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Thomas S, Schäfer J, Kanske P, Trautmann S. Patterns of social-affective responses to trauma exposure and their relation to psychopathology. PLoS One 2024; 19:e0289664. [PMID: 38442107 PMCID: PMC10914253 DOI: 10.1371/journal.pone.0289664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 02/01/2024] [Indexed: 03/07/2024] Open
Abstract
INTRODUCTION Traumatic event exposure is a risk factor for the development and maintenance of psychopathology. Social-affective responses to trauma exposure (e.g. shame, guilt, revenge, social alienation) could moderate this relationship, but little is known about their relevance for different types of psychopathology. Moreover, the interplay of different social-affective responses to trauma exposure in predicting psychopathology is poorly understood. METHODS In a sample of N = 1321 trauma-exposed German soldiers, we examined cross-sectional associations of trauma-related social alienation, revenge, guilt and shame with depressive disorder, alcohol use disorder, posttraumatic stress disorder and dimensional measures of depression and anxiety. Latent class analysis was conducted to identify possible patterns of social-affective responses to trauma exposure, and their relation to psychopathology. RESULTS All social-affective responses to trauma exposure predicted current posttraumatic stress disorder, depressive disorder, alcohol use disorder and higher depressive and anxiety symptoms. Three latent classes fitted the data best, reflecting groups with (1) low, (2) moderate and (3) high risk for social-affective responses to trauma exposure. The low-risk group demonstrated the lowest expressions on all psychopathology measures. CONCLUSIONS Trauma-related social alienation, shame, guilt, and revenge are characteristic of individuals with posttraumatic stress disorder, depressive disorder, alcohol use disorder, and with higher anxiety and depressive symptoms. There was little evidence for distinctive patterns of social-affective responses to trauma exposure despite variation in the overall proneness to show social-affective responses. Social-affective responses to trauma exposure could represent promising treatment targets for both cognitive and emotion-focused interventions.
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Affiliation(s)
- Sarah Thomas
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Judith Schäfer
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Philipp Kanske
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Sebastian Trautmann
- Institute of Clinical Psychology and Psychotherapy, Faculty of Psychology, Technische Universität Dresden, Dresden, Germany
- Department of Psychology, Faculty of Human Science, Medical School Hamburg, Hamburg, Germany
- ICPP Institute of Clinical Psychology and Psychotherapy, Medical School Hamburg, Hamburg, Germany
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Whiteford S, Quigley M, Dighton G, Wood K, Kitchiner N, Armour C, Dymond S. Anxiety, distress tolerance, and the relationship between complex posttraumatic stress disorder symptoms and alcohol use in veterans. J Clin Psychol 2024; 80:158-169. [PMID: 37860949 DOI: 10.1002/jclp.23604] [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: 01/24/2023] [Revised: 09/07/2023] [Accepted: 09/30/2023] [Indexed: 10/21/2023]
Abstract
OBJECTIVES Little is known about whether distress tolerance and anxiety mediate the relationship between comorbid complex posttraumatic stress disorder (CPTSD) and alcohol use among military veterans. Here, we investigated the contribution of distress tolerance and anxiety on the strength of the CPTSD and alcohol use association. We hypothesized that the impact of a two-factor model of CPTSD derived from subscale scores on the International Trauma Questionnaire (ITQ)-namely ITQ PTSD and ITQ Disturbances in Self Organization (DSO; e.g., issues with affective regulation/self-belief and shame)-on alcohol use severity would be mediated by anxiety but not by distress tolerance. METHODS Participants included 403 community-dwelling United Kingdom (UK) veterans (91.64% male, Mage = 51.15 years, SD = 12.48) recruited as part of a larger, online study. RESULTS Findings indicated that the influence of CPTSD symptoms on alcohol use severity was mediated by anxiety, not by distress tolerance, with greater relative impact due to ITQ DSO status than ITQ PTSD status. CONCLUSIONS We identified the mediational influence of anxiety and distress tolerance on the association between CPTSD subscales and alcohol use in UK veterans. Interventions for anxiety may be adapted for reducing problematic alcohol use and the impact of CPTSD symptoms in veterans with comorbid PTSD and alcohol use disorder.
