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Nordstrand AE, Bøe HJ, Hjemdal O, Huffman AH, Noll LK, Reichelt JG, Bakker LP, Anyan F. Differences in resilience profiles between military veterans and the general population: An exploratory latent profile analysis using the HUNT-4 survey. Stress Health 2024; 40:e3343. [PMID: 37929999 DOI: 10.1002/smi.3343] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 09/20/2023] [Accepted: 10/25/2023] [Indexed: 11/07/2023]
Abstract
Using latent profile analyses, the current work investigated levels of adverse childhood experiences, symptoms of anxiety and depression and 3 dimensions of relational promotive factors) to identify resilience profiles in a large general population sample (N = 161,622, mean age = 53.02; SD = 17.80; 56.1% females). We then used the same method to identify the resilience profiles of military veterans (N = 386, mean age = 43.47; SD = 10.08; 9.8% females), all of whom had served in Afghanistan. A four-profile-solution was the best fitting for the general population (High resilient 30%, Moderate resilient 13%, Low resilient 53%, Work/social-based resilience 4%), while a three-profile-solution had the best fit in the veteran cohort (Family-based resilience 28%, Work/social-based resilience 62%, Hardy loners 10%). To ground the identified profiles in occupational function, we also checked how they predicted reports of sleep difficulties, job demand and job control. Despite both samples inhabiting a geographic region known for high socioeconomic similarity among residents, we found marked differences in profile-solutions between the military veterans and the general population. Our findings suggests that resilience profiles are highly influenced by cohort characteristics and the specific resources needed to manage a given stressor load. Accordingly, the generalisability of specific protective factors may be low across distinct cohorts, and reliable findings need to be obtained in specific populations as defined by stressor context, sample characteristics, and relevant outcomes.
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Affiliation(s)
- Andreas Espetvedt Nordstrand
- Norwegian Armed Forces, Joint Medical Services, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Psychological Sciences, Northern Arizona University (NAU), Flagstaff, Arizona, USA
| | - Hans Jakob Bøe
- Norwegian Armed Forces, Joint Medical Services, Oslo, Norway
- Department of Psychology, University of Oslo (UiO), Oslo, Norway
| | - Odin Hjemdal
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Ann Hergatt Huffman
- Department of Psychological Sciences, Northern Arizona University (NAU), Flagstaff, Arizona, USA
| | - Laura Katherine Noll
- Department of Psychological Sciences, Northern Arizona University (NAU), Flagstaff, Arizona, USA
| | | | | | - Frederick Anyan
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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Başcıllar M, Güre MDP, Sakarya H. Examination of the relationship between post-traumatic growth and social support and life satisfaction in wounded veterans in Turkey. Arch Psychiatr Nurs 2023; 47:10-15. [PMID: 38070988 DOI: 10.1016/j.apnu.2023.10.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/18/2023] [Indexed: 12/18/2023]
Abstract
AIM This study aims to examine the effects of social support and life satisfaction on post-traumatic growth in wounded veterans in Turkey. METHODS 1175 wounded veterans participated in the cross-sectional study. The sociodemographic questionnaire, the Post-Traumatic Growth Inventory, the Multidimensional Scale of Perceived Social Support, and the Satisfaction with Life Scale were used to collect data. Data were analyzed via SPSS. RESULTS The results of the study show that the mean age is 43.04 ± 7.36. The participants are low in education and socioeconomic level. The mean of the Post-Traumatic Growth Inventory score is 43.44 ± 21.18, the mean of the Multidimensional Scale of Perceived Social Support score is 50.01 ± 15.23, and the mean of the Satisfaction With Life Scale score is 9.86 ± 4.04. The results of the study show that there is a positive relationship between social support and life satisfaction and post-traumatic growth. CONCLUSION It can be suggested to develop psychosocial intervention strategies and service delivery systems to promote the life satisfaction, social support mechanisms of wounded veterans.
