Posttraumatic Stress Disorder Symptom Clusters and the Interpersonal Theory of Suicide in a Large Military Sample

Prior studies examining posttraumatic stress disorder (PTSD) symptom clusters and the components of the interpersonal theory of suicide (ITS) have yielded mixed results, likely stemming in part from the use of divergent samples and measurement techniques. This study aimed to expand on these findings by utilizing a large military sample, gold standard ITS measures, and multiple PTSD factor structures. Utilizing a sample of 935 military personnel, hierarchical multiple regression analyses were used to test the association between PTSD symptom clusters and the ITS variables. Additionally, we tested for indirect effects of PTSD symptom clusters on suicidal ideation through thwarted belongingness, conditional on levels of perceived burdensomeness. Results indicated that numbing symptoms are positively associated with both perceived burdensomeness and thwarted belongingness and hyperarousal symptoms (dysphoric arousal in the 5‐factor model) are positively associated with thwarted belongingness. Results also indicated that hyperarousal symptoms (anxious arousal in the 5‐factor model) were positively associated with fearlessness about death. The positive association between PTSD symptom clusters and suicidal ideation was inconsistent and modest, with mixed support for the ITS model. Overall, these results provide further clarity regarding the association between specific PTSD symptom clusters and suicide risk factors.     

地震对灾民创伤后应激障碍的长期影响

创伤后应激障碍是震后最常见的心理创伤。以往研究多关注灾民在震后短时间内的应激反应, 地震两年后创伤心理研究非常缺乏。本研究拟结合汶川地震后进行的6次重复测量数据(2008~2016)重点探讨：创伤后应激障碍在震后不同时点的变化轨迹及影响因素; 震后针对创伤后应激障碍在不同时点的干预内容。预期研究成果不仅是对灾后心理创伤长期影响研究的补充, 也将为灾后救助政策以及心理干预提供依据。     

创伤后应激障碍诊治的思考

创伤后应激障碍随着人类灾害事故的频发升级,已引起了世界范围内的高度关注和研究.本文就思考缘起、疾病发病态势、疾病临床表现、其生物学变化及疾病预后所引发的思考启示、提醒当前要加强公众教育,并从中体悟疾病所映射的医学、物理学、心理学、社会学、宗教、哲学方面的涵义做一探索.     

The Comorbidity of Post-traumatic Stress Disorder and Suicidality in Vietnam Veterans

Vietnam veterans (N = 232) recruited from three sources were assessed for suicidal thinking and behaviors, and symptoms of posttraumatic stress disorder (PTSD) and depression. Findings support the notion that suicidal thoughts are prevalent in this group, with veterans in psychotherapy reporting a greater likelihood of such symptoms (82.6%) than veterans in the community (35.7%) or those seeking assistance through a veteran's outreach center (66.7%). Thoughts of ending one's life and a previous suicide attempt were significantly correlated with a diagnosis of PTSD (r = .53, p < .001; and r = .33, p < .001, respectively). Veterans with a diagnosis of PTSD and depression or dysthymia were also more likely to report suicidal thinking and behaviors than veterans with only one of the diagnoses.     

Perceptual Implicit Memory for Trauma-related Information in Post-traumatic Stress Disorder

We used a perceptual identification paradigm to investigate whether Vietnam combat veterans with post-traumatic stress disorder (PTSD), compared to healthy combat veterans, exhibit an implicit memory bias for trauma-related information. Subjects viewed a series of trauma, positive, and neutral words, and subsequently saw these "old" words intermixed with an equivalent number of "new" distractor words of the same types. During this test phase, each word appeared for 100 milliseconds and was replaced by a visual mask. Although both groups exhibited implicit memory by accurately identifying more old words than new words, this priming effect was not enhanced for trauma words in the PTSD group. Tasks that primarily tap perceptual implicit memory may be relatively insensitive to emotional variables.     

