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Newberger NG, Forkus SR, Thomas ED, Goldstein SC, Ferguson JJ, Sullivan TP, Weiss NH. Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence. Drug Alcohol Depend 2023; 250:110905. [PMID: 37515827 PMCID: PMC10530157 DOI: 10.1016/j.drugalcdep.2023.110905] [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: 02/10/2023] [Revised: 07/13/2023] [Accepted: 07/16/2023] [Indexed: 07/31/2023]
Abstract
BACKGROUND Women experiencing intimate partner violence (IPV) are at increased risk for developing hazardous patterns of cannabis use. Research suggests that women experiencing IPV use cannabis to cope with posttraumatic stress disorder (PTSD) symptoms. To advance research, we used experience sampling methods to explicate the within-day concurrent and proximal relations between PTSD symptom clusters and cannabis use among women experiencing IPV. METHOD Participants were 145 community women (M age = 40.66, 41.6% white, 31.4% Black, 10.9% Hispanic or Latina, 8% American Indian/Alaska Native, 5.8% Bi-/multi-racial) experiencing IPV and using substances who completed three surveys a day for 30 days. RESULTS Externalizing behavior (OR = 1.37, 95% CI [1.15, 1.65], p < 0.001) and dysphoric arousal (OR = 1.27, 95% CI [1.09, 1.49], p = 0.002) PTSD symptom clusters were associated with cannabis use reported in the same survey period. Results from the lagged models found no proximal associations between PTSD symptom clusters and cannabis use. CONCLUSIONS Results highlight the acute effects of externalizing behavior and dysphoric arousal PTSD symptoms on cannabis use among women experiencing IPV. These findings may inform prevention and intervention efforts for cannabis use in this population.
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Affiliation(s)
- Noam G Newberger
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Shannon R Forkus
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Emmanuel D Thomas
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | - Silvi C Goldstein
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | - Tami P Sullivan
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA.
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2
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Contractor AA, Batley PN, Compton SE, Weiss NH. Relations Between Posttraumatic Stress Disorder Symptoms and Positive Memory Characteristics Among Women Reporting Intimate Partner Violence: A Micro-Longitudinal Study. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7266-7295. [PMID: 36541198 DOI: 10.1177/08862605221143200] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Evidence links posttraumatic stress disorder (PTSD) symptoms to positive autobiographical memory characteristics. To extend this research, we uniquely utilized micro-longitudinal data to examine (1) the trajectory of PTSD symptom count across 30 days; and (2) if more vividness and accessibility of retrieved positive memories at the daily level predicted decreases in the trajectory of PTSD symptom count across 30 days. The current study was a secondary data analysis of a larger study. The sample included 74 women who reported physical or sexual victimization in the past 30 days by their current male partner and reported the use of alcohol and/or drugs during that time (Mage = 39.68 years; 37.80% with diagnostic PTSD; 43.2% White; 37.8% Black or African American). They completed thrice daily measures of PTSD symptoms and positive memory characteristics (vividness and accessibility) across 30 days. Results of the random effects longitudinal multilevel model indicated that, on average, the relation between PTSD symptom count and positive memory vividness was positive and statistically significant (0.19, 95% Confidence Interval [CI] [0.2, 0.35]); and the relation between PTSD symptom count and positive memory accessibility was positive and statistically significant (0.31, 95% CI [0.15, 0.47]). The relationship between PTSD symptom count and positive memory vividness/accessibility (i.e., slopes) varied significantly across participants, with a wide range of positive and negative regression coefficients. Future research needs to investigate why and how positive memory vividness and accessibility may relate to trajectories of PTSD symptoms over time, with potential clinical implications for positive memory interventions addressing PTSD.
