Posttraumatic stress disorder symptom severity predicts aggression after treatment

Predicting aggressive behaviors: Examining unique and interactive roles of PTSD and emotion dysregulation in a minority sample

Aggression is a costly public health problem with severe and multi-faceted negative consequences and thus, identifying factors that contribute to aggression, particularly in understudied populations, is necessary to develop more effective interventions to reduce the public health cost of aggression. The goal this study was to test whether difficulties regulating emotions moderated the association between posttraumatic stress disorder (PTSD) symptoms and aggression in a community sample of predominantly Black females with high levels of trauma exposure. Furthermore, we explored unique relations between PTSD symptom clusters and distinct subscales of difficulties regulating emotions and aggression. The sample included 601 community participants recruited from an urban public hospital. Symptoms were assessed using self-report measures including the Difficulties in Emotion Regulation Scale (DERS) and Behavioral Questionnaire-Short. Regression analyses were conducted using PTSD symptoms and total DERS to test their interaction as predictors for aggression (using BQ-Short). We found that higher levels of PTSD arousal symptoms and difficulty controlling impulses when upset were positively related to aggression. We also conducted an exploratory analysis to examine the association between PTSD symptom clusters using the Alternative Symptom Clusters hybrid model. The results suggest that some PTSD symptoms (externalizing behavior) and some emotion dysregulation processes (difficulties controlling impulses when upset), relate to aggression in independent, rather than multiplicative ways. These results offer insights for new directions of research that focuses on the independent association between specific emotion dysregulation processes and PTSD symptoms on aggression.

Pandemic Exposure, Post-traumatic Stress Disorder, Conflict Behaviors, and Online Aggressive Behaviors Among College Students During the COVID-19 Pandemic: Examining the Moderating Role of Gender

The COVID-19 pandemic impacts people's mental health and behaviors, but the influence mechanism between pandemic exposure, conflict behaviors, and online aggressive behaviors during the COVID-19 outbreak remains unclear. This study will address this gap. Data were collected from 1,153 college students in an online survey that included an pandemic experiences scale, a post-traumatic stress disorder (PTSD) scale, a conflict behaviors scale, and an online aggressive behaviors scale. Structural equation modeling and multi-group comparisons were used to analyze the data. Pandemic exposure positively predicted conflict and online aggressive behaviors through hyperarousal symptoms, and negatively predicted these behaviors through intrusive symptoms. The mediating roles of avoidance and negative alterations in cognition and mood symptoms in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors were non-significant. Among male students, pandemic exposure directly predicted conflict and online aggressive behaviors, but for female students, pandemic exposure indirectly influenced these behaviors through intrusive and hyperarousal symptoms. The intrusive and hyperarousal symptoms play mediating roles in the relations between pandemic exposure and conflict behaviors and online aggressive behaviors. Gender plays a moderating role in the above mediating mechanism.

Trauma Exposure, Posttraumatic Stress Disorder, and Aggression Among Civilian Females

Trauma exposure and posttraumatic stress disorder (PTSD) have evinced ties to increased risk for aggressive behavior. However, very little information is known regarding the relations between trauma exposure, PTSD, and aggression among non-veteran women. Furthermore, research has not examined the associations between trauma exposure, PTSD symptoms, and aggression using the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) PTSD criteria. The primary aim of the current study was to investigate the relationships between trauma exposure, PTSD symptoms, and aggression among women. The secondary aim was to examine the specific PTSD symptom clusters in relation to indices of aggression. A total of 217 civilian, trauma-exposed female undergraduate students participated in the study (M_age = 24.30, SD = 6.83, 63.2% White). Higher levels of trauma exposure and PTSD symptoms corresponded with anger (b = .47, 95% CI = [0.11-0.83]; b = .11, 95% CI = [0.05-0.16], respectively) and verbal aggression (b = .50, 95% CI = [0.21-0.78]; b = .06, 95% CI = [0.01-0.10], respectively). PTSD symptoms, but not cumulative trauma exposure, was associated with hostility (b = .23, 95% CI = [0.14-0.59]), whereas physical aggression was only related to trauma exposure (b = .69, 95% CI = [0.31-1.06]). Furthermore, there was a significant indirect effect of cumulative trauma through PTSD symptoms on anger and verbal aggression (b = .15, 95% CI = [0.05-0.32]; b = .09, 95% CI = [0.02-0.20], respectively). Trauma-exposed civilian females with higher levels of PTSD symptoms may be at increased risk for several indices of aggressive behavior. Furthermore, PTSD symptoms may better account for some, but not all, aspects of aggression in trauma-exposed women.

Nonsuicidal self-injury among adolescents and young adults with prolonged exposure to violence: The effect of post-traumatic stress symptoms

Less is known about nonsuicidal self-injury (NSSI) among adolescents and young adults living in areas under prolonged political violence. This study aims to explore the frequencies of NSSI as well as the severity of post-traumatic stress symptoms (PTSS), depression, anxiety, and sleep problems among 889 Palestinian adolescents and young adults. The participants completed self-report questionnaires assessing NSSI, PTSS, depression, anxiety symptoms, and sleep difficulties. The results found that 13.8% of the total sample are frequently engaging in some form of NSSI behavior. Moreover, 43.1% exhibited severe symptoms of PTSD, and almost one-third of the sample reported severe symptoms of depression (30.1%); more than two-thirds of the sample (68.4%) experience sleep difficulties. Those who engage in NSSI were found to be at higher risk for sleep problems, depression, and PTSS. Avoidance/numbing, as well as hyperarousal symptoms clusters of PTSS, were significantly associated with NSSI above and beyond depressive symptoms. These results suggest that NSSI is frequently a sequelae of prolonged exposure to trauma and violence, and highlight the importance of routine assessment of this behavior. It is crucial to be familiar with the association between PTSS, sleep difficulties, and NSSI in a clinical setting to implement programs focusing on preventing these domains.

