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Messman BA, Compton SE, Majeed I, Weiss NH, Contractor AA. Beyond the mean: examining associations between intraindividual variability in posttraumatic stress disorder symptoms and posttrauma reckless behaviors. ANXIETY, STRESS, AND COPING 2024; 37:615-631. [PMID: 38268223 PMCID: PMC11266525 DOI: 10.1080/10615806.2024.2307465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/07/2024] [Accepted: 01/14/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND/OBJECTIVES Posttrauma reckless behaviors have been linked to the onset and exacerbation of posttraumatic stress disorder (PTSD) symptoms. However, PTSD symptoms fluctuate across time, triggered by environmental stimuli in daily life, referred to as (intraindividual) variability in PTSD symptoms. DESIGN We utilized experience sampling methods to investigate associations between engagement in posttrauma reckless behaviors and variability in PTSD symptoms and the moderating role of emotion dysregulation in this association. METHODS Data from 166 trauma-exposed university students (Mage = 21.43 ± 5.07, 85.4% women) were collected between January 2019 to August 2020. Participants completed baseline and follow-up surveys to assess engagement in posttrauma reckless behaviors and daily surveys (10-days) to assess variability in PTSD symptoms. Results. Analyzes indicated greater baseline engagement in posttrauma reckless behaviors was associated with greater 10-day variability in PTSD symptoms (β = 0.23, p = .031), and baseline emotion dysregulation moderated this association (β = -0.33, p = .003). Additionally, greater 10-day variability in PTSD symptoms was associated with greater follow-up engagement in posttrauma reckless behaviors (β = 0.14, p = .045). CONCLUSIONS Findings substantiate the interplay between engagement in posttrauma reckless behaviors and daily fluctuations in PTSD symptoms and support therapeutically targeting both engagement in posttrauma reckless behaviors and emotion dysregulation to impact PTSD symptoms.
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Affiliation(s)
- Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Sidonia E Compton
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Ifrah Majeed
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
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Stumps A, Bounoua N, Sadeh N. Emotional reactivity linking assaultive trauma and risky behavior: Evidence of differences between cisgender women and men. J Trauma Stress 2024; 37:492-503. [PMID: 38454638 PMCID: PMC11176033 DOI: 10.1002/jts.23028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/09/2024] [Accepted: 02/01/2024] [Indexed: 03/09/2024]
Abstract
Accumulating evidence suggests that trauma exposure is positively associated with future engagement in risky behavior, such as substance misuse, aggression, risky sex, and self-harm. However, the psychological factors driving this association and their relevance across gender groups require further clarification. In a community sample of 375 adults with a high rate of trauma exposure (age range: 18-55 years, M = 32.98 years, SD = 10.64; 76.3% assaultive trauma exposure), we examined whether emotional reactivity linked lifetime assaultive trauma exposure with past-month risky behavior. We also explored whether this model differed for cisgender women (n = 178, 47.6%) and men (n = 197, 52.5%). As hypothesized, assaultive trauma was positively related to emotional reactivity, β = .20, SE = 0.03, t(369) = 3.65, p < .001, which, in turn, partially accounted for the association between assaultive trauma and past-month risky behavior, indirect effect: β = .03, SE = 0.01, 95% bootstrapped CI [0.01, 0.06]. Gender moderated this association such that assaultive trauma was indirectly associated with risky behavior via emotional reactivity for women but not for men, index moderation: B = -0.03, SE = 0.02, 95% bootstrapped CI [-0.07, -0.01]. Cross-sectional results suggest that emotional reactivity may be a proximal target for clinical intervention to aid in the reduction of risky behavior among women.
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Affiliation(s)
- Anna Stumps
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Nadia Bounoua
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Naomi Sadeh
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
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George R, Gudegowda K, Partheeban I, Sobagaiah R. A cross-sectional study to assess the post-traumatic stress disorder among discharged coronavirus disease-19-infected individuals in Karnataka, Southern India. JOURNAL OF CURRENT RESEARCH IN SCIENTIFIC MEDICINE 2023. [DOI: 10.4103/jcrsm.jcrsm_77_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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Rodrik O, Weaver S, Kiehl KA, Koenigs M. Correlates of externalizing psychopathology in incarcerated men. Psychol Assess 2022; 34:912-922. [PMID: 35849404 PMCID: PMC10049692 DOI: 10.1037/pas0001161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Externalizing traits are extremely costly for society and disproportionately prevalent among incarcerated individuals. The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirically derived classification system that approaches psychopathology dimensionally and was developed in response to critiques of current diagnostic classification systems. The Externalizing Spectrum Inventory-100 item version (ESI-100) is an assessment of externalizing problems that fits within the HiTOP framework and characterizes dimensional externalizing traits. The present study aimed to replicate prior research examining the convergent validity of the ESI Total Score by examining associations with psychopathy, conduct disorder, and substance use among incarcerated males. A total of 1,808 participants had ESI-100 data, although sample sizes across criterion measures varied. The majority of results replicated relationships between the ESI 159-item version and externalizing disorders and negative emotionality. Less is known about the dimensional relationships between externalizing traits as measured by the ESI-100 and internalizing disorders and symptoms, and other correlates of externalizing. The study extended previous results by examining associations between the ESI-100 and internalizing disorders, impulsivity, childhood trauma, and emotion regulation (ER) as a test of discriminant validity. Analyses revealed associations between the ESI-100 and childhood trauma, impulsivity, emotion regulation difficulties, and symptoms (but not diagnoses) of internalizing disorders. These results enhance our understanding of dimensional traits of externalizing and suggest nuanced relationships between externalizing and internalizing traits. Results have important implications (e.g., transdiagnostic treatment targets) for treatment of mental health disorders by highlighting the importance of cross-diagnostic treatment approaches. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Odile Rodrik
- Department of Psychology, University of Wisconsin-Madison, 1202 West Johnson Street, Madison, Wisconsin, 53706, USA
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, Wisconsin, 53719, USA
| | - Shelby Weaver
- Department of Psychology, University of Wisconsin-Madison, 1202 West Johnson Street, Madison, Wisconsin, 53706, USA
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, Wisconsin, 53719, USA
