Using Client Narratives to Identify Predictors of Outcome in Written Exposure Therapy and Cognitive Processing Therapy

Written exposure therapy (WET) is a brief, five-session treatment for posttraumatic stress disorder (PTSD) that aims to improve access to care. WET has been demonstrated to be an efficacious PTSD treatment with lower rates of dropout and noninferior PTSD symptom outcome compared to cognitive processing therapy (CPT), a 12-session, gold-standard treatment. To identify predictors of treatment outcome in both WET and CPT, the current study examined the content of participants’ written narratives. Participants were 123 adults with PTSD who were randomly assigned to receive WET (n = 61) or CPT (n = 62). The Change and Growth Experiences Scale (CHANGE) coding system was used to code all available narratives in both treatment conditions for variables hypothesized to be relevant to therapeutic change. Linear regression analyses revealed that in WET, higher average levels of accommodated (healthy, balanced) beliefs and an increase in accommodated beliefs from the first to the final impact statement predicted better PTSD symptom outcome at 12 weeks postrandomization. In CPT, higher average levels of overgeneralized and accommodated beliefs and lower levels of avoidance expressed in the narratives predicted better PTSD outcome. There were no significant predictors of outcome in analyses of change from the first to final impact statement in CPT. These findings add to research identifying predictors of change in WET and CPT by highlighting the importance of low avoidance in CPT and of trauma-related cognitions in both CPT and WET, even though WET is a brief written intervention that does not explicitly target cognitive change.     

The Head,the Heart,and the Community: Piloting a Brief Home-Based Mindfulness Intervention for Couples With Low Income

Although mindfulness is documented to reduce both individual and relationship stress and has the flexibility to be taught anywhere (e.g., at home, clinic setting, etc.), research examining mindfulness interventions among individuals with low income and economic marginalization (LIEM; APA, 2019), or persons whose economic position negatively impacts their health or well-being due to factors such as access to healthcare, is limited. To address this gap, the author and colleagues used Community Based Participatory Research methods to develop a brief, couple-based, mindfulness intervention tailored for communities with LIEM (see Lenger et al., 2022). The present study tested this newly developed brief, couple-based, mindfulness intervention's effectiveness in improving individual and relationship health through 1- and 2-months post-intervention. The intervention was piloted on a sample of 39 couples with an overrepresentation of couples with LIEM. To improve access to care, couples could participate in their home or a variety of local clinics. Thirty-nine couples received the intervention and completed assessments on mindfulness, depression, anxiety, stress, relationship satisfaction, and communication at baseline, 1-month, and 2-months post-intervention. Results revealed that mindfulness, depression, and relationship satisfaction improved from baseline to 1-month post-intervention. Mindfulness improved at a greater rate for couples with LIEM relative to couples with higher incomes. From baseline to 2-months post-intervention, depression and stress significantly improved at similar rates for couples with higher income and couples with LIEM. Thus, this study indicates that mindfulness can be taught in a brief, two-session format, and can have favorable outcomes on individual and relationship functioning.     

Post-traumatic stress disorder and hiring: The role of social media disclosures on stigma and hiring assessments of veterans

A significant percentage of veterans suffer from post-traumatic stress disorder (PTSD). Veterans are often directed to social media platforms to seek support during their transition to civilian life. However, social media platforms are increasingly used to aid in hiring decisions, and these platforms may make veterans’ PTSD more discoverable during the hiring process. Based on social identity theory and identity management theory, the integrated suspicion model, and the stigma literature, we conducted four studies that examine veterans’ PTSD disclosures on social media and the consequences in the hiring process. Study 1 suggests that 16%–34% of veterans included cues related to PTSD status on social media. Study 2, based on 290 upper-level business students, shows that veterans with PTSD were more stigmatized than veterans without PTSD, and stigmatization is associated with more suspicion and lower hiring-related ratings (of expected task performance, expected organizational citizenship behaviors (OCB), expected counterproductive work behaviors (CWB), and intention to interview). Study 3, based on 431 working professionals with hiring experience, further supports relationships from Study 2. Study 4, based on 298 working professionals, identifies peril (i.e., perceptions regarding danger) as an additional mediator for the effects of PTSD on hiring-related ratings. In sum, we identify and explore the identity management conundrum that social media disclosure poses for veterans with PTSD in the hiring process and discuss potential remedies and avenues for future research.     

Job Stress and Employee Well-Being Among Airline Personnel in an Asian Developing Country

This study examined the relationship between job stress and employees' well-being in a developing country in Asia. Job stress was operationalized in terms of perceived experiences at jobs which were chronic in nature. Employee well-being was operationalized in terms of organizational commitment, job involvement, and job satisfaction. Data were collected by means of a structured questionnaire from 150 employees working in a national carrier in a developing country in Asia. Pearson correlation and moderated multiple regression were used to analyze the data. Job stress was significantly related to organizational commitment and job satisfaction. Moderated multiple regression did not support the role of gender as a moderator of the stress–outcome relationship.     

