Relationship of posttraumatic growth to symptoms of posttraumatic stress disorder and depression: A pilot study of Iraqi students

Posttraumatic growth (PTG) and psychopathology are common outcomes following exposure to adversity and trauma. We examined the relationship of PTG to posttraumatic stress disorder (PTSD) and depression in a group of young Iraqi students with war trauma exposure. These young Iraqis had experienced an average of 13 different war‐related adversities. The prevalence of probable PTSD was 17.2% and probable depression 23.1%. PTSD was associated with higher and depression with lower PTG. In addition, the relationship between PTG and PTSD was stronger among males than females. Although PTSD and depression were relatively common, they were related to PTG in opposite directions.     

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.     

Daily Posttraumatic Stress Disorder Symptom Accommodation and Relationship Functioning in Military Couples

Romantic partners’ accommodation of trauma survivors’ posttraumatic stress disorder (PTSD) symptoms (e.g., taking on tasks, survivors avoid participating in social withdrawal) is associated with lower relationship satisfaction for both partners and survivors. Little is known about associations of partner accommodation with other aspects of relationship functioning, like intimacy. Sixty‐four male military veterans with at least subclinical PTSD and their partners participated in a 2‐week daily diary study. Veterans completed nightly measures of PTSD symptoms, while female partners completed nightly measures of accommodating behaviors performed that day. Both partners reported feelings of intimacy each night. Multilevel models revealed that accommodation was significantly, negatively associated with feelings of intimacy, with stronger effects for partners (t = ?8.70) than for veterans (t = ?5.40), and stronger effects when veterans had lower (t = ?7.43) rather than higher (t = ?5.20) levels of daily PTSD symptoms. Therapists should consider accommodating behaviors as a potential impediment to relationship intimacy, particularly when veterans have less severe symptoms of PTSD. Accommodating behaviors are an ideal treatment target in behavioral couple therapies.     

The Temporal Relations of PTSD Symptoms Among Treatment-Seeking Victims of Sexual Assault: A Longitudinal Study

This prospective study assessed the temporal relationships between the symptom clusters of PTSD in two nonprobability samples of treatment-seeking victims of sexual abuse: rape victims and adult survivors of childhood sexual abuse. Both groups were assessed at three time periods using self-report measures of PTSD symptomology. Findings from two cross-lagged panel analyses indicated weak temporal relationships between the symptom clusters of PTSD; however, avoidance and emotional numbing symptoms were found to exert the strongest cross-lagged effects. Avoidance and emotional numbing symptoms were also found to be the strongest predictor of subsequently meeting caseness for PTSD in both samples. Results suggest that there are minimal cross-lagged effects between the PTSD symptom clusters after three months from traumatic exposure.     

创伤暴露程度对青少年物质滥用的影响：创伤后应激障碍与依恋的中介作用

为了考察汶川地震后青少年的创伤暴露程度、创伤后应激障碍（PTSD）、父母依恋和同伴依恋与物质滥用之间的关系,采用创伤暴露程度问卷、儿童创伤后应激障碍症状量表、父母与同伴依恋问卷和物质滥用问卷对汶川县和茂县的1435名中学生进行调查,选取有物质滥用的青少年354名作为本研究的对象。结果发现：创伤暴露程度可以直接正向预测作用物质滥用。不过,在创伤暴露与物质滥用直接关系之间加入PTSD、父母和同伴依恋之后,创伤暴露程度对物质滥用的直接预测作用不再显著,并且创伤暴露程度不能通过同伴依恋预测物质滥用,也不能通过PTSD经同伴依恋对物质滥用发挥多重中介作用;但创伤暴露程度能通过PTSD正向预测物质滥用,可以通过父母依恋负向预测物质滥用,并且创伤暴露程度还可以通过PTSD经过父母依恋对物质滥用发挥正向的多重中介作用。     

The Psychology of Health and Illness: The Mental Health and Physiological Effects of Intimate Partner Violence on Women

Violence against women is a global public health problem with about one in three women experiencing either physical and or sexual intimate partner violence during their lifetime. Globally as many as 38% of homicides committed against women are by a male intimate partner. Violence against women may have negative effects on their mental, physical, and reproductive health (WHO fact sheet, 2016). Untreated individuals who have experienced violence or life-threatening situations may develop posttraumatic stress disorder (PTSD). This disorder has the potential to be life-changing and cause negative psychological and medical issues (Rokach, Ahmed, & Patel, 2017). This potentially life-changing nature and consequence of violence affecting women world-wide deserves greater attention to ensure elimination of risk factors, financial support of investigational studies to promote detection of victims, and research to increase therapeutic efficacy of remediation. These efforts should be bolstered by all physicians, mental health experts, social service specialists, and public health advocates.     