| | - Kent A. Kiehl
- The Mind Research Network, Departments of Psychology, Neuroscience and Law, University of New Mexico, Albuquerque, New Mexico, 87106, USA
| | - Michael Koenigs
- Department of Psychiatry, University of Wisconsin-Madison, 6001 Research Park Boulevard, Madison, Wisconsin, 53719, USA
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Kearns NT, Contractor AA, Weiss NH. Measurement Invariance of the Reckless and Self-destructive Behaviors Construct Assessed by the Posttrauma Risky Behaviors Questionnaire (PRBQ) Across Trauma Type and Trauma Count. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-021-09923-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Gambling problems and associated harms in United Kingdom Royal Air Force personnel. Addict Behav 2022; 126:107200. [PMID: 34906882 DOI: 10.1016/j.addbeh.2021.107200] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 11/01/2021] [Accepted: 11/22/2021] [Indexed: 11/22/2022]
Abstract
International evidence indicates that currently serving and former military personnel may be at heightened vulnerability to problem gambling. The aim of the present study was to undertake the first survey of gambling experience and potential problems among serving United Kingdom Royal Air Force (RAF) personnel. Our objectives were to survey the frequency of gambling problems, types of gambling activities, examine mental health, alcohol use, and COVID-19-related associations with gambling, and identify potential risk factors for problem gambling among RAF personnel. A cross-sectional online survey was distributed to all serving RAF personnel in January 2021 and the final dataset consisted of n = 2119 responses. The Problem Gambling Severity Index (PGSI) identified gambling severity, the Patient Health Questionnaire (PHQ-9) assessed depression, the Generalized Anxiety Disorder assessment (GAD-7) measured anxiety, and alcohol use was assessed with the Alcohol Use Disorders Identification Test (AUDIT). Questions relating to COVID-19 asked whether the pandemic had impacted one's gambling, mental health, and alcohol use. Findings indicated that 12.5% of personnel reported gambling problems, which included 8.0% with PGSI scores indicating low-risk gambling (1-2), 2.9% with moderate-risk gambling scores (3-4), and 1.6% with scores indicating problem gambling (≥8). Most personnel had no symptoms of depression or anxiety, and most experienced lower risk drinking levels. The likelihood of any gambling problem (PGSI ≥ 1) in RAF personnel was associated with age (18-24 years old), male gender, and Non-Commissioned ranks. Most participants reported a deterioration in their mental health due to COVID-19 and increased risky gambling. These findings indicate that gambling problems and associated harms are significant concerns for serving RAF personnel.
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Bounoua N, Sadeh N. A longitudinal investigation of the impact of emotional reactivity and COVID-19 stress exposure on substance use during the pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2021; 6:100284. [PMID: 34901917 PMCID: PMC8645250 DOI: 10.1016/j.jadr.2021.100284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/04/2021] [Accepted: 11/24/2021] [Indexed: 11/08/2022] Open
Abstract
Background Substance use has spiked during the COVID-19 pandemic, highlighting potential links between reactivity to pandemic-related stress and increases in substance use engagement. Leveraging population-level exposure to a novel environmental stressor, the current study investigated whether emotion reactivity measured prior to the pandemic predicts the degree to which COVID-related stress impacts future substance use during the pandemic. Methods Participants included 240 socioeconomically diverse adults (M/SDage=33.47/9.39 years old) who were recruited from communities disproportionately impacted by the pandemic, with COVID-19 positivity and unemployment rates higher than the national average. All participants completed a research study prior to the start of the pandemic, and 90 of those participants were randomly selected to complete a follow-up study approximately six months into the pandemic. Results On average, the sample reported high levels of stressors that they attributed specifically to the COVID-19 pandemic. Results revealed that trait emotional reactivity moderated the impact of pandemic-inflicted stressors on future substance use, such that COVID-related stress exposure was associated with an increase in substance use for individuals who tend to experience negative emotions for prolonged periods of time. Limitations Limitations of the study are that the data were collected in a fixed timeframe of the COVID-19 pandemic and the exclusive use of self-report measures. Conclusions The longitudinal design of the present study extends the current literature by highlighting the potential role of emotional reactivity in predicting substance use coping behaviors. Findings suggest that emotion reactivity may be a useful intervention target among individuals highly impacted by the pandemic.
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Affiliation(s)
- Nadia Bounoua
- Department of Psychological and Brain Sciences, University of Delaware, United States
| | - Naomi Sadeh
- Department of Psychological and Brain Sciences, University of Delaware, United States
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Cohen RL, Drewes JL, Queen SE, Freeman ZT, Pate KM, Adams RJ, Graham DR, Hutchinson EK. Elucidation of the Central Serotonin Metabolism Pathway in Rhesus Macaques ( Macaca mulatta) with Self-injurious Behavior. Comp Med 2021; 71:466-473. [PMID: 34794530 PMCID: PMC8715763 DOI: 10.30802/aalas-cm-21-000020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/10/2021] [Accepted: 07/30/2021] [Indexed: 11/05/2022]
Abstract
Macaques with self-injurious behavior (SIB) have been used as a model of human SIB and have previously been shown to respond to treatments targeting enhancement of central serotonin signaling, whether by supplementation with tryptophan, or by inhibiting synaptic reuptake. Decreased serotonin signaling in the brain has also been implicated in many human psychopathologies including major depression disorder. A disturbance in tryptophan metabolism that moves away from the production of serotonin and toward the production of kynurenine has been proposed as a major etiological factor of depression. We hypothesized that in macaques with SIB, central tryptophan metabolism would be shifted toward kynurenine production, leading to lower central serotonin (5-hydroxytryptamine). We analyzed tryptophan metabolites in the cerebral spinal fluid (CSF) of macaques with and without SIB to determine whether and where tryptophan metabolism is altered in affected animals as compared with behaviorally normal controls. We found that macaques with SIB had lower CSF concentrations of serotonin than did behaviorally normal macaques, and that these deficits were inversely correlated with the severity of abnormal behavior. However, our results suggest that this decrease is not due to shifting of the tryptophan metabolic pathway toward kynurenine, as concentrations of kynurenine were also low. Concentrations of IL6 were elevated, suggesting central inflammation. Determining the mechanism by which serotonin function is altered in self-injurious macaques could shed light on novel therapies for SIB and other disorders of serotonin signaling.