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Affiliation(s)
- Mehmet Başcıllar
- Faculty of Health Sciences, Malatya Turgut Özal University, Malatya, Turkey.
| | | | - Hakan Sakarya
- Social Work Department, Hacettepe University, Ankara, Turkey
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Clapp JD, Gray MJ, Litz BT, Lang AJ, Sowers AF. Development and Validation of the Disclosure Expectancy Scale. Assessment 2023; 30:1969-1984. [PMID: 36321556 DOI: 10.1177/10731911221128947] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023]
Abstract
Although the disclosure of traumatic experiences is believed to influence trajectories of post-trauma recovery, less is known about individual differences that affect survivors' motivation to share. The current project describes the development and evaluation of the Disclosure Expectancy Scale (DExS), a novel instrument intended to assess survivors' expectations about the potential risks and benefits of disclosure. Items targeting both positive and negative expectancies were generated based on existing research and the authors' clinical experience with various survivor populations. Preliminary analyses in trauma-exposed undergraduates (N = 359) offer support for hypothesized positive and negative expectancy dimensions with evidence for the convergent and discriminant validity of scores. Subsequent evaluation in active-duty, help-seeking military personnel (N = 35) provides further evidence of validity based on correlations with relevant clinical measures. A final regression demonstrating unique effects of initial disclosure expectancies on post-traumatic stress disorder (PTSD) severity following trauma-focused treatment highlights the predictive validity of DExS scores.
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Affiliation(s)
| | | | - Brett T Litz
- VA Boston Healthcare System and Boston University, Jamaica Plain, MA, USA
| | - Ariel J Lang
- VA San Diego Center of Excellence for Stress and Mental Health (CESAMH), CA, USA
- University of California San Diego (UCSD), USA
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Clapp JD, Sowers AF, Freng SA, Elmi LM, Kaya RA, Bachtel AR. Public beliefs about trauma and its consequences: Profiles and correlates of stigma. Front Psychol 2023; 13:992574. [PMID: 36687984 PMCID: PMC9846146 DOI: 10.3389/fpsyg.2022.992574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N 1 = 404; N 2 = 502) and MTurk (N 3 = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.
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Geraci JC, Finley EP, Edwards ER, Frankfurt S, Kurz AS, Kamdar N, Vanneman ME, Lopoo LM, Patnaik H, Yoon J, Armstrong N, Greene AL, Cantor G, Wrobleski J, Young E, Goldsmith M, Seim RW, Goodman M. Partnered implementation of the veteran sponsorship initiative: protocol for a randomized hybrid type 2 effectiveness-implementation trial. Implement Sci 2022; 17:43. [PMID: 35804354 PMCID: PMC9264302 DOI: 10.1186/s13012-022-01212-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 05/15/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The USA is undergoing a suicide epidemic for its youngest Veterans (18-to-34-years-old) as their suicide rate has almost doubled since 2001. Veterans are at the highest risk during their first-year post-discharge, thus creating a "deadly gap." In response, the nation has developed strategies that emphasize a preventive, universal, and public health approach and embrace the value of community interventions. The three-step theory of suicide suggests that community interventions that reduce reintegration difficulties and promote connectedness for Veterans as they transition to civilian life have the greatest likelihood of reducing suicide. Recent research shows that the effectiveness of community interventions can be enhanced when augmented by volunteer and certified sponsors (1-on-1) who actively engage with Veterans, as part of the Veteran Sponsorship Initiative (VSI). METHOD/DESIGN The purpose of this randomized hybrid type 2 effectiveness-implementation trial is to evaluate the implementation of the VSI in six cities in Texas in collaboration with the US Departments of Defense, Labor and Veterans Affairs, Texas government, and local stakeholders. Texas is an optimal location for this large-scale implementation as it has the second largest population of these young Veterans and is home to the largest US military installation, Fort Hood. The first aim is to determine the effectiveness of the VSI, as evidenced by measures of reintegration difficulties, health/psychological distress, VA healthcare utilization, connectedness, and suicidal risk. The second aim is to determine the feasibility and potential utility of a stakeholder-engaged plan for implementing the VSI in Texas with the intent of future expansion in more states. The evaluators will use a stepped wedge design with a sequential roll-out to participating cities over time. Participants (n=630) will be enrolled on military installations six months prior to discharge. Implementation efforts will draw upon a bundled implementation strategy that includes strategies such as ongoing training, implementation facilitation, and audit and feedback. Formative and summative evaluations will be guided by the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework and will include interviews with participants and periodic reflections with key stakeholders to longitudinally identify barriers and facilitators to implementation. DISCUSSION This evaluation will have important implications for the national implementation of community interventions that address the epidemic of Veteran suicide. Aligned with the Evidence Act, it is the first large-scale implementation of an evidence-based practice that conducts a thorough assessment of TSMVs during the "deadly gap." TRIAL REGISTRATION ClinicalTrials.gov ID number: NCT05224440 . Registered on 04 February 2022.
