Modeling anxiety and fear of COVID-19 using machine learning in a sample of Chinese adults: associations with psychopathology, sociodemographic, and exposure variables

OBJECTIVES

Research during prior virus outbreaks has examined vulnerability factors associated with increased anxiety and fear.

DESIGN

We explored numerous psychopathology, sociodemographic, and virus exposure-related variables associated with anxiety and perceived threat of death regarding COVID-19.

METHOD

We recruited 908 adults from Eastern China for a cross-sectional web survey, from 24 February to 15 March 2020, when social distancing was heavily enforced in China. We used several machine learning algorithms to train our statistical model of predictor variables in modeling COVID-19-related anxiety, and perceived threat of death, separately. We trained the model using many simulated replications on a random subset of participants, and subsequently externally tested on the remaining subset of participants.

RESULTS

Shrinkage machine learning algorithms performed best, indicating that stress and rumination were the most important variables in modeling COVID-19-related anxiety severity. Health anxiety was the most potent predictor of perceived threat of death from COVID-19.

CONCLUSIONS

Results are discussed in the context of research on anxiety and fear from prior virus outbreaks, and from theory on outbreak-related emotional vulnerability. Implications regarding COVID-19-related anxiety are also discussed.

Molecular genetics of neurotransmitters and neuropeptides involved in Internet use disorders including first insights on a potential role of hypothalamus' oxytocin hormone

This chapter covers the phenomenon of Internet use disorders (IUDs) and putative associations with different neurotransmitter and neuropeptide systems. Genes coding for such messengers can be seen as an important starting point in the complicated quest to understand human behavior including new phenomena such as IUDs. Therefore, a special focus of this chapter will lie on individual differences in molecular genetic underpinnings of neurotransmitter and neuropeptide systems and their associations with individual differences in tendencies towards IUDs. By shedding light on these associations, putative predisposing molecular genetic factors for the emergence and maintenance of IUDs can be carved out. Therefore, first an introduction to IUDs and a model that can guide research on putative associations of IUDs with different specific neurotransmitters and neuropeptides will be presented. Subsequently, twin studies on the heritability of IUDs are reviewed. Finally, studies on differences in molecular genetic predispositions and their associations with differences in IUDs will be presented and discussed, including targets related to the dopaminergic and serotonergic system as well as the hypothalamic neuropeptide oxytocin. The chapter closes with a conclusion about what is already known and what needs to be investigated in future studies to gain further insights into putative associations between molecular genetic markers and IUDs.

The influence of depressive symptoms and fear of missing out on severity of problematic smartphone use and Internet gaming disorder among Chinese young adults: A three-wave mediation model

Internet gaming disorder (IGD) and problematic smartphone use (PSU) symptoms are associated with increased depression symptom severity across studies. The current study aimed to examine the fear of missing out (FoMO) as a possible mediator in this relationship. We employed a three-wave longitudinal design among 341 Chinese university students. Results indicated that depression severity was significantly related to increased symptoms of PSU and IGD symptoms. FoMO significantly mediated the linkage between depression and PSU severity. IGD symptoms also partially mediated the relation between FoMO and PSU severity. This longitudinal study demonstrates the key role of FoMO in the linkage between psychopathology symptoms and Internet-related overuse.

Test of the dynamic interplay between DSM-5 PTSD symptom clusters in children and adolescents

BACKGROUND

Revealing the dynamic interplay between posttraumatic stress disorder (PTSD) symptom clusters has always been an important topic in traumatic stress studies. Based on longitudinal studies, different hypotheses have been proposed to explain PTSD symptom dynamics. But currently, no study have been conducted to test these hypotheses in children and adolescents.

METHODS

Data were derived from a longitudinal study of child and adolescent traumatic event survivors of an explosion accident (N = 659). DSM-5 PTSD symptoms was measured by the PTSD Checklist-5 (PCL-5) at 4, 8, and 13 months after the disaster. Latent difference score (LDS) modeling was used to evaluate the dynamic interplay between clusters.