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Key Words
- 3hk, 3-hydroxykynurenine
- 5hiaa, 5-hydroxyindoleacetic acid
- 5-ht, serotonin
- d, depression
- ido, indoleamine 2,3-dioxygenase enzyme
- mrm, multiple reaction monitoring
- nhps, nonhuman primates
- nsf, no significant findings
- ptsd, post-traumatic stress disorder
- tdo, sd, suicidal depression
- sib, self-injurious behavior
- tryptophan 2,3-dioxygenase enzyme
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Affiliation(s)
- Rachael L Cohen
- Department of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Julia L Drewes
- Division of Infectious Diseases, Department of Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Suzanne E Queen
- Department of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Zachary T Freeman
- Unit for Laboratory Animal Medicine, University of Michigan, Ann Arbor, MI
| | - Kelly Metcalf Pate
- Department of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD
- Division of Comparative Medicine, Massachusetts Institute of Technology, Cambridge, MA
| | - Robert J Adams
- Department of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - David R Graham
- Anesthesiology and Critical Care Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD
| | - Eric K Hutchinson
- Department of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD;,
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Moore LH, Grubbs JB. Gambling Disorder and comorbid PTSD: A systematic review of empirical research. Addict Behav 2021; 114:106713. [PMID: 33268184 DOI: 10.1016/j.addbeh.2020.106713] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2020] [Revised: 09/28/2020] [Accepted: 10/12/2020] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Gambling Disorder (GD) and Posttraumatic Stress Disorder (PTSD) are frequently comorbid and often associated with a more severe clinical profile compared to those with either diagnosis alone. Despite recent growing interest in this comorbidity, there has been little effort to synthesize this domain of research and define areas of need for future research. DESIGN The present work details a systematic review of empirical studies examining the relationship between PTSD and GD-related factors. This review encompassed 74 studies each examining the overlap between GD and the following domains: PTSD, Trauma, Adverse Childhood Experiences, and Stressful Life Events. FINDINGS The included studies yielded 91 independent samples each providing associations between the above-mentioned constructs. The present work found that stress, trauma, and symptom severity of PTSD each influence the severity of both GD and subclinical levels of GD. The severity, type, and time at which trauma occurs in the lifespan all appear to influence the predictive strength of trauma on GD severity. However, PTSD symptoms appear to have a greater impact on GD severity compared to trauma alone. CONCLUSION PTSD symptoms result in increased severity of GD, and pathological dissociation plays a particularly important role in exacerbating this relationship. Clinical and etiological implications, as well as direction for future research from these findings, are revealed and discussed.
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Affiliation(s)
- Louis H Moore
- Bowling Green State University, Department of Psychology, United States.
| | - Joshua B Grubbs
- Bowling Green State University, Department of Psychology, United States.
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10
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Contractor AA, Jin L, Weiss NH, O'Hara S. A psychometric investigation on the diagnostic utility of the posttrauma risky behaviors questionnaire. Psychiatry Res 2021; 296:113667. [PMID: 33360968 PMCID: PMC7855932 DOI: 10.1016/j.psychres.2020.113667] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/19/2020] [Indexed: 11/21/2022]
Abstract
The Posttrauma Risky Behaviors Questionnaire (PRBQ) is a screening measure for posttrauma reckless and self-destructive behaviors (RSDBs). We examined (1) PRBQ's predictive relations with clinical (vs. not) endorsements of distinct RSDBs, and (2) PRBQ's optimal cutoff score yielding the most appropriate balance of sensitivity and specificity statistics. The sample included 354 adult trauma-exposed community participants (Mage=35.76 years; 57.90% female). Logistic regression analyses indicated that the PRBQ significantly differentiated individuals endorsing (vs. not) clinical levels of alcohol/drug misuse, disordered eating, problematic gambling, and compulsive buying. Receiver operating characteristic (ROC) curve analyses indicated that the 14-item PRBQ total score had moderate accuracy in differentiating individuals endorsing clinical vs. non-clinical levels of drug misuse, disordered eating, problematic gambling, compulsive buying, and engagement in RSDBs (PTSD's E2 Criterion); and low accuracy for alcohol misuse. ROC curve analyses indicated 3.5-6.5 as the optimal range of PRBQ cutoff scores. Thus, the PRBQ has good ability to discriminate participants endorsing (vs. not) clinical levels of alcohol/drug misuse, disordered eating, problematic gambling, and compulsive buying (lowest accuracy in identifying participants with clinical levels of alcohol misuse), and a minimum cutoff score between 3.5 and 6.5 may suggest using additional diagnostic assessments and clinical interventions.
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Affiliation(s)
- Ateka A Contractor
- Department of Psychology, University of North Texas, 369 Terrill Hall, Denton, TX, USA.
| | - Ling Jin
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Seanne O'Hara
- Department of Psychology, University of North Texas, Denton, TX, USA
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Lowe SR, Raker EJ, Arcaya MC, Zacher ML, Waters MC, Rhodes JE. A Life-Course Model of Trauma Exposure and Mental Health Among Low-Income Survivors of Hurricane Katrina. J Trauma Stress 2020; 33:950-961. [PMID: 32816358 PMCID: PMC7725975 DOI: 10.1002/jts.22581] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 05/11/2020] [Accepted: 06/10/2020] [Indexed: 12/26/2022]
Abstract
Prior research has provided robust evidence that exposure to potentially traumatic events (PTEs) during a disaster is predictive of adverse postdisaster mental health outcomes, including posttraumatic stress symptoms (PTSS) and nonspecific psychological distress (PD). However, few studies have explored the role of exposure to other PTEs over the life-course in shaping postdisaster mental health. Based on the broader literature on trauma exposure and mental health, we hypothesized a path analytic model linking predisaster PTEs to long-term postdisaster PTSS and PD via predisaster PD, short-term postdisaster symptoms, and disaster-related and postdisaster PTEs. We tested this model using data from the Resilience in Survivors of Katrina study, a longitudinal study of low-income, primarily non-Hispanic Black mothers exposed to Hurricane Katrina and assessed before the disaster and at time points 1, 4, and 12 years thereafter. The models evidenced a good fit with the data, RMSEA < .01-.04, CFIs > .99. In addition, 44.1%-67.4% of the effect of predisaster PTEs on long-term postdisaster symptoms was indirect. Descriptive differences were observed across models that included PTSS versus PD, as well as models that included all pre- and postdisaster PTEs versus only those that involved assaultive violence. The results suggest the importance of incorporating disaster preparedness in clinical work with trauma survivors and the value in attending to other lifetime PTEs when working in postdisaster contexts.
