Suicide by crashing into a heavy vehicle: A one-year follow-up study of professional drivers

Train and heavy vehicle drivers can experience a traumatic event caused by people attempting suicide by crashing into their vehicles or jumping in front of them. While there are a number of studies on train drivers showing the negative consequences these events can have on their well-being, there are no studies on heavy vehicle drivers involved in these types of crashes. In the current study, we surveyed Finnish heavy vehicle drivers (N = 15) involved in a suicide crash in the year 2017 regarding their experiences and coping approximately one month (T1) and one year (T2) after the crash. Ten of these drivers reported one or various combinations of measurable consequences such as minor physical injuries, shorter or longer sickness absences, significant posttraumatic stress symptoms (measured using the Impact of Events Scale-Revised) and requiring psychological help. Posttraumatic stress symptoms decreased over time; however, three out of the four drivers who had a high IES-R score at T1 were still around the IES-R cut-off score at T2. This research raises questions whether and what kind of support heavy vehicle drivers who have been involved in a suicide crash should be given.     

Long term consequences of suppression of intrusive anxious thoughts and repressive coping

The current experiment employed a thought suppression paradigm to investigate whether repressors (N=40) are more skilled in suppressing positive and anxious autobiographical thoughts than low anxious (N=40), high anxious (N=40), and defensive high anxious (N=40) individuals, both immediately and over a longer time period (i.e., 7 days). Regardless of suppression instructions, repressors reported during their lab visit fewer target thoughts for their most anxious events than participants in the other three groups. However, over a 7 days period, repressors showed the highest number of intrusive thoughts about their anxious autobiographical events. Thus, our results demonstrate that repressive coping might be adaptive in the short run, but counterproductive in the long run.     

Prolonged exposure in patients with chronic PTSD: predictors of treatment outcome and dropout

The present study investigated predictors of treatment outcome and dropout in two samples of PTSD-patients with mixed traumas treated using prolonged imaginal exposure. Possible predictors were analysed in both samples separately, in order to replicate in one sample findings found in the other. The only stable finding across the two groups was that patients who showed more PTSD-symptoms at pre-treatment, showed more PTSD-symptoms at post-treatment and follow-up. Indications were found that benzodiazepine use was related to both treatment outcome and dropout, and alcohol use to dropout. Demographic variables, depression and general anxiety, personality, trauma characteristics, feelings of anger, guilt, and shame and nonspecific variables regarding therapy were not related to either treatment outcome or dropout, disconfirming generally held beliefs about these factors as contra-indications for exposure therapy. It is concluded that it is difficult to use pre-treatment variables as a powerful and reliable tool for predicting treatment outcome or dropout. Clinically seen, it is therefore argued that exclusion of PTSD-patients from prolonged exposure treatment on the basis of pre-treatment characteristics is not justified.     

New York City young adults’ psychological reactions to 9/11: findings from the Reach for Health longitudinal study

This research examines psychological distress among 955 economically disadvantaged New York City residents surveyed during high school and again after the September 11th terrorist attacks (9/11), when they were young adults. As part of the longitudinal Reach for Health study, young adult surveys were conducted from 6–19 months post-9/11 (average 8 months), providing opportunity to assess types of exposures and psychological distress, including symptoms of post-traumatic stress disorder (PTSD), depression, hopelessness, and anger. Regressions of psychological distress on 9/11 exposure were performed, controlling for high school distress, prior exposure to violence victimization, and socio-demographic characteristics. Exposure to 9/11 was positively associated with anger, hopelessness, and PTSD symptoms and a measure of global distress. The relationship was greater among women for PTSD symptoms. Although those who reported high school distress also reported more distress in young adulthood, prior psychological distress did not moderate the relationship between exposure and psychological outcomes. Greater exposure is related to distress among those who, during high school, reported lower distress, as well as among those who reported prior greater distress.     

Increased use of safety-seeking behaviors in chronic back pain patients with high health anxiety

Many patients with chronic pain also exhibit elevated levels of health anxiety. This study examined the effect of health anxiety on the use of safety-seeking behaviors (SSBs) in pain-provoking situations. Participants were 20 chronic back pain patients with high health anxiety (Group H), 20 with low health anxiety (Group L) and 20 pain-free controls (Group C). Two physical tasks were video recorded, and compared both for overt pain behavior (identified by blind observers following a standardized procedure) and for the occurrence of SSB (identified by showing the participants video playback and asking them to specify motivation for all actions/behaviors displayed during the tasks). While there were no differences in the display of overt pain behaviors, Group H deployed a greater number of SSBs than Groups L and C. This finding held true for both tasks and remained significant when concurrent pain and mood ratings were statistically controlled for. SSB was correlated with catastrophizing thoughts but not pain intensity; pain intensity was correlated with overt pain behavior but not catastrophizing. Taken together, these findings suggest that SSB is distinct from overt pain behavior and may be a defining characteristic of chronic pain patients reporting high levels of health anxiety.     