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3
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Ortega Ceballos PA, Rivera Rivera L, Reynales Shigematsu LM, Austria Corrales F, Toledano-Toledano F, Pérez Amezcua B. Psychological distress, intimate partner violence and substance use in a representative sample from Mexico: A structural equation model. Front Public Health 2023; 11:1101487. [PMID: 36935665 PMCID: PMC10018179 DOI: 10.3389/fpubh.2023.1101487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 01/23/2023] [Indexed: 03/06/2023] Open
Abstract
Introduction Intimate Partner Violence (IPV) is a public health concern associated with multiple adverse health outcomes, including psychological distress (PD). Objective To assess the association of IPV and psychological distress, and the mediation of tobacco and alcohol consumption in a national representative sample from Mexico. Material and methods Data from the Encuesta Nacional de Consumo de Drogas, Tabaco y Alcohol (ENCODAT) were analyzed. The sample included 34,864 people between the ages of 12 and 65 with a partner. Using Structural Equation Modeling (SEM), the association between IPV, use alcohol, tobacco and psychological distress was measured. Results The population was composed of women (51.9%) and men (48.1%); 15.1% (women = 18.2% and men = 11.9%) reported IPV in the last year. The prevalence of psychological distress in the last year was 3.3%, being 3.8% in women, and 2.7% in men. Results from the SEM in women indicated a direct positive effect of the IPV construct on psychological distress (β = 0.298, p < 0.01); these findings confirmed that IPV tended to systematically increase psychological distress. Likewise, the presence of IPV increased the consumption of tobacco (β = 0.077, p < 0.01) and alcohol (β = 0.072, p < 0.01). The SEM results in men showed that alcohol and tobacco consumption tended to increase in the presence of IPV (β = 0.121, p < 0.01, and β = 0.086, p < 0.01, respectively), and in turn, alcohol consumption and tobacco tended to increase psychological distress (β = 0.024, p < 0.01, and β = 0.025, p < 0.01, respectively). Conclusion This study indicated that in women, IPV had a direct effect on psychological distress and on alcohol and tobacco consumption. Meanwhile in men, alcohol and tobacco consumption had a mediating effect between IPV and psychological distress. The empirical findings of this study will contribute toward the design of public health policies for the prevention and attention of IPV, alcohol and tobacco consumption, and consequently address the mental health consequences derived from these problems.
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Affiliation(s)
| | - Leonor Rivera Rivera
- Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | | | | | - Filiberto Toledano-Toledano
- Unidad de Investigación en Medicina Basada en Evidencias, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
- Unidad de Investigación Sociomédica, Instituto Nacional de Rehabilitación Luis Guillermo Ibarra Ibarra, Mexico City, Mexico
| | - Berenice Pérez Amezcua
- Centro de Investigación Transdisciplinar en Psicología, Universidad Autónoma del Estado de Morelos, Cuernavaca, Morelos, Mexico
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4
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A Culture of Secrecy: Uncovering the Psychosocial Historical Context of Sexual Health in African American Populations. Sex Transm Dis 2023; 50:104-106. [PMID: 36098567 DOI: 10.1097/olq.0000000000001701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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5
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Glynn H, Knowles SR. A Phenomenological Investigation of Trauma in 18 Adults Living With Inflammatory Bowel Disease. Clin Nurs Res 2023; 32:159-170. [PMID: 35156407 DOI: 10.1177/10547738221075649] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
While trauma is recognized as being common in Inflammatory Bowel Disease (IBD) cohorts, limited research has explored how trauma impacts the lived experience of IBD. The aim of this study was to develop an understanding of how trauma impacts the experience of living with IBD and its subsequent management. An interpretative phenomenological analysis with thematic analysis was conducted. Eighteen adults with IBD participated in this qualitative research study. Key themes identified included: (1) Trauma was associated with the journey of IBD; (2) the impact of IBD and trauma, and (3) coping strategies. Pre-existing non-IBD trauma was prevalent, with several participants reporting links between traumatic events and their IBD diagnosis. Experiences of IBD trauma were described by participants across all stages of their illness journey. The study can assist healthcare professionals to better understand the experience of living with IBD and trauma and the factors that can contribute to traumatic responses.