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Affiliation(s)
- Sarah R. Lowe
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, USA
| | - Ethan J. Raker
- Department of Sociology, Harvard University, Cambridge, Massachusetts, USA
| | - Mariana C. Arcaya
- Department of Urban Studies, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Meghan L. Zacher
- Population Studies and Training Center, Brown University, Providence, Rhode Island, USA
| | - Mary C. Waters
- Department of Sociology, Harvard University, Cambridge, Massachusetts, USA
| | - Jean E. Rhodes
- Department of Psychology, University of Massachusetts Boston, Boston, Massachusetts, USA
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Cowlishaw S, Metcalf O, Lawrence-Wood E, Little J, Sbisa A, Deans C, O'Donnell M, Sadler N, Van Hooff M, Crozier M, Battersby M, Forbes D, McFarlane AC. Gambling problems among military personnel after deployment. J Psychiatr Res 2020; 131:47-53. [PMID: 32920277 DOI: 10.1016/j.jpsychires.2020.07.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/18/2020] [Accepted: 07/25/2020] [Indexed: 12/01/2022]
Abstract
Military and veteran populations may exhibit heightened vulnerability to gambling problems; however, there is scant relevant evidence outside the US, and few studies of transition periods, including return from operational deployment. The aim of this study was thus to highlight the extent, risk-factors, and implications of gambling problems among current members of the Australian Defence Force (ADF) following deployment to the Middle East Area of Operations (MEAO). It involved analyses of data from n = 1324 ADF personnel who deployed between 2010 and 2012, and completed surveys within four months of returning to Australia. The Problem Gambling Severity Index (PGSI) identified Problem Gambling (PG: PGSI ≥5) and At-Risk Gambling (ARG: PGSI 1-4), alongside measures of Depression (PHQ-9), Posttraumatic Stress Disorder (PCL-C), alcohol use problems (AUDIT), distress (K10), and post-deployment stressors. Analyses indicated that 7.7% of personnel reported at least some gambling problems post-deployment, including 2.0% that were distinguished by PG, and 5.7% indicating ARG. These figures were comparable to conditions including probable depression and alcohol dependence, while levels of any gambling problems were high relative to harmful drinking. Higher levels were observed among personnel who were aged 18-24, reported 0-4 years of military service, served in the Army, and comprised Non-Commissioned Officers/Other Ranks. There were strong associations with gambling problems and various indicators of mental health and wellbeing, and self-reported post-deployment difficulties. The findings indicate that gambling problems are salient concerns for some Australian military personnel post-deployment, and highlight the need for increased recognition and responses to these problems.
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Affiliation(s)
- Sean Cowlishaw
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia; Population Health Sciences, Bristol Medical School, University of Bristol, United Kingdom.
| | - Olivia Metcalf
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Ellie Lawrence-Wood
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Jonathon Little
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Alyssa Sbisa
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Carolyn Deans
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Meaghan O'Donnell
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Nicole Sadler
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Miranda Van Hooff
- Australian Centre for Excellence in Posttraumatic Stress, The Road Home, The Hospital Research Foundation, Australia
| | - Matilda Crozier
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Malcolm Battersby
- College of Medicine and Public Health, Flinders University, Australia
| | - David Forbes
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia
| | - Alexander C McFarlane
- Phoenix Australia Centre for Posttraumatic Mental Health, Department of Psychiatry, The University of Melbourne, Australia; University of Adelaide, Adelaide, Australia
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Chang MC, Park D. Incidence of Post-Traumatic Stress Disorder After Coronavirus Disease. Healthcare (Basel) 2020; 8:E373. [PMID: 33008081 PMCID: PMC7712968 DOI: 10.3390/healthcare8040373] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 12/20/2022] Open
Abstract
Background: The coronavirus disease (COVID-19) emerged from China and rapidly spread to many other countries. In this study, we investigated the prevalence of post-traumatic stress disorder (PTSD) among patients with COVID-19 who were treated and discharged from a university hospital in Daegu, Korea. Methods: In total, 64 patients who were diagnosed with COVID-19 and then hospitalized, treated and discharged from the university hospital between February and April 2020 participated in our study. We conducted telephone interviews with the participants and evaluated the presence of PTSD using the Post-Traumatic Stress Disorder Checklist-5 (PCL-5) based on the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; score range: 0-80). If a score of ≥33 was obtained, then a diagnosis of PTSD was made. We analyzed the association between PTSD and demographic and clinical characteristics using the Mann-Whitney U and chi-square tests. Results: In total, 13 patients had a PCL-5 score of ≥33, which indicated that 20.3% (n = 64) of the patients had PTSD. No significant differences were observed in demographic characteristics, including, sex, age, hospitalization time and duration after discharge, between patients with PTSD and those without PTSD. Conclusions: The prevalence rate of PTSD was 20.3% in patients with COVID-19 who had been hospitalized, treated and discharged. Accordingly, clinicians should be aware of the high possibility of PTSD among COVID-19 patients. Mental health interventions supporting the mental health of patients should be provided to affected patients.
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Affiliation(s)
- Min Cheol Chang
- Department of Physical Medicine and Rehabilitation, College of Medicine, Yeungnam University, Daegu 38541, Korea;
| | - Donghwi Park
- Department of Physical Medicine and Rehabilitation, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan 44033, Korea
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Oe M, Kobayashi Y, Ishida T, Chiba H, Matsuoka M, Kakuma T, Frewen P, Olff M. Screening for psychotrauma related symptoms: Japanese translation and pilot testing of the Global Psychotrauma Screen. Eur J Psychotraumatol 2020; 11:1810893. [PMID: 33062213 PMCID: PMC7534387 DOI: 10.1080/20008198.2020.1810893] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 06/24/2020] [Accepted: 07/03/2020] [Indexed: 12/14/2022] Open
Abstract
Background: The impact of traumatic experiences or adverse life experiences has been shown to potentially affect a wide range of mental health outcomes. However, there was no brief instrument to screen for a range of psychological problems in different domains after a potentially traumatic event, and for risk factors and protective factors. Objective: The aim of this study is to examine the internal consistency and concurrent validity of the Japanese version of the Global Psychotrauma Screen (GPS) in a traumatized sample in Japan. Method: A total sample (n = 58) with varying levels of potential posttrauma symptoms due to domestic violence or other events were recruited into this study. Self-rating measures of posttraumatic stress disorder (PTSD), depression, anxiety, and alcohol problems were conducted to investigate the concurrent validity. Results: The results show that a range of posttrauma symptoms assessed by the GPS were highly endorsed by this traumatized sample in all domains except for self-harm, derealization, and depersonalization. The GPS sum score was highly correlated (r > 0.79) with other measures of PTSD, depression, and anxiety symptoms. Also, the subdomain scores showed acceptable correlations with corresponding domain measures. Participants who had been sexually assaulted or had unwanted sexual experiences, and participants who had been physically assaulted during childhood, had higher scores on the total GPS and on subdomains of PTSD, as well as symptoms associated with Complex PTSD. Conclusions: This study provides an initial indication that the GPS may be a useful screening tool for trauma survivors and elucidates that the consequences of trauma are not limited to PTSD.