RESULTS

The results of LDS model indicated that intrusion level positively predicted subsequent rate of increase for hyperarousal (p = .008) and negative changes in cognitions and mood symptoms (p = .036). Also, intrusion level trended to positively predict subsequent increase rate of avoidance symptoms (p = .059).

CONCLUSIONS

This study expands previous knowledge of dynamic relations between symptom clusters during the maintenance and fluctuation of child and adolescent PTSD symptoms. By using new methodology, this study provided novel evidence for the hypothesis that intrusion symptom plays an important role in maintaining other PTSD symptoms.

Health anxiety related to problematic smartphone use and gaming disorder severity during COVID-19: Fear of missing out as a mediator

Health anxiety has been linked with fear and anxiety regarding COVID-19. Higher levels of health anxiety likely increased social distancing and self-isolating during the pandemic. We investigated relations among health anxiety, fear of missing out (FOMO) on rewarding social experiences from social distancing, and consequential levels of problematic smartphone use (PSU) and gaming disorder (GD). We surveyed a broad sample of 812 U.S. and Canadian participants during the pandemic, in late-May 2020, using the Short Health Anxiety Inventory, FOMO Scale, Smartphone Addiction Scale-Short Version, and GD test. Significant bivariate relationships were found among health anxiety, FOMO, PSU, and GD severity. Using structural equation modeling, FOMO mediated relations between health anxiety and both PSU and GD severity. We discuss FOMO as an important variable explaining problematic digital technology use to compensate for unmet social needs from social distancing. We discuss these findings within the context of the Interaction of Person-Affect-Cognition-Execution theoretical model of problematic internet use. Results offer novel insight into the role of health anxiety on FOMO from unmet social needs during the COVID-19 pandemic, and consequential problematic internet use.

Discussing digital technology overuse in children and adolescents during the COVID-19 pandemic and beyond: On the importance of considering Affective Neuroscience Theory

INTRODUCTION

During the 2020 COVID-19 pandemic and associated lockdown/social distancing, many scientists pointed towards the problem of increased digital technology overuse in both children and adolescents.

METHODS

Although a review of the literature shows that digital technology overuse in youth represents an important topic to be studied itself (during the pandemic and afterwards), the present work also takes into account findings from Affective Neuroscience Theory (ANT).

RESULTS

An investigation of digital overuse while the COVID-19 pandemic (and beyond) against the background of ANT calls for a shift of perspective in research, at least as an important supplement to research efforts querying the actual nature of digital overuse. In the present work, we argue that it is high time to more comprehensively address why children spend too much time with screens and to also highlight the indirect media effects of screen time use (e.g. less mammalian rough and tumble PLAY time outside and elevated SADNESS due to parental neglect).

CONCLUSIONS

In sum, insights from ANT are put forward to guide research shedding light on detrimental aspects of too much screen time in youth.

Fear of Missing Out (FoMO) and social media's impact on daily-life and productivity at work: Do WhatsApp, Facebook, Instagram, and Snapchat Use Disorders mediate that association?

Fear of Missing Out (FoMO) is the tendency to experience anxiety over missing out on rewarding experiences of others. It has been associated with daily-life disruptions, such as distractions during driving. FoMO has also consistently been a predictor of Internet, smartphone, and social networks use disorders. In the current work, we investigated the association between FoMO and social media use's impact on daily-life and productivity at work. In addition, we aimed to determine whether WhatsApp, Facebook, Instagram, and Snapchat Use Disorders mediate that relationship. The effective sample comprised 748 German-speaking study participants from the general population (age M = 38.63, SD = 12.10; 336 men, 412 women) who took part in an online survey study. Bivariate analyses showed that severity of all social networks use disorders were positively correlated with FoMO and social media's negative impact on daily-life and productivity at work. Furthermore, controlling for age and gender, mediation analyses showed that out of all platforms, only Snapchat Use Disorder did not mediate the association between FoMO and social media's negative impact on daily-life and productivity at work. These results provide further evidence about FoMO's central role in digital technology use-related disorders.

