Assessment and treatment of adult acute responses to traumatic stress following mass traumatic events

Assessment and treatment of acute responses to traumatic stress has received much attention since September 11, 2001. This article elucidates principles of early intervention with adults in the immediate (within 48 hours) and early recovery phase (within the first week). The principles have been drawn from research on risk and recover factors, stress and traumatic stress theory, and expert consensus recommendations. The debriefing model is discussed, and principle interventions of psychological first aid, pharmacology, and mass trauma systems are described. This article concludes with brief guidelines for longer-term interventions and recommendations for future research.     

The tie that binds? Coherence among emotion experience, behavior, and physiology

Emotion theories commonly postulate that emotions impose coherence across multiple response systems. However, empirical support for this coherence postulate is surprisingly limited. In the present study, the authors (a) examined the within-individual associations among experiential, facial behavioral, and peripheral physiological responses during emotional responding and (b) assessed whether emotion intensity moderates these associations. Experiential, behavioral, and physiological responses were measured second-by-second during a film that induced amusement and sadness. Results indicate that experience and behavior were highly associated but that physiological responses were only modestly associated with experience and behavior. Intensity of amusement experience was associated with greater coherence between behavior and physiological responding; intensity of sadness experience was not. These findings provide new evidence about response system coherence in emotions.     

Contemporary longitudinal methods for the study of trauma and posttraumatic stress disorder

Traditional methods for analyzing trends in longitudinal data have typically emphasized average group change over time. In this article, we propose multilevel, regression-based methods for examining inter-individual differences in intra-individual change and apply these methods to research in trauma and posttraumatic stress disorder (PTSD). The outcome or dependent variable of interest is reconceptualized as an index of dynamic change reflecting the trend or trajectory of an individual's PTSD symptom severity scores across time. A basic statistical model is presented, and analyses and findings are demonstrated with an existing database used in previously published studies. The methods offer promise for future study of the natural course of PTSD chronicity or recovery, risk and resilience factors that influence individual growth or decline, and critical timepoints for intervention.     

Genetics of posttraumatic stress disorder

Posttraumatic stress disorder (PTSD) is a prevalent anxiety disorder marked by behavioral, physiologic, and hormonal alterations. PTSD is disabling and commonly follows a chronic course. The etiology of PTSD is unknown, although exposure to a traumatic event constitutes a necessary, but not sufficient, factor. A twin study of Vietnam veterans has shown significant genetic contribution to PTSD. The fact that PTSD's underlying genotypic vulnerability is only expressed following trauma exposure limits the usefulness of family-based linkage approaches. In contrast to the other major psychiatric disorders, large studies for the search of underlying genes have not been described in PTSD to date. Complementary approaches for locating involved genes include association-based studies employing case-control or parental genotypes for transmission dysequilibrium analysis and quantitative trait loci studies in animal models. Identification of susceptibility genes will increase our understanding of traumatic stress disorders and help to elucidate their molecular basis. The current review provides an up-to-date outline of progress in the field of PTSD.     

The effects of depression on the emotional responses of Spanish-speaking Latinas

Emotional responses (physiology, self-report, and facial expression) of 12 depressed and 10 nondepressed Spanish-speaking Latinas during sad and amusing film clips of human and animal content were compared. Depressed Latinas demonstrated less electrodermal reactivity across all the film clips and displayed fewer social smiles during the amusing-human film clip than nondepressed Latinas. No differences emerged for cardiovascular measures, reports of emotion, or facial expressions of happiness and negative emotion. Observed differences in electrodermal reactivity are similar to results from previous studies of Anglo Americans, suggesting that reduced electrodermal activity may be linked to depression across cultures. The findings also suggest that, for Latinas, depression may selectively alter expressions that serve interpersonal functions.     

Longitudinal findings from the Normative Aging Study: III. Personality, individual health trajectories, and mortality

Individual differences in physical and psychological health trajectories were examined in 1,515 Normative Aging Study men. Mean age at baseline was 47.15 years (range = 28-80), and average follow up was 18.55 years (range = 8-25). Both linear and nonlinear growth curves were estimated with random-effects models and then clustered to identify patterns of change. Men whose physical health trajectories were characterized by high, increasing symptoms were higher in hostility and anxiety, were overweight, and smoked. Those whose trajectories were characterized by low symptoms were emotionally stable, educated, nonsmokers, and thin. Men with high, stable psychological trajectories had high hostility; those with low, stable trajectories had high emotional stability; those with moderate anxiety levels had nonlinear trajectories with peaks in psychological symptoms at different life stages. Personality had life-long effects on health trajectories, but these effects varied across traits and health outcomes.     

Rebound from marital conflict and divorce prediction.

Marital interaction has primarily been examined in the context of conflict resolution. This study investigated the predictive ability of couples to rebound from marital conflict in a subsequent positive conversation. Results showed that there was a great deal of consistency in affect across both conversations. Also examined was the ability of affective interaction to predict divorce over a 4-year period, separately in each of the two conversations. It was possible to predict divorce using affective variables from each conversation, with 82.6% accuracy from the conflict conversation and with 92.7% accuracy from the positive rebound conversation.     

Anger and sadness in response to an emotionally neutral film: evidence for age-specific associations with well-being

When the association between emotion and well-being is being considered, positive emotions usually come to mind. However, negative emotions serve important adaptive functions and particular negative emotions may be especially adaptive at different stages of adult development. We examined the associations between self-reported negative emotions in response to an emotionally neutral, thematically ambiguous film and subjective well-being among 76 young (age 20-29), 73 middle-aged (age 40-49), and 73 older (age 60-69) adults. Results indicated that higher self-reported anger in response to the film was associated with higher well-being for middle-aged adults, but not for young and older adults. Higher self-reported sadness in response to the film was associated with higher well-being for older adults, but not for young and middle-aged adults. These findings were stronger for cognitive well-being (i.e., satisfaction with life) than for affective well-being (i.e., ratio of dispositional positive to negative affect) and were specific to these emotions (not found for self-reported disgust or fear) and to the emotionally neutral film (not found for sad or disgusting films). Results are discussed in terms of the functions that anger and sadness are thought to serve and the control opportunities afforded in midlife and late life that render these functions differentially adaptive.     

Meditation and the startle response: a case study

The effects of two kinds of meditation (open presence and focused) on the facial and physiological aspects of the defensive response to an aversive startle stimulus were studied in a Buddhist monk with approximately 40 years of meditation experience. The participant was exposed to a 115-db, 100-ms acoustic startle stimulus under the 2 meditation conditions, a distraction condition (to control for cognitive and attentional load) and an unanticipated condition (startle presented without warning or instruction). A completely counterbalanced 24-trial, single-subject design was used, with each condition repeated 6 times. Most aspects of the participant's responses in the unanticipated condition did not differ from those of a comparison group of 12 age-matched male controls. Both kinds of meditation produced physiological and facial responses to the startle that were smaller than in the distraction condition. Within meditation conditions, open presence meditation produced smaller physiological and facial responses than focused meditation. These results from a single highly expert meditator indicate that these 2 kinds of meditation can differentially alter the magnitude of a primitive defensive response.