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Affiliation(s)
- Misari Oe
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Yudai Kobayashi
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Tetsuya Ishida
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Hiromi Chiba
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | - Michiko Matsuoka
- Department of Neuropsychiatry, Kurume University School of Medicine, Kurume, Fukuoka, Japan
| | | | - Paul Frewen
- Department of Psychiatry, Western University, London, Canada
| | - Miranda Olff
- Department of Psychiatry, Amsterdam UMC, Amsterdam
Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
- ARQ National Psychotrauma Centre, Diemen, The Netherlands
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15
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Banducci AN, Contractor AA, Weiss NH, Dranger P. Do positive memory characteristics relate to reckless behaviours? an exploratory study in a treatment-seeking traumatised sample. Memory 2020; 28:950-956. [PMID: 32633631 PMCID: PMC7484292 DOI: 10.1080/09658211.2020.1788603] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 06/13/2020] [Indexed: 10/23/2022]
Abstract
Reckless and self-destructive behaviours (RSDBs), common among traumatised individuals, are associated with negative health consequences. Gaining a stronger understanding of factors associated with an increased likelihood of RSDBs among traumatised individuals offers potential new avenues for research and treatment. Mounting evidence indicates relations between traumatic experiences and deficits/disturbances in characteristics of positive memories; however, relations between RSDBs and positive memory characteristics has been understudied. Using hierarchical multiple regression, we examined relations between positive memory characteristics (Memory Experiences Questionnaire-Short Form; MEQ-SF) and RSDBs, controlling for PTSD and depression severity, among a sample of treatment-seeking trauma-exposed individuals (N = 77; Mage = 33.96; 57.10% female). Results indicated that MEQ-SF subscales of Accessibility, Coherence, Emotional Intensity, and Sensory Details were significantly associated with engagement in RSDBs, above and beyond PTSD and depressive severity. Those who easily accessed emotionally evocative positive memories tended to engage in elevated RSDBs; those with less coherence and fewer sensory details in their positive memories were also more likely to engage in RSDBs. Theories related to emotion dysregulation and cognitive deficits may explain these obtained relations.
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Affiliation(s)
- Anne N Banducci
- The National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA
- Boston University School of Medicine, Boston, MA, USA
| | | | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Paula Dranger
- Counseling Services, Valparaiso University, Valparaiso, IN, USA
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16
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Carmassi C, Dell'Oste V, Pedrinelli V, Barberi FM, Rossi R, Bertelloni CA, Dell'Osso L. Is Sexual Dysfunction in Young Adult Survivors to the L'Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective. J Sex Med 2020; 17:1770-1778. [PMID: 32641255 DOI: 10.1016/j.jsxm.2020.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 04/02/2020] [Accepted: 05/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Mental disorders are frequently related to sexual dysfunction (SD) but scant data are still available on trauma-related disorders, particularly post-traumatic stress disorder (PTSD). AIM To evaluate the relationships between SD and PTSD in 2009 L'Aquila (Italy) earthquake young adult survivors, with particular attention to gender differences. METHODS Five hundred twelve high-school senior students were assessed 21 months after exposure by the following: Trauma and Loss Spectrum-Self-Report (TALS-SR), for post-traumatic spectrum symptoms; Mood Spectrum-Self-Report (MOODS-SR) lifetime version, for mood spectrum symptoms (including SD-related symptoms). Descriptive and inferential statistics were adopted. OUTCOMES TALS-SR and MOODS-SR scores were analyzed to evaluate PTSD- and SD-related symptoms. RESULTS Around 6.5% of subjects reported SD-related symptoms with males showing higher rates than females in each symptom, with a statistically significant difference in item n = 154 (…less sexually active). Survivors with symptomatological PTSD reported rates up to 10%, with higher ratio of endorsing at least one SD-related symptom than with NO-PTSD. Significantly higher total MOODS-SR SD-related symptom scores emerged in survivors with symptomatological PTSD than in those with NO-PTSD, and a 2-way ANOVA showed a significant main effect of symptomatological PTSD and gender and gender × PTSD interaction. CLINICAL IMPLICATIONS SD-related symptoms are reported among young adult survivors to earthquake exposure and the number of symptoms is related to PTSD, particularly in males, suggesting the need for accurate evaluation. STRENGTHS & LIMITATIONS Strengths are the large sample of young adult survivors to a massive natural disaster; the long-time frame from exposure corroborating the role of PTSD; the assessment of symptoms specifically occurring after exposure. Limitations are as follows: the lack of a specific scale for SD; the self-report instruments other than clinical interviews, that may be less accurate; the lack of information on the presence of somatic illness and other mental disorders; the lack of a control group; the young age of the sample because of the lifetime sexual experiences of the subjects, in addition to the lack of a comparison measure of sexual functioning before the earthquake. CONCLUSIONS Our results highlight relevant rates of SD-related symptoms in young adults exposed to the L'Aquila earthquake, particularly males and subjects with PTSD, suggesting SD may represent a specific male gender-related somatic complaint. Our results highlight the need for accurate investigation of SD in such population to improve clinical management and appropriate treatment. Carmassi C, Dell'Oste V, Pedrinelli V, et al. Is Sexual Dysfunction in Young Adult Survivors to the L'Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective. J Sex Med 2020;17:1770-1778.
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Affiliation(s)
- Claudia Carmassi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Valerio Dell'Oste
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy.
| | - Virginia Pedrinelli
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Filippo Maria Barberi
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Rodolfo Rossi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Carlo Antonio Bertelloni
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
| | - Liliana Dell'Osso
- Department of Clinical and Experimental Medicine, Section of Psychiatry, University of Pisa, Pisa, Italy
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17
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Sommer JL, El-Gabalawy R, Contractor AA, Weiss NH, Mota N. PTSD's risky behavior criterion: Associated risky and unhealthy behaviors and psychiatric correlates in a nationally representative sample. J Anxiety Disord 2020; 73:102247. [PMID: 32502805 DOI: 10.1016/j.janxdis.2020.102247] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2019] [Revised: 05/15/2020] [Accepted: 05/22/2020] [Indexed: 02/06/2023]
Abstract
Criterion E2 ("reckless or self-destructive behavior") was added to the DSM-5 posttraumatic stress disorder (PTSD) criteria to reflect the established association between PTSD and risky and unhealthy behaviors (RUBs); however, previous research has questioned its clinical significance. To determine whether criterion E2 adequately captures reckless/self-destructive behavior, we examined the prevalence and associations of RUBs (e.g., substance misuse, risky sexual behaviors) with criterion E2 endorsement. Further, we examined associations between criterion E2 and psychiatric conditions (e.g., depressive disorders, anxiety disorders) in a population-based sample of trauma-exposed adults. We analyzed data from the 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions (N = 36,309). The Alcohol Use Disorder and Associated Disabilities Interview Schedule-5 assessed lifetime DSM-5 psychiatric conditions and self-reported RUBs. Among trauma-exposed adults (n = 23,936), multiple logistic regressions examined criterion E2's associations with RUBs and psychiatric conditions. After adjusting for covariates, all RUBs were associated with E2 endorsement (AOR range: 1.58-3.97; most prevalent RUB among those who endorsed E2: greater substance use than intended [57.0 %]) except binge eating, and E2 endorsement was associated with increased odds of PTSD, bipolar disorder, substance use disorders, and schizotypal, borderline, and antisocial personality disorders (AOR range: 1.65-2.75), and decreased odds of major depressive disorder (AOR = 0.76). Results support the clinical significance of criterion E2 through identifying associated RUBs and distinct correlates. These results may inform screening and intervention strategies for at-risk populations.
