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Riviere LA, Kim PY, Baker MD, Beymer MR. Training, Deployment Preparation, and Behavioral Health of New York National Guard Personnel Deployed to Assist with COVID-19 Decedent Work. Mil Med 2024; 189:e705-e713. [PMID: 37847572 DOI: 10.1093/milmed/usad395] [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: 06/23/2023] [Revised: 08/26/2023] [Accepted: 09/21/2023] [Indexed: 10/19/2023] Open
Abstract
INTRODUCTION A small body of research conducted mostly among civilians has shown that adequate training and preparation can prevent or reduce the development of behavioral health problems in first responders. Several civilian studies have shown that social support is protective against behavioral health problems. However, very few studies have examined the impact of these factors on the behavioral health of military first responders. Military first responders, who serve in the aftermath of natural disasters and disease outbreaks such as the coronavirus disease 2019 (COVID-19) pandemic, are often members of the National Guard (NG). The purpose of this study was to examine the impact of mortuary affairs training/handling human remains, role preparation, equipment preparation, and unit social support provided to families on the behavioral health of New York (NY) NG personnel deployed to assist the NY Office of Chief Medical Examiner with handling the remains of COVID-19 decedents. MATERIALS AND METHODS We invited 410 NYNG personnel who deployed for the Office of Chief Medical Examiner mission to complete an anonymous online questionnaire 3 to 6 months post-mission. Of the 158 participants, we used the data of the 141 participants who provided consent. Standard behavioral health measures (depression, anxiety, post-traumatic stress disorder, alcohol misuse, and insomnia) as well as study-specific items designed to understand the unique dynamics of this deployment were included. Hierarchical logistic regression analysis was used to examine the relationships between mortuary training, role preparation, equipment preparation, and unit support with behavioral health. RESULTS Close to two-thirds of the sample reported that they had not been trained in mortuary affairs/handling human remains before the mission. We also found that that lower levels of role preparation and unit support provided to the service members' families increased the odds of meeting criteria for one or more behavioral health problems, but that training in mortuary affairs and equipment preparation was unrelated to behavioral health. CONCLUSIONS Our research points to the importance of emotionally and cognitively preparing service members for the specific dynamics of a deployment and the roles that that they are expected to play. Furthermore, it suggests that supporting the families of NG personnel during domestic missions can benefit the behavioral health of the NG personnel. Additional research is needed to corroborate these findings, particularly the impact of unit support provided to family members on service members' behavioral health.
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Affiliation(s)
- Lyndon A Riviere
- Center for Military Psychiatry & Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Paul Y Kim
- Center for Military Psychiatry & Neuroscience, Walter Reed Army Institute of Research, Silver Spring, MD 20910, USA
| | - Matthew D Baker
- New York Army National Guard, Connecticut Street Armory-C, Buffalo, NY 14213, USA
| | - Matthew R Beymer
- Division of Behavioral and Social Health Outcomes Practice, Defense Centers for Public Health-Aberdeen, Aberdeen Proving Ground, MD 21010, USA
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2
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Polusny MA, Erbes CR. A dynamic, multilevel approach to conceptualising and designing resilience research in the context of military stress. Stress Health 2023; 39:40-47. [PMID: 37248806 PMCID: PMC10528202 DOI: 10.1002/smi.3277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Challenges in conceptualising resilience have impeded advancements in resilience science. In response, the National Institutes of Health (NIH) developed a general framework for harmonising the conceptualisation of resilience as a dynamic process determined by multiple systems and levels of analysis. Consistent with the NIH Resilience Framework, this paper presents a conceptual model of resilience applied to military service members. This model encompasses four core components necessary for resilience research: (1) the presence of significant challenge, (2) successful adaptation in response to the challenge, (3) the capacity for resilience (i.e., protective factors), and (4) the processes (i.e., mechanisms) by which protective factors exert positive effects on an individual's response. Guided by this conceptual model, we outline key methodological recommendations to advance resilience research and illustrate each using the Advancing Research on Mechanisms of Resilience study as an exemplar. We emphasise the need for future research to examine resilience as a dynamic process and apply a multilevel approach. We hope to provide a basic road map to those interested in improving the rigour of future research on resilience in a military context, the results of which can inform the development of interventions.