Clusters of Trauma Types as Measured by the Life Events Checklist for DSM-5

Experiences of potentially traumatic events (PTE), commonly assessed with the Life Events Checklist for DSM-5 (LEC-5), can be both varied in pattern and type. An understanding of LEC-assessed PTE type clusters and their relation to psychopathology can enhance research feasibility (e.g., address low base rates for certain PTE types), research communication/comparisons via the use of common terminology, and nuanced trauma assessments/treatments. To this point, the current study examined (1) clusters of PTE types assessed by the LEC-5; and (2) differential relations of these PTE type clusters to mental health correlates (i.e., posttraumatic stress disorder [PTSD] severity, depression severity, emotion dysregulation, reckless and self-destructive behaviors [RSDBs]). A trauma-exposed community sample of 408 participants was recruited via Amazon's Mechanical Turk (M age = 35.90 years; 56.50% female). Network analyses indicated three PTE type clusters: Accidental/Injury Traumas (LEC-5 items 1, 2, 3, 4, 12), Victimization Traumas (LEC-5 items 6, 8, 9), and Predominant Death Threat Traumas (LEC-5 items 5, 7, 10, 11, 13-16). Multiple regression analyses indicated that the Victimization Trauma Cluster significantly predicted PTSD severity (β = .23, p <.001), depression severity (β = .20, p =.001), and negative emotion dysregulation (β = .22, p <.001); and the Predominant Death Threat Trauma Cluster significantly predicted engagement in RSDBs (β = 31, p <.001) and positive emotion dysregulation (β = .26, p <.001), accounting for the influence of other PTE Clusters. Results support three PTE type classifications assessed by the LEC-5, with important clinical and research implications.

Applying fairness in labeling various types of internet use disorders. •

We comment on arguments about internet and smartphone use disorders by Montag, Wegmann, Sariyska, Demetrovics, and Brand (2020). Although not currently official diagnoses, we emphasize that for some individuals, excessive internet/smartphone use can have dangerous consequences. We discuss the challenges with ICD-11 codifying only internet gaming as an internet use-related disorder, neglecting other types of excessive internet users. Montag et al.'s approach to classifying a broader range of internet use disorders seems more fair than the current system in aiding individuals needing treatment resources for excessive internet use.

The association between the Big Five personality traits and smartphone use disorder: A meta-analysis

BACKGROUND AND AIMS

Personality is one of the most frequently investigated variables to shed light on the putatively addictive use of the smartphone. By investigating associations between personality and individual differences in addictive smartphone use, researchers aim to understand if some personality traits predispose technology users to develop addictive behaviors. Here, based on existing empirical literature, we aimed at determining the strength of associations between Big Five personality traits and smartphone use disorder (SmUD) by a meta-analytic approach.

METHOD

For each Big Five personality trait, we performed a meta-analysis of correlations representing their association with SmUD. We also investigated possible publication bias and the moderating effects of age, gender, nationality, length of personality assessments, and time of publication.

RESULTS

We found n = 26 eligible studies. In line with both the Interaction of Person-Affect-Cognition-Execution (I-PACE) model and the framework on problematic mobile-phone use by Billieux, we observed a positive association between Neuroticism and SmUD (r = 0.25), while the association between Extraversion and SmUD was not significant. Partially in line with the aforementioned theoretical frameworks, Conscientiousness was negatively associated with SmUD (r = -0.16). Remaining traits showed smaller associations. No significant publication bias emerged. Moderator analyses showed that time of publication moderated the link between Conscientiousness and SmUD. Moreover, Agreeableness and Conscientiousness showed a heightened inverse association with SmUD among older samples.

CONCLUSIONS

The present meta-analysis provides robust empirical evidence that Big Five personality traits can help to understand individual differences in SmUD, supporting the usefulness of their assessment when planning and targeting interventions aimed at at-risk individuals.