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Affiliation(s)
- Joseph C Geraci
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA. .,Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA. .,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA. .,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Erin P Finley
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Center for the Study of Healthcare Innovation, Implementation, and Policy (CSHIIP), VA Greater Los Angeles Healthcare System, New York, USA
| | - Emily R Edwards
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sheila Frankfurt
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Central Texas Veterans Healthcare System, Temple, TX, USA
| | - A Solomon Kurz
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA
| | - Nipa Kamdar
- Center for Innovations in Quality, Effectiveness and Safety, VA, VA, Houston, USA
| | - Megan E Vanneman
- Informatics, Decision-Enhancement and Analytic Sciences (IDEAS) Center, VA Salt Lake City Health Care System, Salt Lake City, UT, USA.,Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, USA.,Division of Health System Innovation and Research, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Leonard M Lopoo
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Hannah Patnaik
- Department of Public Administration and International Affairs, Syracuse University, Syracuse, NY, USA
| | - Jean Yoon
- VA Health Economics Resource Center, VA Palo Alto Healthcare System, Livermore, CA, USA.,Center for Primary Care and Outcomes Research, Stanford University, Palo Alto, CA, USA
| | - Nicholas Armstrong
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Ashley L Greene
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Gilly Cantor
- Institute for Veterans and Military Families, Syracuse University, Syracuse, NY, USA
| | - Joseph Wrobleski
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA
| | - Erin Young
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA.,Global Mental Health Lab, Teachers College, Columbia University, New York, NY, USA
| | - Matthew Goldsmith
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Resilience Center for Veterans & Families, Teachers College, Columbia University, New York, NY, USA
| | - Richard W Seim
- Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA
| | - Marianne Goodman
- Transitioning Servicemember/Veteran And Suicide Prevention Center (TASC), VISN 2 Mental Illness Research, Education and Clinical Center, James J. Peters VA Medical Center, Bronx, NY, USA.,Center of Excellence for Research on Returning War Veterans, VISN 17, Doris Miller VA Medical Center, Waco, TX, USA.,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Saltzman LY, Canetti D, Hobfoll SE, Hall BJ. The impact of political violence on posttraumatic stress symptomology: a longitudinal analysis. ANXIETY, STRESS, AND COPING 2022; 35:219-231. [PMID: 34269153 PMCID: PMC8761218 DOI: 10.1080/10615806.2021.1950694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE The current paper uses the Conservation of Resources Theory to frame an examination of the impact of exposure to political violence on posttraumatic stress symptomology among three groups within Israeli society: (1) Native Born Jews; (2) Foreign Born Jews; and (3) Palestinian Citizens of Israel. METHODS The study population was a large nationally representative sample of 1613 respondents collected during The Second Intifada. The sample consists of approximately 40% Jews born in Israel (n = 652), 30% (n = 484) were Jews who immigrated to Israel, and close to 30% (n = 477) were Palestinian Citizens of Israel. Mediation analyses explored the role of resource loss in the relationship between social status and posttraumatic stress disorder (PTSD) symptom severity. RESULTS Compared to native born Jews, foreign born Jews and Palestinian Citizens of Israel reported greater PTSD symptom severity at wave III. These relationships were not mediated by psychosocial resource loss or economic resource loss. CONCLUSIONS We discuss the importance of tailored interventions with minority groups in the context of ongoing political violence.
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Affiliation(s)
| | - Daphna Canetti
- Professor and Head School of Political Science University of Haifa
| | | | - Brian. J Hall
- Associate Professor of Global Public Health, NYU Shanghai
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7
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Etchin AG, Fonda JR, Howard EP, Fortier CB, Milberg WP, Pounds K, McGlinchey RE. Childhood Trauma Differentially Impacts Depression and Stress Associations with Reintegration Challenges Among Post-9/11 U.S. Veterans. Nurs Outlook 2021; 70:323-336. [PMID: 34895737 DOI: 10.1016/j.outlook.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 09/30/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Post-9/11 veterans exhibit high prevalence of deployment stress, psychological conditions, and traumatic brain injury (TBI) which impact reintegration, especially among those with a history of interpersonal early life trauma (I-ELT). The relative importance of each risk factor is unclear. PURPOSE We examined major deployment and clinical exposures of reintegration challenges among veterans with and without I-ELT. METHOD We analyzed cross-sectional data of 155 post-9/11 veterans from the Translational Research Center for TBI and Stress Disorders study. FINDINGS Depression severity had the strongest association with reintegration challenges, followed by posttraumatic stress disorder (PTSD) severity, post-deployment stress, and deployment safety concerns. Deployment safety concerns had a stronger, significant association among veterans with I-ELT. In nearly every model, PTSD and depression severities were weaker for veterans with I-ELT, compared to those without. DISCUSSION Clinicians should consider the relative risk of concurrent clinical conditions and trauma histories when considering veterans' reintegration needs.
