Crowdsourcing Trauma: Psychopathology in a Trauma-Exposed Sample Recruited via Mechanical Turk

Associations among posttraumatic stress disorder symptoms, suicidal ideation, suicide attempts, and reward discounting

Posttraumatic stress disorder (PTSD) is associated with suicidal thoughts and behaviours. Decision-making processes and risk-taking are prominent for coping in both, but the implications for guaranteed and probabilistic reward discounting, important components in behavioural decision-making processes, are unclear. This study explored the relationships between PTSD and suicide risk with tendencies towards devaluing guaranteed rewards that are larger but delayed (i.e., delay discounting; DD) and devaluing larger but uncertain rewards (i.e., probability discounting; PD) for immediate but smaller rewards. The current study evaluated 498 participants (majority male [51.4%] and white [63.8%]; 33.3% screening positive for probable PTSD; 19.2% with lifetime suicide attempts; 30.8% with recent suicide ideation) on both delayed discounting and PD tasks. Provisional PTSD diagnosis, but not suicide attempts or ideation, was associated with increased PD (i.e., more devaluation of uncertain rewards). Conversely, PTSD interacted with both attempt history and ideation to predict increased delayed discounting (i.e., more devaluing of greater but delayed rewards). These results highlight how those with PTSD symptoms assign valuations to rewards, as well as how the addition of suicide risk interacts to impact these decision-making processes. While further research is needed, this suggests potential implications for treatment as they may benefit from structuring progress in smaller, more immediate goals.

The Cyborg Method: A Method to Identify Fraudulent Responses from Crowdsourced Data

Crowdsourcing is an essential data collection method for psychological research. Concerns about the validity and quality of crowdsourced data persist, however. A recent documented increase in the number of invalid responses within crowdsourced data has highlighted the need for quality control measures. Although a number of approaches are recommended, few have been empirically evaluated. The present study evaluated a Cyborg Method that used automated evaluation of participant meta-data and a review of short answer responses. Two samples were recruited - in the first, the Cyborg Method was applied after data collection to gauge the extent to which invalid responses were collected when a priori quality controls were absent. In the second, the Cyborg Method was applied during data collection to determine if the method would proactively screen invalid responses. Results suggested that Cyborg Method identified a substantial portion of invalid responses and both automated and human evaluation components was necessary. Furthermore, the Cyborg Method could be applied proactively to screen invalid responses and substantially reduced the per participant cost of data collection. These results suggest that the Cyborg Method is a promising means by which to collect high quality crowdsourced data.

Posttraumatic stress symptoms and risky alcohol use: The roles of negative social reactions to sexual assault disclosure and trauma-related shame

INTRODUCTION

Posttraumatic stress symptoms (PTS) and risky alcohol use (RAU) frequently co-occur among those with a history of sexual assault, and this co-occurrence has been linked to severe psychosocial and functional impairment.

OBJECTIVE

The current study examined the roles of negative social reactions to sexual assault disclosure and trauma-related shame in the association between PTS severity and RAU. This was tested by examining the separate and sequential indirect effects of negative social reactions and trauma-related shame in the PTSD-RAU relation among individuals with a history of sexual assault.

METHOD

Data were collected from 235 individuals who endorsed a history of sexual assault (Mage = 35.45, 70.5% women, 83.8% White).

RESULTS

Negative social reactions (b = .03, SE = .01, p < .05, 95% CI [.005, .06]) and trauma-related shame (b = .03, SE = .01, p < .05, 95% CI [.003, .06]), separately, and sequentially (b = .01, SE = .004, p < .05, 95% CI [.001, .02]) explained the relation between PTS severity and RAU.

CONCLUSIONS

Findings suggest that it may be valuable to assess and neutralize negative social reactions to reduce trauma-related shame and subsequent RAU among individuals with a history of sexual assault who experience more severe PTS severity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Daily-level associations between posttraumatic stress disorder symptoms and reactions to retrieving positive autobiographical memories

Trauma survivors with posttraumatic stress disorder (PTSD) report difficulties accessing and describing positive memories. To understand these patterns, we examined daily-level relations of PTSD symptoms with affective, cognitive (dwelling/rumination; pushing memory out of one's mind; suppression; avoidance; distraction; thinking about something else; remembering negative or positive memories/events; negative or positive thoughts; accepting or disapproving memory; reinterpreting memory), and behavioral (using alcohol/drugs; smoking cigarettes; cravings for or seeking out cigarettes/alcohol/drugs; craving, seeking out, or consuming large amounts of food; dissociation; engaging in risky behaviors; sharing memories; interference with ongoing task; arousal) reactions to retrieving positive memories. Eighty-eight trauma survivors (Mage= 39.89 years; 59.1% female) completed 7 daily measures of PTSD and reactions to retrieving positive memories. Days with more PTSD severity were associated with higher odds of same-day suppression, avoidance, distraction, thinking about something else, smoking cigarettes, craving substances, craving, seeking out, or consuming large amounts of food, dissociation, remembering negative memories/events/thoughts, engaging in risky behaviors, interference with ongoing tasks, and arousal (ORs=1.10-1.22); and greater negative affect (β = 0.27). Supplemental lagged analyses indicated some associations between previous-day reactions to positive memory retrieval and next-day PTSD severity and vice versa. Trauma survivors with PTSD symptoms report negative and avoidance-oriented reactions to retrieving positive memories.

Emotion-related impulsivity across transdiagnostic dimensions of psychopathology

OBJECTIVE

Several dimensions have received attention for their potential role in explaining shared variance in transdiagnostic symptoms of psychopathology. We hypothesized emotion-related impulsivity, the trait-like tendency toward difficulty restraining responses to emotion, would relate to symptoms of psychopathology, with two separable dimensions of emotion-related impulsivity relating distinctly to internalizing and externalizing symptoms.

METHOD

Across two studies, we tested hypotheses using structural equation models of emotion-related impulsivity and multiple indicators of internalizing, externalizing, and thought symptoms.

RESULTS

In Study 1 (658 undergraduates), emotion-related impulsivity was highly correlated with the general psychopathology (p) factor. In study 2 (421 Mechanical Turk participants), models did not support a general p factor; however, we replicated the hypothesized associations of emotion-related impulsivity dimensions with internalizing and externalizing factors. Across both studies, forms of emotion-related impulsivity uniquely and differentially related to internalizing and externalizing symptoms.

CONCLUSIONS

Findings indicate emotion-related impulsivity may help explain transdiagnostic dimensions of psychopathology, such as the p factor.