Social Class Differences and Occupational Stress

This paper examines the findings of a large community-wide survey on occupational stress. Data were collected on a random sample of the general population within the North East of England. A total of 2345 people returned completed questionnaires, which represented all socioeconomic groups. The bivariate results revealed that job satisfaction is significantly greater among the higher socioeconomic groups, but no differences were found in mental and physical (psychosomatic) health among the various socioeconomic groups. The results from a multiple regression analysis provided evidence that the issue of control is significant in predicting greater job satisfaction among all social classes, but not for mental or physical well being.     

An Examination of Exchange Quality and Work Stressors in Leader–Follower Dyads

This study examined the relationship between quality of leader–member exchange and follower perceptions of work stress. It was proposed that followers in higher quality exchanges were less likely to perceive work stressors than followers in exchanges of lower quality. Data collected from 215 employees of a midsized public university substantially supported this proposition. Quality of leadermember exchange was negatively related to role conflict, role ambiguity, low job scope, lack of career progress, and lack of participation experienced by followers.     

Physiological arousal and attention in veterans with posttraumatic stress disorder

Psychophysiological reactivity has been well documented in WWII, Korean Conflict, and Vietnam veterans with posttraumatic stress disorder (PTSD). In addition, these individuals have demonstrated cognitive impairments within the domains of attention, concentration, new learning, and memory. However, there has been no research examining the impact of physiological arousal on attention in individuals with PTSD. This study documents the level of physiological arousal and associated disruption of attentional abilities in 28 Persian Gulf War veterans (18 without PTSD or other psychopathology and 10 with PTSD). This population represents a group of combat trauma victims who experienced a relatively acute onset of PTSD, thus providing a unique opportunity to compare prior psychophysiological and cognitive results with a group of veterans who manifested a recent onset of PTSD. Results indicated relatively comparable psychophysiological reactivity and arousal between Persian Gulf War veterans with PTSD and Persian Gulf War veterans without PTSD. Furthermore, attentional processes of veterans with PTSD were not more disrupted than in comparison soldiers. Results suggest that the intensity and chronicity of the disorder may impact physiological arousal and disruption of cognitive functioning. Following Persian Gulf War veterans with PTSD over time may reveal that psychophysiological arousal becomes more pronounced with chronicity, perhaps as memory networks become strengthened and/or neuroendocrine systems become increasingly disrupted.     

The functional state of the central nervous system in chemical stress

The psychosocial and physical factors, including chemical ones, which affect the human organism are considered by some authors to be stress factors which affect the functional state (FS) of the central nervous system (CNS). We calculated correlations among the clinical, psychological/psychometric, and quantitative electropsychological (QEEG) variables of the functional changes of the CNS in chemical stress. These data were based on occupational contact with lead as experienced by 402 workers, with styrene by 96, with shale-oil products by 252, with organic solvents by 77 workers, and a control group of 145 workers in different age groups. The QEEG data of 77 patients were analyzed to determine the chronic neurotoxic effects of industrial chemical substances by diagnosing the functional changes at the syndrome level. We concluded that occupational chemical factors impact the functional state of the CNS. During chemical stress -activity and total cerebral bioelectrical activity (BA) decreases. The use of psychometric/ psychological and QEEG methods makes it possible to diagnose the changes of the CNS as hypersthenic, hyposthenic, and organic psychosyndromes.     

人格特质与高温运动应激后免疫功能变化的关系

观察了１１名护士实习生在高温运动应激下免疫功能的变化及其与人格特质的关系。结果表明：（１）高温运动应激可导致Ｔ３、Ｔ４、淋巴细胞百分比明显降低,皮质醇、ＩＬ—１明显升高。人格特质变化组应激前后Ｔ３、Ｔ４及淋巴细胞变化明显,而ＩＬ—１上升幅度小,提示机体对应激源的低反应性和异常人格特质对免疫的抑制作用。（２）Ｔ３应激时的变化值与Ｘ２、Ｘ３、Ｙ１呈明显正相关,与Ｘ１、ＳＴＡＩ（２）、ＳＣＬ—９０明显负相关;Ｔ４变化值与ＳＣＬ－９０、ＳＴＡＩ（１）、ＳＴＡＩ（２）、ＳＤＳ呈明显负相关;ＩＬ—１与Ｙ１、Ｘ２呈明显正相关,与ＳＤＳ呈明显负相关;皮质醇变化与人格特质无显著性相关,Ｘ４与免疫功能变化无显著性相关。