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Affiliation(s)
- Anna G Etchin
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA.
| | - Jennifer R Fonda
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Boston University Medical Campus, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA
| | - Elizabeth P Howard
- Connell School of Nursing, Boston College, Chestnut Hill, MA; The Hinda and Arthur Marcus Institute for Aging Research (The Marcus Institute), Hebrew Senior Life, Boston, MA
| | - Catherine B Fortier
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA
| | - William P Milberg
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA
| | - Karen Pounds
- College of Nursing and Health Sciences, University of Massachusetts Dartmouth, North Dartmouth, MA
| | - Regina E McGlinchey
- Translational Research Center for TBI & Stress Disorders, VA Boston Healthcare System, Boston, MA; Department of Psychiatry, Harvard Medical School, Boston, MA; Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA
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Lamb D, Withnall RD. A qualitative study to investigate the psychosocial effects of operational deployments on Medical Emergency Response Team personnel. Stress Health 2021; 37:364-377. [PMID: 33112039 DOI: 10.1002/smi.3001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 09/07/2020] [Accepted: 09/22/2020] [Indexed: 11/11/2022]
Abstract
The stressors associated with emergency medical teams responding to critical incidents are well documented; however, the impact of such duties on the UK military personnel had never been investigated. This study explored the psychosocial effects of Medical Emergency Response Teams (MERT) operating in Afghanistan to inform the development of a Resilience Model. A structured and contextually relevant process could then be applied for a team's preparation for, delivery of and recovery from, their duties. A qualitative cross-sectional design used semi-structured interviews and 15 multidisciplinary team members participated. Interviews were transcribed verbatim and data were systematically analysed using grounded theory. Emergent theory poses that developing resilience against the demands of this role is dependent upon personnel having a realistic understanding of the deployed environment by phased immersion within it. This preparatory training generates situational awareness, trust and strong team cohesion, which together with peer and organizational support are necessary factors to effectively cope with the role. To limit the costs of caring, there is a need for MERT personnel to segregate the physiological and emotional aspects of delivering care to the injured; those unable to do so may be at greater risk of poor mental health outcomes. The preparatory training of MERT personnel must be further developed to provide an immersive environment that more closely matches the reality of the role. A period of stability is required post deployment with the support of peers to enable personnel to more efficiently transition back to their home life.
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Affiliation(s)
- Di Lamb
- Academic Department of Military Nursing, Royal Centre for Defence Medicine, Birmingham, UK
| | - Rich Dj Withnall
- Royal Centre for Defence Medicine, Research & Clinical Innovation, Birmingham, UK
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Jacobson IG, Adler AB, Roenfeldt KA, Porter B, LeardMann CA, Rull RP, Hoge CW. Combat Experience, New-Onset Mental Health Conditions, and Posttraumatic Growth in U.S. Service Members. Psychiatry 2021; 84:276-290. [PMID: 34340639 DOI: 10.1080/00332747.2021.1929770] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Objective: Studies examining posttraumatic growth (PTG) rely on surveys evaluating PTG in relation to prior traumatic experiences, resulting in psychometric problems due to the linkage of the dependent and independent variables. Few studies have assessed PTG following combat deployment while also controlling for mental health problems.Method: Longitudinal data on PTG, combat experience, and mental health were examined among U.S. Millennium Cohort Study deployers (n = 8732). Scores from a short-form (SF) version of the PTG inventory assessing current-state beliefs (C-PTGI-SF) independent of any predictor variables were assessed at time 1 (T1), before deployment, and change in scores were assessed approximately 3 years later after deployment at time 2 (T2). All participants screened negative for posttraumatic stress disorder (PTSD) and depression at T1.Results: Combat deployment severity was associated with a worsening of C-PTGI-SF scores at T2 among participants with moderate C-PTGI-SF scores at T1. A positive screen for comorbid PTSD/depression was associated with a worsening of C-PTGI-SF scores at T2 among participants with moderate or high C-PTGI-SF scores at T1. At T2, a strong inverse correlation was found between C-PTGI-SF scores and PTSD (r = -0.38) and depression (-0.41). Only 5% of participants who screened positive for a mental health problem at T2 (23/517) also experienced positive growth.Conclusions: These results challenge the clinical utility of the PTG construct. While PTG may be a useful framework for supporting trauma recovery on an individual basis, PTG does not appear to be distinct and independent from the negative psychological impact of traumatic experiences.