集体特大交通事故所致创伤后应激障碍症状的分析

评估经历两次撞击的集体特大交通事故中36名伤员1周内的创伤后应激障碍症状.以PCL-C为提纲,结合伤员自身、家属和同病房伤员的描述由评估者经过个体晤谈后完成评定.结果显示伤员最常见的症状是:创伤提示异常心理痛苦(83.33％),闯入性回忆(69.44％),回避创伤提示物品或境遇(66.67％),惊跳反应(63.89％),回避创伤相关思考(61.11％)和睡眠障碍(61.11％);63.89％的伤员PCL-C总分≥41;维吾尔族伤员创伤后应激障碍症状严重程度高于汉族伤员.     

Amygdalar Volume in Borderline Personality Disorder With and Without Comorbid Post-traumatic Stress Disorder: A Meta-analysis

IntroductionFour studies have found a smaller amygdalar volume in patients with borderline personality disorder (BPD) relative to controls, whereas four other studies have found similar amygdalar volume in BPD patients relative to controls. This study aims to compare amygdalar volumes of BPD patients with controls, and also to compare BPD patients with and without post-traumatic stress disorder (PTSD) with controls in order to determine whether PTSD can explain the heterogeneity of findings.MethodSystematic review and meta-analysis of magnetic resonance imaging studies that measured amygdalar volumes in BPD patients and healthy controls.FindingsA significant reduction of amygdalar volumes in BPD patients was confirmed (p < .001). However, data from the studies that discriminated BPD patients with and without PTSD indicated that amygdalar volumes were significantly smaller in BPD patients without PTSD relative to controls (left: p = .02; right: p = .05), but not in BPD patients with PTSD relative to controls (left: p = .08; right: p = .20).ConclusionThis meta-analysis suggests that amygdalar volumes are reduced in patients with BPD. This pattern is confirmed in BPD patients without PTSD, but not in BPD patients with PTSD, raising the possibility that reduced amygdalar volume in BPD patients cannot be explained by comorbid PTSD.     

Ethnic Identity,Family Cohesion,and Symptoms of Post-traumatic Stress Disorder in Maltreated Youth

Post-traumatic stress disorder (PTSD) is prevalent among maltreated youth, but little empirical work exists regarding the role of ethnic identity and family cohesion as influential factors among different ethnic groups. This study included an ethnically diverse sample of adolescents affiliated with a state-administered residential facility for maltreated youth. Variables included ethnic identity and family cohesion, as well as symptoms of PTSD, depression, dissociation, and post-traumatic cognitions. The most prominent finding was that low family cohesion predicted greater PTSD symptoms, depression, dissociation, and post-traumatic cognitions. This finding was especially pronounced for multiracial youth. Results are discussed within the context of developmental pathways regarding ethnic identity development in multiracial youth.     

Attachment Representation and Sensitivity: The Moderating Role of Posttraumatic Stress Disorder in a Refugee Sample

It has been hypothesized that adult attachment representations guide caregiving behavior and influence parental sensitivity, and thus affect the child's socio‐emotional development. Several studies have shown a link between posttraumatic stress disorder (PTSD) and reduced parental sensitivity, so it is possible that PTSD moderates the relationship between insecure attachment representations and insensitivity. In this study symptoms of PTSD (Harvard Trauma Questionnaire), parental sensitivity (Emotional Availability Scales), and attachment representations (Attachment Script Assessment) were assessed in 53 parents who were asylum seekers or refugees. Results showed that when parents were less able to draw on secure attachment representations, symptoms of PTSD increased the risk of insensitive parenting. These findings suggest that parental sensitivity is affected not just by attachment representations, but by a conjunction of risk factors including symptoms of PTSD and insecure attachment representations. These parents should therefore be supported to establish or confirm secure models of attachment experiences, to facilitate their ability interact sensitively and form a secure relationship with their children.     

Natural Disasters and Post-traumatic Stress Disorder Short-Term versus Long-Term Recovery in Two Disaster-Affected Communities1

Post-traumatic stress disorder (PTSD) in adults following disaster-precipitated family relocation was investigated in a longitudinal study of family and individual response to natural disasters. Adult participants included 78 women and 77 men in two communities. Psychosocial adjustment was measured at two points in time: at 4 months and 16 months after the disaster. Instruments used for assessing stress-related symptomatology included the Horowitz Impact of Event Scale (HIES) and the Diagnostic Interview Schedule (DIS). Major findings included: (a) levels of short-term stress symptomatology and diagnosable PTSD were substantial in both communities; (b) significant decrements in these levels occurred by 16-months postdisaster;(c) substantial gender differences (greater levels for women) were apparent in both short- and long-term PTSD response rates; and (d) patterns and levels of PTSD symptoms were different in the two communities. Findings have implications for the interpretation of PTSD within the context of family- and community-level variables.     

