Examination of the PC-PTSD in previously deployed Air Force Medical Service personnel

This study assessed the performance of the PC-PTSD in diagnosing postdeployment posttraumatic stress disorder (PTSD) in a cohort of Air Force Medical Services personnel (N = 18,530). The prevalence of PTSD in the cohort was 5.18% based on medical record data. The area under the receiver operating characteristic curve was 0.69, indicating poor classification accuracy. Sensitivity was 47.55%, specificity was 90.68%, positive predictive value was 21.79%, and negative predictive value was 96.94%. The positive and negative likelihood ratios were 5.10 and 0.58, respectively. Several risk factors were found to be associated with a diagnosis of postdeployment PTSD: being a nurse, being enlisted in the medical service career field, being enlisted in the mental health service career field, those over age 30, being a member of the Active Duty service component, and having one’s first deployment be to Iraq. Being an officer was found to be a protective characteristic. These factors could potentially improve screening for PTSD among Air Force healthcare personnel.     

Cognitive Behavioral Therapy and the Treatment of Posttraumatic Stress Disorder: Where Counseling and Neuroscience Meet

There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioral therapy and other well‐researched cognitive interventions. The purpose of this article is to describe the neurobiological context underlying the formation and treatment of posttraumatic stress disorders, a mental disorder frequently encountered by counselors, from a cognitive therapy framework.     

Individual differences and propensity to engage with in-vehicle distractions - A self-report survey

Ratings of severity and frequency of engagement with distracting driver behaviours are reported in this paper. Survey data were collected using an anonymous online questionnaire. Four hundred eighty-two respondents contributed to the survey during a 2 month data collection period. Results indicate that the three behaviours rated as most distracting when driving were (i) writing text messages (41%), (ii) reading text messages (62%), and (iii) using a cellular telephone hand-held (52%). The three most frequently reported distracting behaviours that resulted in accidents were (i) ‘interaction with child passengers’ 2.1% (near misses = 7.5%), (ii) both, route guidance destination entry with 2% (near misses = 2.8%) and use of an ‘… add-on media device, e.g., an iPod’ with 2% (near misses = 3.9%), and (iii) the three items ‘reading a text message’, ‘following advice from a route guidance system’, and ‘interaction with pets’, all with 1.7% of respondents reporting an accident when undertaking the activity (with 6.5%, 3%, and 2.2% respectively for near misses). Two hierarchical regression models were explored. The first introducing personal factors, i.e., age, extraversion, agreeableness, conscientiousness, emotional stability and intellect (R² = 0.131, p < 0.001). The second controlled for variables in the first model and introduced driver-related variables, mileage, penalty points, and frequency of accidents with assumed responsibility (R² = 0.253, p < 0.001). This model identified age, extraversion, mileage, penalty points and accidents all to be significant predictors of engagement with unnecessary distractions. The data presents a picture of widespread awareness of, and engagement with, distracting behaviours by drivers in the United Kingdom. Findings from the hierarchical regressions suggest scope may exist to mediate the levels of distracting behaviours by exploring individual differences and driving styles.     

Mental health problems and post-migration stress among multi-traumatized refugees attending outpatient clinics upon resettlement to Norway

Refugees have often been exposed to multiple traumas making them prone to mental health problems later. The aim of this study is to describe the prevalence and symptom load of psychiatric disorders in refugees admitted to psychiatric outpatient clinics and to investigate the relationship between multiple exposure to traumatic events, the severity of traumatic symptoms and post-migration stressors. A clinical sample of 61 refugee outpatients from psychiatric clinics in Southern Norway was cross-sectionally examined using three structured clinical interviews (SCID-PTSD, SIDES and MINI) and self-report psychometric instruments (HSCL-25, IES-R). Post-traumatic Stress Disorder (PTSD) was diagnosed in 82% of the patients, while Disorders of Extreme Stress Not Otherwise Specified (DESNOS) was present in 16% of them. Comorbidity was considerable; 64% of the patients had both PTSD and major depression disorder (MDD) and 80% of those who had PTSD had three or more additional diagnoses. Multi-traumatized refugees in outpatient clinics have high prevalence of PTSD, DESNOS, comorbid depression and anxiety disorders. A more severe symptomatology was found in patients diagnosed with both PTSD and DESNOS, than in those diagnosed with only PTSD. Higher rates of unemployment, weak social network and weak social integration were also prevalent in these outpatients, and related to increased psychiatric comorbidity and severity of symptoms. Further research may clarify the existence of a cumulative relationship between pre-resettlement traumas and post-resettlement stressors in the mental health of refugees, which in turn may help to improve therapeutic interventions.     