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Affiliation(s)
- Melissa A. Polusny
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School
| | - Christopher R. Erbes
- Minneapolis Veterans Affairs Health Care System, Minneapolis, MN
- Center for Care Delivery and Outcomes Research, Minneapolis, MN
- Department of Psychiatry and Behavioral Science, University of Minnesota Medical School
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3
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Edwards AC, Ohlsson H, Barr PB, Sundquist J, Kendler KS, Sundquist K. Military service and risk of subsequent drug use disorders among Swedish men. Soc Psychiatry Psychiatr Epidemiol 2023; 58:1039-1048. [PMID: 36680575 PMCID: PMC10916707 DOI: 10.1007/s00127-023-02426-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Accepted: 01/12/2023] [Indexed: 01/22/2023]
Abstract
PURPOSE Environmental factors contribute substantially to risk for drug use disorders (DUD). The current study applies multiple methods to empirically test whether military service is associated with subsequent DUD, as previous findings are inconsistent. METHODS Longitudinal Swedish national registry data on a cohort of male conscripts born 1972-1987 (maximum N = 485,900) were used to test the association between military service and subsequent registration for DUD. Cox proportional hazard models were used in preliminary analyses, followed by three methods that enable causal inference: propensity score models, co-relative models, and instrumental variable analysis. RESULTS Across all methods, military service was causally associated with lower risk of DUD. Hazard ratios ranged from HR = 0.43 (95% confidence intervals [CI] 0.37; 0.50) in the instrumental variable analysis to 0.77 (0.75; 0.79) in the multivariate propensity score matching analysis. This effect diminished across time. In the model including a propensity score, HRs remained below 1 across the observation period, while confidence intervals included 1 after ~ 11 years in the co-relative analysis and after ~ 21 years in the instrumental variable analysis. CONCLUSIONS In this cohort of Swedish men, complementary methods indicate that military service conferred substantial but time-limited protection against subsequent DUD. The observed effect could be due to reduced opportunity for substance use during service, social cohesion experienced during and after service, and/or socioeconomic advantages among veterans. Additional research is necessary to clarify these protective mechanisms and determine how other environmental contexts can provide similar benefits.
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Affiliation(s)
- Alexis C Edwards
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Box 980126, RichmondRichmond, VA, 23298-0126, USA.
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Peter B Barr
- Department of Psychiatry and Behavioral Sciences, State University of New York-Downstate, Brooklyn, NY, USA
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Box 980126, RichmondRichmond, VA, 23298-0126, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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4
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Krauss A, Edwards ER, Ruiz D, Epshteyn G, Coolidge B, Goodman M. Understanding changes in aggression among U.S. army soldiers: The role of trauma exposure during deployment. J Psychiatr Res 2023; 164:202-208. [PMID: 37356353 DOI: 10.1016/j.jpsychires.2023.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 06/05/2023] [Accepted: 06/15/2023] [Indexed: 06/27/2023]
Abstract
Aggression is one of the leading concerns reported by United States service members and veterans. Trauma and posttraumatic stress disorder (PTSD) symptoms have emerged as key drivers of aggression. Research to date, however, has largely overlooked the effect of aggression on increasing risk of trauma exposure and subsequent PTSD. The current study addresses this gap by examining whether (a) pre-deployment aggression predicts trauma exposure on deployment and post-deployment PTSD, (b) trauma exposure on deployment and post-deployment PTSD predict post-deployment aggression, and (c) trauma exposure on deployment and post-deployment PTSD symptoms explain changes in aggressive behavior from pre-to post-deployment. Data from the Army Study to Assess Risk and Resilience in Servicemembers (Army STARRS) Pre/Post Deployment Study (PPDS) on nationally representative sample of 8558 Active-duty Army soldiers were analyzed. Results revealed positive correlations between pre-deployment aggression (assessed via items from the Joint Mental Health Advisory Team 7), trauma exposure on deployment (assessed via items from the Deployment Stress Scale), post-deployment PTSD symptoms (assessed via items from the civilian PTSD Checklist and PTSD Checklist for DSM-5), and post-deployment aggression. Further, pre-deployment aggression predicted trauma exposure on deployment and post-deployment PTSD; trauma exposure on deployment and post-deployment PTSD predicted post-deployment aggression; and changes in aggression from pre-to post-deployment were partially mediated by trauma exposure on deployment and post-deployment PTSD symptoms. Collectively, these findings highlight the utility of identifying and addressing pre-deployment aggression in mitigating trauma exposure and later psychopathology.