To Look or Not to Look: Instagram's Sensitive-Content Screens Do Not Deter Vulnerable People From Viewing Negative Content

By blurring sensitive images and providing a warning, Instagram's sensitive-content screens seek to assist users-particularly vulnerable users-in making informed decisions about what content to approach or avoid. Yet, prior research found most people (∼85%) chose to uncover a single screened negative image (Bridgland, Bellet, et al., 2022). Here, we extended on and addressed shortcomings of this previous research. Across two studies, we presented participants with a series of sensitive-content screens covering negative content that appeared among neutral and positive images; participants could choose to uncover screens (or not). We found most participants opted to uncover the first screen they came across, and many continued to uncover screens over a series of images. We also found no evidence suggesting vulnerable people (e.g., people with higher rates of depression) are more likely to avoid sensitive content: people similarly uncovered sensitive-content screens irrespective of their vulnerabilities. Thus, sensitive-content screens may be ineffective in deterring people from exposing themselves to sensitive content. Additionally, avoidance behavior, information seeking behavior, negative affect driven behavior, and positive affect driven behavior appeared to underpin participants' decisions to uncover screened content.

Online crowdsourcing to study trauma and mental health symptoms in military populations: A case for Amazon's Mechanical Turk (MTurk) platform

INTRODUCTION

Amazon's Mechanical Turk (MTurk) appears to be a reliable resource for studying clinical populations and accessing hard-to-reach populations. Recent research suggests that MTurk may also be a viable option for military recruitment.

OBJECTIVE

The goal of the current study was to examine the utility of collecting clinical data on military samples recruited via MTurk.

METHOD

Participants were 535 military veterans (Mage = 37.45; 71.8% men; 69.5% White) who completed measures assessing trauma and mental health.

RESULTS

Findings indicate that rates of military traumas and mental health diagnoses were higher than published comparisons; posttraumatic stress disorder (PTSD) and depression symptoms were found to be higher than values found in a nationally representative sample, lower than a treatment-seeking sample, and comparable to a MTurk-recruited military sample. Alcohol misuse was found to be higher than both nationally representative and treatment-seeking samples. Psychometric analyses indicated support for convergent validity of measures, and confirmatory factor analysis results demonstrated that empirically supported factor models of PTSD were replicated in the current sample; the hybrid model demonstrated the best fit.

CONCLUSIONS

Our findings support the utility of MTurk for collecting clinical data on military samples. Increasing access to and recruitment of military samples is important for advancing the field of military psychology. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A preliminary evaluation of the supportive other experiences questionnaire: Integrating the perspectives of SS providers after traumatic injury

BACKGROUND

Social support is a protective factor against the development of Posttraumatic Stress Disorder (PTSD). However, examinations of the social support after trauma have relied primarily on the self-reports of trauma survivors to the exclusion of their support providers. A new measure, the Supportive Other Experiences Questionnaire (SOEQ) was adapted from a well-established behavioral coding schema of support behaviors to capture social support experiences from the support provider perspective.

METHOD

513 Concerned Significant Others (CSOs) recruited on MTurk who had served as support providers to a traumatically injured romantic partner were recruited to respond to SOEQ candidate items and other relevant measures of psychopathology and relational factors. Factor analytic, correlational and regression analyses were conducted.

RESULTS

Confirmatory factor analytic results of SOEQ candidate items provide evidence for three support types (i.e., informational, tangible, and emotional) and two support processes (i.e., frequency, difficulty), producing a final 11-item version of the SOEQ. Evidence of convergent and discriminant validity provide good psychometric support for the measure. Evidence of construct validity was derived from support for two hypotheses: (1) difficulty providing social support is negatively associated with CSO perceptions of trauma survivor recovery, (2) social support provision frequency is positively associated with relationship satisfaction.

LIMITATIONS

Though factor loadings for support types were significant, several were small, limiting interpretability. Cross-validation in a separate sample is needed.

CONCLUSIONS

The final version of the SOEQ demonstrated promising psychometric properties, and can provide key information one the experiences of CSOs as social support providers for trauma survivors.

Religiosity and hazardous substance use: The moderating role of trauma-related shame

BACKGROUND AND OBJECTIVES

Hazardous substance use is a major public health concern among individuals with a history of sexual victimization. Although increased religiosity has been known to serve as a protective factor against hazardous substance use, religious individuals with a history of sexual victimization may be at a greater risk for hazardous substance use due to difficulties reconciling sexual victimization with their religious beliefs. Individuals with greater trauma-related shame may engage in hazardous substance use as a means of coping with the traumatic event.

METHOD

The present study consisted of 614 participants (Mage  = 34.57, 50% women).

RESULTS

Results suggested that organizational, nonorganizational, and intrinsic religiosity were positively associated with hazardous alcohol use at higher, but not lower, levels of trauma-related shame. Organizational and intrinsic religiosity were positively associated with hazardous drug use at higher, but not lower, levels of trauma-related shame.

CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE

This is the first study to examine the role of trauma-related shame in the relationship between religiosity and hazardous substance use. The findings underline the importance of targeting trauma-related shame in religious individuals with a history of sexual victimization.

The influence of trauma-related shame on the associations between posttraumatic symptoms and impulsivity facets

INTRODUCTION

The co-occurrence of posttraumatic symptoms (PTS) and impulsivity is associated with higher levels of risky and self-destructive behaviors and consequent safety and health risks. Trauma-related shame (TRS) may influence the association between PTS and impulsivity such that engaging in impulsive behaviors may serve to cope with emotional distress. Alternatively, TRS may motivate a deliberate consideration of behaviors (i.e., less impulsivity) to prevent further cognitive and emotional distress.

OBJECTIVE

The goal of the current study was to examine the influence of TRS on the associations between PTS and impulsivity facets (lack of premeditation, lack of perseverance, negative urgency, positive urgency, sensation seeking).

METHOD

Data were collected from 506 community individuals who endorsed lifetime sexual trauma (Mage = 34.56, 54.3% women, 78.7% White).

RESULTS

Findings indicated that TRS moderated associations between PTS and impulsivity facets of lack of perseverance, b = -.001, SE = .0003; t = -2.68, p = .008, 95% confidence interval [-.001, -.0002], and premeditation, b = -.001, SE = .0003; t = -3.70, p < .001, [-.002, -.001]; these associations were significant at low, but not high, levels of TRS.