Preliminary study examining the mediational link between mild traumatic brain injury, acute stress, and post-traumatic stress symptoms following trauma

Background: The presence of mild traumatic brain injury (mTBI) increases post-traumatic stress disorder (PTSD) symptoms in the months following injury. However, factors that link mTBI and PTSD development are still unclear. Acute stress responses after trauma have been associated with PTSD development. mTBI may impair cognitive functions and increase anxiety immediately after trauma. Objective: This research aimed to test the possibility that mTBI increases acute stress symptoms rapidly, which in turn results in PTSD development in the subsequent months. Method: Fifty-nine patients were recruited from the emergency rooms of local hospitals. Post-mTBI, acute stress, and PTSD symptom severity were measured using the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), Acute Stress Disorder Scale (ASDS), and PTSD Checklist for DSM-5 (PCL-5), respectively. Results: Moderated mediation analysis indicated that ASDS, at 2 weeks post-trauma, mediated the relationship between RPQ scores at 2 weeks and PCL-5 scores at 3 months post-trauma, only for patients who met mTBI diagnostic criteria. Conclusions: These findings present preliminary evidence suggesting that acute stress disorder symptoms may be one of the mechanisms involved in the development of PTSD among trauma survivors who have experienced mTBI, which provides a theoretical basis for early intervention of PTSD prevention after mTBI.

Comparing Smartphone, WhatsApp, Facebook, Instagram, and Snapchat: Which Platform Elicits the Greatest Use Disorder Symptoms?

In recent years, smartphone and social networking services (SNS) use have received a great amount of scholarly attention regarding their potentially addictive effects. Conceptualized as smartphone or SNS use disorder, research has consistently demonstrated relations with daily-life impairments. However, Smartphone Use Disorder (SmUD), WhatsApp Use Disorder (WAUD), Facebook Use Disorder (FBUD), Instagram Use Disorder (IGUD), or Snapchat Use Disorder (SCUD) scores have not been compared with each other. This comparison could provide insight into which device/platform could be most related to daily-life impairments. The effective sample of this study comprised 439 German-speaking individuals (age M = 25.08, SD = 9.74; 271 women) who reported actively using a smartphone, as well as WhatsApp, Facebook, Instagram, and Snapchat, and responded to the respective use disorder scales. Within-subjects analysis of variance and post hoc tests (p values adjusted with the Holm method) were used to compare smartphone and SNS use disorder scale scores. The results suggest that SmUD scores are highest in comparison with other SNS platforms. Although WAUD and IGUD scores did not differ from each other, these scores were higher than for FBUD and SCUD. SCUD scores were higher than FBUD scores. These results provide novel insight into how the smartphone and different SNSs may relate to engagement in problematic digital technology use.

COVID-19 anxiety symptoms associated with problematic smartphone use severity in Chinese adults

BACKGROUND

COVID-19 is fast-spreading and potentially fatal, introducing home quarantine, social distancing, and increased internet usage globally. We investigated COVID-19 anxiety, general anxiety and depression symptoms, and their impact on problematic smartphone use (PSU) severity METHODS: Participants were 908 residents of a large Eastern Chinese city, surveyed from late-February to mid-March, 2020. We administered online measures including the Depression Anxiety Stress Scale-21, Smartphone Addiction Scale-Short Version, and items querying COVID-19-related news exposure and threat of death. Additionally, participants rated anxiety using the Generalized Anxiety Disorder Scale-7 with reference to COVID-19.

RESULTS

COVID-19 anxiety correlated with severity of PSU, depression and anxiety. Using established cut-off scores, 12% of participants were identified with at least moderate depression, and 24% with moderate anxiety. Using structural equation modeling, COVID-19 anxiety related to PSU severity, mediating relations between general anxiety and PSU severity. However, controlling PSU for general anxiety and depression severity, COVID-19 anxiety no longer predicted PSU severity.