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Affiliation(s)
- Alison Krauss
- VA VISN 17 Center of Excellence for Research on Returning War Veterans, Central Texas Veterans Health Care System, Waco, TX, USA.
| | - Emily R Edwards
- VISN 2 Mental Illness Research, Education And Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Danny Ruiz
- VISN 2 Mental Illness Research, Education And Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA
| | - Gabriella Epshteyn
- VISN 2 Mental Illness Research, Education And Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Brettland Coolidge
- VISN 2 Mental Illness Research, Education And Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA; Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Marianne Goodman
- VISN 2 Mental Illness Research, Education And Clinical Center (MIRECC), James J. Peters VA Medical Center, Bronx, NY, USA; Icahn School of Medicine at Mt. Sinai Hospital, New York, NY, USA
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5
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Pre-deployment aggressiveness, combat exposure and moral injury as contributors to posttraumatic stress symptoms among combatants: A two-year prospective study. J Psychiatr Res 2023; 161:158-164. [PMID: 36931133 DOI: 10.1016/j.jpsychires.2023.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/07/2023] [Accepted: 03/08/2023] [Indexed: 03/19/2023]
Abstract
Combatants who are exposed to events which transgress deeply held moral beliefs might face lasting psychopathological outcomes such as Moral Injury (MI) and posttraumatic stress symptoms (PTSS). However, insight about pre-deployment personality factors which might facilitate the MI process and its negative consequences is sparse. In this prospective study, we examined pre-deployment aggressiveness as a possible predictor of exposure to combat and potentially morally injurious events (PMIEs), trauma-related guilt and shame and PTSS among Israeli active-duty combatants. A sample of 335 active-duty Israeli combatants participated in a 2.5-year prospective study with three waves of measurements (T1: 12 months before enlistment, T2: 6 months following enlistment-pre deployment, and T3: 18 months following enlistment-post deployment). Participants' characteristics were assessed via semi-structured interviews (T1) and validated self-report measures of aggressiveness (T2), combat exposure, PMIEs and PTSS (T3) between 2019 and 2021. Results show that higher levels of pre-deployment aggressiveness predicted both combat exposure and PMIEs-'betrayal'. Combat exposure mediated the association between aggressiveness and PTSS post deployment. Importantly, pre-deployment aggressiveness was significantly associated with the PMIEs-'betrayal' that are associated with trauma-related guilt and shame, which in turn were associated with high levels of PTSS post deployment. Our results highlight the implications of pre-deployment aggressiveness for different forms of exposure to potentially traumatic events during military service. Identification of at-risk combatants for PTSS following exposure to PMIEs of betrayal might provide these combatants with a tailor-made type of preparation regarding moral and ethical situations, which should be investigated in future studies.
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6
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Hawn SE, Wolf EJ, Neale Z, Miller MW. Conceptualizing traumatic stress and the structure of posttraumatic psychopathology through the lenses of RDoC and HiTOP. Clin Psychol Rev 2022; 95:102177. [PMID: 35690042 DOI: 10.1016/j.cpr.2022.102177] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 04/14/2022] [Accepted: 06/01/2022] [Indexed: 11/03/2022]
Abstract
Trauma-related psychopathology, most notably posttraumatic stress disorder (PTSD), poses unique challenges for psychiatric nosology due to the wide range of symptoms and diagnoses associated with trauma and challenges representing the impact of trauma exposure on psychopathology. In this paper, we review the literature on categorical (i.e., Diagnostic and Statistical Manual of Mental Disorders and International Classification of Diseases systems) versus dimensional conceptualizations of trauma-related symptoms with an emphasis on the Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) frameworks. We identify strengths of each approach and challenges in accommodating the full range of trauma-related psychopathology and the clinical implications thereof. We discuss several potential approaches for improving the representation of traumatic stress, including the use of PTSD subtypes, trauma-related specifiers for psychiatric diagnoses, and the development of a dimension that we call the traumatic stress spectrum, which spans both adaptive and adverse reactions to trauma. These approaches to representing traumatic stress can be evaluated empirically and further refined. We also discuss how the use of an integrated RDoC-HiTOP approach to reconceptualize traumatic stress might maximize the ability to model valid and reliable trauma-related phenotypes, which would aid in the investigation of clinically relevant biological correlates.
