An abbreviated PTSD checklist for use as a screening instrument in primary care

Although the importance of recognizing posttraumatic stress disorder (PTSD) in primary care has been well-established, routine screening for PTSD remains unfeasible for many primary care clinics because of the length of the available screening instruments. Thus, the purpose of this work was to develop and validate a brief screening tool for PTSD. In Study 1, four short forms of the PTSD Checklist-civilian version were identified that captured a majority of the variance in the measure. In Study 2, the performance of these short forms was evaluated in a separate sample of primary care patients. We found that both two-item and six-item versions have adequate psychometric properties for screening purposes and suggest that the selection of one version over the other depends on the specific needs of each primary care clinic.     

Stress priming in picture naming: an SOA study

This study investigates whether or not the representation of lexical stress information can be primed during speech production. In four experiments, we attempted to prime the stress position of bisyllabic target nouns (picture names) having initial and final stress with auditory prime words having either the same or different stress as the target (e.g., WORtel-MOtor vs. koSTUUM-MOtor; capital letters indicate stressed syllables in prime-target pairs). Furthermore, half of the prime words were semantically related, the other half unrelated. Overall, picture names were not produced faster when the prime word had the same stress as the target than when the prime had different stress, i.e., there was no stress-priming effect in any experiment. This result would not be expected if stress were stored in the lexicon. However, targets with initial stress were responded to faster than final-stress targets. The reason for this effect was neither the quality of the pictures nor frequency of occurrence or voice-key characteristics. We hypothesize here that this stress effect is a genuine encoding effect, i.e., words with stress on the second syllable take longer to be encoded because their stress pattern is irregular with respect to the lexical distribution of bisyllabic stress patterns, even though it can be regular with respect to metrical stress rules in Dutch. The results of the experiments are discussed in the framework of models of phonological encoding.     

Anger-associated panic attacks in Cambodian refugees with PTSD; a multiple baseline examination of clinical data

Despite the increasing recognition of the importance of anger as a key aspect of post-traumatic stress disorder (PTSD), the presence of anger-induced panic attacks has been understudied in traumatized groups. The present investigation determines the prevalence of anger-associated panic attacks among Cambodian refugees suffering from PTSD. Specific characteristics of these episodes that were examined included frequency, symptoms, and cognitions (in particular, fear of death from bodily dysfunction). In a survey of 100 Khmer patients suffering PTSD, 58% reported anger-associated panic attacks in the last month. These attacks occurred at a mean rate of 6.2 attacks a month and were characterized by extreme arousal and in 81% of these cases, fears of death due to bodily dysfunction during the anger-induced panic. Mechanisms for this high rate of fear of death during anger arousal are discussed with a focus on culture-specific catastrophic cognitions.     

Psychological Distress and Symptoms of Posttraumatic Stress Disorder in Jewish Adolescents Following a Brief Exposure to Concentration Camps

We investigated the psychological impact of an organized visit to Polish concentration camps on Jewish-American adolescents. Eighty-seven adolescents who participated in a B'nai B'rith memorial visit to concentration camps in Poland completed measures of general psychological adjustment and posttraumatic stress disorder (PTSD) at four time-points: pretest, posttest, 6-month follow-up and 12-month follow-up. Measures included the SCL-90-R, the Mississippi Scale for PTSD, and the Impact of Events Scale (IES) for PTSD. On the SCL-90-R, changes in somatization, interpersonal sensitivity, obsessive-compulsive tendencies, depression, anxiety, and phobic anxiety were observed over time, with peak symptom scores at posttest and 6-month follow-up. Scores on the Mississippi Scale for PTSD and the IES Intrusion subscale also increased at 6-months. Predictors of PTSD symptoms on the Mississippi Scale included previous psychiatric treatment and SCL-90-R symptoms of paranoia, depression, and psychosis. Elevated psychotic symptoms on the SCL-90-R predicted PTSD symptoms on the IES. Jewish adolescents with preexisting symptoms of generalized distress or psychoticism appeared at increased risk for PTSD symptoms following exposure to Holocaust stimuli. This study contributes a prospective, multi-measure assessment of trauma reactions in adolescents.     

