Latent Profiles of Comorbid Depression as Predictors of PTSD Treatment Outcome

Posttraumatic stress disorder (PTSD) frequently co-occurs with major depressive disorder, and empirically supported PTSD treatments consistently improve depression. However, both diagnoses are heterogeneous and specific patterns of symptom overlap may be related to worse treatment outcome. Two hundred individuals with chronic PTSD participated in a doubly randomized preference trial comparing prolonged exposure and sertraline. Latent Profile Analysis was used to identify classes based on PTSD and depression symptoms prior to starting treatment. A three-class model best fit the data, with a high depression and PTSD severity class (distressed), a moderate depression and low PTSD avoidance class (depressive), and a low depression and high PTSD avoidance class (avoidant). The avoidant class showed the lowest rates of major depressive disorder diagnosis and transdiagnostic vulnerabilities to depression. Patients in the distressed class experienced more robust PTSD treatment response, with no differences between prolonged exposure and sertraline. These findings highlight the role of avoidance in nondepressed PTSD presentations while also demonstrating that co-occurring depression is not contraindicated in evidence-based PTSD treatment.     

Islamic Trauma Healing: Integrating Faith and Empirically Supported Principles in a Community-Based Program

Access to adequate, much less state-of-the-art, mental health care is a global problem. Natural disasters, civil war, and terrorist conflict have forcibly displaced millions of Muslims and have resulted in a remarkable level of individual and communitywide trauma exposure. As a result, many are at risk for posttraumatic stress and other trauma-related disorders. Many religiously oriented Muslims traditionally rely on Islamic principles and teachings, as well as their community, to cope with and address trauma-related distress. Islamic Trauma Healing is a six-session, lay-led group intervention developed within a Somali Muslim community that integrates evidence-based trauma-focused cognitive-behavioral therapy principles with cultural and religious practices aimed to enhance uptake and create an easily up-scalable intervention for a wide range of trauma. In sessions, narratives of prophets who have undergone trauma (e.g., Prophet Ayyub, faith during hard times) present Islamic principles and facilitate cognitive shifts. Group members spend individual time turning to Allah in dua (i.e., informal prayer), focused on exposure to trauma memories. Program themes arc across suffering to healing to growth following trauma. This paper describes the core theoretical principles and methods in the Islamic Trauma Healing program. We also describe leader perspectives and the program’s train-the-trainer model, in which lay leaders are trained to further disseminate the program and allow Islamic Trauma Healing to be owned and sustained by the Muslim community.     

Optimal combination of environmental cues and path integration during navigation

Navigation is influenced by body-based self-motion cues that are integrated over time, in a process known as path integration, as well as by environmental cues such as landmarks and room shape. In two experiments we explored whether humans combine path integration and environmental cues (Exp. 1: room shape; Exp. 2: room shape, single landmark, and multiple landmarks) to reduce response variability when returning to a previously visited location. Participants walked an outbound path in an immersive virtual environment before attempting to return to the path origin. Path integration and an environmental cue were both available during the outbound path, but experimental manipulations created single- and dual-cue conditions during the return path. The response variance when returning to the path origin was reduced when both cues were available, consistent with optimal integration predicted on the basis of Bayesian principles. The findings indicate that humans optimally integrate multiple spatial cues during navigation. Additionally, a large (but not a small) cue conflict caused participants to assign a higher weight to path integration than to environmental cues, despite the relatively greater precision afforded by the environmental cues.     