Introduction

Cognitive behavioral therapy evolved from systematic studies testing learning theories. This research led to the development of effective treatment approaches for a variety of disorders. In more recent years we have moved away from relying on experimental psychopathology studies to directly inform our treatment approaches. This paper describes why the alienation from experimental psychopathology studies is detrimental to the advancement of treatment approaches. Examples of how systematic research can be conducted to address questions regarding treatment mechanisms and moderators are provided. Drawing on experimental psychopathology research can also lead to a better understanding of core processes of psychopathology, which in turn can lead to transdiagnostic treatment approaches.     

Illness perception in people with chronic obstructive pulmonary disease

Illness perception (IP) concerns how patients evaluate living with a disease. To get a broader understanding of IP in patients with chronic obstructive pulmonary disease (COPD), we investigated whether breathlessness is an important precursor of IP and whether IP in its turn is related to mental health, physical health and global quality of life (QOL). One hundred and fifty‐four patients with COPD participated in a cross‐sectional survey. Participants underwent pulmonary function testing, provided socio‐demographic and clinical information, and completed the following standardized instruments: Brief Illness Perception Questionnaire, Respiratory Quality of Life Questionnaire, Short‐Form 12 Health Survey and the Quality of Life Scale. Multiple regression analyses were performed. A high IP score indicates that a patient believes that his/her illness represents a threat. Participants with a high score on the IP dimensions consequences, identity, concern and emotional representation, experienced more breathlessness. High scores on the IP dimensions consequences, identity and concern were associated with impaired physical health and high scores on the IP dimensions consequences, identity and emotional representation were associated with impaired mental health. Impaired global QOL was associated with high scores on the IP dimensions consequences, identity, concern, coherence and emotional representation. The strength of the associations between breathlessness and physical/mental health and global QOL decreased when certain dimensions of IP were included as predictors, indicating that IP to some extent acts as a mediating factor. These findings may have practical implications of patient counselling by helping COPD patients to cope with their disease by restructuring their personal models of illness.     

Effects of an early intervention on maternal post-traumatic stress symptoms and the quality of mother–infant interaction: The case of preterm birth

Preterm birth may represent a traumatic situation for both parents and a stressful situation for the infant, potentially leading to difficulties in mother–infant relationships. This study aimed to investigate the impact of an early intervention on maternal posttraumatic stress symptoms, and on the quality of mother–infant interactions, in a sample of very preterm infants and their mothers. Half of the very preterm infants involved in the study (n = 26) were randomly assigned to a 3-step early intervention program (at 33 and 42 weeks after conception and at 4 months’ corrected age). Both groups of preterm infants (with and without intervention) were compared to a group of full-term infants. The impact of the intervention on maternal posttraumatic stress symptoms was assessed 42 weeks after conception and when the infants were 4 and 12 months of age. The impact of the intervention on the quality of mother–infant interactions was assessed when the infants were 4 months old. Results showed a lowering of mothers’ posttraumatic stress symptoms between 42 weeks and 12 months in the group of preterm infants who received the intervention. Moreover, an enhancement in maternal sensitivity and infant cooperation during interactions was found at 4 months in the group with intervention. In the case of a preterm birth, an early intervention aimed at enhancing the quality of the mother–infant relationship can help to alleviate maternal post-traumatic stress symptoms and may have a positive impact on the quality of mother–infant interactions.     

The Development and Experience of Combat‐Related PTSD: A Demand for Neurofeedback as an Effective Form of Treatment

Veterans experience a considerable course of posttraumatic stress disorder (PTSD), and because of several psychosocial issues, traditional interventions and traditional intervention settings are ineffective for this population. A new cutting‐edge approach, known as neurofeedback, trains clients to control and manipulate their central nervous system and ameliorate physiological symptoms of stress disorders. The authors delineate how neurofeedback can be an effective and innovative intervention for PTSD experienced by the military population.