The Mediating Role of Trauma Symptoms in the Association between Past and Future Teen Dating Violence Victimization

We examined whether the frequency of recent physical and sexual teen dating violence (TDV) victimization is positively associated with trauma symptom clusters (re-experiencing, avoidance, and hyperarousal), and whether these symptom clusters, in turn, are positively associated with the frequency of later TDV victimization. Participants were recruited primarily from truancy courts, and the sample consisted of 108 (47% female) 14-to-17-year-olds. Participants completed three assessments, spaced three months apart. Results indicated that the frequency of recent TDV victimization related positively to all three trauma symptom clusters. Re-experiencing symptoms mediated the relation between recent TDV victimization and TDV victimization six months later, even after controlling for exposure to community and interparental violence and demographic variables. The findings suggest that the trauma symptom clusters may differentially contribute to risk of future TDV victimization. Further research examining the cognitive and emotional processes involved in re-experiencing trauma symptoms will likely enhance our understanding of risk factors for TDV re-victimization.

Effects of social support and resilient coping on violent behavior in military veterans

Violence toward others has been identified as a serious postdeployment adjustment problem in a subset of Iraq- and Afghanistan-era veterans. In the current study, we examined the intricate links between posttraumatic stress disorder (PTSD), commonly cited psychosocial risk and protective factors, and violent behavior using a national randomly selected longitudinal sample of Iraq- and Afghanistan-era United States veterans. A total of 1,090 veterans from the 50 United States and all United States military branches completed 2 waves of self-report survey-data collection 1 year apart (retention rate = 79%). History of severe violent behavior at Wave 1 was the most substantial predictor of subsequent violence. In bivariate analyses, high correlations were observed among risk and protective factors, and between risk and protective factors and severe violence at both time points. In multivariate analyses, baseline violence (OR = 12.43, p < .001), baseline alcohol misuse (OR = 1.06, p < .05), increases in PTSD symptoms between Waves 1 and 2 (OR = 1.01, p < .05), and decreases in social support between Waves 1 and 2 (OR = .83, p < .05) were associated with increased risk for violence at Wave 2. Our findings suggest that rather than focusing specifically on PTSD symptoms, alcohol use, resilience, or social support in isolation, it may be more useful to consider how these risk and protective factors work in combination to convey how military personnel and veterans are managing the transition from wartime military service to civilian life, and at what point it might be most effective to intervene. (PsycINFO Database Record

BEATVIC, a body-oriented resilience training with elements of kickboxing for individuals with a psychotic disorder: study protocol of a multi-center RCT

BACKGROUND

Individuals with a psychotic disorder are at an increased risk of becoming victim of a crime or other forms of aggression. Research has revealed several possible risk factors (e.g. impaired social cognition, aggression regulation problems, assertiveness, self-stigma, self-esteem) for victimization in patients with a psychotic disorder. To address these risk factors and prevent victimization, we developed a body-oriented resilience training with elements of kickboxing: BEATVIC. The present study aims to evaluate the effectiveness of the intervention.

METHODS/DESIGN

Seven mental health institutions in the Netherlands will participate in this study. Participants will be randomly assigned to either the BEATVIC training or the control condition: social activation. Follow-ups are at 6, 18 and 30 months. Short term effects on risk factors for victimization will be examined, since these are direct targets of the intervention and are thought to be mediators of victimization, the primary outcome of the intervention. The effect on victimization will be investigated at follow-up. In a subgroup of patients, fMRI scans will be made before and after the intervention period in order to assess potential neural changes associated with the effects of the training.

DISCUSSION

This study is the first to examine the effectiveness of an intervention targeted at victimization in psychosis. Methodological issues of the study are addressed in the discussion of this paper.

TRIAL REGISTRATION

Current Controlled Trials: ISRCTN21423535 . Retrospectively registered 30-03-2016.

Aggressive behavior among military veterans in substance use disorder treatment: the roles of posttraumatic stress and impulsivity

This study examined posttraumatic stress disorder (PTSD) symptom severity and impulsivity as predictors of aggressive behavior among 133 male military veterans entering substance abuse treatment who endorsed difficulty controlling anger in the past year. At treatment intake, participants completed measures assessing PTSD symptom severity, impulsivity and aggressive behavior. Perpetration of aggressive behavior was reassessed 4 months later. Results from multivariate models indicated that PTSD symptom severity and impulsivity explained unique variance in aggressive behavior at intake but not follow-up. Mediation models indicated that the association between PTSD symptom severity and aggressive behavior was accounted for by impulsivity. The identification of impulsivity as a key mediator between trauma symptoms and aggressive behavior has significant clinical and research implications. Based on these findings, clinicians are encouraged to consider a standard assessment of impulsivity and the selection of interventions that target impulsivity as a trans-diagnostic process among at-risk client populations.