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Affiliation(s)
- Seb Whiteford
- School of Psychology, Swansea University, Swansea, UK
| | | | - Glen Dighton
- School of Psychology, Swansea University, Swansea, UK
| | - Katie Wood
- School of Psychology, Swansea University, Swansea, UK
| | - Neil Kitchiner
- Veterans NHS Wales, Cardiff and Vale University Health Board, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Cherie Armour
- Research Centre for Stress Trauma and Related Conditions (STARC), School of Psychology, Queen's University Belfast, Belfast, UK
| | - Simon Dymond
- School of Psychology, Swansea University, Swansea, UK
- Department of Psychology, Reykjavík University, Reykjavík, Iceland
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Na PJ, Montalvo-Ortiz J, Petrakis I, Krystal JH, Polimanti R, Gelernter J, Pietrzak RH. Trajectories of alcohol consumption in U.S. military veterans: Results from a 10-year population-based longitudinal study. Drug Alcohol Depend 2023; 246:109833. [PMID: 36963160 PMCID: PMC10811960 DOI: 10.1016/j.drugalcdep.2023.109833] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 02/18/2023] [Accepted: 02/21/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Alcohol use disorder is a public health problem, especially among US veterans. This study examined the nature and predictors of 10-year trajectories of alcohol consumption in US veterans. METHODS Data were analyzed from the 2011-2021 National Health and Resilience in Veterans Study, a nationally representative, longitudinal study of 2309 US veterans. RESULTS Latent growth mixture modeling analyses revealed four trajectories of alcohol consumption (Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]) over a 10-year period: excessive (4.1%; mean [standard deviation] AUDIT-C baseline=8.6 [2.0], slope= -0.33 [0.07]); at-risk (22.1%; baseline=4.1 [1.6], slope=0.02 [0.07]); rare (71.7%; baseline=1.2 [1.3], slope= -0.01 [0.03]); and recovering alcohol consumption (2.1%; baseline=8.4 [1.9], slope= -0.70 [0.14]). The strongest predictors of excessive vs. rare alcohol consumption group were younger age (relative variance explained [RVE]=27.8%), and lower agreeableness (RVE=27.0%); at-risk vs. rare alcohol consumption group were fewer medical comorbidities (RVE=82.3%); recovering vs. rare alcohol consumption group were greater dysphoric arousal symptoms (RVE=46.1%) and current mental health treatment (RVE=26.5%); excessive vs. at-risk alcohol consumption group were younger age (RVE=25.9%), greater dysphoric arousal symptoms of posttraumatic stress disorder (RVE=22.0%), and lower conscientiousness (RVE=19.1%); and excessive vs. recovering alcohol consumption group were current mental health treatment (RVE=61.1%) and secure attachment style (RVE=12.4%). CONCLUSIONS Over the past decade, more than 1 in 4 US veterans consumed alcohol at the at-risk-to-excessive level. Veterans who are younger, score lower on agreeableness and conscientiousness, endorse greater dysphoric arousal symptoms, and currently not engaged in mental health treatment may require close monitoring and prevention efforts to mitigate the risk of a chronic course of at-risk-to-excessive alcohol consumption.
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Affiliation(s)
- Peter J Na
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA.
| | - Janitza Montalvo-Ortiz
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Ismene Petrakis
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; National Center for PTSD, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Miethe S, Wigger J, Wartemann A, Fuchs FO, Trautmann S. Posttraumatic Stress Symptoms and its Association with Rumination, Thought Suppression and Experiential Avoidance: a Systematic Review and Meta-Analysis. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2023. [DOI: 10.1007/s10862-023-10022-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
AbstractPosttraumatic stress disorder (PTSD) is a severe mental disorder causing high individual and societal costs. The use of maladaptive emotion regulation (ER) strategies has been identified as a potential contributing factor. This meta-analysis aimed to quantify the associations between PTSD symptoms and rumination, thought suppression and experiential avoidance. The systematic literature search resulted in 5574 studies, 75 of which were included in the analysis. From those eligible studies 189 effect sizes were obtained. For symptoms of posttraumatic stress, large effects were found for associations with rumination (r = .52) and experiential avoidance (r = .48), whereas a medium effect size was found for thought suppression (r = .29). With respect to different PTSD symptom clusters, associations ranged between r = .35 and r = .41 for associations with intrusive re-experiencing, between r = .39 and r = .41 for associations with avoidance, between r = .50 and r = .53 for associations with alterations in cognitions and mood and between r = .41 and r = .45 for associations with alterations in arousal and activity. Few available studies provide some evidence that associations might be somewhat reduced but still substantial in longitudinal compared to cross-sectional studies. These findings provide valuable targets for future investigations with the long-term goal of improving targeted interventions for the prevention and treatment of PTSD symptoms.