Happiness and Personal Growth are Attainable in Interferon-Beta-1a Treated Multiple Sclerosis Patients

Multiple sclerosis (MS) is a chronic debilitating disease. MS is associated with high rates of depression and dissatisfaction with life. “Positive psychology,” (PoP) has endeavored to better understand happiness, meaning in life and how these can be developed. There is a growing interest amongst clinicians and consumers in happiness and personal growth as indicators of patients’ well-being. To evaluate happiness and personal growth in treated relapsing-remitting (RR) MS patients compared with age and gender matched healthy subjects. The Oxford Happiness Inventory (OHI), the Satisfaction with Life Scale (SLS) and the Personal Growth Initiative Scale (PGIS) were completed by 105 RR-MS patients [70 females, mean age 44.4 ± 13.3 years, Expanded Disability Status Scale (EDSS) 3.6 ± 2.3] and 87 healthy subjects (66 females, mean age 39.7 ± 11.5 years). Scores were correlated with disease and treatment related parameters. All patients were treated for at least 6 months with interferon-beta-1a (Rebif). Mean happiness scores in MS patients for the OHI (103.1 ± 17.0), the SLS (23.9 ± 6.8) and the PGIS (40.1 ± 7.6) were not statistically different from those of healthy subjects. Categorical analysis of the SLS demonstrated a different distribution wherein more MS patients were in the “dissatisfied” subgroup (SLS score < 20) as compared to healthy subjects (24.8% vs. 12.6%, p = 0.045), while rates were similar in the extremely satisfied subgroup (SLS ≥ 30). Happiness was scored similarly in treated RR-MS patients and healthy subjects despite a greater percentage of patients reporting being dissatisfied with their lives. These findings may reflect positive treatment effects, hedonic adaptation or their combination.     

震后青少年创伤后应激障碍与社会支持、人格的关系

采用问卷调查法对地震地区933名中学生进行调查,考察青少年创伤后应激障碍的状况,并探讨社会支持在人格与创伤后应激障碍之间的调节作用。结果表明：（1）震后六个月,约67.6%的青少年患有PTSD或部分PTSD。（2）大五人格特质中的神经质对事件影响量表总分以及唤醒、侵扰、逃避均有预测作用;宜人性对事件影响量表总分、侵扰、唤醒有预测作用。验证了社会支持在大五人格与逃避、人格与唤醒、人格与事件影响量表总分间调节效应显著的结论。     

Memory Bias for Faces that are Perceived as Hostile by Crime Victims with Acute Post-traumatic Stress Disorder

The present study tested, and found support for, the hypotheses that crime victims with acute post-traumatic stress disorder have: (i) a general memory impairment for faces; and (ii) a memory bias for faces that they perceive as hostile, even when these faces are not arranged to show any hostile face expressions. It is suggested that crime victims with acute post-traumatic stress disorder perform worse on recognition memory due to impaired concentration, and that they allocate their limited attentional resources to the detection of hostility in others in order to avoid being victimized again. This produces a memory bias for perceived hostility even in relatively innocuous everyday interactions with others, which contributes to maintaining the sense of serious current threat that characterizes post-traumatic stress disorder.     