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Affiliation(s)
- Heidi Glynn
- Swinburne University of Technology, Melbourne, Australia
| | - Simon R Knowles
- Swinburne University of Technology, Melbourne, Australia.,St Vincent's Hospital, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Australia
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6
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Goddard-Eckrich D, Henry BF, Sardana S, Thomas BV, Richer A, Hunt T, Chang M, Johnson K, Gilbert L. Evidence of Help-Seeking Behaviors Among Black Women Under Community Supervision in New York City: A Plea for Culturally Tailored Intimate Partner Violence Interventions. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2022; 3:867-876. [PMID: 36479367 PMCID: PMC9712050 DOI: 10.1089/whr.2022.0004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 09/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Black women involved in the legal system disproportionately experience intimate partner violence (IPV); however, current research does not satisfactorily describe the risk and protective factors associated with IPV among Black women under community supervision. METHODS We conducted a subgroup analysis of Black women (N = 128) using data from a randomized controlled trial that evaluated the feasibility and efficacy of two IPV screening and prevention programs for women under community supervision. Participants in the original study were randomized into two IPV prevention conditions-computerized or case manager Women Initiating New Goals of Safety (WINGS). In this study, we examine the effects of that study's two conditions on linkage to IPV services and secondary outcomes, specifically among Black participants who experienced physical, sexual, and psychological IPV. RESULTS Both conditions showed significant reductions in days of substance use abstinence over the 3-month period among Black women who experienced sexual or verbal IPV. Participants in the case manager arm were 14 times more likely to receive IPV services in the past 90 days-from baseline to the 3-month follow-up (adjusted odds ratio = 14.45, 95% confidence interval [CI] = 1.25 to 166.51, p = 0.032). Participants in the computerized arm were significantly more likely to report receiving social support from baseline to the 3-month follow-up assessment (regression coefficient [b] = 2.27, 95% CI = 0.43 to 4.11, p = 0.015). CONCLUSIONS Although both conditions showed significant reductions in the number of days of abstinence from substance use among this subgroup of Black women, the findings showed differential effectiveness between the computerized WINGS arm and the case manager WINGS arm in improving social support and linkage to services. These findings may indicate that different modalities of WINGS may work better for specific activities and point to the need for a hybrid format that optimizes the use of distinct modalities for delivering activities.
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Affiliation(s)
- Dawn Goddard-Eckrich
- The Social Intervention Group, Columbia University, School of Social Work, New York, New York, USA
| | - Brandy F. Henry
- Rehabilitation and Human Services, Educational Psychology, Counseling, and Special Education, College of Education, Consortium on Substance Use and Addiction, Social Science Research Institute, The Pennsylvania State University, University Park, Pennsylvania, USA
| | - Srishti Sardana
- Clinical Psychology, Teachers College, Columbia University, New York, New York, USA
| | - Brittany V. Thomas
- The Social Intervention Group, Columbia University, School of Social Work, New York, New York, USA
| | - Ariel Richer
- The Social Intervention Group, Columbia University, School of Social Work, New York, New York, USA
| | - Timothy Hunt
- The Social Intervention Group, Columbia University, School of Social Work, New York, New York, USA
| | - Mingway Chang
- The Social Intervention Group, Columbia University, School of Social Work, New York, New York, USA
| | - Karen Johnson
- University of Alabama, School of Social Work, Little Hall Room 2005, Tuscaloosa, Alabama, USA
| | - Louisa Gilbert
- The Social Intervention Group, Columbia University, School of Social Work, New York, New York, USA
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Haro B, López-Goñi JJ, Fernández-Montalvo J, Arteaga A. Prevalence and Differential Profile of Patients with Substance Use Disorder Who Have Suffered Physical and/or Sexual Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP12820-NP12837. [PMID: 33729037 DOI: 10.1177/08862605211001463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Patients with substance use disorder (SUD) who undergo treatment present a high prevalence of lifetime physical and/or sexual abuse. Studies about this phenomenon and the specific needs of patients with a history of abuse must be carried out to tailor treatment programs. The first goal of this article was to determine the prevalence of physical and/or sexual abuse among patients with SUD, and the second goal was to analyze the specific characteristics of these patients. A sample of 418 subjects was assessed to achieve the first goal and 104 subjects (52 with and 52 without a history of physical and/or sexual abuse) were examined to reach the second goal. All patients sought treatment for SUD in two Spanish clinical centers. The results showed that 15.5% of the sample had a history of physical and/or sexual abuse (42.3% of women and 9.9% of men). Patients with a history of abuse presented a higher need for SUD treatment in family and psychiatric areas and more psychopathological symptoms than patients without a history of abuse. According to this more serious profile, a patient-centered intervention considering the history of abuse is recommended. This will allow the specific needs of these patients to be met, thus improving SUD treatment success.