CONCLUSIONS

Findings suggest that in the context of PTS, TRS may reduce certain forms of impulsivity, potentially as a means to self-protect against further cognitive and emotional distress. Findings have important implications for understanding how individuals regulate and respond to shame in the context of PTS. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Role of Emotion Dysregulation in the Relationship Between Sleep Disturbances and PTSD Symptom Severity

ABSTRACT

Emotion dysregulation is implicated in the development, maintenance, and treatment of sleep disturbances and posttraumatic stress disorder (PTSD) separately. However, few studies have assessed interactions among these variables. To address this gap, this study examined whether the associations of sleep quality and sleep quantity with PTSD severity were stronger at higher levels of negative and positive emotion dysregulation in a community sample of 199 trauma-exposed individuals. This study found that both poorer sleep quality and lower sleep quantity were associated with greater PTSD severity at low to average (but not high) levels of negative emotion dysregulation. Positive emotion dysregulation did not moderate the relationships between sleep quality or quantity and PTSD severity. Exploratory additive multiple moderation analyses showed significant associations between poorer sleep quality and lower sleep quantity with greater PTSD severity at low to average levels of negative emotion dysregulation, coupled with any level of positive emotion dysregulation. Findings inform theoretical perspectives on the sleep-PTSD relationship and clinical applications of targeting emotion dysregulation in the treatment of sleep disturbances and PTSD symptoms for trauma-exposed individuals.

Daily reciprocal relations between emotion dysregulation and non-suicidal self-injury among individuals with a history of sexual assault: The influence of posttraumatic stress symptoms

INTRODUCTION

Non-suicidal self-injury (NSSI) is a serious public health concern that can be understood within an emotion dysregulation framework. The current study adds to the literature by utilizing a micro-longitudinal design and novel statistical modeling to test reciprocal associations between emotion dysregulation and NSSI, as well as the potential moderating effect of posttraumatic stress symptoms (PTSS).

METHODS

Participants were 81 individuals with a history of sexual assault and NSSI (M_age  = 33.80; 67.9% women; 80.2% white) recruited from the community who self-reported on symptoms of emotion dysregulation and NSSI thoughts/behaviors once daily for 7 days. Average compliance rate was 72.8% (SD = 31.3%) and 34 participants (42.0%) endorsed NSSI thoughts/behaviors over the course of the study.

RESULTS

Findings revealed a significant positive effect of NSSI thoughts/behaviors on subsequent abilities to regulate negative emotions. Furthermore, while results did not detect a moderating influence of baseline PTSS on the relation between emotion dysregulation and NSSI thoughts/behaviors over time, individuals with higher baseline PTSS were found to experience heightened levels of NSSI thoughts/behaviors and emotion dysregulation on average.

CONCLUSION

Information from this study may be useful for future research and intervention development focused on the intersection of NSSI, PTSS, and emotion dysregulation.

An examination of the heterogeneity of the relationships between posttraumatic stress disorder, self-compassion and gratitude

Previous research has found both self-compassion and gratitude to be protective against overall posttraumatic stress disorder (PTSD) symptom severity. PTSD is a highly heterogeneous disorder; however, it is unclear if these protective constructs are differentially associated with each cluster of PTSD. The present study examined differences in the association of self-compassion and gratitude with the four clusters of PTSD as indicated by the DSM-5. Participants were 1424 trauma-exposed individuals recruited via Amazon's Mechanical Turk. The mean age of participants was 31.49 (SD = 11.25) years old, and 55.3% of the sample identified as female. A structural equation model (SEM) approach was used to examine relationships between factors of gratitude, self-compassion and the four PTSD symptom clusters. A two-factor model of self-compassion best fits the data. Both the self-compassion and gratitude factors were significantly associated with all symptom clusters of PTSD. Wald chi-square tests indicated self-compassion and gratitude to have the strongest association with negative alterations in cognitions and mood (NACM) PTSD symptoms. These findings may have important implications for treatment targets to reduce specific symptoms of PTSD, particularly in PTSD symptoms related to negative affect.

Daily reciprocal relations between negative and positive emotion dysregulation and posttraumatic stress symptoms among individuals with a history of sexual assault

Posttraumatic stress symptoms (PTSS) are a debilitating health concern that can develop following sexual assault. One factor central to PTSS is emotion dysregulation. However, little is known about how emotion dysregulation, particularly the dysregulation of positive (versus negative) emotions, relates to the maintenance of PTSS over time. This study aimed to address this gap in the literature by using a micro-longitudinal approach to examine daily reciprocal relations between negative and positive emotion dysregulation and PTSS. Participants were 121 individuals with a history of sexual assault (M_age = 35.27; 70.2% women; 81.0% white) recruited from the community. Participants self-reported on negative and positive emotion dysregulation as well as PTSS once daily for seven days. Findings provide support for the effects of both negative and positive emotion dysregulation on increases in next-day PTSS. Results carry important implications for PTSS assessment and intervention efforts among those with a history of sexual assault.

Intimate Partner Violence and Posttraumatic Stress Symptoms: Indirect Effects Through Negative and Positive Emotion Dysregulation

Women who experience intimate partner violence (IPV) are at heightened risk for developing posttraumatic stress (PTS). Emotion dysregulation has been linked to both IPV and PTS, separately, however, unknown is the role of emotion dysregulation in the relation of IPV to PTS among women who experience IPV. Moreover, existing investigations in this area have been limited in their focus on negative emotion dysregulation. Extending prior research, this study investigated whether physical, sexual, and psychological IPV were indirectly associated with PTS symptom severity through negative and positive emotion dysregulation. Participants were 354 women who reported a history of IPV recruited from Amazon's MTurk platform (M_age = 36.52, 79.9% white). Participants completed self-report measures assessing physical (Conflict Tactics Scale), sexual (Sexual Experiences Scale), and psychological (Psychological Maltreatment of Women) IPV; negative (Difficulties in Emotion Regulation Scale) and positive (Difficulties in Emotion Regulation Scale-Positive) emotion dysregulation; and PTS symptom severity (PTSD Checklist for DSM-5) via an online survey. Pearson's correlation coefficients examined intercorrelations among the primary study variables. Indirect effect analyses were conducted to determine if negative and positive emotion dysregulation explained the relations between physical, sexual, and psychological IPV and PTS symptom severity. Physical, sexual, and psychological IPV were significantly positively associated with both negative and positive emotion dysregulation as well as PTS symptom severity, with the exception that psychological IPV was not significantly associated with positive emotion dysregulation. Moreover, negative and positive emotion dysregulation accounted for the relationships between all three IPV types and PTS symptom severity, with the exception of positive emotion dysregulation and psychological IPV. Our findings provide support for the potential underlying role of both negative and positive emotion dysregulation in the associations of IPV types to PTS symptom severity. Negative and positive emotion dysregulation may be important factors to integrate into interventions for PTS among women who experience IPV.

Engagement, Predictors, and Outcomes of a Trauma Recovery Digital Mental Health Intervention: Longitudinal Study

BACKGROUND

Worldwide, exposure to potentially traumatic events is extremely common, and many individuals develop posttraumatic stress disorder (PTSD) along with other disorders. Unfortunately, considerable barriers to treatment exist. A promising approach to overcoming treatment barriers is a digital mental health intervention (DMHI). However, engagement with DMHIs is a concern, and theoretically based research in this area is sparse and often inconclusive.