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MoshirPanahi S, Moradi AR, Ghaderi B, McEwen C, Jobson L. Predictors of positive and negative post-traumatic psychological outcomes in a sample of Iranian cancer survivors. Br J Health Psychol 2020; 25:390-404. [PMID: 32348016 DOI: 10.1111/bjhp.12412] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Revised: 02/25/2020] [Indexed: 12/26/2022]
Abstract
Objectives This study aimed to identify predictors of positive and negative post-traumatic psychological outcomes within a sample of Iranian cancer survivors. Methods In this cross-sectional research, 300 (167 females; age M = 53.00, SD = 27.57) cancer survivors (breast cancer, leukaemia, colorectal cancer) were recruited from oncology outpatient clinics in Iran. Participants completed measures of post-traumatic stress disorder (PTSD), post-traumatic growth (PTG), cognitive processing, attentional biases, and autobiographical memory specificity. Results Using partial least square structural equation modelling, it was found that the proposed model was capable of predicting PTSD and PTG. Negative attentional biases were significantly associated with PTSD symptoms, but were not significantly associated with PTG. In contrast, memory specificity and positive attentional biases tended to be associated with PTG, but were not significantly associated with PTSD symptoms. Second, negative cognitive processing was significantly associated with PTSD symptoms, while positive cognitive processing was significantly associated with PTG. Finally, there was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing. Conclusions Our findings support growing evidence for differential trajectories to PTG and PTSD symptoms in cancer. Such cognitive factors may be important therapeutic targets in psycho-oncology interventions. Statement of contribution What is already known on this subject? The diagnosis of cancer and its subsequent treatment can result in symptoms of post-traumatic stress disorder (PTSD). Positive changes and psychosocial growth (post-traumatic growth; PTG) are also common as a result of patients' experience of cancer. What does this study add? This study identified predictors of positive (PTG) and negative trauma (PTSD) outcomes within a sample of Iranian cancer survivors (N = 300). General habitual cognitive tendencies (memory specificity, attentional biases) were associated with cognitive processing, which in turn contributed to psycho-traumatic adaption. There was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing.
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Affiliation(s)
- Shiva MoshirPanahi
- Kharazmi University and the Institute for Cognitive Science Studies, Tehran, Iran
| | - Ali Reza Moradi
- Kharazmi University and the Institute for Cognitive Science Studies, Tehran, Iran
| | - Bayazid Ghaderi
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Cassandra McEwen
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Laura Jobson
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
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Knobloch LK, Knobloch-Fedders LM, Yorgason JB. Mental health symptoms and the reintegration difficulty of military couples following deployment: A longitudinal application of the relational turbulence model. J Clin Psychol 2018; 75:742-765. [PMID: 30569467 DOI: 10.1002/jclp.22734] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2018] [Revised: 10/01/2018] [Accepted: 11/06/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Understanding the factors that predict the reintegration difficulty of military couples during the postdeployment transition has important implications for theory, research, and practice. Building on the logic of the relational turbulence model, this paper evaluates the relationship processes of reunion uncertainty and reintegration interference from a partner as mediators of the connection between people's mental health symptoms and their difficulty with reintegration after deployment. METHOD Dyadic longitudinal data were collected from 555 US military couples once per month for 8 consecutive months. RESULTS Findings mapped the trajectory of reintegration difficulty and suggested reunion uncertainty and reintegration interference from a partner as mediators of the link between people's depressive and posttraumatic stress symptoms and the magnitude of their reintegration difficulty. CONCLUSION These results highlight relationship processes as a key domain of intervention to preserve the well-being of military couples during the postdeployment transition.
