quality moderated the effects of treatment (Cognitive–behavioral group therapy [CBGT] vs. mindfulness-based stress reduction [MBSR] vs. waitlist [WL]) on social anxiety, (3) sleep quality changed over treatment, and (4) changes in sleep quality predicted anxiety 12-months post-treatment.

Design: Participants were 108 adults with SAD from a randomized controlled trial of CBGT vs. MBSR vs. WL and 38 HCs.

Methods: SAD and sleep quality were assessed pre-treatment and post-treatment; SAD was assessed again 12-months post-treatment.

Results: Participants with SAD reported poorer sleep quality than HCs. The effect of treatment condition on post-treatment social anxiety did not differ as a function of baseline sleep quality. Sleep quality improved in MBSR, significantly more than WL, but not CBGT. Sleep quality change from pre- to post-treatment in CBGT or MBSR did not predict later social anxiety.

Conclusions: MBSR, and not CBGT, improved sleep quality among participants. Other results were inconsistent with prior research; possible explanations, limitations, and implications for future research are discussed. ClinicalTrials.gov identifier: NCT02036658.