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Affiliation(s)
- Jordana L Sommer
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, 671 William Avenue, Winnipeg, Manitoba, R3E 0Z2, Canada; Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2, Canada
| | - Renée El-Gabalawy
- Department of Anesthesiology, Perioperative and Pain Medicine, University of Manitoba, 671 William Avenue, Winnipeg, Manitoba, R3E 0Z2, Canada; Department of Psychology, University of Manitoba, 190 Dysart Road, Winnipeg, Manitoba, R3T 2N2, Canada; Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada; Department of Psychiatry, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada
| | - Ateka A Contractor
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX, 76203, United States
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, 142 Flagg Road, Kingston, RI, 02881, United States
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada; Department of Psychiatry, University of Manitoba, 771 Bannatyne Avenue, Winnipeg, Manitoba, R3E 3N4, Canada.
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18
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Armour C, Greene T, Contractor AA, Weiss N, Dixon-Gordon K, Ross J. Posttraumatic Stress Disorder Symptoms and Reckless Behaviors: A Network Analysis Approach. J Trauma Stress 2020; 33:29-40. [PMID: 32086982 DOI: 10.1002/jts.22487] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 10/21/2019] [Accepted: 12/10/2019] [Indexed: 12/17/2022]
Abstract
Existing literature indicates a theoretical and empirical relation between engagement in reckless behaviors and posttraumatic stress disorder (PTSD). Thus, the DSM-5 revision of the PTSD nosology added a new "reckless or self-destructive behavior" (RSDB) symptom (Criterion E2). The current study applied a network analytic approach to examine the item-level relations among a range of reckless behaviors and PTSD symptom clusters. Participants were recruited from Amazon's Mechanical Turk (N = 417), and network analysis was conducted with 20 variables: six PTSD symptom clusters, corresponding to the hybrid model of PTSD (Armour et al., 2015) and excluding the externalizing behavior cluster (Community 1), and 14 items related to reckless behavior (Community 2). The results showed that the network associations were strongest within each construct (i.e., within PTSD and within reckless behaviors), although several bridge connections (i.e., between PTSD clusters and reckless behaviors) were identified. Most reckless behavior items had direct associations with one or more PTSD symptom clusters. The present findings support the existence of close relations between a variety of reckless behaviors and PTSD symptom clusters beyond their relations with DSM Criterion E2. The results provide testable hypotheses about the associations between specific reckless behaviors and PTSD symptom clusters, which may inform future research.
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Affiliation(s)
- Cherie Armour
- School of Psychology, Queen's University Belfast, Northern Ireland, United Kingdom
| | - Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | | | - Nicole Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| | - Katherine Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Jana Ross
- School of Psychology, Queen's University Belfast, Northern Ireland, United Kingdom
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19
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Contractor AA, Weiss NH, Kearns NT, Caldas SV, Dixon-Gordon K. Assessment of PTSD's E2 Criterion: Development, Pilot Testing, and Validation of the Posttrauma Risky Behaviors Questionnaire. INTERNATIONAL JOURNAL OF STRESS MANAGEMENT 2019; 27:292-303. [PMID: 33767575 PMCID: PMC7989649 DOI: 10.1037/str0000145] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Nathan T Kearns
- Department of Psychology, University of North Texas, Denton, TX, USA
| | | | - Katherine Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, MA, USA
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20
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Kolacz J, Kovacic KK, Porges SW. Traumatic stress and the autonomic brain-gut connection in development: Polyvagal Theory as an integrative framework for psychosocial and gastrointestinal pathology. Dev Psychobiol 2019; 61:796-809. [PMID: 30953358 DOI: 10.1002/dev.21852] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 02/12/2019] [Accepted: 02/23/2019] [Indexed: 12/14/2022]
Abstract
A range of psychiatric disorders such as anxiety, depression, and post-traumatic stress disorder frequently co-occur with functional gastrointestinal (GI) disorders. Risk of these pathologies is particularly high in those with a history of trauma, abuse, and chronic stress. These scientific findings and rising awareness within the healthcare profession give rise to a need for an integrative framework to understand the developmental mechanisms that give rise to these observations. In this paper, we introduce a plausible explanatory framework, based on the Polyvagal Theory (Porges, Psychophysiology, 32, 301-318, 1995; Porges, International Journal of Psychophysiology, 42, 123-146, 2001; Porges, Biological Psychology, 74, 116-143, 2007), which describes how evolution impacted the structure and function of the autonomic nervous system (ANS). The Polyvagal Theory provides organizing principles for understanding the development of adaptive diversity in homeostatic, threat-response, and psychosocial functions that contribute to pathology. Using these principles, we outline possible mechanisms that promote and maintain socioemotional and GI dysfunction and review their implications for therapeutic targets.
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Affiliation(s)
- Jacek Kolacz
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, Indiana
| | - Katja K Kovacic
- Division of Pediatric Gastroenterology, Hepatology & Nutrition, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Stephen W Porges
- Traumatic Stress Research Consortium at the Kinsey Institute, Indiana University, Bloomington, Indiana.,Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
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21
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Kerig PK. Linking childhood trauma exposure to adolescent justice involvement: The concept of posttraumatic risk‐seeking. CLINICAL PSYCHOLOGY-SCIENCE AND PRACTICE 2019. [DOI: 10.1111/cpsp.12280] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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22
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Grant JE, Lust K, Christenson GA, Redden SA, Chamberlain SR. Gambling and its clinical correlates in university students. Int J Psychiatry Clin Pract 2019; 23:33-39. [PMID: 29426260 PMCID: PMC5955216 DOI: 10.1080/13651501.2018.1436715] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE This study sought to examine the prevalence of gambling disorder (GD) in a university sample and its associated physical and mental health correlates. METHODS A 156-item anonymous online survey was distributed via random email generation to a sample of 9449 university students. Current use of alcohol and drugs, psychological and physical status and academic performance were assessed, along with questionnaire-based measures of impulsivity and compulsivity. Positive screens for GD were based upon individuals meeting DSM-5 criteria. RESULTS A total of 3421 participants (59.7% female) were included in the analysis. The overall prevalence of GD was 0.4%, while an additional 8.4% reported subsyndromal symptoms of GD. GD was significantly associated with past-year use of cocaine, heroin/opiate pain medications, sedatives, alcohol and tobacco. Those with GD were more likely to have generalized anxiety, PTSD and compulsive sexual behavior. Questionnaire-based measures revealed higher levels of both compulsivity and impulsivity associated with disordered gambling. CONCLUSIONS Some level of gambling symptomatology is common in young adults and is associated with alcohol and drug use, as well as impulsive and compulsive behaviors. Clinicians should be aware of the presentation of problematic gambling and screen for it in primary care and mental health settings.