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Affiliation(s)
- Leanne K Knobloch
- Department of Communication, University of Illinois, Urbana, Illinois
| | - Lynne M Knobloch-Fedders
- Department of Counselor Education and Counseling Psychology, Marquette University, Milwaukee, Wisconsin
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12
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Mark KM, Stevelink SAM, Choi J, Fear NT. Post-traumatic growth in the military: a systematic review. Occup Environ Med 2018; 75:904-915. [DOI: 10.1136/oemed-2018-105166] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 09/07/2018] [Accepted: 09/24/2018] [Indexed: 11/04/2022]
Abstract
BackgroundPost-traumatic growth is defined as positive psychological, social or spiritual growth after a trauma.ObjectivesThis systematic review aimed to identify studies that quantitatively measured post-traumatic growth among (ex-) military personnel, to determine whether there is evidence of growth in this context and whether such growth is associated with any sociodemographic, military, trauma or mental health factors.Data sourcesThe electronic databases PsycInfo, OVIDmedline and Embase were searched for studies published between 2001 and 2017.Study eligibility criteria and participantsPapers were retained if they involved military or ex-military personnel, where some had been deployed to Iraq or Afghanistan.Study appraisalQuality assessment was conducted on all studies.Results21 studies were retained. The Post-Traumatic Growth Inventory was employed by 14 studies: means ranged from 32.60 (standard deviation = 14.88) to 59.07 (23.48). The Post-Traumatic Growth Inventory Short Form was used by five studies: means ranged from 17.11 (14.88) to 20.40 (11.88). These values suggest moderate growth. Higher levels of social support, spirituality and rumination and minority ethnicity were most frequently associated with more post-traumatic growth.LimitationsThe involved studies may lack generalisability and methodological quality.ConclusionsOverall, this paper confirms that negative reactions to trauma, particularly post-traumatic stress disorder, are not the only possible outcomes for service personnel, as moderate post-traumatic growth can also be observed.Implications of key findingsInterventions aimed at helping current and former armed forces personnel to identify and promote post-traumatic growth post-conflict may be beneficial for their well-being.
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Arandia AMH, Mordeno IG, Nalipay MJN. Assessing the Latent Structure of Posttraumatic Growth and Its Relationship With Cognitive Processing of Trauma Among Filipino Women Victims of Intimate Partner Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2018; 33:2849-2866. [PMID: 26920395 DOI: 10.1177/0886260516632354] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The study intends to find out which model best represents posttraumatic growth's (PTG) latent factor structure in a sample of Asian, particularly Filipino, women victims of intimate partner abuse (IPA) using Posttraumatic Growth Inventory (PTGI). In addition, it also aims to find out the differential relationships of the components of the best-fitting PTG model with cognitive processing strategies. Confirmatory factor analyses were conducted with the one-factor, three-factor, and five-factor models of PTG in a sample of 217 Filipino women who have history of IPA within the last 6 months of a previous or current relationship. Results revealed that the five-factor model comprised of appreciation of life, new possibilities, personal strength, spiritual change, and relating to others best fits the sample. Furthermore, all the components of the five-factor model were found to be positively correlated with cognitive processing of trauma strategies, including positive cognitive restructuring, denial, downward comparison, regret, and resolution/acceptance, albeit in varying degrees. These findings confirmed the robustness of the five-factor model of PTG compared with other models in a sample of women victims of IPA. In addition, the findings demonstrated the relationship of PTG with cognitive processing of trauma. These findings would be useful in developing cognitive interventions for women who experienced IPA.
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Affiliation(s)
- Amor Mia H Arandia
- 1 University of Santo Tomas Graduate School Psychotrauma Clinic, Manila, Philippines
| | - Imelu G Mordeno
- 2 Mindanao State University-Iligan Institute of Technology, Iligan, Philippines
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Zanbar L, Kaniasty K, Ben-Tzur N. Engagement in community activities and trust in local leaders as concomitants of psychological distress among Israeli civilians exposed to prolonged rocket attacks. ANXIETY, STRESS, AND COPING 2018; 31:431-446. [PMID: 29631436 DOI: 10.1080/10615806.2018.1460747] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
BACKGROUND AND OBJECTIVES Present study, conducted in the aftermath of the 2014 Israel-Gaza conflict, investigated psychological toll of exposure to rockets attacks in a sample of residents of central and southern Israel. Analyses focused on the distress-protective functions of collectively grounded resources: engagement in community activities and trust in local leadership. DESIGN This cross-sectional study was conducted between 2 and 3 months after the hostilities. METHOD Participants (N = 764) were recruited by an online survey company that distributed a questionnaire assessing, in addition to focal predictors, sociodemographic factors and prior exposure to trauma. The outcome variables were post-traumatic stress disorder (PTSD) and nonspecific distress symptoms. RESULTS Conservative regression analyses revealed that greater exposure to rocket attacks was predictive of higher levels of posttraumatic stress symptoms. Higher engagement in community activities exhibited a partial trauma-buffering function. However, higher levels of trust in local leaders appeared to exacerbate, rather than diminish, negative impact of rocket exposure on PTSD. Symptoms of psychological distress were not influenced neither by trauma exposure nor by stressor interactions with resources. Trust in local leadership exerted a beneficial main effect on distress. CONCLUSIONS Collectively based resources are important for coping in times of community-wide stressors, yet their role is complex.