OBJECTIVE

The focus of this study is on the complex issue of DMHI engagement. On the basis of the social cognitive theory framework, the conceptualization of engagement and a theoretically based model of predictors and outcomes were investigated using a DMHI for trauma recovery.

METHODS

A 6-week longitudinal study with a national sample of survivors of trauma was conducted to measure engagement, predictors of engagement, and mediational pathways to symptom reduction while using a trauma recovery DMHI (time 1: N=915; time 2: N=350; time 3: N=168; and time 4: N=101).

RESULTS

Confirmatory factor analysis of the engagement latent constructs of duration, frequency, interest, attention, and affect produced an acceptable model fit (χ²₂=8.3; P=.02; comparative fit index 0.973; root mean square error of approximation 0.059; 90% CI 0.022-0.103). Using the latent construct, the longitudinal theoretical model demonstrated adequate model fit (comparative fit index 0.929; root mean square error of approximation 0.052; 90% CI 0.040-0.064), indicating that engagement self-efficacy (β=.35; P<.001) and outcome expectations (β=.37; P<.001) were significant predictors of engagement (R²=39%). The overall indirect effect between engagement and PTSD symptom reduction was significant (β=-.065; P<.001; 90% CI -0.071 to -0.058). This relationship was serially mediated by both skill activation self-efficacy (β=.80; P<.001) and trauma coping self-efficacy (β=.40; P<.001), which predicted a reduction in PTSD symptoms (β=-.20; P=.02).

CONCLUSIONS

The results of this study may provide a solid foundation for formalizing the nascent science of engagement. Engagement conceptualization comprised general measures of attention, interest, affect, and use that could be applied to other applications. The longitudinal research model supported 2 theoretically based predictors of engagement: engagement self-efficacy and outcome expectancies. A total of 2 task-specific self-efficacies-skill activation and trauma coping-proved to be significant mediators between engagement and symptom reduction. Taken together, this model can be applied to other DMHIs to understand engagement, as well as predictors and mechanisms of action. Ultimately, this could help improve the design and development of engaging and effective trauma recovery DMHIs.

Elucidating the Association Between Military Sexual Trauma Types and Different Types of Risky Behaviors

Military sexual harassment (MSH) and assault (MSA) are associated with serious mental and physical health outcomes among military personnel and veterans. However, less is known about how these experiences relate to risky, impulsive, and health-compromising behaviors. The goal of the current study was to assess MSH and MSA in relation to a wide range of risky behaviors. Participants were 512 veterans in the community (M age = 41.36, 71.3% male, 71.3% white) who completed an online survey via Amazon's Mechanical Turk (MTurk). Compared to veterans who reported MSH only or no history of MST, veterans with a MSA history reported greater past-month risky behavior engagement, both overall and for specific behaviors, including problematic use of alcohol, drugs, gambling, technology, risky sexual behaviors, eating behaviors, illegal behaviors, reckless spending, physically aggressive behaviors, verbally aggressive behaviors, property destruction, reckless driving, non-suicidal self-injury, and suicidal behavior. Our findings emphasize the importance of differentiating between MSH and MSA when detecting and intervening with veterans at risk for engaging in risky behaviors.

Disclosure of suicidal thoughts and behaviors: The impact of suicide event type

OBJECTIVES

Despite its importance, limited work has investigated the nuances of suicidal thoughts and behavior self-disclosure. The present study aimed to examine potential differences in self-disclosure based on whether an individual has disclosed suicidal thinking versus behavior.

METHODS

Two hundred and four participants having disclosed their suicidal thoughts or behaviors completed a battery of online questionnaires assessing several key aspects of disclosure (i.e., disclosure recipient, perceived helpfulness of disclosure, impact on treatment seeking), as it pertained to both one's first and overall disclosure experiences.

RESULTS

Individuals who disclosed a suicide attempt, versus ideation, were more likely to have disclosed to a formal support (i.e., health professional) and to seek professional help following disclosure. No significant group differences in perceived helpfulness of experiences were found.

CONCLUSION

It may be beneficial to increase opportunities for disclosure of suicidal thinking. Overall, disclosures were perceived as helpful and may not impede future help-seeking behavior.

Posttraumatic stress disorder symptom severity modulates avoidance of positive emotions among trauma-exposed military veterans in the community

OBJECTIVE

Theoretical and empirical evidence links emotional avoidance to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms. However, few studies have tested whether these findings extend to positive emotional avoidance. Addressing this important gap in the literature, the current study examined the moderating role of PTSD symptom severity in the relation between positive emotional intensity and positive emotional avoidance.

METHOD

Participants were 465 trauma-exposed veterans recruited from the community (M_age = 38.00, 71.6% male, 69.5% White).

RESULTS

The interaction between positive emotional intensity and PTSD symptom severity on positive emotional avoidance was significant. Analysis of simple slopes revealed that positive emotional intensity was significantly positively associated with positive emotional avoidance when participants endorsed high, but not low, levels of PTSD symptom severity.

CONCLUSIONS

Veterans with more severe PTSD symptoms may utilize avoidance strategies in the context of intense positive emotions. These findings may suggest the potential need for addressing positive emotional avoidance in interventions to reduce PTSD symptom severity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Posttraumatic stress disorder symptoms associated with protective and risky behaviors for coronavirus disease 2019

OBJECTIVE

Psychiatric disorders increase risk for contracting coronavirus disease 2019 (COVID-19), but we know little about relationships between psychiatric symptoms and COVID-19 risky and protective behaviors. Posttraumatic stress disorder (PTSD) has been associated with increased propensity to engage in risky behaviors, but may also be associated with increased COVID-19 protective behaviors due to increased threat sensitivity and social isolation.

METHOD

We examined associations of PTSD symptoms with COVID-19-related protective and risky behaviors using data from a cross-sectional online United States study among 845 US adults in August through September 2020. PTSD symptoms (PTSD Checklist-5), sociodemographics, COVID-19-related experiences and vulnerabilities, and past 30-day engagement in 10 protective and eight risky behaviors for COVID-19 were assessed via self-report. We examined associations between PTSD symptoms and COVID-19 protective and risky behaviors with linear regressions, adjusting for covariates.

RESULTS

Probable PTSD and higher PTSD symptom severity were associated with greater engagement in protective behaviors, but also greater engagement in risky behaviors. Associations were only slightly attenuated by adjustment for COVID-19 exposures and perceived likelihood and severity of COVID-19. Associations varied by PTSD clusters: intrusions and arousal were associated with both more protective and more risky behaviors, whereas negative cognitions or mood was associated only with more risky, and avoidance only with more protective, behaviors.