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TSURKAN-SAIFULINA YULIIA. Social and Psychological Rehabilitation of War Veterans. SCIENTIFIC BULLETIN OF MUKACHEVO STATE UNIVERSITY SERIES “PEDAGOGY AND PSYCHOLOGY” 2022. [DOI: 10.52534/msu-pp.8(3).2022.96-104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The subject of the study is determined by the need for effective rehabilitation of war veterans and the presence of many problems of sociopsychological recovery after being in the zone of active combat operations, and the need to develop an effective rehabilitation programme for this category of people. The purpose of the study is to conduct a comprehensive analysis of the features of socio-psychological rehabilitation, identify the relationship of physiological states with individual psychological components of the individual’s functioning in specific conditions of life, determine which measures are most effective for the establishment of areas of work in the aspect of socio-psychological rehabilitation of war veterans. The basis of the methodological approach in this study is the analysis and generalisation based on the results of the examination of scientific and theoretical material, which determines the establishment of conclusions and recommendations in the field under study. The following methods of scientific knowledge are used: dialectical, logical-semantic, system-structural, functional, and logicalnormative. The study proves the direct connection between the presence of a person in a war zone and their psychoemotional state. It is considered which psychophysiological disorders can be caused by involvement in armed conflicts. The conclusion is formulated that participants in military operations need social and psychological rehabilitation, and problematic issues and prospects for rehabilitation are outlined. Specific medical and socio-psychological aspects are highlighted, the avoidance or generation of which will help in the process of rehabilitation of military personnel and their families. It was identified that although psychological rehabilitation is generally conducted, it requires more government support, popularisation, and wider involvement of both war veterans and experts. Ways to improve approaches to providing psychological assistance to military personnel and their families in Ukraine are proposed. The conclusions of the study are of substantial importance for psychologists and social workers, psychology students and teaching staff of psychology faculties as a doctrinal basis for the educational process
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Feingold D, Zerach G. Parental Reflectiveness, Posttraumatic Symptoms and Alcohol Use Disorder among Israeli Combat-Veteran Fathers. JOURNAL OF CHILD AND FAMILY STUDIES 2021; 30:2155-2164. [PMID: 34230797 PMCID: PMC8249432 DOI: 10.1007/s10826-021-02024-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 06/16/2021] [Indexed: 06/13/2023]
Abstract
Combat veterans are highly prone to develop Alcohol Use Disorder (AUD) following their release from duty, presumably due to high prevalence of prolonged aversive emotional symptoms such as Posttraumatic Stress Symptoms (PTSS). Parental Reflective Functions (PRF) and Parental Sense of Competence (PSOC) have been identified as key protective factors in predicting maternal functioning and well-being, yet little is known of its role among fathers, let alone combat veteran fathers. In this study we explored whether PRF and PSOC moderated the association between PTSS and AUD among 189 Israel Defense Forces (IDF) male combat veterans. Participants filled out validated measures assessing PTSS, PRF, PSOC and AUD. Results indicated that PTSS, as well as PRF's "interest and curiosity regarding the child's mental states" subscale, were positively correlated to AUD. In addition, PRF's "certainty about child mental states" subscale moderated the association between PTSS and AUD, so that PTSS and AUD were significantly correlated for participants who reported average or high levels of certainty about their child's mental states. This finding may imply that intrusive mentalizing ("hypermentalizing") by veteran fathers may facilitate the association between PTSS and AUD, presumably by constituting a maladaptive mechanism for coping with the stressful uncertainty embedded in the parent-child relationship.
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Affiliation(s)
| | - Gadi Zerach
- Department of Psychology, Ariel University, Ariel, Israel
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