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Affiliation(s)
- Lea Zanbar
- a School of Social Work , Ariel University , Ariel , Israel
| | - Krzysztof Kaniasty
- b Department of Psychology , Indiana University of Pennsylvania , Indiana , PA , USA.,c Institute of Psychology , Polish Academy of Sciences , Warsaw , Poland
| | - Navit Ben-Tzur
- a School of Social Work , Ariel University , Ariel , Israel
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Chen YY, Kao MC. Prior disclosure and emotional expression: Interactive effects on post-traumatic stress disorder symptoms. Int J Psychiatry Med 2018; 53:189-196. [PMID: 29271269 DOI: 10.1177/0091217417749790] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
UNLABELLED Background Previous research has revealed mixed findings with regard to the effects of disclosure on trauma recovery. More recently, studies on psychological trauma have found associations among religion, meaning, and health. This study investigated prior disclosure as a moderator for the association between religious emotional expression and adaptive trauma processing, as measured by post-traumatic stress disorder (PTSD) symptoms. Methods Using Pennebaker's written emotional expression paradigm, 105 participants were assigned to either a conventional trauma-writing condition or religious trauma-writing condition. PTSD symptoms were assessed at baseline and again at one-month post writing. Results A two-way interaction was found between prior disclosure and writing condition on PTSD symptoms at follow-up. For the religious trauma-writing condition only, there was a significant difference between low versus high disclosure participants in PTSD symptoms at follow-up, such that low prior disclosure participants registered fewer PTSD symptoms than high prior disclosure participants, while prior disclosure did not have such effect in the conventional trauma-writing condition. LIMITATIONS This two-way interaction may be further qualified by other important psychosocial variables, such as differences in personality, coping style, social support, or use of prayer as a form of disclosure, which were not assessed in this study. Conclusion Religious emotional expression may encourage adaptive trauma processing, especially for individuals with low prior disclosure. These findings encourage further investigation of the conditions under which disclosure and religion may be a beneficial factor in trauma adaptation and treatment.
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Affiliation(s)
- Yung Y Chen
- 1 Institute of Cognitive Neuroscience, 34911 National Central University , Jhongli City, Taiwan
| | - Min C Kao
- 1 Institute of Cognitive Neuroscience, 34911 National Central University , Jhongli City, Taiwan
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Diab SY, Isosävi S, Qouta SR, Kuittinen S, Punamäki RL. The protective role of maternal posttraumatic growth and cognitive trauma processing among Palestinian mothers and infants. Infant Behav Dev 2017; 50:284-299. [PMID: 28619421 DOI: 10.1016/j.infbeh.2017.05.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Revised: 05/21/2017] [Accepted: 05/22/2017] [Indexed: 11/29/2022]
Abstract
War survivors use multiple cognitive and emotional processes to protect their mental health from the negative impacts of trauma. Because mothers and infants may be especially vulnerable to trauma in conditions of war, it is urgent to determine which cognitive and emotional processes are effective for preventing negative trauma impacts." This study examined whether mothers' high posttraumatic growth (PTG) and positive posttraumatic cognitions (PTC) protected (a) their own mental health and (b) their infants' stress regulation and sensorimotor and language development from the effects of war trauma. The participants were 511 Palestinian mothers and their infants living in the Gaza strip. The mothers were interviewed in their second trimester of pregnancy (T1) as well as when the infant was four months (T2) and twelve months (T3). Mothers reported posttraumatic growth (PTG; Tedeschi & Calhoun, 1996) at T1 and posttraumatic cognitions (PTCI; Foa et al., 1999) at T2. They also reported their exposure to traumatic war events both at T1 and T3 and described their mental health conditions (e.g., PTSD and/or depressive and dissociation symptoms) at T3. The Infant Behaviour Questionnaire (IBQ) was used to measure infants' stress regulation at T2 and sensorimotor and language development at T3. The results, based on regression analyses with interaction terms between trauma and PTG, showed that high levels of traumatic war events were not associated with high levels of PTSD, depressive, or dissociation symptoms among mothers showing high levels of PTG. This suggests that PTG may protect maternal mental health from the effects of trauma. In turn, positive maternal PTCs appeared to protect the infants' stress regulation from the effects of war trauma. The study concludes by discussing ways to develop and implement preventive interventions for mother-infant dyads in war conditions.
