The SF-36 Among Cambodian and Vietnamese Refugees: An Examination of Psychometric Properties

Among traumatized Cambodian (N=90) and Vietnamese (N=94) refugees attending a psychiatric clinic, the study examined the validity and psychometric properties of the Short Form-36 Health Survey (SF-36), a measure of self-perceived mental and physical health. In both patient samples, all eight SF-36 scales displayed excellent internal consistency (item-scale correlations and Cronbach's α). But, similar to other studies of Asian samples, (a) the Vitality (VT) scale did not separate from the Mental Health (MH) and General Health (GH) scales, as evidenced by item-scale and interscale correlations, and (b) the VT scale loaded as strongly (Vietnamese sample) or more strongly (Cambodian sample) than the MH scale on the so-called Mental Factor in a two-factor solution of the eight scales (with the GH scale also loading heavily on the same factor).     

Keeping memories at an arm's length: vantage point of trauma memories

This study investigated the relationship between memory vantage point and avoidance following trauma. Sixty trauma survivors with differing levels of avoidance were interviewed about the vantage point of their memory for trauma, a positive memory, and a neutral memory. Avoidant individuals were more likely to remember their trauma from an observer perspective than individuals with a lower level of avoidance. Avoidance did not influence vantage point for positive or neutral memories. These data support the proposal that adoption of the observer vantage point for trauma memories may serve an avoidant function for people affected by trauma.     

The impact of dissociation and depression on the efficacy of prolonged exposure treatment for PTSD

This study investigates the impact of dissociative phenomena and depression on the efficacy of prolonged exposure treatment in 71 patients with posttraumatic stress disorder (PTSD). Diagnoses, comorbidity, pretreatment depressive symptoms, PTSD symptom severity, and dissociative phenomena (trait dissociation, numbing, and depersonalization) were assessed at pretreatment using semi-structured interviews and questionnaires. In a pretreatment behavioral exposure test, patients were imaginally exposed to (part of) their trauma memory for 9 min, during which subjective fear was assessed. At posttreatment and 6 months follow-up PTSD, depressive and dissociative symptoms were again assessed in the completers (n = 60). Pretreatment levels of dissociative and depressive symptoms were similar in dropouts and completers and none of the dissociative phenomena nor depression predicted improvement. Against expectations, dissociative phenomena and depression were associated with enhanced rather than impeded fear activation during the behavioral exposure test. However, these effects disappeared after controlling for initial PTSD severity. Hence, rather than supporting contraindication, the current results imply that patients presenting with even severe dissociative or depressive symptoms may profit similarly from exposure treatment as do patients with minimal dissociative or depressive symptoms.     

Cumulative Adversity as a Correlate of Posttraumatic Growth: The Effects of Multiple Traumas,Discrimination, and Sexual Harassment

While trauma is, by definition, a necessary precursor of posttraumatic growth, other aspects of individuals’ life experiences affect their ability to cope with trauma, foster resilience, and grow following adversity. Most research on posttraumatic growth overlooks the accumulation of trauma and sub-trauma stressors as possible predictors of growth. In addition, most research on cumulative adversity omits all but the most extreme examples of discrimination and sexual harassment stressors. This exploratory study of 46 university students with trauma histories used measures of posttraumatic growth, trauma, major (sub-trauma) life events, chronic stressors, sexual harassment, and discrimination to examine the relationship between cumulative adversity and the development of posttraumatic growth. We found that cumulative adversity is positively correlated with posttraumatic growth, and that there are important relationships between gender, race, and cumulative adversity. A hypothesized curvilinear relationship between cumulative adversity and posttraumatic growth was not supported. These findings suggest that successfully coping with some amount of sub-trauma adversity may facilitate the development of posttraumatic growth. Additionally, sexual harassment and discrimination were closely linked to the number of chronic stressors; thus, they need to be included in measures of cumulative adversity to more fully represent the experiences of marginalized groups.     

Self-consciousness impairments in schizophrenia with and without first rank symptoms using the moving rubber hand illusion

IntroductionThe moving rubber hand illusion allows the evaluation both the sense of body ownership and agency using visuo-motor stimulations.MethodsWe used the moving rubber hand illusion in anatomic congruence with explicit measures to compare active asynchronous and passive synchronous movements in patients diagnosed with schizophrenia with first rank symptoms (FRS) (n = 31) versus without FRS (n = 25).ResultsPatients with FRS are characterized by a lack of agency in active asynchronous condition. The two groups had no sense of ownership in synchronous passive condition. Using a multivariate regression model, we found an association between agency and body ownership measures in the active asynchronous condition in two groups (OR: 1.825, p < 0.001). In the passive condition, this association was only present in the group with first rank symptoms (OR: 2.04, p < 0.001).ConclusionTemporal proximity and sensorimotor information are essential in the understanding of self-consciousness disorders in schizophrenia.     