A new diagnosis of complex Post-traumatic Stress Disorder,PTSD – a window of opportunity for the treatment of patients in the NHS?

The concept of complex trauma has been around for a long time and in 2018, it’s expected to become a new diagnosis in the International Classification of Diseases eleventh revision, ICD-11, the World Health Organisation, WHO, manual used formally in the NHS. Psychiatric diagnosis often does not sit well with psychoanalysis, which is at least as interested in unconscious phantasy as it is in symptoms. But as psychodynamically-trained practitioners in the NHS we need to engage with ICD-11 and apply our own understanding to service design so that patients have access to treatment which works for them. The service where I work (a secondary mental health team in the London borough of Lewisham) has already been receiving referrals for ‘complex trauma’ for some time, despite its not being formally classified. Patients so described are most often those with a history of childhood sexual abuse, and refugees with a history of brutality and torture. Differential diagnosis includes personality disorder since many have difficulties with interpersonal issues. In this paper I want to discuss how we might understand the new diagnosis of complex Post-traumatic Stress Disorder, PTSD, and its implications for treatment in the NHS.     

The relationships between family functioning and attachment orientations to post-traumatic stress symptoms among young adults who were evacuated from Gaza Strip settlements as adolescents

Background and Objectives: This study examined post-traumatic stress disorder (PTSD) symptoms among young adults that were evicted from their residences in Gaza settlements (“Gush Katif”) as adolescents and actively participated in the resistance events. Furthermore, we examined the moderating role of exposure to forced relocation on the association between attachment orientations and family functioning and PTSD symptoms. Design: We conducted a correlative, cross-sectional study in 2013. Methods: Participants were Israeli evicted residents (ER group; N = 102), comparison groups of evicted nonresidents (ENR group; N = 27), and nonevicted nonresidents (NENR group; N = 53). All participants completed a battery of self-reported questionnaires. Results: The ER group reported a higher number of PTSD symptoms as compared to the comparison groups. However, ER participants did not differ from ENR and NENR participants in their perception of family functioning. Importantly, the group (ER vs. NENR) moderated the association between attachment-anxiety and PTSD symptoms and between family adaptability and PTSD symptoms. Conclusions: Nine years after the forced relocation from Gaza settlements, young adults that were evicted from their residences as adolescents suffer from PTSD symptoms that are more related to the relocation itself than the stress entailed in the resistance events.     

Clinical Application of the Couple Adaptation to Traumatic Stress (CATS) Model: A Pragmatic Framework for Working With Traumatized Couples

ABSTRACT

The authors attempt to apply knowledge of traumatization to clinical practice with couple dyads. Elaborating on the Couple Adaptation to Traumatic Stress (CATS) Model (Nelson Goff & Smith, 2005), the authors have worked to bridge the gap between a general understanding of trauma's impact on the couple relationship and couples' treatment. This article facilitates the application of the CATS Model to clinical work with couples impacted by trauma. Incorporating Herman's (1997) traumatic process with the original CATS Model, the authors created a more specific, clinically useful framework for clinicians. The goal of the current article is to provide clinicians with a pragmatic illustration articulating a clinical framework for understanding and treating posttraumaumitc symptoms and processes within the couple relationship. The main implication is that clinicians will be able to conduct effectively guided systemic therapy with distressed couples necessary to generate progress in the treatment of symptomatology and couple functioning of trauma survivors and their partners.     

Psychological Predictors of Neurobehavioral Symptoms in a Polytrauma Veteran Sample

Given the high prevalence of comorbid conditions found in polytrauma settings, effective screening measures are needed. Several screening tools are commonly used in polytrauma clinics within the Department of Veterans Affairs (VA). This study examined the use of three screening measures—the Beck Depression Inventory-II (BDI-II), Beck Anxiety Inventory (BAI), and PTSD Checklist–Civilian Version (PCL-C)—to predict scores on the Neurobehavioral Symptom Inventory (NSI). Research suggests that the presence of mental health conditions, such as PTSD, shares a significant amount of variance with postconcussive symptoms. The investigators hypothesized that the PCL-C would be the best predictor of scores on the NSI. All subjects were administered the screening measures as part of an evaluation in an outpatient Level III polytrauma clinic. Regression analysis was used to determine which instrument might serve as the best predictor of NSI total scores. Regression analysis revealed that BAI, BDI-II, and PCL-C total scores were good predictors of NSI total scores, with the BAI accounting for the majority of the variance. Mental health conditions can account for higher scores on the NSI, and screening of other mental health conditions should be taken into account when reviewing the NSI for individuals in polytrauma settings.