LIMITATIONS

Limitations include the cross-sectional research design and reliance on data from only one country.

CONCLUSIONS

Results are discussed in context of the I-PACE model of excessive internet use. While COVID-19 anxiety is likely a global anxiety-provoking event, other everyday worries and anxiety are additionally clinically important in driving excessive internet use.

Associations between symptoms of problematic smartphone, Facebook, WhatsApp, and Instagram use: An item-level exploratory graph analysis perspective

BACKGROUND AND AIMS

Studies have demonstrated associations between both problematic smartphone and social networks use with everyday life adversities. However, examination of associations between problematic smartphone use (PSU) and problematic use of specific social networking platforms, especially on item-level data, has received relatively little attention. Therefore, the aim of the current study was to explore how items of problematic smartphone, Facebook, WhatsApp, and Instagram use are associated.

METHODS

949 German-speaking adults participated in a web survey study. The participants were queried about their socio-demographics as well as levels of problematic smartphone, Facebook, WhatsApp, and Instagram use. In addition to bivariate correlation analysis, exploratory graph analysis (EGA), a type of network analysis, was conducted.

RESULTS

The results showed that while problematic Facebook and Instagram use seem to be distinct phenomena, problematic smartphone and WhatsApp use were heavily intertwined. Furthermore, the only cross-platform symptom observed was the extent of reported pain in wrists and neck due to digital technology use. The EGA network models showed very good stability in bootstrap analyses.

DISCUSSION AND CONCLUSIONS

In general, the results of this study suggest that while Instagram and Facebook use may potentially constitute distinct problematic behaviors, problematic smartphone/WhatsApp use scales may be measuring highly similar or even the same construct.

An exploration of the DSM-5 posttraumatic stress disorder symptom latent variable network

BACKGROUND

Both the latent variable model and the network model have been widely used to conceptualize mental disorders. However, it has been pointed out that there is no clear dichotomy between the two models, and a combination of these two model could enable a better understanding of psychopathology. The recently proposed latent network model (LNM) has provided a statistical framework to enable this combination. Evidence has shown that posttraumatic stress disorder (PTSD) could be a suitable candidate disorder to study the combined model. In the current study, we initiated the first investigation of the latent network of PTSD symptoms.

METHODS

The latent network of DSM-5 PTSD symptoms was estimated in 1196 adult survivors of China's 2008 Wenchuan earthquake. Validation testing of the latent network was conducted in a replication sample of children and adolescent who experienced various trauma types. PTSD symptoms were measured by the PTSD Checklist for DSM-5 (PCL-5). The latent network was estimated using the seven-factor hybrid model of DSM-5 PTSD symptoms, analysed using the R package lvnet.

RESULTS

The latent network model demonstrated good fit in both samples. A strong weighted edge between the intrusion and avoidance dimensions was identified (regularized partial correlation = 0.75). The externalizing behaviour dimension demonstrated the highest centrality in the latent network.

CONCLUSIONS

This study is the first to investigate the latent network of DSM-5 PTSD symptoms. Results suggest that both latent symptom dimension and associations between the dimensions should be considered in future PTSD studies and clinical practices.

A comparison of ICD- 11 and DSM-5 criteria for PTSD among a representative sample of Chinese earthquake survivors

BACKGROUND

Striking differences regarding the diagnosis of PTSD exist between the ICD-11 and DSM-5. This study compared the prevalence and comorbidity of PTSD between the ICD-11 and DSM-5.

METHODS

An epidemiological sample of 1160 Chinese adult earthquake survivors collected nine and a half years following the Wenchuan earthquake, in Sichuan province. The PTSD Checklist for DSM-5 (PCL-5), the Patient Health Questionnaire (PHQ-9), and the Generalized Anxiety Disorder-7 (GAD-7) were used to measure PTSD, depression, and anxiety symptoms.

RESULTS

The ICD-11 PTSD criteria yielded higher prevalence estimates than the DSM-5 criteria. There were no significant differences in PTSD's comorbidity with major depressive disorder (MDD) or generalized anxiety disorder (GAD) between the ICD-11 and DSM-5 criteria.