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Affiliation(s)
- Jon E Grant
- a Department of Psychiatry & Behavioral Neuroscience , University of Chicago , Chicago , IL , USA
| | - Katherine Lust
- b Boynton Health Service , University of Minnesota USA , Minneapolis , MN , USA
| | - Gary A Christenson
- b Boynton Health Service , University of Minnesota USA , Minneapolis , MN , USA
| | - Sarah A Redden
- a Department of Psychiatry & Behavioral Neuroscience , University of Chicago , Chicago , IL , USA
| | - Samuel R Chamberlain
- c Department of Psychiatry , University of Cambridge; & Cambridge and Peterborough NHS Foundation Trust (CPFT) , Cambridge , UK
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23
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Typologies of PTSD clusters and reckless/self-destructive behaviors: A latent profile analysis. Psychiatry Res 2019; 272:682-691. [PMID: 30832187 DOI: 10.1016/j.psychres.2018.12.124] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2018] [Revised: 12/22/2018] [Accepted: 12/22/2018] [Indexed: 11/20/2022]
Abstract
Posttraumatic stress disorder (PTSD) is comorbid with diverse reckless and self-destructive behaviors (RSDBs). We examined the nature and construct validity (covariates of age, gender, depression severity, number of trauma types, functional impairment) of the optimal class solution categorizing participants based on PTSD symptom and RSDB endorsement. The sample included 417 trauma-exposed individuals recruited through Amazon's MTurk platform who completed the Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, the Posttrauma Risky Behaviors Questionnaire, and Patient Health Questionnaire-9. Latent profile analyses indicated an optimal three-class solution: the Low PTSD-RSDBs, High PTSD-Low RSDBs, and High PTSD-RSDBs classes. Multinomial logistic regression indicated that impairment and depression predicted the High PTSD-Low RSDBs vs. the Low PTSD-RSDBs classes. Impairment, age, being female, and depression predicted the High vs. Low PTSD-RSDBs classes. Number of trauma types, age, being female, and depression predicted the High PTSD-RSDBs vs. High PTSD-Low RSDBs classes. Results support the presence of a reckless behaviors subtype of PTSD (characterized by greater depression, greater impariment, greater number of trauma types, being male, and being younger), conducting comprehensive assessments of RSDBs for individuals reporting PTSD symptoms and of PTSD symptoms for individuals reporting RSDBs, and the need to tailor interventions to treat PTSD and RSDBs concurrently.
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24
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Abstract
Few studies have examined problem gambling among veterans and, of those studies, there are conflicting conclusions surrounding correlates of problem gambling in veterans. Our study aims to assess problem gambling prevalence among veterans using non-Veterans Affairs data and to evaluate correlates of problem gambling among veterans in a general population sample. We obtained a probability sample of adult Massachusetts residents using address based sampling in 2013-2014. Participants completed a questionnaire on demographics, veteran status, and gambling behaviors and motivations. We identified n = 129 problem gamblers from a sample of n = 9578 participants. Of the problem gamblers who had veteran status information, 20.6% were veterans. Due to sample size limitations, we analyzed veteran problem and at-risk gamblers compared to veteran recreational gamblers. Having friends and family members engaged in gambling and engaging in more gambling formats were significantly, positively associated with veteran problem and at-risk gambler status. Participating in raffles in the past year was associated with lower odds of being a veteran problem and at-risk gambler compared to veteran recreational gamblers (OR 0.31, 95% CI 0.18-0.52). These discriminators of at-risk and problem gambling may be useful in developing clinical treatment approaches for veteran problem gamblers. Future studies should focus on changes in the prevalence of veteran problem gambling and additional correlates that may better capture social support domains and gambling activity among veterans.
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25
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Athey A, Overholser J, Bagge C, Dieter L, Vallender E, Stockmeier CA. Risk-taking behaviors and stressors differentially predict suicidal preparation, non-fatal suicide attempts, and suicide deaths. Psychiatry Res 2018; 270:160-167. [PMID: 30253320 PMCID: PMC6292776 DOI: 10.1016/j.psychres.2018.09.032] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2017] [Revised: 09/10/2018] [Accepted: 09/15/2018] [Indexed: 10/28/2022]
Abstract
Negative life events are elevated in suicidal populations. Diathesis-stress and kindling effects models suggest different mechanisms by which negative life events increase suicide risk. Different forms of negative life events - risk-taking behaviors and stressors - may have different effects on non-fatal suicide attempts and suicide. We assessed the effects of risk-taking behaviors and stressors on suicide, history of non-fatal suicide attempts, and active preparation for suicide in a sample of adults who died by suicide or other causes (N = 377). Psychological autopsy procedures using family member interviews and collateral record review were used to complete a risk-taking behaviors composite measure from the Structured Interview for DSM-IV Personality Disorders, the Modified Life Experiences Scale, and the planning subscale of the Suicide Intent Scale. Stressors were significantly associated with death by suicide, even when accounting for demographic and diagnostic characteristics. Risk-taking behaviors were significantly associated with non-fatal suicide attempts, even when accounting for demographic and diagnostic characteristics. Suicide decedents who did not actively prepare for suicide showed significantly higher risk-taking scores than suicide decedents who actively planned for suicide. Our results suggest that risk-taking behaviors and stressors impact suicide risk through separate mechanisms. Risk-taking behaviors may represent a longstanding vulnerability to act impulsively on suicidal thoughts. Stressors may impact risk for fatal suicidal behaviors in mood disordered populations.