CONCLUSION

Higher PTSD symptoms were associated with engagement in more protective but also more risky behaviors for COVID-19. Mental health should be considered in the design of public health campaigns dedicated to limiting infectious disease spread. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Metacognitive Beliefs about Uncontrollability Relate Most Strongly to Health Anxiety among U.S.-based non-Latinx White Primary Care Patients: Comparing Strength of Relations with U.S.-based non-Latinx Black and Latinx Primary Care Patients

Metacognitive beliefs have emerged as important to health anxiety, particularly beliefs that health-related thoughts are uncontrollable. Preliminary research examining generalized worry indicates uncontrollability beliefs relate more strongly to anxiety among U.S.-based self-identifying White relative to Black college students. The present study sought to extend that line of research by examining if metacognitive beliefs about the uncontrollability of health-related thoughts differentially relate to health anxiety among self-identifying non-Latinx Black (n = 123), Latinx (n = 104), and non-Latinx White (n = 80) U.S.-based primary care patients. As predicted, although positive associations were seen across all three groups, beliefs that health-related thoughts are uncontrollable more strongly related to health anxiety among White patients compared to both Black and Latinx patients. Those differential relations held in multivariate analyses while statistically controlling for positive depression screening status, generalized anxiety symptom severity, and medical morbidity. Although the effect size surrounding the differential relations was small in magnitude, the present results further support the notion that metacognitive beliefs about uncontrollability relate less strongly to anxiety among U.S.-based ethnoracial minorities compared to White individuals. Potential reasons for the differential relations are discussed, along with additional areas for future research.

The Effect of Cognitive-Affective Factors on PTSD and Alcohol Use Symptoms: An Investigation on Rumination, Suppression, and Reappraisal

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) are mental health conditions that often co-occur. The complexity of this comorbidity is well-documented, though the role of malleable cognitive-affective factors in PTSD/AUD warrants further study. Specifically, attaining a more comprehensive understanding of the role of malleable cognitive-affective factors in individuals with symptoms of PTSD/AUD may have important implications for future research, such as in treatment-seeking individuals. Extant examinations of cognitive-affective factors have demonstrated unique associations of cognitive reappraisal, expressive suppression, and rumination in PTSD symptom severity, though these effects had yet to be explored in subgroups of comorbid PTSD/AUD.Methods: In a sample of trauma-exposed individuals (n = 334) recruited to participate through an internet labor market, we first empirically examined latent subgroups of PTSD/AUD symptoms using latent profile analysis, then included expressive suppression, cognitive reappraisal, and four dimensions in the model to elucidate their role in specific profile patterns of PTSD/AUD symptom typologies.Results: Our results support a four-class model of PTSD/AUD symptoms, with unique predictive effects of expressive suppression, problem-focused thoughts, repetitive thoughts, and anticipatory thoughts on latent profile status.Conclusions: These findings may have important implications for future research focused on examining cognitive-affective patterns as they apply to intervention techniques in treatment-seeking individuals with symptoms of PTSD/AUD.

Positive emotion dysregulation and posttraumatic stress disorder symptoms: Investigating the role of anxiety sensitivity

OBJECTIVE

Posttraumatic stress disorder (PTSD) symptoms are prevalent and deleterious among individuals who have experienced a sexual assault. Although an emerging field of research has established a link between positive emotion dysregulation and PTSD symptoms, there is a limited understanding of mechanisms underlying this relation. Individuals who have experienced a sexual assault may begin to fear any arousal-related sensations via stimulus generalization, including that associated with positive emotions, which, in turn, may amplify PTSD symptoms. Thus, the current study examined the role of anxiety sensitivity in the association between positive emotion dysregulation and PTSD symptoms.

METHODS

A sample of 500 community members reporting a history of sexual assault (M_age=34.54, 54.4% male, 79.0% white) completed measures of positive emotion dysregulation, anxiety sensitivity, and PTSD symptoms.

RESULTS

Findings detected a significant indirect effect of anxiety sensitivity in the relation between positive emotion dysregulation and PTSD symptoms (β = 0.28, SE=0.03, 95% CI [0.22, 0.34]). Supplementary analyses revealed that effects held for subscales of anxiety sensitivity (i.e., cognitive, physical, social concerns) and PTSD symptom clusters (i.e., intrusions, avoidance, negative alternations in cognitions and mood, alternations in arousal and reactivity).

CONCLUSIONS

This study offers preliminary empirical support for the assertion that fear of arousal-related sensations associated with positive emotions may partially explain the link between positive emotion dysregulation and PTSD symptoms among those who have experienced a sexual assault. Information from this study could advance future research and treatment.

Sexual victimization and disordered eating among community individuals: The influence of negative and positive emotion dysregulation

OBJECTIVE

Individuals with a history of sexual victimization are at increased odds of developing an eating disorder in their lifetime. Emotion dysregulation has been identified as an outcome of sexual victimization and a vulnerability factor in the emergence and maintenance of disordered eating. However, research in this area has been limited by its narrow focus on dysregulation stemming from negative emotions. The aim of the current study was to explore the potential moderating roles of negative and positive emotion dysregulation in the relations between sexual victimization and disordered eating.

METHOD

Study participants included 473 community individuals who endorsed a history of sexual assault (M_age = 34.66; 44.8% male; 78.4% White). Participants completed measures assessing sexual victimization, negative and positive emotion dysregulation, and disordered eating. Data was collected from January to April of 2020 via Amazon's Mechanical Turk.

RESULTS

Results indicated significant positive relations among sexual victimization, negative and positive emotion dysregulation, and disordered eating. Sexual victimization was found to be more strongly associated with disordered eating at high (vs. low) levels of negative and positive emotion dysregulation.

DISCUSSION

This study provides evidence for the strengthening roles of both high negative and positive emotion dysregulation in the relation between sexual victimization and disordered eating, suggesting the potential utility of targeting both negative and positive emotion dysregulation in disordered eating interventions among individuals with a history of sexual victimization.

Posttraumatic stress disorder symptoms moderate the relation between childhood sexual abuse and disordered eating in a community sample

OBJECTIVE

Previous work has found clear associations between childhood sexual abuse (CSA) and disordered eating in adulthood. However, further research is needed to clarify factors that may influence this relationship. The current study advanced existing research by examining the moderating influence of posttraumatic stress disorder (PTSD) symptom severity in the association between CSA and disordered eating.

METHOD

Data were collected from 463 individuals with a history of sexual assault or other unwanted sexual experience(s) (M_age  = 34.71, 54.9% women, 77.5% white) who were recruited from MTurk.

RESULTS

Results indicated significant positive relations among CSA, PTSD symptom severity, and disordered eating. CSA was found to be associated with disordered eating at high, but not low, levels of PTSD symptom severity.

DISCUSSION

This study highlights the importance of assessing disordered eating and PTSD symptoms in individuals who report a history of CSA. Clinicians aiming to reduce their patients' symptoms of disordered eating may benefit from considering the potential role of PTSD symptom severity as a barrier to achieving treatment gains.