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Affiliation(s)
- Begoña Haro
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - José J López-Goñi
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Javier Fernández-Montalvo
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Alfonso Arteaga
- Universidad Pública de Navarra, Pamplona, Spain
- Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
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Mekawi Y, Silverstein MW, Walker A, Ishiekwene M, Carter S, Michopoulos V, Stevens JS, Powers A. Examining the psychometric properties of the PCL-5 in a black community sample using item response theory. J Anxiety Disord 2022; 87:102555. [PMID: 35338915 PMCID: PMC9275184 DOI: 10.1016/j.janxdis.2022.102555] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 02/03/2022] [Accepted: 03/02/2022] [Indexed: 10/18/2022]
Abstract
Black Americans are more likely to be exposed to certain types of traumatic events and experience posttraumatic stress disorder (PTSD) compared to other racial groups. Consequently, sound assessment of PTSD in this underserved and understudied population is necessary to develop and accurately answer research questions about etiology and intervention efficacy. However, the item-level psychometric properties of one of the most commonly used assessment tools, the PTSD Checklist for DSM-5 (PCL-5), has yet to be examined among Black Americans. To address this gap, we used item response theory (IRT) to assess item difficulty and discrimination in a sample of Black American adults (n = 307). We employed a graded response model with all 20 items of the PCL-5 loading on to a latent PTSD factor. At clinically significant levels of PTSD, the most discriminating items were flashbacks, inability to experience positive emotions, and nightmares and the least discriminating items were cued emotional distress, diminished interest, and hypervigilance. These results emphasize the importance of flashbacks, inability to experience positive emotions, and nightmares and deemphasize the importance of hypervigilance and sleep difficulties when assessing for clinically significant symptoms of PTSD in Black Americans. Treatment implications include a nuanced approach towards hypervigilance.
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Affiliation(s)
- Yara Mekawi
- University of Louisville, Department of Psychological and Brain Sciences, USA.
| | | | - Aisha Walker
- Georgia State University, Department of Psychology, USA
| | | | - Sierra Carter
- Georgia State University, Department of Psychology, USA
| | | | - Jennifer S Stevens
- Emory School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
| | - Abigail Powers
- Emory School of Medicine, Department of Psychiatry and Behavioral Sciences, USA
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9
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Hampton-Anderson JN, Watson-Singleton NN, Mekawi Y, Dunn SE, Kaslow NJ. Intimate Partner Violence, Existential Well-Being, and Africultural Coping in African American Women. JOURNAL OF AGGRESSION, MALTREATMENT & TRAUMA 2022; 31:660-676. [PMID: 35846383 PMCID: PMC9282718 DOI: 10.1080/10926771.2022.2038751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 09/03/2021] [Accepted: 11/08/2021] [Indexed: 06/15/2023]
Affiliation(s)
| | | | - Yara Mekawi
- Department of Psychological and Brain Science, University of Louisville
| | - Sarah E. Dunn
- Department of Psychiatry and Behavioral Sciences, Emory University
| | - Nadine J. Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University
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10
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Jarnecke AM, Leone RM, Kirby C, Flanagan JC. Intimate Partner Violence and Couple Conflict Behaviors: The Moderating Effect of Drug Use Problem Severity. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP1170-NP1196. [PMID: 32437311 PMCID: PMC7679273 DOI: 10.1177/0886260520922369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Intimate partner violence (IPV) is a maladaptive conflict behavior, and IPV is both a precipitant and consequence of drug use problems among couples. It is unknown how drug use problem severity modulates the association between IPV and observed conflict behaviors. As part of a larger clinical trial, a sample of 30 different-sex substance-misusing couples completed self-report questionnaires and participated in a laboratory conflict resolution task. The current exploratory study tested whether drug use severity moderated the association between IPV perpetration and positive and negative conflict resolution behaviors, respectively, while controlling for IPV victimization. The results suggest that among men, drug use severity moderates the association between psychological IPV perpetration and negative conflict behaviors. Men who report more severe IPV display more negative behaviors when their drug use problems are more severe. Among women, drug use severity moderated the effect between psychological IPV perpetration and negative conflict behaviors among women, such that women with lower drug use problem severity displayed more negative conflict behaviors when psychological IPV perpetration was more versus less severe. Drug use severity also moderated the association between physical IPV perpetration and negative and positive conflict behaviors among women. That is, women who reported more severe physical IPV displayed more negative and fewer positive behaviors when their drug use problems were more severe. Results have preliminary implications for targeting conflict resolution strategies differentially in men and women with drug use and a history of IPV perpetration. Future studies should replicate the current findings in larger, more representative samples, and examine the role specific drugs have on the association between IPV and conflict behaviors.
