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.     

Does Traumatic Brain Injury Attenuate the Exposure Therapy Process?

Research indicates that exposure therapy is efficacious for combat-related posttraumatic stress disorder (PTSD) comorbid with traumatic brain injury (TBI) as is shown by reduced PTSD treatment outcome scores. What is unknown, however, is whether the process of fear extinction is attenuated in veterans with TBI history. Increased PTSD symptomatology and possible cognitive deficits associated with TBI sequelae may indicate additional or longer exposure sessions to achieve habituation and extinction comparable to individuals without TBI history. As such, a more extensive course of treatment may be necessary to achieve comparable PTSD treatment outcome scores for individuals with TBI history. Using a sample of veterans with combat-related PTSD, some of whom were comorbid for TBI, this study compared process variables considered relevant to successful treatment outcome in exposure therapy. Individuals with and without TBI demonstrated similar rates of fear activation, length and number of exposure sessions, within-session habituation, between-session habituation, and extinction rate; results remained consistent when controlling for differential PTSD symptomatology. Furthermore, results indicated that self-perception of executive dysfunction did not impact the exposure process. Results suggest that individuals with PTSD and TBI history engage successfully and no differently in the exposure therapy process as compared to individuals with PTSD alone. Findings further support exposure therapy as a first-line treatment for combat-related PTSD regardless of TBI history.     

In the grip of fear: Dissociations in attentional processing of animal fearful individuals

Using a modified attention paradigm we investigated specific attentional mechanisms in processing animal feared stimuli. In this paradigm arrays of four pictures were displayed and after its disappearance from view a probe (a letter, X or P) then followed unpredictably in the location of one of the four pictures. The results showed that discriminations of probes tended to be impeded by spider stimuli, compared to snake stimuli. This effect was potentiated by high anxiety but only for those individuals fearful of spiders, since no such effect was observed for snake fearful individuals. Moreover, the discrimination of the probes was not facilitated when presented after the feared stimuli. The implications of these findings are discussed as a function of the cognitive bias involved in specific fear.     

“Reading” Paintings: Evidence for Trans-Symbolic and Symbol-Specific Comprehension Processes

Art-based reading instruction and interventions for elementary and middle school students are growing in popularity despite scant theoretical rationale and empirical research support. This study explored the degree to which painting comprehension processes map onto text comprehension processes in this population. In particular, we used think aloud protocols to examine the painting comprehension processes used by 35 fourth-grade and 34 eighth-grade students and compared the manifest processes to the literature on text comprehension. Protocol analysis revealed six painting comprehension processes—observing, activating prior knowledge, inferring and interpreting, elaborating, evaluating and responding, and monitoring—comprising 23 subprocesses. Of the identified painting comprehension subprocesses, 17 are commonly associated with text comprehension. These findings suggest that compositions—be they encoded visually, linguistically, or in another symbol system—may entail comprehension processes that transcend symbol systems, as well as processes that are particular to a given symbol system.     

Gender Differences in Experiences with Couples Treatment for IPV

Evidence suggests that conjoint treatment can be effective for certain violent couples in certain situations (Finkel in Rev Gen Psychol 11:193–207, 2007; LaTaillade et al. in J Cogn Psychother 20:393–410, 2006; Fals-Stewart et al. in J Consult Clin Psych 73:239–248, 2005; Stith et al. in J Marital Fam Ther 29(3):407–426, 2003). However, not as much is known about which aspects of conjoint treatment make a difference, nor if male and female participants experience these elements of treatment differently. Knowing which components of couples’ treatment clients perceive as helpful—and whether their perceptions differ by gender—will allow us to redefine models with an eye toward making them more effective. In this study we used qualitative methods to examine the aspects of a particular couples’ treatment program (Stith and McCollum in Aggress Violent Beh 16(4):312–318, 2011) that clients found useful while also considering the differences between men’s and women’s responses. Fourteen couples, in which the male had been identified as the primary aggressor, were interviewed multiple times to gain their perspectives about components of the program they found helpful and their suggestions for program improvement. Themes are analyzed by gender. Implications for treatment and future research are provided.     

Children's Theory of Mind,Self‐Perceptions,and Peer Relations: A Longitudinal Study

This longitudinal study explored Theory of Mind (ToM), self‐perceptions, and teacher ratings of peer relations of 91 children (52 females, ages 6–8 years) drawn from two schools situated in a mainly Euro‐Canadian, middle socioeconomic status, semi‐rural central Canadian context. ToM, self‐perceptions, and teacher ratings of peer relations were assessed at Time 1 (T1, M = 6 y 2 m) and 2 years later at Time 2 (T2, M = 8 y 5 m). Findings showed that ToM scores and perceptions of global self‐worth and physical appearance significantly increased with time across both genders. Positive longitudinal associations were found between teacher ratings of sociable peer relations at T1 and children's T2 moral self‐perceptions. A positive longitudinal correlation was found between T1 ToM and T2 teacher ratings of anxious/fearful peer relations. Individual variation in ToM at age 6 predicted teacher ratings of anxious and fearful behaviours in 8 year olds. In contrast, teacher ratings at age 6 did not predict ToM ability in 8 year olds. Educational implications for social and emotional competencies are discussed. Copyright © 2014 John Wiley & Sons, Ltd.