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Affiliation(s)
- Safwat Y Diab
- Al Quds Open University, Department of Educational Psychology, Gaza Strip, Palestine
| | - Sanna Isosävi
- University of Tampere, Faculty of Social Sciences, Department of Psychology, Finland
| | - Samir R Qouta
- Islamic University Gaza, Department of Education and Psychology, Gaza, Palestine
| | - Saija Kuittinen
- University of Tampere, Faculty of Social Sciences, Department of Psychology, Finland
| | - Raija-Leena Punamäki
- University of Tampere, Faculty of Social Sciences, Department of Psychology, Finland; Universidad de Sevilla, Facultad de Psicología, Departemento de Psicologia Evolutiva y de la Education, Spain.
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Xu W, Wang J, Wang Z, Li Y, Yu W, Xie Q, He L, Maercker A. Web-based intervention improves social acknowledgement and disclosure of trauma, leading to a reduction in posttraumatic stress disorder symptoms. J Health Psychol 2016; 21:2695-2708. [PMID: 25934590 DOI: 10.1177/1359105315583371] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
This study aims to investigate the effectiveness of web-based intervention on social acknowledgement and disclosure of trauma and to examine the mediating effect of the improvement in social acknowledgement and disclosure of trauma on the reduction of posttraumatic stress disorder symptoms. A randomized controlled trial was used, with 21 participants in a web-based intervention group and 29 participants in a wait-list control group completing a pre-test and post-test. Results showed that social acknowledgement and disclosure of trauma improved significantly after 1-month intervention, and this improvement mediated the reduction in the posttraumatic stress disorder symptoms. Implications and limitations of this study are discussed.
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Affiliation(s)
- Wei Xu
- 1 Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, P.R. China
| | - Jianping Wang
- 1 Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, P.R. China.,2 Capital Medical University, P.R. China
| | | | - Yifei Li
- 1 Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, P.R. China
| | - Wei Yu
- 1 Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, P.R. China
| | - Qiuyuan Xie
- 1 Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, P.R. China
| | - Li He
- 1 Beijing Key Laboratory of Applied Experimental Psychology, School of Psychology, Beijing Normal University, P.R. China
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Wiley RE. A Case Study of Cognitive Processing Therapy for a Military Medic With Posttraumatic Stress Disorder. J Cogn Psychother 2016; 30:203-220. [PMID: 32755925 DOI: 10.1891/0889-8391.30.3.203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Cognitive processing therapy (CPT) is an effective treatment for posttraumatic stress disorder (PTSD) in the active duty and veteran population. This case study provides a thorough example of the use of this therapeutic modality with an active duty military service member who was exposed to several traumatic events. Over the course of 13 sessions, "Master Sergeant Smith," a middle-aged, White male, made significant progress on his treatment plan goals and reductions in PTSD symptoms. This case study describes the theoretical and research basis for treatment and course of treatment and illustrates the use of CPT in an outpatient setting while describing important areas of focus and how to overcome clinical challenges.
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Dong C, Gong S, Jiang L, Deng G, Liu X. Posttraumatic growth within the first three months after accidental injury in China: the role of self-disclosure, cognitive processing, and psychosocial resources. PSYCHOL HEALTH MED 2014; 20:154-64. [PMID: 24819014 DOI: 10.1080/13548506.2014.913795] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The primary goals of this study, were to identify the posttraumatic growth (PTG) level of accidentally injured Chinese patients shortly after an accident occurred and to determine whether cognitive processing, self-disclosure, and psychosocial resources predicted PTG. A total of 232 patients were recruited from two public hospitals in Shanghai within the first three months of an accidental injury. Patients completed self-report questionnaires to assess severity of injury, cognitive processing, self-disclosure, psychosocial resources, and PTG. Patients reported a mid-low level of PTG (M = 50.38, SD = 18.12) in the short length of time post-injury. Hierarchical regression analysis indicated that subjective accident severity, deliberate rumination, perceived social support, and attitude towards disclosure were strong predictors of PTG. A moderating role of self-disclosure between intrusive rumination and PTG was identified. These findings support an interaction effect of rumination and self-disclosure on PTG and have implications for early intervention of accidentally injured patients.
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Affiliation(s)
- Chaoqun Dong
- a School of Nursing , Secondary Military Medical University , Shanghai , China
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