The role of emotion dysregulation in the association between posttraumatic stress disorder symptoms and suicidal thoughts and behaviors among veterans

OBJECTIVE

Although research has established a link between posttraumatic stress disorder (PTSD) symptoms and suicidal thoughts and behaviors (STBs), little is known about factors that may accentuate this relation. This study evaluated the influences of negative and positive emotion dysregulation on the association between PTSD symptoms and STBs among veterans.

METHODS

Four-hundred and sixty-five trauma-exposed military veterans in the community (M age  = 38.00, 71.4% male, 69.5% White) completed online questionnaires.

RESULTS

Negative emotion dysregulation did not moderate the relation between PTSD symptoms and STBs. Results showed significant interactive effects of PTSD symptoms and positive emotion dysregulation on STBs, such that PTSD symptoms were more strongly related to STBs at high (vs. low) levels of positive emotion dysregulation. This effect was sustained across domains of positive emotion dysregulation.

CONCLUSIONS

Findings suggest a potential need to consider positive emotion dysregulation in the assessment and treatment of STBs among veterans with PTSD symptoms.

Moderating effects of sleep difficulties on relations between posttraumatic stress disorder symptoms and positive memory count

OBJECTIVES

Posttraumatic stress disorder (PTSD) severity relates to positive memory retrieval difficulties. One variable potentially influencing this relation is sleep difficulties. We examined moderating effects of sleep difficulties (duration and quality) on relations between PTSD severity and count of specific positive memories covarying for age, gender, and depression.

METHODS

Participants were an Amazon Mechanical Turk-recruited trauma-exposed community sample of 205 respondents (M age  = 35.44; 61.40% women).

RESULTS

Moderated regression analyses indicated significant interaction effects between sleep quality (b = 0.03; p = 0.036) and PTSD severity on specific positive memory count. Among individuals reporting better sleep quality, there were negative associations between PTSD severity and specific positive memory count (b = -0.04, SE = 0.02, p = 0.010). Similar results were obtained for PTSD's intrusion and arousal clusters.

CONCLUSION

Results support targeting sleep quality and PTSD severity to improve positive memory retrieval in PTSD and memory interventions, and the importance of considering sleep when examining links between PTSD and positive memory retrieval.

The differential relation of trauma types with negative and positive emotion dysregulation

Background and Objectives: Research provides robust support for an association between traumatic exposure and emotion dysregulation. Less understood is the relation of emotion dysregulation stemming from positive emotions to traumatic exposure, or the extent to which negative and positive emotion dysregulation may be uniquely related to specific trauma types.Design and Methods: The present study explored the associations between negative and positive emotion dysregulation and specific trauma types in a community sample of 433 adults (M age = 43.81, 68.4% women).Results: Results highlighted three main findings: (1) negative and positive emotion dysregulation were significantly higher among individuals with vs. without exposure to six and nine specific trauma types, respectively; (2) negative and positive emotion dysregulation were significantly and positively related to total number of specific traumatic events; and (3) negative emotion dysregulation was significantly higher among individuals with Victimization Traumas in the overall sample as well as the no-PTSD and no-MDD subsamples, and positive emotion dysregulation was significantly lower among individuals with Accidental/Injury Traumas and Victimization Traumas in the PTSD subsample.Conclusions: Results underscore the relative and unique roles of negative and positive emotion dysregulation in trauma types; these findings may inform future research.

Quality control questions on Amazon's Mechanical Turk (MTurk): A randomized trial of impact on the USAUDIT, PHQ-9, and GAD-7

Crowdsourced psychological and other biobehavioral research using platforms like Amazon's Mechanical Turk (MTurk) is increasingly common - but has proliferated more rapidly than studies to establish data quality best practices. Thus, this study investigated whether outcome scores for three common screening tools would be significantly different among MTurk workers who were subject to different sets of quality control checks. We conducted a single-stage, randomized controlled trial with equal allocation to each of four study arms: Arm 1 (Control Arm), Arm 2 (Bot/VPN Check), Arm 3 (Truthfulness/Attention Check), and Arm 4 (Stringent Arm - All Checks). Data collection was completed in Qualtrics, to which participants were referred from MTurk. Subjects (n = 1100) were recruited on November 20-21, 2020. Eligible workers were required to claim U.S. residency, have a successful task completion rate > 95%, have completed a minimum of 100 tasks, and have completed a maximum of 10,000 tasks. Participants completed the US-Alcohol Use Disorders Identification Test (USAUDIT), the Patient Health Questionnaire (PHQ-9), and a screener for Generalized Anxiety Disorder (GAD-7). We found that differing quality control approaches significantly, meaningfully, and directionally affected outcome scores on each of the screening tools. Most notably, workers in Arm 1 (Control) reported higher scores than those in Arms 3 and 4 for all tools, and a higher score than workers in Arm 2 for the PHQ-9. These data suggest that the use, or lack thereof, of quality control questions in crowdsourced research may substantively affect findings, as might the types of quality control items.

Examining the relations among moral foundations, potentially morally injurious events, and posttraumatic stress disorder symptoms

Military veterans are exposed to unique deployment stressors that can precipitate the onset of various psychological difficulties, including the perception that an important moral standard has been transgressed (i.e., potentially morally injurious events [PMIEs]) and the development of posttraumatic stress disorder (PTSD) symptoms. Vulnerability to these outcomes may be related to individual differences in moral foundations, including those that function to protect the individual (i.e., individualizing) and those that function to protect the group (i.e., binding).

OBJECTIVE

This study examined the direct and indirect associations among moral foundations, PMIEs, and PTSD symptoms.

METHOD

Participants were 203 military veterans (M age = 35.08, 77.30% male) who completed an online survey.

RESULTS

Only the binding moral foundation was found to be significantly and positively associated with both PMIEs and PTSD symptoms. Further, the association between the binding foundation and PTSD symptoms was explained by PMIEs.

CONCLUSIONS

These findings suggest that certain moral foundations, particularly those that serve "binding" functions-loyalty, authority, and purity-may be important considerations in military mental health. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Alcohol to down-regulate negative and positive emotions: Extending our understanding of the functional role of alcohol in relation to posttraumatic stress disorder

INTRODUCTION

Functional models of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) underscore the role of internally-driven negative reinforcement. However, with the focus of these models being on negative emotions broadly, there is limited understanding of the effect of alcohol use to down-regulate specific forms of negative emotions or positive emotions generally. Among populations characterized by PTSD, there is growing evidence that positive emotions may elicit aversive reactions and thus be intentionally reduced, including via alcohol use.