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Affiliation(s)
| | | | - Charli Kirby
- Medical University of South Carolina, Charleston, USA
| | - Julianne C. Flanagan
- Medical University of South Carolina, Charleston, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
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11
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Bocknek EL, Lozada FT, Richardson P, Brown D, McGoron L, Rajagopalan A. Paternal biopsychosocial resilience in triadic interactions among African American/Black families exposed to trauma and socioeconomic adversity. Dev Psychobiol 2021; 63:e22168. [PMID: 34314023 DOI: 10.1002/dev.22168] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Revised: 05/20/2021] [Accepted: 06/07/2021] [Indexed: 11/11/2022]
Abstract
Fathers have a distinct and unique effect on child development, but little is known about fathering beyond White or majority White families. The current study includes African American/Black biological fathers (N = 88) and their two-year-old children. Fathers reported low incomes and high rates of depression and posttraumatic stress disorder (PTSD). Parenting behaviors were observed in high-stress and low-stress triadic contexts. In the high-stress condition, we assessed paternal responses to children's bids after the family was reunited following a separation paradigm. In the low-stress condition, we assessed parenting behaviors during a teaching task. Fathers' social baseline respiratory sinus arrhythmia (RSA) was obtained as an index of parasympathetic arousal. RSA moderated the association between PTSD and fathers' responsiveness (F = 6.90, p = .00, R2 = .30), with no association between PTSD and responsiveness demonstrated among fathers with the highest levels of RSA relative to the sample (effect = .04, p = .00; CI [0.02, 0.06]). RSA did not moderate the association between paternal depression and parenting behaviors (p > .05). Furthermore, responsiveness was only significantly associated with low-stress paternal teaching behaviors for fathers with lower RSA (F = 4.34, p = .01, R2 = .21; effect = -.19, p = .00; CI [0.06, 0.32]). Findings demonstrate significant relationships among RSA, PTSD, and parenting for African American/Black men in contexts of economic adversity.
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Affiliation(s)
| | | | - Patricia Richardson
- Michigan State University College of Human Medicine, East Lansing, Michigan, USA
| | - Deon Brown
- Virginia Commonwealth University, Richmond, Virginia, USA
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12
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Letica-Crepulja M, Stevanović A, Grković J, Rončević-Gržeta I, Jovanović N, Frančišković T. Posttraumatic stress disorder symptoms and coping with the lockdown among help-seeking veterans before and during the COVID-19 pandemic. Croat Med J 2021; 62:241-249. [PMID: 34212561 PMCID: PMC8275948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Accepted: 05/05/2021] [Indexed: 04/03/2024] Open
Abstract
AIM To compare the severity of posttraumatic stress disorder (PTSD) symptoms and of particular PTSD clusters among help-seeking veterans before and during the COVID-19 lockdown. The second aim was to identify the main coping strategies used. METHODS Male war veterans (N=176) receiving outpatient treatment at the Referral Center for PTSD were assessed at baseline (12-18 months before the pandemic declaration in March 2020) and during the COVID-19 pandemic lockdown (March-June 2020). The Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, and The Brief COPE were used. RESULTS Direct exposure to the virus in our sample was low, and the majority of participants followed the preventive measures. The severity of the overall PTSD symptoms and of clusters of symptoms significantly decreased compared with the first assessment. At the second assessment, all participants still fulfilled the PTSD diagnosis criteria. During the lockdown, the participants used emotion-focused and problem-focused coping rather than dysfunctional coping. CONCLUSION The severity of PTSD symptoms decreased during the lockdown. Further research is needed to study the trajectories of long-term psychopathology.
