Clinical research on behavioral activation as treatment for post‐traumatic stress disorder: A brief review and meta‐analysis

Behavioral activation (BA), an effective treatment for depression, has recently been receiving attention as a possible intervention for PTSD. BA interventions could be particularly useful in treating underserved populations (i.e., individuals with lower socioeconomic status). A literature search was conducted, which identified seven outcome studies that examined the effectiveness of stand‐alone BA treatment for individuals with PTSD. All studies identified for this brief review demonstrated clinically significant reductions in PTSD symptoms using BA as an intervention. A meta‐analysis of these few studies revealed a nonsignificant effect (Cohen's d = 0.713, p = .512) despite reporting an average symptom reduction of 25.8%. Other studies utilizing BA treatment for PTSD do so in tandem with other interventions and were excluded from analysis. This brief review summarizes the literature on the use of BA as a stand‐alone treatment for PTSD and suggests that future research seek to confirm the usefulness of BA as a potential treatment modality for mental health‐care providers treating individuals with PTSD.     

工作反刍及其“双刃剑”效应

工作反刍指在没有要求其出现的情境下, 有意识的、重复发生的工作方面的相关想法, 分为工作相关情感反刍与工作相关问题解决沉思两个维度。工作反刍对个体健康、工作及幸福感的影响有“双刃剑”效应。持续性认知理论、压力认知激活模型与认知资源视角理论, 可以解释该效应的内在机制。未来研究应分析影响双刃剑效应的边界条件, 寻求减少消极效应、增加积极效应的途径, 拓展其双刃剑效应心理机制的分析视角和该效应的作用层面。     

A thematic analysis of practitioners' understanding of domestic abuse in terms of post‐traumatic stress disorder (PTSD) and complex‐PTSD (C‐PTSD)

There is a growing body of evidence suggesting that domestic abuse (DA) should be conceptualised within the complex post‐traumatic stress disorder (C‐PTSD) model. Recently, in the draft of the International Classification of Diseases, Eleventh Revision, produced by the World Health Organization (WHO), C‐PTSD was included as a separate criterion in which DA is incorporated (ICD‐11, WHO, 2018). In this study, a thematic analysis was used to explore to what extent practitioners working with DA survivors are familiar with PTSD and C‐PTSD. Research into such a prevalent and detrimental problem as DA is important to understand whether the development of theoretical knowledge about DA and C‐PTSD is addressed in practice. In a Women's Centre in South London, six semi‐structured interviews with middle‐aged female practitioners were conducted to investigate each counsellor's experiences, knowledge and reflections. Six final themes were constructed to summarise the main results. The findings demonstrate limited practitioner understanding of DA in terms of C‐PTSD, which seems to impact not only the effectiveness of treatment plans with DA survivors, but also counsellors’ own psychological and physical states. It is also indicated that DA can be conceptualised within the C‐PTSD model that corresponds with previous literature indicating the complex nature of DA. The overall results of the current research acknowledge that DA sectors should not be neglected and better funding and effective psychoeducation in this field are needed.     

公安民警的创伤后应激症状对执行功能的影响—基于Stroop范式的探究

公安民警常常身临应激和危险情境中,是创伤事件的易感人群,但其创伤后应激症状对执行功能的影响研究尚且缺乏。已有研究发现,具有创伤后应激症状的个体的执行功能存在缺陷,表现在对冲突信息的抑制能力受损以及对创伤相关信息的注意偏向和情绪唤起。本研究以公安民警为实验组被试,据其创伤后应激症状分为高低两组,在校大学生为对照组被试,采用Stroop范式探究创伤后应激症状对公安民警“冷”、“热”执行功能的影响。结果表明,具有创伤后应激症状的公安民警在“冷”、“热”执行功能上不存在缺陷,但仍在一定程度上受到创伤后应激症状的影响。启示对具有创伤后应激症状的公安民警进行干预时,应关注其症状的严重程度,在“热”执行功能上寻求更有效的干预方式。     

The impact of communal-mastery versus self-mastery on emotional outcomes during stressful conditions: a prospective study of Native American women

Past research has examined the stress resiliency of individuals high in sense of personal-mastery. However, it has been theorized that within more collectivist cultures, a sense of shared efficacy, which we call communal-mastery, may be more central to people's resiliency in the face of challenging life circumstances. We compared the impact of sense of self-mastery (i.e., I am the key to my success) to that of communal-mastery (i.e., I am successful by virtue of my social attachments) in a prospective study among a group of rural 103 Native American women residing on Indian Reservations in Montana. We found that women high in communal-mastery experienced less increase in depressive mood and anger, especially when faced with high stress circumstances, than women who were low in communal-mastery. In addition, the beneficial impact of communal-mastery was found to be more effective than self-mastery for these women.     

Beyond bruises and broken bones: the joint effects of stress and injuries on battered women's health

We investigated the joint mediating effects of injuries and stress on the relationship between abuse and women's health. A community sample of 397 women, half of whom had been assaulted by an intimate partner within the prior 6 months, was interviewed about their experience of intimate partner violence, injuries, stress, income, depression, and physical health problems. Structural equation modeling techniques confirmed the complex model of hypothesized indirect effects of abuse on women's physical health problems through injuries, stress, and depression. Stress accounted for 80% of the indirect effect of abuse on women's physical health. Its direct effect on physical health was somewhat larger than its indirect effect through depression, but both processes played a key role in determining the effect of abuse on women's physical health problems. Furthermore, abuse was a stronger predictor of women's stress than was poverty. Implication and future research are discussed.     

The Dental Subscale of the Children's Fear Survey Schedule: Predictive Value and Clinical Usefulness

This study reports on the predictive value and clinical usefulness of the Dutch parental version of the Dental Subscale of the Children's Fear Survey Schedule (CFSS-DS). Parents of 718 children (4–12 years) completed this CFSS-DS version before or during the child's visit. The dentist rated the child's dental fear during treatment on a 5-point Likert-type Scale from 1 (not afraid at all) to 5 (very afraid). Reliability analysis was performed, and correlation coefficients between the two measures were calculated. The reliability of the scale proved to be high (Cronbach's = .93) and significant correlation coefficients were found (r = .58 and r = .68, p < .01). The negative predictive value of the CFSS-DS was high (.96), whereas its positive predictive value was relatively low (0.41). It was concluded that the CFSS-DS might be of clinical value as a screening device of dental fear, whereas its predictive value of fearful behavior should not be overestimated.     

Neurocognitive Functioning in Posttraumatic Stress Disorder

This paper reviews the literature on performance on standard neuropsychological tests among individuals with posttraumatic stress disorder (PTSD). Of 19 studies, 16 reported impairment of attention or immediate memory (or both); however, most of these studies included PTSD patients with significant psychiatric comorbidity, so that the extent to which the observed deficits are specifically attributable to PTSD remains unclear. Other potential confounds, including medical illness, substance abuse, and motivational factors, further preclude definitive conclusions at present. Results of structural and functional neuroimaging studies of PTSD are also summarized. Two studies have reported correlations between hippocampal volume and cognitive findings in PTSD patients; functional studies have indicated specific findings in limbic regions, although the relationship of these results to neuropsychological performance remains to be explored.