OBJECTIVE

The current study examined the associations among PTSD symptom severity, alcohol use to down-regulate both negative (i.e., despondency and anger) and positive emotions, and alcohol misuse.

METHOD

Data were collected from 320 trauma-exposed, substance-using individuals in the community (M age = 35.78, 46.9% women).

RESULTS

Individuals with greater PTSD symptom severity reported significantly higher alcohol use to down-regulate despondency, anger, and positive emotions, which, in turn, were linked to greater alcohol misuse.

CONCLUSIONS

Alcohol use may serve to down-regulate both negative (i.e., despondency and anger) and positive emotions, and these functions may help to explain the association of PTSD symptom severity to alcohol misuse. PTSD-AUD models may benefit from specifying a negatively reinforcing function of alcohol use in the context of positive emotions.

A machine learning approach to modeling PTSD and difficulties in emotion regulation

Despite evidence for the association between emotion regulation difficulties and posttraumatic stress disorder (PTSD), less is known about the specific emotion regulation abilities that are most relevant to PTSD severity. This study examined both item-level and subscale-level models of difficulties in emotion regulation in relation to PTSD severity using supervised machine learning in a sample of U.S. adults (N=570). Participants were recruited via Amazon's Mechanical Turk (MTurk) and completed self-report measures of emotion regulation difficulties and PTSD severity. We used five different machine learning algorithms separately to train each statistical model. Using ridge and elastic net regression results in the testing sample, emotion regulation predictor variables accounted for approximately 28% and 27% of the variance in PTSD severity in the item- and subscale-level models, respectively. In the item-level model, four predictor variables had notable relative importance values for PTSD severity. These items captured secondary emotional responding, experiencing emotions as out-of-control, difficulties modulating emotional arousal, and low emotional granularity. In the subscale-level model, lack of access to effective emotion regulation strategies, lack of emotional clarity, and emotional nonacceptance subscales had the highest relative importance to PTSD severity. Results from analyses modeling a probable diagnosis of PTSD based on DERS items and subscales are presented in supplemental findings. Findings have implications for developing more efficient, targeted emotion regulation interventions for PTSD.

Moderating effects of dysregulation and fear of positive emotions on the relationship between posttraumatic stress disorder symptoms and positive memory count

OBJECTIVES

We examined moderating effects of positive emotion dysregulation and fear of positive emotions in the relation between posttraumatic stress disorder (PTSD) severity and positive memory count.

METHOD

Participants were 205 trauma-exposed community individuals (Mage  = 35.44; 61.50% female).

RESULTS

Moderation analyses indicated interaction effects of PTSD severity with nonacceptance of positive emotions (b = -0.01, p = .002) and difficulties with goal-directed behaviors when experiencing positive emotions (b = -0.01, p = .006) on positive memory count.

CONCLUSIONS

Greater PTSD severity was associated with more specific positive memories when individuals reported less nonacceptance of positive emotions and fewer difficulties engaging in goal-directed behaviors in the context of positive emotions. Greater PTSD severity was associated with fewer specific positive memories when individuals reported greater nonacceptance of positive emotions and greater difficulties engaging in goal-directed behaviors in the context of positive emotions. Results support addressing positive emotion dysregulation in memory-focused interventions for PTSD.

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

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

Behavioral economics and coping-related drinking motives in trauma exposed drinkers: Implications for the self-medication hypothesis

Behavioral economic theory can help researchers understand complex behavior by considering the availability and economic value associated with an individual's choices. This study explored how behavioral economic constructs relate to alcohol consumption and alcohol problems in a sample of trauma-exposed young adults. We further explored whether these behavioral economic constructs explained unique variance in alcohol outcomes beyond coping-related drinking motives. Participants were 91 trauma-exposed young adults who reported recent alcohol consumption (M_age = 26.53, female = 36.26%, non-White = 41.75%). Participants were recruited through Amazon Mechanical Turk. Questionnaires measured alcohol consumption, problems, and motives for use, as well as alcohol demand, delay discounting, future orientation, and access to environmental reward. Future orientation (ΔR2 = .05, p = .03) and delay discounting (ΔR2 = .04, p = .05) explained unique variance in alcohol problems after controlling for coping-related drinking motives. Further, alcohol demand indices (ΔR2s = .04-.10, ps = .00-.05) explained unique variance in alcohol consumption after controlling for coping-related drinking. Both coping motives and behavioral economic variables contribute to alcohol consumption and alcohol-related consequences among trauma-exposed young adults. Findings suggest that, beyond coping motives, behavioral economics may play a meaningful role in understanding alcohol misuse. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Alcohol misuse to down-regulate positive emotions: A cross-sectional multiple mediator analysis among US military veterans

INTRODUCTION

The co-occurrence of posttraumatic stress disorder (PTSD) and alcohol misuse presents a pervasive and clinically relevant concern among US military veterans.

OBJECTIVE

The current investigation sought to examine the role of positive emotion dysfunction in the relation between PTSD symptomatology and alcohol misuse. To do so, we examined the separate and sequential roles of positive emotional intensity and positive emotional avoidance in the relation between PTSD symptoms and alcohol misuse among US military veterans.

METHOD

Cross-sectional data were collected from 468 US military veterans (M age = 37.74, 70.5% male, 69.0% White) who responded to an online survey.

RESULTS

Findings suggest that positive emotional avoidance, separately, and positive emotional intensity and positive emotional avoidance, sequentially, mediated the relation between PTSD symptoms and alcohol misuse.

CONCLUSIONS

Findings advance theory on the role of positive emotions and related processes in the co-occurrence of PTSD and alcohol misuse, and highlight important avenues for future research and treatment focused on the PTSD-alcohol misuse co-occurrence.

Posttraumatic Stress Disorder Symptoms and Reckless Behaviors: A Network Analysis Approach

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.

Coping Styles Mediate the Association between Posttraumatic Stress Disorder Symptoms and Alcohol Outcomes in College Students

College students report high rates of alcohol consumption and Criterion A traumatic events, which puts them at higher risk for dangerous alcohol-related negative consequences when compared to the general population. The self-medication theory suggests coping as the potential link between substance use and psychological distress, and it has been found that ineffective coping styles are related to increased PTSD symptom severity and harmful drinking behaviors. Purpose: This study evaluated the mediating role of coping styles (i.e. problem-solving and avoidance coping) on the relationship between posttraumatic stress disorder (PTSD) symptoms and alcohol outcomes (i.e. hazardous drinking and alcohol-related negative consequences [ARNC]). Methods: A national sample of 672 traditional age (i.e. 18-25 years old; M = 22.35, SD = 1.97) college students who reported alcohol consumption in the past month were recruited via Amazon's Mechanical Turk website. Participants were 55.1% male and 60.9% White and completed measures of PTSD symptoms, coping styles, hazardous drinking, and ARNC. Results: Problem-solving coping mediated the positive relationship between PTSD symptoms and hazardous drinking such that PTSD symptoms were negatively associated with problem-solving coping, which was negatively associated with hazardous drinking. Avoidance coping mediated the positive relationship between PTSD symptoms and ARNC through a positive association between PTSD symptoms and avoidance coping. Conclusions: These novel findings highlight the importance of adaptive coping styles as a protective factor for college students experiencing co-occurring PTSD symptoms and harmful alcohol use.