Development of a Measure of Coping with Multiple Sclerosis Caregiving

Development of a self-report measure of coping specific to multiple sclerosis (MS) caregiving is needed to advance our understanding of the role of coping in adaptation to caring for a person with MS and to contribute to a lack of empirical data on MS caregiving. A total of 213 MS caregivers and their care recipients completed a Coping with MS Caregiving Inventory (CMSCI) and measures of adjustment (psychological distress), appraisal and illness. A subsample ( n = 64) also completed the Ways of Coping Checklist (WCC) and additional adjustment measures (depression, caregiving impact, dyadic adjustment, and relationship conflict and reciprocity). Factor analyses revealed 5 factors: Supportive Engagement, Criticism and Coercion, Practical Assistance, Avoidance, and Positive Reframing. Subscales had internal reliabilities comparable to similar scales and were empirically distinct. Preliminary construct validation data are consistent with recent MS caregiving research that links passive avoidant emotion-focused coping with poorer adjustment, and relationship-focused coping caregiving research that links greater reliance on positive relationship-focused coping and less reliance on criticism with better adjustment. Results extend this research by revealing new relations between coping and adaptation to MS caregiving. Convergent validation data suggest that although the inventory differs from the WCC, it does share certain conceptual similarities with this scale.     

青少年感恩与创伤后应激障碍症状的关系:社会支持和心理弹性的中介作用

在"5.12"汶川地震后18个月时,采用青少年感恩量表、社会支持评定量表、心理弹性量表和创伤后应激障碍自评量表,对都江堰地区1439名经历地震的青少年进行问卷调查,考察感恩、社会支持、心理弹性与创伤后应激障碍(PTSD)症状的关系。结果表明:(1)感恩、社会支持和心理弹性均与PTSD症状呈显著的负相关,相关系数分别为-0.18,-0.17和-0.24;(2)感恩不仅直接影响PTSD症状,而且还通过社会支持和心理弹性的部分中介作用间接影响PTSD症状,中介效应占总效应的62%。     

Facets of Emotion Regulation and Emotional Disorder Symptom Dimensions: Differential Associations and Incremental Validity in a Large Clinical Sample

A growing literature suggests robust associations between dimensions of emotion regulation and emotional disorder psychopathology. However, limited research has investigated associations of emotion regulation dimensions across several emotional disorders (transdiagnostic associations), or the incremental validity of emotion regulation versus the higher-order construct of neuroticism. The current study used exploratory structural equation modeling and a large clinical sample (N = 1,138) to: (a) develop a multidimensional emotion regulation measurement model, (b) evaluate the differential associations between latent emotion regulation dimensions and five latent emotional disorder symptom dimensions (social anxiety, depression, agoraphobia/panic, obsessions/compulsions, generalized worry), and (c) determine the incremental contribution of emotion regulation in predicting symptom dimensions beyond neuroticism. The best-fitting measurement model of emotion regulation included four dimensions: Problematic Responses, Poor Recognition/Clarity, Negative Thinking, and Emotional Inhibition/Suppression. Although many zero-order associations between the four latent emotion regulation dimensions and five latent symptom dimensions were significant, few associations remained significant in a structural regression model that included neuroticism. Specifically, Negative Thinking and Problematic Responses incrementally predicted depression symptoms, while Emotional Inhibition/Suppression predicted both social anxiety and depression symptoms. Associations between neuroticism and the emotional disorder dimensions were similar regardless of whether the emotion regulation dimensions were held constant. These results suggest that self-reported emotion regulation dimensions are associated with the severity and expression of a range of emotional disorder symptoms, but that some emotion regulation dimensions have limited incremental validity after accounting for general emotional reactivity. Studies of emotion regulation should assess neuroticism as a key covariate.     

Social Cognition in Multiple Sclerosis: a Meta-Analysis

Multiple sclerosis (MS) is associated with cognitive decline and impairment in social functioning. Accumulating evidence suggests that patients with MS are impaired in social cognition, including theory of mind (ToM) and emotion recognition. In this meta-analysis of 24 studies, facial emotion recognition and ToM performances of 989 patients with MS and 836 healthy controls were compared. MS was associated with significant impairments with medium effect sizes in ToM (d?=?0.57) and facial emotion recognition (d?=?0.61). Among individual emotions recognition of fear and anger were particularly impaired. The severity of social cognitive deficits was significantly associated with non-social cognitive impairment. These deficits in social cognition may underpin difficulties in social functioning in MS. However, there is a need for further studies investigating the longitudinal evolution of social cognitive deficits and their neural correlates in MS.