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Affiliation(s)
- Marina Letica-Crepulja
- Marina Letica-Crepulja, Department of Psychiatry and Psychological Medicine, Faculty of Medicine, University of Rijeka, Braće Branchetta 20, 51 000 Rijeka, Croatia,
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13
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Fernández-Fillol C, Pitsiakou C, Perez-Garcia M, Teva I, Hidalgo-Ruzzante N. Complex PTSD in survivors of intimate partner violence: risk factors related to symptoms and diagnoses. Eur J Psychotraumatol 2021; 12:2003616. [PMID: 34925711 PMCID: PMC8682852 DOI: 10.1080/20008198.2021.2003616] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND In 2018, the World Health Organization proposed a new diagnosis entitled Complex Posttraumatic Stress Disorder (CPTSD) in the ICD-11. It is a diagnosis that encompasses the classic symptoms of PTSD, along with symptoms of disturbances in self-organization (DSO). Although this disorder has been studied in several countries and populations, research on the population of women survivors of intimate partner violence (IPV) is scarce. OBJECTIVES 1) To analyse the prevalence of CPTSD and PTSD according to ICD-11 criteria; 2) To analyse the associations between CPTSD symptomatology and severity of violence, level of fear, resilience and strategies of emotion regulation; 3) To analyse which risk factors (severity of violence, level of fear, resilience and strategies of emotion regulation) may differ between female survivors with CPTSD or PTSD. METHOD 162 women IPV survivors who completed a socio-demographic and violence-related interview, as well as questionnaires to assess PTSD and CPTSD, severity of violence, resilience and emotion regulation strategies. RESULTS The results showed a higher prevalence of CPTSD (39.50%), compared to PTSD (17.90%). Moreover, a high level of fear was related to re-experiencing in the here and now, avoidance, current sense of threat and disturbances in relationships. Low levels of resilience and maladaptive emotion regulation strategies such as expressive suppression were related to affective dysregulation, negative self-concept and disturbances in relationships. Finally, the results showed that maladaptive emotion regulation strategies differentiated between meeting CPTSD and PTSD criteria in women survivors of IPV. CONCLUSION The findings of this study indicated that CPTSD was twice as prevalent as PTSD within the sample. Moreover, maladaptive emotion regulation strategy as expressive suppression was the main variable related to experiencing CPTSD, in contrast to PTSD. These findings may have important implications for the design of specific treatments aimed at women survivors of IPV, who also suffer CPTSD.
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Affiliation(s)
- C Fernández-Fillol
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - C Pitsiakou
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain
| | - M Perez-Garcia
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Psychology, Department of Personality, Assessment and Psychological Treatment, University of Granada, Granada, Spain
| | - I Teva
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Education, Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
| | - N Hidalgo-Ruzzante
- Mind, Brain and Behavior Research Center (CIMCYC), University of Granada, Granada, Spain.,Faculty of Education, Department of Developmental and Educational Psychology, University of Granada, Granada, Spain
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14
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"Kept in Check": Representations and Feelings of Social and Health Professionals Facing Intimate Partner Violence (IPV). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217910. [PMID: 33126683 PMCID: PMC7663014 DOI: 10.3390/ijerph17217910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 10/18/2020] [Accepted: 10/24/2020] [Indexed: 12/02/2022]
Abstract
Social and health professionals facing gender-based violence in Intimate Partner Violence (IPV) express feelings and thoughts closely connected to their place of work and the users of their services. However, research on professionals’ reflexivity and their implications has not been closely investigated. Therefore, this article will describe representations of IPV among social and health professionals facing gender-based violence as well as their personal feelings in accomplishing their job. Fifty interviews with health and social professionals were analyzed using grounded theory methodology supported by Atlas.ti 8.4. Five macrocategories will describe this phenomenon, leading to the final explicative core category that summarizes professionals’ attitudes toward it. Being “kept in check” among partners, partners and families, services, and institutional duties is the core category that best expressed their feelings. Therefore, implications for services and training will be further discussed.