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Affiliation(s)
- Sage E Hawn
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA
| | - Erika J Wolf
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA
| | - Zoë Neale
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA
| | - Mark W Miller
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, USA; Boston University School of Medicine, Department of Psychiatry, Boston, MA, USA.
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7
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Dretsch MN, Trachik B, Taylor M, Kotov R, Krueger R. Variability in the stability of personality traits across a single combat deployment. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.2003147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Michael N. Dretsch
- US Army Aeromedical Research Laboratory, Fort Rucker, Alabama, USA
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Benjamin Trachik
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Maura Taylor
- US Army Medical Research Directorate-West, Walter Reed Army Institute of Research, Joint Base Lewis-McChord, Washington, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, New York, USA
| | - Robert Krueger
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota, USA
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8
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Polusny MA, Marquardt CA, Campbell EH, Filetti CR, Noël VV, Disner SG, Schaefer JD, Davenport N, Lissek S, Noorbaloochi S, Sponheim SR, Erbes CR. Advancing Research on Mechanisms of Resilience (ARMOR) Longitudinal Cohort Study of New Military Recruits: Results from a Feasibility Pilot Study. RESEARCH IN HUMAN DEVELOPMENT 2021; 18:212-229. [PMID: 34887706 DOI: 10.1080/15427609.2021.1964898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Psychological resilience as a longitudinal process is highly relevant for understanding the functioning outcomes of military populations. Here, we review the extant literature on resilience among military service members, focusing on National Guard Soldiers. Our specific project (Advancing Research on Mechanisms of Resilience, "ARMOR") aims to develop a comprehensive model of resilience using a multilevel perspective. We report results from our prospective pilot study (n = 103) conducted in preparation for our large-scale longitudinal cohort study of Basic Combat Training (BCT) and its impact on military recruits' wellbeing. Results support feasibility of the larger study, evidence for a new measure of BCT stressor exposure, and demonstrate preliminary associations with BCT-related stressors and longitudinal changes in adaptive functioning. Future directions for our larger study will utilize data from survey responses, structured clinical interviews, neurobehavioral tasks, and neurobiological measures (functional and structural MRI and electroencephalography [EEG]) to examine individual differences in self-regulation as a predictor of resilience-related processes. ARMOR is well positioned to elucidate mechanisms that could be targeted for promoting wellbeing, preventing psychopathology, and facilitating long-term recovery.