CONCLUSIONS

Results found that the ICD-11 and DSM-5 performed differently in assessing PTSD prevalence, but showed similar co-occurrence with MDD and GAD. This study adds to knowledge about the similarities and differences of using different PTSD criteria and carries implications for clinical and research utilization of the two widely used PTSD diagnostic criteria.

Depicting the associations between different forms of psychopathology in trauma-exposed adolescents

Psychiatric comorbidity in traumatized youth is prevalent, but such associations between two disorders may be confounded with other comorbid conditions. Few studies have examined the unique relationships among multiple disorders. Which disorders maximally explain the relationships between others and whether such disorders differ by sex remain largely unknown. Using a construct-level network approach, this study characterized the independent associations among nine prevalent emotional and behavioral disorders/problems evaluated by the PTSD Checklist for DSM-5, the Revised Children's Anxiety and Depression Scale, and the Youth Self-Report in a sample of 1181 disaster-exposed adolescents (53.9% girls; a mean age of 14.3 ± 0.8 years). The associations were strong among the seven internalizing problems and between the two externalizing ones, but weaker between these two spectra of psychopathology. Major depressive disorder (MDD) was most strongly connected with others, maximally accounting for the associations, especially those between the two spectra. Overall and individual association strength and the connecting role of MDD were generally equivalent across sex. These findings highlight the necessity of MDD in linking comorbid forms of psychopathology in traumatized youth, and suggest MDD as a potential intervention priority in this population.

Depression, anxiety and fear of missing out as correlates of social, non-social and problematic smartphone use

Few studies have examined mental health variables in relation to social vs. non-social smartphone use, and how such types of use relate to problematic smartphone use (PSU). We conducted a web survey of 316 American undergraduate students about severity of depression, anxiety, fear of missing out (FOMO), social and non-social smartphone use, and PSU. Using structural equation modeling, we found that compared to social smartphone use, non-social use was more strongly linked with severity of PSU (β = 0.18, p < .05) and FOMO (β = 0.24, p < .05). FOMO mediated relations between depression severity and non-social smartphone use (β = 0.09, p = .04). Furthermore, FOMO mediated relations between both depression (β = 0.23, p < .001) and anxiety (β = 0.16, p = .04) with PSU severity. We discuss non-social smartphone use as a possible avoidance strategy among anxious individuals, and the role of FOMO in individuals desiring social connectedness but also feeling socially anxious. Results are discussed in the context of a comprehensive theoretical model on pathways toward excessive internet use.

One Social Media Company to Rule Them All: Associations Between Use of Facebook-Owned Social Media Platforms, Sociodemographic Characteristics, and the Big Five Personality Traits

Currently, 2.7 billion people use at least one of the Facebook-owned social media platforms - Facebook, WhatsApp, and Instagram. Previous research investigating individual differences between users and non-users of these platforms has typically focused on one platform. However, individuals typically use a combination of Facebook-owned platforms. Therefore, we aim (1) to identify the relative prevalence of different patterns of social media use, and (2) to evaluate potential between-group differences in the distributions of age, gender, education, and Big Five personality traits. Data collection was performed using a cross-sectional design. Specifically, we administered a survey assessing participants' demographic variables, current use of Facebook-owned platforms, and Big Five personality traits. In N = 3003 participants from the general population (60.67% females; mean age = 35.53 years, SD = 13.53), WhatsApp emerged as the most widely used application in the sample, and hence, has the strongest reach. A pattern consisting of a combined use of WhatsApp and Instagram appeared to be most prevalent among the youngest participants. Further, individuals using at least one social media platform were generally younger, more often female, and more extraverted than non-users. Small differences in Conscientiousness and Neuroticism also emerged across groups reporting different combinations of social media use. Interestingly, when examined as control variables, we found demographic characteristics partially accounted for differences in broad personality factors and facets across different patterns of social media use. Our findings are relevant to researchers carrying out their studies via social media platforms, as sample characteristics appear to be different depending on the platform used.