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Carnevale S, Di Napoli I, Esposito C, Arcidiacono C, Procentese F. Children Witnessing Domestic Violence in the Voice of Health and Social Professionals Dealing with Contrasting Gender Violence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4463. [PMID: 32575898 PMCID: PMC7344581 DOI: 10.3390/ijerph17124463] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/26/2020] [Revised: 06/12/2020] [Accepted: 06/15/2020] [Indexed: 11/16/2022]
Abstract
Witnessing domestic violence (WDV) is recognized by the Istanbul Convention as psychological abuse that has dramatic consequences on the psychophysical health of children. Therefore, professionals who form the support network for WDV victims play a very fundamental role. In order to draw up useful guidelines for services dealing with WDV, and to give children more awareness of supportive settings, this study analyzes WDV in the perception of health and welfare professionals to enhance their skills and strategies for contrasting gender violence. Sixteen Neapolitan specialists dealing with WDV children were interviewed. A theoretical intentional sampling was used. Narrative focused interviews were carried out, transcribed verbatim and analyzed through the grounded theory methodology, using the ATLAS.ti 8 software (Scientific Software Development GmbH, Berlin, Germany). We assigned 319 codes and grouped these into 10 categories and 4 macro-categories. The analysis of the texts led to the definition of the core category as "The Crystal Fortress". It summarizes the image of the WDV children as described by the professionals working in contrasting domestic violence. In this structure the parental roles of protection and care (fortress) are suspended and everything is extremely rigid, fragile and always at risk of a catastrophe. It also symbolizes the difficult role of health professionals in dealing with such children and their families. For WDV children, protective factors guarantee solid development and supportive settings help them to learn proper emotional responsiveness and expressiveness and to develop their skills in talking with adults while avoiding negative consequences.
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Affiliation(s)
| | | | | | - Caterina Arcidiacono
- Department of Humanities, University of Naples “Federico II”, 80138 Napoli, Italy; (S.C.); (I.D.N.); (C.E.); (F.P.)
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16
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Lorenz P, Schindler L, Steudte-Schmiedgen S, Weidner K, Kirschbaum C, Schellong J. Ecological momentary assessment in posttraumatic stress disorder and coping. An eHealth study protocol. Eur J Psychotraumatol 2019; 10:1654064. [PMID: 31528269 PMCID: PMC6735333 DOI: 10.1080/20008198.2019.1654064] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 12/23/2022] Open
Abstract
Background: It is well known from cross-sectional studies that individual coping strategies significantly influence the pathogenesis of posttraumatic stress disorder (PTSD). Equally, undisputed is the role of biological processes, e.g. of the so-called 'stress hormone' cortisol for the trajectory of PTSD. Ecological momentary assessment (EMA), the repeated collection of self-reported momentary states via smartphones, is ideal for shedding light upon symptom fluctuations and coping strategies. EMA may also constitute a promising approach to provide closer associations to biomarkers than retrospective self-report. The mobile application 'CoachPTBS', created to facilitate transition into health-care systems, bridges waiting periods for trauma-specific psychotherapy. CoachPTBS offers tools akin to EMA that could elucidate coping with stress symptoms. Moreover, the app's self-management tools may improve coping strategies. However, these processes have never been examined in a combined, longitudinal fashion. Objective: The aim of the current study is to assess symptom fluctuations, coping strategies and long-term endocrine correlates of PTSD by a longitudinal, multimodal approach, combining traditional, online and EMA self-report with hair cortisol data and CoachPTBS as a possible novel mHealth tool. Method: 120 participants waiting for PTSD psychotherapy will be randomly grouped. After in-situ assessment and hair sample collection, 40 will receive CoachPTBS, using it daily throughout 4 weeks. A parallel group of 40 will participate in EMA, completing daily questionnaires on symptoms and coping. In between, online surveys will be conducted. After 6 weeks, a final interview and another hair sample collection will follow. Comparisons between these groups and waitlist-control, also consisting of 40 PTSD participants, and 40 non-traumatized participants assessed via EMA regarding aversive emotions and coping are planned. Discussion: Novel insights into the interplay of biological and coping strategies in PTSD are expected due to the innovative multimodal study design. Results will further explore benefits of eHealth tools on coping with PTSD.