Attentional bias towards angry faces in trait-reappraisal

Emotion regulation (ER) strategies differ in when and how they influence emotion experience, expression, and concomitant cognition. However, no study to date has directly compared cognition in individuals who have a clear disposition for either cognitive or behavioural ER strategies. The present study compared selective attention to angry faces in groups of high trait-suppressors (people who are hiding emotional reactions in response to emotional challenge) and high trait-reappraisers (people who cognitively reinterpret emotional events). Since reappraisers are also low trait-anxious and suppressors are high trait-anxious, high and low anxious control groups, both being low in trait-ER, were also included. Attention to angry faces was assessed using an emotional dot-probe task. Trait-reappraisers and high-anxious individuals both showed attentional biases towards angry faces. Trait-reappraisers’ vigilance for angry faces was significantly more pronounced compared to both trait-suppressors and low anxious controls. We suggest that threat prioritization in high trait-reappraisal may allow deeper cognitive processing of threat information without being associated with psychological maladjustment.     

The cost of action miscues: hemispheric asymmetries

Adaptive behaviors require preparation and when necessary inhibition or alteration of actions. The right hemisphere has been posited to be dominant for preparatory motor activation. This experiment was designed to learn if there are hemispheric asymmetries in the control of altered plans of actions. Cues, both valid and invalid, which indicate the hand most likely to be called onto respond, as well as the imperative stimuli that indicate the actual response hand, were presented to either the right or left visual fields of 14 normal right handed participants. The delay after a miscue is dependent on the time taken to inhibit the premotor and motor systems of the incorrectly activated hemisphere, as well as to activate the motor systems of the opposite hemisphere, which might have been interhemispherically inhibited by this miscue. Analyses of reaction times revealed that miscues presented in left hemispace (right hemisphere) cost more time than those miscues presented in right hemispace (left hemisphere), suggesting that activation of the preparatory systems controlled by the right hemisphere may take longer to reverse than those controlled by the left hemisphere. This asymmetry may be related to asymmetries in the strength of hemispheric activation with contralateral inhibition.     

Cognitive Processing Therapy Versus Supportive Counseling for Acute Stress Disorder Following Assault: A Randomized Pilot Trial

The study tested the efficacy and tolerability of cognitive processing therapy (CPT) for survivors of assault with acute stress disorder. Participants (N = 30) were randomly allocated to CPT or supportive counseling. Therapy comprised six individual weekly sessions of 90-min duration. Independent diagnostic assessment for PTSD was conducted at posttreatment. Participants completed self-report measures of posttraumatic stress, depression, and negative trauma-related beliefs at pre-, posttreatment, and 6-month follow-up. Results indicated that both interventions were successful in reducing symptoms at posttreatment with no statistical difference between the two; within and between-group effect sizes and the proportion of participants not meeting PTSD criteria was greater in CPT. Treatment gains were maintained for both groups at 6-month follow-up.     

Gender Role Traits Among Individuals with Social Anxiety Disorder

The present study investigated differences between individuals with and without social anxiety disorder (SAD) in instrumentality and expressiveness, personality traits traditionally linked to the male and female gender roles, respectively. Based on evolutionary and self-discrepancy theories, it was hypothesized that individuals with SAD would score lower on instrumentality and report a discrepancy between their perceived and ideal level of instrumentality compared to control participants. Sixty-four patients with SAD and 31 non-anxious control participants completed a battery of questionnaires, including ratings of their perceived and ideal gender role attributes and current psychosocial distress. Results supported the hypotheses, and provided initial evidence that a discrepancy between perceived and ideal instrumentality may be linked to social anxiety severity, depression and lower quality of life. No differences were detected between groups in expressiveness. The present findings suggest that individuals with SAD perceive themselves to be deficient in instrumentality. They also suggest that increasing instrumentality among individuals with SAD may be beneficial for treatment.