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Affiliation(s)
- Melissa A Polusny
- Minneapolis VA Health Care System, Minneapolis, MN.,Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Craig A Marquardt
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Emily Hagel Campbell
- Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Clarissa R Filetti
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Valentin V Noël
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Seth G Disner
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | | | - Nicholas Davenport
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Shmuel Lissek
- Department of Psychology, University of Minnesota - Twin Cities
| | - Siamak Noorbaloochi
- Minneapolis VA Health Care System, Minneapolis, MN.,Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Medicine, University of Minnesota, Minneapolis, MN
| | - Scott R Sponheim
- Minneapolis VA Health Care System, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Christopher R Erbes
- Minneapolis VA Health Care System, Minneapolis, MN.,Center for Care Delivery and Outcomes Research, Minneapolis, MN.,Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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9
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Ka L, R E, K W, G J, Lje B. Associations between Facets and Aspects of Big Five Personality and Affective Disorders:A Systematic Review and Best Evidence Synthesis. J Affect Disord 2021; 288:175-188. [PMID: 33901698 DOI: 10.1016/j.jad.2021.03.061] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 03/03/2021] [Accepted: 03/19/2021] [Indexed: 12/30/2022]
Abstract
BACKGROUND Big Five personality traits correlate with affective disorders, with neuroticism considered a risk factor, and conscientiousness and extroversion considered protective factors. However, the relationships between affective disorders and lower-order personality facets and aspects are less clear. METHOD A systematic review was carried out to identify studies measuring associations between lower-order personality constructs and affective disorders. Big Five facets were measured using the NEO-PI-R, and aspects using the BFAS. PsycINFO, EMBASE, MedLine and OpenGrey were searched from January 1st, 1985 to June 30th, 2020. Fifteen studies met criteria and reported a total of 408 associations. Data were analysed using best evidence synthesis. RESULTS Most facets of neuroticism were positively associated with affective disorders. Positive emotion in extroversion, and competence and self-discipline in conscientiousness, were negatively associated with affective disorders. Trust in agreeableness, and actions in openness, were negatively associated with anxiety disorders, whereas fantasy in openness was positively associated with anxiety disorders. At the aspect level, withdrawal in neuroticism was positively associated with MDD, whereas industriousness in conscientiousness was negatively associated with MDD. LIMITATIONS Due to the use the heterogenous measures between studies, a meta-analysis could not be performed. Only Big Five personality constructs were investigated, limited to BFAS personality aspects, and NEO-PI-R personality facets. CONCLUSIONS Neuroticism, positive emotion, competence and self-discipline correlate with various anxiety and depressive disorders. These facets may be endophenotypes for affective disorders in general. Future research is needed to investigate mediating pathways between personality facets and affective disorders.
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Affiliation(s)
- Lyon Ka
- Division of Neuroscience and Experimental Psychology, University of Manchester, M13 9PG.
| | - Elliott R
- Division of Neuroscience and Experimental Psychology, University of Manchester, M13 9PG
| | - Ware K
- Division of Psychology and Mental Health, University of Manchester, M13 9PL
| | - Juhasz G
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary; SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
| | - Brown Lje
- Division of Psychology and Mental Health, University of Manchester, M13 9PL
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10
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Bowes SM, Brown AL, Thompson WW, Sellbom M, Lilienfeld SO. Do Psychopathic Traits Statistically Protect Against PTSD? A Retrospective Study of Vietnam Veterans. J Pers Disord 2021; 35:127-144. [PMID: 31206341 DOI: 10.1521/pedi_2019_33_432] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Although psychopathy traits are traditionally associated with maladaptivity, certain traits may statistically buffer against risk for posttraumatic stress disorder (PTSD). Research suggests that psychopathy traits are differentially associated with PTSD, as boldness traits are negatively related to PTSD whereas disinhibition features are positively related. The authors sought to clarify the relations between psychopathy and PTSD in a large sample of Vietnam veterans (N = 2,598) and to examine the statistical interactions among (a) psychopathy traits and (b) combat exposure and psychopathy traits in predicting PTSD. Results indicate that psychopathy traits are differentially associated with PTSD in combat-exposed veterans, although the authors found little evidence that boldness was protective against PTSD. Nonetheless, meanness was significantly, albeit weakly, protective against PTSD in the presence of combat exposure. The authors consider the implications of these findings for future research, including the need to consider fearlessness as a heterogeneous construct, and they examine whether the findings generalize to PTSD in DSM-5.