Do Difficulties Regulating Positive Emotions Contribute to Risky Sexual Behavior? A Path Analysis

Within the U.S., risky sexual behavior (RSB) is the primary mode of HIV transmission. The role of emotion dysregulation in RSB has received growing attention over the past decade. However, this literature has been limited in its focus on emotion dysregulation stemming from negative (but not positive) emotions. The goal of the current study was to extend research by examining the relative and unique contributions of dimensions of difficulties regulating positive emotions (i.e., nonacceptance of positive emotions [Accept], difficulties controlling impulsive behaviors when experiencing positive emotions [Impulse], and difficulties engaging in goal-directed behaviors when experiencing positive emotions [Goals]) to RSB. Participants were 386 trauma-exposed individuals recruited from Amazon's MTurk (M age = 35.85 years; 57.5% female; 76.4% White). At the bivariate level, dimensions of difficulties regulating positive emotions were significantly positively associated with sexual risk taking with uncommitted partners, impulsive sex behaviors, and intent to engage in risky sexual behaviors (with the exception of Goals to sexual risk taking with uncommitted partners), and significantly negatively associated with risky sex acts. Regarding the unique contributions of difficulties regulating positive emotions to RSB, (1) Accept was significantly positively associated with impulsive sexual behaviors and intent to engage in risky sexual behaviors; (2) Impulse was significantly positively associated with risky anal sex acts; and (3) Goals was significantly negatively associated with risky anal sex acts. Findings suggest the potential utility of targeting difficulties regulating positive emotions in treatments aimed at reducing RSB.

Posttraumatic stress disorder and substance use: Identifying the underlying role of difficulties regulating positive emotions

The co-occurrence of posttraumatic stress disorder (PTSD) and substance use is clinically-relevant. Emotion dysregulation is one factor that has been shown to underlie this association. However, literature in this area has been limited in its exclusive focus on emotion dysregulation stemming from negative emotions. The goal of the current study was to extend prior research by exploring the role of difficulties regulating positive emotions in the associations between PTSD symptom severity and both alcohol use and problems from drug use. Participants were 463 trauma-exposed individuals recruited from Amazon's MTurk (M age = 35.66 years; 55.7% female; 76.6% White). PTSD symptom severity, difficulties regulating positive emotions, alcohol use, and problems from drug use demonstrated significant positive zero-order correlations. Further, difficulties regulating positive emotions were found to account for the associations between PTSD symptom severity and both alcohol use and problems from drug use. Our results suggest the potential utility of addressing difficulties regulating positive emotions in interventions aimed at reducing substance use and abuse among individuals with PTSD.

Relation of positive memory recall count and accessibility with post-trauma mental health

Positive memory encoding and retrieval deficits have an empirical relation with several post-trauma outcomes. Drawing from the Contractor et al. model, we examined relations between positive memory characteristics and post-trauma mental health indicators. A trauma-exposed community sample of 203 participants (Mage = 35.40 years; 61.10% female) was recruited via Amazon's Mechanical Turk. Participants completed measures of posttraumatic stress disorder (PTSD; PTSD Checklist for DSM-5), depression (Patient Health Questionnaire-9), posttraumatic cognitions (Posttraumatic Cognitions Inventory), affect (Positive and Negative Affect Schedule), count/number of recalled specific positive memories (Autobiographical Memory Test) and accessibility of a specific positive memory (i.e., subjective ease of recalling details of a memory; Memory Experiences Questionnaire-Short Form). Linear regression results indicated that PTSD intrusion severity, PTSD negative alterations in cognitions and mood (NACM) severity, PTSD alterations in arousal and reactivity (AAR) severity, self-blame, and positive affect significantly and negatively predicted the count of specific positive memories. Further, PTSD NACM severity, PTSD AAR severity, negative cognitions about the self, and negative affect significantly and negatively predicted accessibility of a specific positive memory. Thus, count/accessibility of specific positive memories was associated with several post-trauma mental health indicators; this highlights the relevance and potential impact of integrating positive memories into trauma treatment.

Confirmatory validation of the factor structure and psychometric properties of the Difficulties in Emotion Regulation Scale-Positive

OBJECTIVES

Emotion dysregulation is a transdiagnostic factor central to the etiology and treatment of various clinical difficulties. Yet, research in this area has focused almost exclusively on emotion dysregulation stemming from negative emotions. The current study confirmed the factor structure of the Difficulties in Emotion Regulation Scale-Positive (DERS-P) and further examined its reliability and validity.

METHOD

Participants in Study 1 were 229 college students (M age = 19.37 years; 66.8% female; 67.2% White). Participants in Study 2 were 353 trauma-exposed community individuals ( M age = 35.77 years; 57.8% female; 71.2% White).

RESULTS

Findings supported the three-factor structure of the DERS-P. Mean levels of the DERS-P scales demonstrated convergent and discriminant validity and differentiated individuals with (vs. without) probable posttraumatic stress disorder, depression, alcohol use, and drug use disorders.

CONCLUSIONS

Findings provide additional support for the factor structure, reliability, and validity of the DERS-P, thereby adding to its clinical utility.

Typologies of PTSD clusters and reckless/self-destructive behaviors: A latent profile analysis

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.

The symptoms at the center: Examining the comorbidity of posttraumatic stress disorder, generalized anxiety disorder, and depression with network analysis

Comorbid mental health disorders are highly common in trauma-exposed individuals with posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) among the most common co-occurring conditions. Network models of psychopathology offer a novel method to understand how this comorbidity manifests. The present study examined the presence of symptom communities (groups of highly connected symptoms) within a network of these disorders and hub symptoms (symptoms that connect such communities). Cross-sectional data were obtained from a community sample (N = 1184) of trauma exposed adults. Network analyses identified 5 communities: 1 containing all depression and GAD symptoms and 4 for PTSD. The PTSD communities corresponded to symptoms of intrusion and avoidance, hyperarousal, dysphoria, and negative affect. These communities had varying levels of connectivity to the Depression & GAD community. Symptoms of GAD (inability to relax) and PTSD (restricted or diminished positive emotion) were identified as key hub symptoms for the network. The results suggest symptoms of depression and GAD are highly interrelated and that PTSD is heterogeneous. The comorbidity among these diagnoses is thought to stem from their overlap with negative affect.