Recruitment and Retention of Low‐SES Ethnic Minority Couples in Intervention Research at the Transition to Parenthood

Low‐SES couples have limited resources to manage the chronic and acute stressors with which they are disproportionately faced. Although these couples are at greater risk for negative individual and relationship outcomes, evaluations of the impact of couple relationship education (CRE) in low‐SES couples have been plagued by methodological problems, most notably challenges associated with recruitment and retention. We review the literature on challenges couples face associated with low‐SES, as well as on recruitment, retention, and CRE in low‐SES, ethnic minority populations. We illustrate some of these challenges in a case study of CRE for low‐SES couples transitioning to parenthood. In this pilot study, 21 couples were recruited from a community health clinic and randomized to either an experimental treatment condition (EXP; N = 11) or a treatment‐as‐usual control condition (TAU; N = 10). This study sought to mitigate documented challenges with recruitment and retention: We leveraged community partnerships, attempted to build and maintain strong relationships with study participants, provided incentives for assessments as well as intervention meetings, and attempted to reduce potential barriers to enrollment and retention. Nonetheless, we had low rates of recruitment and retention. We integrate these findings and experiences with our review of previous work in this area. We make recommendations for future CRE research and practice that have potential implications for public policy in this area.     

Stress Overload: A New Approach to the Assessment of Stress

The link between stress and health has not received strong empirical support, possibly due to problems in the stress measures used. Here, the first wholly empirical development of a new “Stress Overload Scale” is described. A pool of 150 items was formed to reflect “overload”, a common denominator in stress theories. Then, the results of five sequenced studies, conducted in heterogeneous community samples, were used to pare the item pool. Exploratory (n = 431) and confirmatory (n = 433) analyses revealed two factors (Event Load and Personal Vulnerability) corresponding to theoretical constructs; only the best factor markers were submitted to further construct validity (n = 310) and reliability tests (n = 342). The 24 strongest items were selected for the SOS, which demonstrated criterion validity in predicting who (n = 285) would become sick following a common stressor. The SOS is (1) psychometrically strong, especially in its validity relative to popular measures; (2) appropriate to community research, due to its brevity and fit to a broad demographic spectrum; (3) unique in its ability to cross‐section individuals into risk categories. It should prove useful to community psychologists in determining etiology, diagnosing risk for pathology, and evaluating the efficacy of interventions.     

Reducing the barriers to accessing psychological therapies for Bengali,Urdu, Tamil and Somali communities in the UK: some implications for training,policy and practice

The aim of this research was to investigate the feasibility of achieving Improving Access to Psychological Therapies (IAPT) for people from Black, Asian and Minority Ethnic (BAME) communities living in the UK, with specific reference to Bengali, Urdu, Tamil and Somali speaking communities. Focus groups were carried out with each of the communities to investigate how they conceptualise and experience ‘mental health issues’ and what they do when faced with what they regard as these issues. A thematic analysis of the data suggested that participants did not fully understand common conceptualisations about mental health issues, nor did they know how to seek mental health support. Implications of cultural barriers and recommendations for IAPT outcomes for the four communities are discussed.     

The more, the merrier? Numerical strength versus subgroup distinctiveness in minority groups

Evidence attests to the efforts made by minority groups to defend and promote ‘distinctive’ attributes that potentially define the ingroup. However, these attributes are often only available to a prototypical minority within the minority category. In two studies we tested the hypothesis that, under certain conditions, large projected increases in the numerical strength of a ‘distinctive’ attribute (emotional intelligence in Study 1; ingroup language in Study 2) within a minority category can paradoxically evoke less-than-positive reactions from those who already have the attribute. Findings confirmed that while a large projected increase in the numerical strength of a ‘distinctive’ attribute was viewed positively when the comparative context focused on the inter-category relation with a majority outgroup, this increase was viewed less positively, and as undermining their own identity, in a narrower intra-category context. Implications for identity management strategies in minority groups are discussed.     

The effect of family processes on school achievement as moderated by socioeconomic context

This longitudinal study examined a model of early school achievement in reading and math, as it varies by socioeconomic context, using data from the NICHD Study of Early Child Care and Youth Development. A conceptual model was tested that included features of family stress, early parenting, and school readiness, through both a single-group analysis and also a multiple-group analysis. Latent profile analysis was used to identify subgroups of more advantaged and less advantaged families. Family stress and parenting were shown to operate differently depending on the socioeconomic context, whereas child-based school readiness characteristics were shown to operate similarly across socieodemographic contexts. Implications for intervention are discussed.