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Affiliation(s)
- Alison Athey
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road Cleveland, OH 44106-7123, USA.
| | - James Overholser
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road Cleveland, OH 44106-7123, USA.
| | - Courtney Bagge
- Department of Psychiatry and Human Behavior, Center for Psychiatric Neuroscience, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA.
| | - Lesa Dieter
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road Cleveland, OH 44106-7123, USA.
| | - Eric Vallender
- Department of Psychiatry and Human Behavior, Center for Psychiatric Neuroscience, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA.
| | - Craig A. Stockmeier
- Department of Psychological Sciences, Case Western Reserve University, 11220 Bellflower Road Cleveland, OH 44106-7123, USA,Department of Psychiatry and Human Behavior, Center for Psychiatric Neuroscience, University of Mississippi Medical Center, 2500 N State Street, Jackson, MS 39216, USA
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26
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Watkins LE, Sippel LM, Pietrzak RH, Hoff R, Harpaz-Rotem I. Clinically Significant Change in Posttraumatic Stress Disorder Symptoms Is Associated With Lower Levels of Aggression After Residential Treatment Discharge. J Trauma Stress 2018; 31:265-272. [PMID: 29603388 DOI: 10.1002/jts.22275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2017] [Revised: 11/04/2017] [Accepted: 12/09/2017] [Indexed: 11/08/2022]
Abstract
Although the link between posttraumatic stress disorder (PTSD) and aggression has been repeatedly demonstrated, to our knowledge no research has examined whether PTSD symptom reductions are linked to less aggression after treatment. The current study aimed to address this gap in the literature by examining the association between reductions in PTSD symptoms and posttreatment aggression among 2,275 veterans in residential treatment for PTSD across 35 Veterans Health Administration sites. We estimated a multilevel model that examined the effect of clinically significant PTSD symptom change on aggression at 4-month posttreatment follow-up, and found significant within-site and between-site contextual effects of clinically significant changes in PTSD symptoms on follow-up aggression. Findings revealed that veterans who reported clinically significant changes in their PTSD symptoms had lower levels of aggression at follow-up than veterans at the same treatment site who did not report clinically significant PTSD change. After we controlled for individual clinically significant PTSD change, participants in treatment sites where the rates of clinically significant PTSD change were higher overall had lower levels of aggression at follow-up. The model explained over one-fourth of the variability in aggression, R2 = .26. Findings from the current study extend previous research that has shown associations between PTSD and aggression, by revealing that clinically significant change in PTSD during residential treatment is associated with less aggression at follow-up. These findings suggest that interventions that effectively reduce PTSD symptoms may also help reduce risk for aggression.
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Affiliation(s)
- Laura E Watkins
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Lauren M Sippel
- National Center for PTSD Executive Division, White River Junction, Vermont, USA.,Geisel School of Medicine, Dartmouth University, Hanover, New Hampshire, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Rani Hoff
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Northeast Program Evaluation Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
| | - Ilan Harpaz-Rotem
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, Connecticut, USA.,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.,Northeast Program Evaluation Center, VA Connecticut Healthcare System, West Haven, Connecticut, USA
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27
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Maniates H, Stoop TB, Miller MW, Halberstadt L, Wolf EJ. Stress-Generative Effects of Posttraumatic Stress Disorder: Transactional Associations Between Posttraumatic Stress Disorder and Stressful Life Events in a Longitudinal Sample. J Trauma Stress 2018; 31:191-201. [PMID: 29630742 PMCID: PMC5906167 DOI: 10.1002/jts.22269] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/17/2017] [Accepted: 12/26/2017] [Indexed: 11/06/2022]
Abstract
Longitudinal studies have demonstrated transactional associations between psychopathology and stressful life events (SLEs), such that psychopathology predicts the occurrence of new SLEs, and SLEs in turn predict increasing symptom severity. The association between posttraumatic stress disorder (PTSD), specifically, and stress generation remains unclear. This study used temporally sequenced data from 116 veterans (87.9% male) to examine whether PTSD symptoms predicted new onset SLEs, and if these SLEs were associated with subsequent PTSD severity. The SLEs were objectively rated, using a clinician-administered interview and consensus-rating approach, to assess the severity, frequency, and personal dependence (i.e., if the event was due to factors that were independent of or dependent on the individual) of new-onset SLEs. A series of mediation models were tested, and results provided evidence for moderated mediation whereby baseline PTSD severity robustly predicted personally dependent SLEs, B = 0.03, p = .006, and dependent SLEs predicted increases in follow-up PTSD symptom severity, B = -0.04, p = .003, among participants with relatively lower baseline PTSD severity. After we controlled for baseline PTSD severity, personality traits marked by low constraint (i.e., high impulsivity) were also associated with an increased number of dependent SLEs. Our results provide evidence for a stress-generative role of PTSD and highlight the importance of developing interventions aimed at reducing the occurrence of personally dependent stressors.
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Affiliation(s)
- Hannah Maniates
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Tawni B. Stoop
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA
| | - Mark W. Miller
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Lisa Halberstadt
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
| | - Erika J. Wolf
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System, Boston, MA, USA,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
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Sadeh N, Spielberg JM, Hayes JP. Impulsive responding in threat and reward contexts as a function of PTSD symptoms and trait disinhibition. J Anxiety Disord 2018; 53:76-84. [PMID: 29220694 DOI: 10.1016/j.janxdis.2017.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/22/2017] [Accepted: 11/01/2017] [Indexed: 11/29/2022]
Abstract
We examined current posttraumatic stress disorder (PTSD) symptoms, trait disinhibition, and affective context as contributors to impulsive and self-destructive behavior in 94 trauma-exposed Veterans. Participants completed an affective Go/No-Go task (GNG) with different emotional contexts (threat, reward, and a multidimensional threat/reward condition) and current PTSD, trait disinhibition, and risky/self-destructive behavior measures. PTSD interacted with trait disinhibition to explain recent engagement in risky/self-destructive behavior, with Veterans scoring high on trait disinhibition and current PTSD symptoms reporting the highest levels of these behaviors. On the GNG task, commission errors were also associated with the interaction of PTSD symptoms and trait disinhibition. Specifically, PTSD symptoms were associated with greater commission errors in threat vs. reward contexts for individuals who were low on trait disinhibition. In contrast, veterans high on PTSD and trait disinhibition exhibited the greatest number of commission errors in the multidimensional affective context that involved both threat and reward processing. Results highlight the interactive effects of PTSD and disinhibited personality traits, as well as threat and reward systems, as risk factors for impulsive and self-destructive behavior in trauma-exposed groups. Findings have clinical implications for understanding heterogeneity in the expression of PTSD and its association with disinhibited behavior.
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Affiliation(s)
- Naomi Sadeh
- University of Delaware, Department of Psychological and Brain Sciences, Newark, DE, United States; National Center for PTSD at VA Boston Healthcare System, Boston, MA, United States.
| | - Jeffrey M Spielberg
- University of Delaware, Department of Psychological and Brain Sciences, Newark, DE, United States
| | - Jasmeet P Hayes
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, United States; Boston University School of Medicine, Boston, MA, United States
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