Efficacy of Treating Sexual Trauma in a Substance Abuse Residential Program for Women

This is a program evaluation of treating sexual trauma in a residential substance abuse treatment program for women. Residents who were seeking treatment for their substance abuse disorder (SUD), also had a history of both childhood and adult sexual trauma. Given the literature supporting concurrent trauma-SUD treatment, the Warrior Renew (WR) protocol (Katz, Warrior Renew: Healing from military sexual trauma, Springer, New York, 2014) was added to the curriculum of Alcoholics Anonymous 12-step groups, relapse prevention, and substance abuse education classes. The WR manual consists of coping skills to address sleep and anxiety, and cognitive/experiential restructuring to address anger/resentments due to injustice, betrayal, and self-blame. It also addresses interpersonal factors such as relationship patterns and healthy interpersonal skills. This evaluation was conducted as part of routine clinical care in a naturalistic setting. Nineteen residents graduated the program and opted to complete pre-and post-treatment assessments. Findings revealed significant decreases in symptoms of anxiety, depression, posttraumatic negative thinking, and PTSD, and significant increases in positive factors of optimism and self-esteem-- all with large effect sizes. In addition, 95% of the sample had a reliable change at the 95% confidence interval. Resident’s feedback to staff reflected strong positive endorsement of the WR program. Results suggest WR is a promising effective treatment for women who have had sexual trauma in a substance abuse residential treatment program.     

What’s Religion Got to Do with It? Exploring College Students’ Sexual and Reproductive Health Knowledge and Awareness of Sexual and Reproductive Health Services in Relation to Their Gender and Religiosity

The purpose of this study was to examine the relationship between religiosity and sexual and reproductive health (SRH) knowledge and awareness of campus SRH services among college students on a racially and ethnically diverse college campus. The sample included 996 undergraduate students at a large public university in California. For women, there was a consistent pattern across religious affiliations of more frequent attenders reporting lower SRH knowledge than less frequent attenders. These findings suggest that higher rates of religious attendance among Catholic, Protestant, and Evangelical women pose a risk for lower SRH knowledge. The results suggest the need for SRH outreach and educational materials targeting men in general, who had lower levels of SRH knowledge and awareness of SRH services overall, and taking religiosity into account, particularly with regard to women.     

Building Capacity of State Adolescent Pregnancy Prevention Coalitions to Implement Science-Based Approaches

A central question in adolescent reproductive health circles is how to effectively disseminate research to practitioners in a way that supports them in using the most scientifically sound and effective programming. In 2002, the Division of Reproductive Health at the Centers for Disease Control and Prevention (CDC) tackled this question by funding three national-level and five state-level organizations focused on adolescent pregnancy prevention to promote the use of science-based programs and approaches. Healthy Teen Network (HTN) and Education, Training and Research Associates (ETR), two national organizations, have partnered under this CDC funding to implement an effective model for capacity building. This paper provides an overview of the approaches used by HTN and ETR in capacity building using a seven-step process. We describe how we modified the Interactive Systems Framework for Dissemination and Implementation (ISF) for science-based innovations to apply to capacity-building for adolescent reproductive health (ARH) programs, and how we developed relevant, sustainable training and technical support. We conclude by reviewing some of the results of this training, and discuss the future work that will likely continue to advance the science behind effective dissemination of ARH research to practice.     

Recognition memory measures yield disproportionate effects of aging on learning face-name associations

No previous research has tested whether the specific age-related deficit in learning face-name associations that has been identified using recall tasks also occurs for recognition memory measures. Young and older participants saw pictures of unfamiliar people with a name and an occupation for each person, and were tested on a matching (in Experiment 1) or multiple-choice (in Experiment 2) recognition memory test. For both recognition measures, the pattern of effects was the same as that obtained using a recall measure: More face-occupation associations were remembered than face-name associations, young adults remembered more associated information than older adults overall, and older adults had disproportionately poorer memory for face-name associations. Findings implicate age-related difficulty in forming and retrieving the association between the face and the name as the primary cause of obtained deficits in previous name learning studies. (PsycINFO Database Record (c) 2008 APA, all rights reserved).     

Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?

Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination partially mediating this association. Finally, based on factor analysis, expressive suppression and cognitive reappraisal appear to be independent constructs. Overall, expressive suppression, much more so than cognitive reappraisal, may play an important role in the experience of stress-related symptoms. Further, given their independence, there are potentially relevant clinical implications, as interventions that shift one of these emotion regulation strategies may not lead to changes in the other.