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Affiliation(s)
| | | | | | | | - Scott O Lilienfeld
- Emory University, Atlanta, Georgia.,University of Melbourne, Melbourne, Australia
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11
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Kerig PK, Mozley MM, Mendez L. Forensic Assessment of PTSD Via DSM-5 Versus ICD-11 Criteria: Implications for Current Practice and Future Research. PSYCHOLOGICAL INJURY & LAW 2020. [DOI: 10.1007/s12207-020-09397-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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12
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Exploring the relations of psychopathic and narcissistic personality traits to military experiences in National Guard personnel. PERSONALITY AND INDIVIDUAL DIFFERENCES 2020. [DOI: 10.1016/j.paid.2019.109554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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13
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Sellbom M. The MMPI-2-Restructured Form (MMPI-2-RF): Assessment of Personality and Psychopathology in the Twenty-First Century. Annu Rev Clin Psychol 2019; 15:149-177. [PMID: 30601687 DOI: 10.1146/annurev-clinpsy-050718-095701] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
This article describes the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) and situates the instrument in contemporary psychopathology and personality literature. The historical evolution of the MMPI instruments is highlighted, including how failure to update the test for several decades resulted in increasing disinterest by basic researchers and how the restructuring efforts beginning in the 2000s promised to realign the instrument with basic research. In this regard, the construct validity associated with MMPI-2-RF scores in the context of contemporary dimensional models of psychopathology is considered. Research supporting the applied utility of the MMPI-2-RF scales in a variety of contexts-including mental health screenings, presurgical evaluations, forensic assessment, and public safety screening-is also reviewed. Critiques of the MMPI-2-RF are described and addressed. Finally, a series of recommendations for future updates of the MMPI-2-RF are described along with a path toward the MMPI-3.
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Affiliation(s)
- Martin Sellbom
- Department of Psychology, University of Otago, Dunedin 9054, New Zealand;
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14
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Schaefer JD. Use of Hierarchical Measures of Psychopathology to Capture the Long (and Wide) Shadow of Early Deprivation in the Bucharest Early Intervention Project Analysis. JAMA Psychiatry 2018; 75:1101-1102. [PMID: 30267048 DOI: 10.1001/jamapsychiatry.2018.2215] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Jonathan D Schaefer
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina
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15
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Sadeh N, Spielberg JM, Hayes JP. Impulsive responding in threat and reward contexts as a function of PTSD symptoms and trait disinhibition. J Anxiety Disord 2018; 53:76-84. [PMID: 29220694 DOI: 10.1016/j.janxdis.2017.11.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Revised: 09/22/2017] [Accepted: 11/01/2017] [Indexed: 11/29/2022]
Abstract
We examined current posttraumatic stress disorder (PTSD) symptoms, trait disinhibition, and affective context as contributors to impulsive and self-destructive behavior in 94 trauma-exposed Veterans. Participants completed an affective Go/No-Go task (GNG) with different emotional contexts (threat, reward, and a multidimensional threat/reward condition) and current PTSD, trait disinhibition, and risky/self-destructive behavior measures. PTSD interacted with trait disinhibition to explain recent engagement in risky/self-destructive behavior, with Veterans scoring high on trait disinhibition and current PTSD symptoms reporting the highest levels of these behaviors. On the GNG task, commission errors were also associated with the interaction of PTSD symptoms and trait disinhibition. Specifically, PTSD symptoms were associated with greater commission errors in threat vs. reward contexts for individuals who were low on trait disinhibition. In contrast, veterans high on PTSD and trait disinhibition exhibited the greatest number of commission errors in the multidimensional affective context that involved both threat and reward processing. Results highlight the interactive effects of PTSD and disinhibited personality traits, as well as threat and reward systems, as risk factors for impulsive and self-destructive behavior in trauma-exposed groups. Findings have clinical implications for understanding heterogeneity in the expression of PTSD and its association with disinhibited behavior.
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Affiliation(s)
- Naomi Sadeh
- University of Delaware, Department of Psychological and Brain Sciences, Newark, DE, United States; National Center for PTSD at VA Boston Healthcare System, Boston, MA, United States.