Investigation of Psychometric Properties of the Georgian Version of Posttraumatic Growth Inventory

This paper reports the analysis of psychometric properties of the Georgian version of the Posttraumatic Growth Inventory (PTGI-Geo). In particular, factor structure, internal consistency of the subscales, gender differences, and relation between traumatic event category and posttraumatic growth (PTG) are examined. The study had 641 participants in two studies (study 1, n = 300; study 2, n = 341 participants). The study revealed that PTGI-Geo consists of four factors, instead of the original five factors; namely, the first three factors (New Possibilities, Relation to Others, and Personal Strength) remained unchanged, while the fourth (Spiritual Change) and the fifth (Appreciation of Life) factors merged and formed a new fourth factor. All four new factors have similar internal consistency as the original inventory. There were also some between-person differences for gender consistent with other research.     

Physical activity and posttraumatic growth: A systematic review of quantitative and qualitative studies

ObjectivesThis systematic review aimed to examine the relationships between physical activity and posttraumatic growth (PTG) following a highly stressful life event.DesignA systematic review was conducted to identify eligible articles. A meta-analysis was conducted for quantitative studies and a meta-ethnographic synthesis was conducted for qualitative studies.MethodAfter systematic searches of five databases and literature screening, 20 quantitative studies and 12 qualitative studies were included in the final review. A meta-analysis of 14 quantitative studies was conducted to examine association between leisure-time physical activity and PTG. A meta-ethnographic synthesis of 10 qualitative studies was conducted to examine the relationship between physical activity and the experience of PTG.ResultsThe meta-analysis revealed a positive, yet small, association between leisure-time physical activity and PTG (average correlation = 0.120; 95% confidence interval: 0.071 to 0.168; p < 0.001). The effect sizes did not differ by measurements of PTG and participants’ age and gender but were smaller in studies with a binary variable of physical activity, a sample of participants with moderate or advanced diseases, and a longer period since the stressful event. The meta-ethnographic synthesis identified potential processes linking physical activity and PTG, including perceptions of self, social experiences, philosophical re-evaluation, and health effects.ConclusionsThis review suggest physical activity is a behavioral factor that may facilitate PTG. It highlights methodological considerations for further research.     

Community,Context, and Coping: How Social Connections Influence Coping and Well-Being for Military Members and Their Spouses

Military members and their spouses (n = 223 families) were selected from an Active Duty Army installation and assessed with regard to their connections with the military community, their levels of coping with military culture demands, and their reports of individual (depression and life satisfaction) and family well-being. Guided by the contextual model of family stress and the social organization theory of action and change, results from a structural equation model indicated that military community connections, for both military members and their civilian spouses, were related to coping with the military culture and its demands, which in turn was related to both individual and family well-being. Unique actor and partner effects also emerged where both active duty military members' and their civilian spouses' perceptions of military community connections influenced the civilian spouses' satisfaction with military life, but only the active duty military members' community connections influenced their military-specific coping. Additionally, the associations between military-specific coping and individual and family well-being only had actor effects. When examined within the context of important military culture elements, namely rank and extent of military transitions (deployment and relocation), these core findings linking communities to coping and well-being were unchanged. Implications for theory, future research, and practice are shared.     

创伤后应激障碍的动物模型及其神经生物学机制

创伤后应激障碍是指个体由于经历对生命具有威胁的事件或严重的创伤,导致症状长期持续的精神障碍。研究创伤后应激障碍的主要动物模型为条件性恐惧和应激敏感化模型。研究表明,创伤后应激障碍中长时程留存的恐惧性记忆、高唤醒等症状与大脑杏仁核、内侧前额叶皮层和海马三个脑区及下丘脑-垂体-肾上腺轴负反馈功能增强密切相关。其中杏仁核活动增强是条件性恐惧记忆获得、保持和表达的关键神经基础。内侧前额叶皮层对杏仁核的去抑制及海马向杏仁核传递的威胁性环境信息,促进创伤后应激障碍症状的出现。在经历创伤应激后糖皮质激素受体的上调及多巴胺活动的增强是创伤后应激障碍产生的主要神经基础。对创伤后应激障碍的药物治疗研究证明多巴胺D2受体在改善患者症状中的作用比较重要,但仍需作更深入的探索