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Affiliation(s)
- Patrick Lorenz
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Lena Schindler
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Susann Steudte-Schmiedgen
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany.,Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Kerstin Weidner
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Clemens Kirschbaum
- Department of Psychology, Technische Universität Dresden, Dresden, Germany
| | - Julia Schellong
- Department of Psychotherapy and Psychosomatic Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
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Andu E, Wagenaar BH, Kemp CG, Nevin PE, Simoni JM, Andrasik M, Cohn SE, French AL, Rao D. Risk and protective factors of posttraumatic stress disorder among African American women living with HIV. AIDS Care 2018; 30:1393-1399. [PMID: 29695184 DOI: 10.1080/09540121.2018.1466981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We sought to examine risk and protective factors for Posttraumatic Stress Disorder (PTSD) among African American women living with HIV. This is a cross-sectional analysis of baseline data from a randomized trial of an HIV stigma reduction intervention. We examined data from two-hundred and thirty-nine African American women living with HIV. We examined whether age, marital status, level of education, internalized HIV-related stigma, and social support as potential protective and risk factors for PTSD symptoms using logistic regression. We analyzed bi-variate associations between each variable and PTSD symptoms, and constructed a multivariate logistic regression model adjusting for all variables. We found 67% reported clinically significant PTSD symptoms at baseline. Our results suggest that age, education, and internalized stigma were found to be associated with PTSD symptoms (p < 0.001), with older age and more education as protective factors and stigma as a risk factor for PTSD. Therefore, understanding this relationship may help improve assessment and treatment through evidence- based and trauma-informed strategies.
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Affiliation(s)
- Eaden Andu
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Brad H Wagenaar
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Chris G Kemp
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Paul E Nevin
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Jane M Simoni
- b Department of Psychology , University of Washington , Seattle , WA , USA
| | | | - Susan E Cohn
- d Department of Infectious Diseases , Northwestern University , Chicago , IL , USA
| | | | - Deepa Rao
- f Department of Global Health/Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA
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18
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Short NA, Boffa JW, Clancy K, Schmidt NB. Effects of emotion regulation strategy use in response to stressors on PTSD symptoms: An ecological momentary assessment study. J Affect Disord 2018; 230:77-83. [PMID: 29407542 PMCID: PMC5811367 DOI: 10.1016/j.jad.2017.12.063] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 11/30/2017] [Accepted: 12/31/2017] [Indexed: 11/25/2022]
Abstract
BACKGROUND Although a burgeoning line of research identifies emotion regulation difficulties as a potential maintenance factor for posttraumatic stress disorder (PTSD), little is known in regard to what emotion regulation strategies individuals with PTSD use in their daily lives, their predictors, and their consequences on later PTSD symptoms. METHOD The current study utilized ecological momentary assessment (EMA) design to explore prospective relationships between maladaptive and adaptive emotion regulation strategy use and PTSD symptoms in participants with PTSD (N = 30). Participants completed 4 EMAs per day over 8 days, assessing stressors, emotional response, and emotion regulation strategy use. RESULTS Individuals with PTSD most commonly used avoidance as an emotion regulation strategy. Multilevel modeling indicated that baseline PTSD symptoms predicted maladaptive emotion regulation strategy use. After covarying for morning PTSD symptoms, maladaptive emotion regulation prospectively predicted increased PTSD symptoms later in the day. Adaptive emotion regulation strategies did not uniquely predict later PTSD symptoms. CONCLUSION In line with conceptualizations of difficulties in emotion regulation as a transdiagnostic maintenance factor in PTSD, findings indicate that maladaptive emotion regulation strategies in response to stressors exacerbate PTSD symptoms. The use of adaptive emotion regulation strategies had no positive or negative impact on subsequent PTSD symptoms. LIMITATIONS Future studies should utilize longer-term prospective designs.
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