| | - Jeffrey M Spielberg
- University of Delaware, Department of Psychological and Brain Sciences, Newark, DE, United States
| | - Jasmeet P Hayes
- National Center for PTSD at VA Boston Healthcare System, Boston, MA, United States; Boston University School of Medicine, Boston, MA, United States
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Naifeh JA, Ursano RJ, Benfer N, Wu H, Herman M, Benedek DM, Russell DW, Benevides KN, Kao TC, Ng THH, Aliaga PA, Wynn GH, Zhang L, Forsten RD, Fullerton CS. PTSD symptom severity and sensitivity to blood, injury, and mutilation in U.S. army special operations soldiers. Psychiatry Res 2017; 250:78-83. [PMID: 28142070 DOI: 10.1016/j.psychres.2017.01.058] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 12/23/2016] [Accepted: 01/22/2017] [Indexed: 10/20/2022]
Abstract
Sensitivity to blood, injury, and mutilation (SBIM) may increase risk for posttraumatic stress disorder (PTSD), given that traumatic events often involve actual or perceived threat of bodily harm to oneself and/or others, including exposure to blood and other mutilation-related stimuli. A self-report questionnaire was administered to male, active duty, U.S. Army Special Operations Command soldiers who had deployed to Iraq and Afghanistan (n =694 males). We first used exploratory factor analysis to examine whether the 30-item Mutilation Questionnaire (Klorman et al., 1974) comprised a unitary measure of SBIM, finding that 10 of the items form a cohesive SBIM factor. Summed, those 10 SBIM items had a significant bivariate correlation with PTSD symptom severity. In a multiple regression analysis that included demographic characteristics and lifetime trauma exposure, SBIM was positively associated with PTSD symptom severity. Other significant multivariate predictors were high lifetime trauma exposure and junior enlisted rank. When trait neuroticism was added to the model to test the robustness of these findings, the association of SBIM with PTSD symptom severity remained significant. The results suggest that SBIM may be a risk factor for PTSD in male soldiers. Further research is warranted to improve measurement and understanding of SBIM.
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Affiliation(s)
- James A Naifeh
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Robert J Ursano
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Natasha Benfer
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Hongyan Wu
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Michelle Herman
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - David M Benedek
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Dale W Russell
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - K Nikki Benevides
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tzu-Cheg Kao
- Division of Epidemiology and Biostatistics, Department of Preventive Medicine and Biometrics, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Tsz Hin H Ng
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Pablo A Aliaga
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Gary H Wynn
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Lei Zhang
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | | | - Carol S Fullerton
- Center for the Study of Traumatic Stress, Department of Psychiatry, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
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Fletcher S, O'Donnell M, Forbes D. Personality and trajectories of posttraumatic psychopathology: A latent change modelling approach. J Anxiety Disord 2016; 42:1-9. [PMID: 27235835 DOI: 10.1016/j.janxdis.2016.05.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 04/12/2016] [Accepted: 05/05/2016] [Indexed: 11/16/2022]
Abstract
BACKGROUND Survivors of traumatic events may develop a range of psychopathology, across the internalizing and externalizing dimensions of disorder and associated personality traits. However, research into personality-based internalizing and externalizing trauma responses has been limited to cross-sectional investigations of PTSD comorbidity. Personality typologies may present an opportunity to identify and selectively intervene with survivors at risk of posttraumatic disorder. Therefore this study examined whether personality prospectively influences the trajectory of disorder in a broader trauma-exposed sample. METHODS During hospitalization for a physical injury, 323 Australian adults completed the Multidimensional Personality Questionnaire-Brief Form and Structured Clinical Interview for DSM-IV, with the latter readministered 3 and 12 months later. Latent profile analysis conducted on baseline personality scores identified subgroups of participants, while latent change modelling examined differences in disorder trajectories. RESULTS Three classes (internalizing, externalizing, and normal personality) were identified. The internalizing class showed a high risk of developing all disorders. Unexpectedly, however, the normal personality class was not always at lowest risk of disorder. Rather, the externalizing class, while more likely than the normal personality class to develop substance use disorders, were less likely to develop PTSD and depression. CONCLUSIONS Results suggest that personality is an important mechanism in influencing the development and form of psychopathology after trauma, with internalizing and externalizing subtypes identifiable in the early aftermath of injury. These findings suggest that early intervention using a personality-based transdiagnostic approach may be an effective method of predicting and ultimately preventing much of the burden of posttraumatic disorder.
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Affiliation(s)
- Susan Fletcher
- Phoenix Australia and Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia.
| | - Meaghan O'Donnell
- Phoenix Australia and Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
| | - David Forbes
- Phoenix Australia and Department of Psychiatry, University of Melbourne, Melbourne, VIC, Australia
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