The mediating effect of rumination between posttraumatic stress disorder symptoms and anger reactions

OBJECTIVE

The relationship between posttraumatic stress disorder (PTSD) and anger is well established. However, further investigation into the underlying mechanisms of this PTSD-anger relationship is needed. Rumination, a construct with a known association to PTSD symptoms, theoretically may mediate this PTSD-anger relationship.

DESIGN

We conducted a mediational model using self-report measures of PTSD symptoms, rumination, and anger reactions from a nonclinical, trauma-exposed sample (N = 339) through Amazon's Mechanical Turk.

RESULTS

Rumination mediated overall PTSD symptoms and anger reactions, controlling for age and gender identity. Further analyses examined this mediating role between PTSD subscale scores and anger. Rumination mediated all PTSD subscales and anger when modeled separately. After adjusting for other PTSD symptoms, only 2 subscales' relationship with anger remained mediated by rumination: negative alterations in cognitions/mood and physiological arousal.

CONCLUSIONS

Rumination should be assessed in the context of PTSD and anger symptoms, specifically physiological arousal and negative moods/cognitions symptoms in PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Excessive reassurance seeking mediates relations between rumination and problematic smartphone use

Aside from depression and anxiety, less is known about the relationship of problematic smartphone use (PSU) to other psychopathology- related variables. The authors' aim was to test previously neglected variables in relation to PSU: rumination and excessive reassurance seeking behavior (ERSB). The authors recruited 295 college students for a web-based survey of smartphone use frequency, PSU, depression and anxiety, ruminative thinking, and ERSB. The authors tested linear regression and mediation models, assessing rumination and ERSB as mediating associations between depression/anxiety severity with PSU, adjusting for age, sex, and smartphone use frequency. Results demonstrate that ERSB was significantly related to PSU severity, and ERSB mediated the association between rumination and PSU. Furthermore, the combination of rumination and ERSB mediated relations between both depression and anxiety severity with PSU. Results provide evidence for ERSB as an important variable in understanding relationships between psychopathology symptoms and PSU severity among college students.

Sexual Dysfunction in Male Canadian Armed Forces Members and Veterans Seeking Mental Health Treatment

INTRODUCTION

There is mixed evidence regarding how posttraumatic stress disorder (PTSD) symptom clusters are associated with sexual dysfunction (SD), and most studies to date have failed to account for potentially confounding variables. Our study sought to explore the unique contribution of PTSD symptom clusters on (a) lack of sexual desire or pleasure, and (b) pain or problems during sexual intercourse, after adjusting for comorbidities and medication usage.

MATERIALS AND METHODS

Participants included 543 male treatment-seeking veterans and Canadian Armed Forces (CAF) personnel (aged <65 years), referred for treatment between September 2006 and September 2014. Each participant completed self-report measures of demographic variables, depressive symptom severity, chronic pain, alcohol misuse, and psychotropic medication usage as part of a standard clinical intake protocol. Hierarchical ordinal logistic regression analyses were used to determine the incremental contribution of PTSD symptom clusters on sexual dysfunction.

RESULTS

Nearly three-quarters (71.5%) of participants reported a lack of sexual desire or pleasure and 40.0% reported pain or problems during intercourse. Regression analyses suggested that avoidant/numbing symptoms were the only symptoms to be independently associated with lacking sexual desire or pleasure (AOR = 1.10; 95% CI 1.05-1.15). None of the PTSD symptom clusters were independently associated with pain or problems during intercourse.

CONCLUSIONS

Sexual dysfunction is prevalent among male treatment-seeking CAF personnel and veterans. Results suggest that PTSD symptoms are differentially associated with sexual desire or pleasure concerns. Assessing sexual function among CAF personnel and veterans seeking treatment for PTSD is critical in order to treat both conditions and improve overall functioning.