Linking attentional control and PTSD symptom severity: the role of rumination

Work Stress and Personal and Relational Well-Being Among Chinese College Teachers: The Indirect Roles of Sense of Control and Work-Related Rumination

Purpose

The association between work stress and well-being has been well documented. However, the underlying mechanism for such association is not clear, especially in terms of how work stress relates to both personal and relational well-being. Based on the Conservation of Resources Theory and the Stress Process Model, the present study examined the potential indirect roles of the sense of control and the work-related rumination in the associations between work stress and both personal and relational well-being.

Methods

Data were collected from 536 married Chinese university teachers (M_age = 39.40 + 7.64, 38.6% males) through an online survey. Analyses were conducted using structural equation modeling via Mplus.

Results

Work stress was indirectly associated with life satisfaction through (a) sense of control, (b) work-related rumination, and (c) a sequential pathway from sense of control to work-related rumination. Work stress was indirectly associated with relationship satisfaction through sense of control.

Conclusion

Findings suggest that sense of control would be an important linking mechanism underlying the association between work stress and college teachers' well-being. Personal well-being may be more vulnerable to work-related rumination than relational well-being. Insights for prevention and intervention efforts in enriching college teachers' well-being are discussed.

Attention deficits as a key player in the symptomatology of posttraumatic stress disorder: A review

Posttraumatic stress disorder (PTSD) is a debilitating psychiatric disorder characterized by symptoms such as re-experiencing of the psychotrauma and hyperarousal. Although current literature mainly discusses the emotionally related aspects of these symptoms, studies also highlight the relation between re-experiencing, hyperarousability, and attention deficits, which are associated with poorer daily function and reduced quality of life. This review provides a comprehensive analysis of the existing research on attention deficits among adults with PTSD. A systematic search through five databases resulted in the inclusion of 48 peer-reviewed, English-language articles, describing 49 distinct studies. Using a total of 47 different attentional assessment tools, the majority of studies investigated sustained (n = 40), divided (n = 16), or selective (n = 14) attention. A total of 30 studies (61.2%) found significant correlations between PTSD symptoms and attention deficits, and 10 studies (20.4%) found that higher levels of attention deficits were predictive of worse PTSD symptoms. Moreover, neuroimaging results of six (f)MRI and three EEG studies identified various potential neurobiological pathways involved, including (pre)frontal attention networks. Together, the body of research shows that attention deficits in individuals with PTSD are common and occur in surroundings with emotionally neutral stimuli. Nonetheless, current treatment strategies do not target these attentional difficulties. We propose a novel perspective to PTSD diagnosis and treatment strategies based on attention deficits and their relation with top-down regulation of re-experiencing and subsequent other PTSD symptoms.

Posttraumatic Stress Symptoms and its Association with Rumination, Thought Suppression and Experiential Avoidance: a Systematic Review and Meta-Analysis

Posttraumatic stress disorder (PTSD) is a severe mental disorder causing high individual and societal costs. The use of maladaptive emotion regulation (ER) strategies has been identified as a potential contributing factor. This meta-analysis aimed to quantify the associations between PTSD symptoms and rumination, thought suppression and experiential avoidance. The systematic literature search resulted in 5574 studies, 75 of which were included in the analysis. From those eligible studies 189 effect sizes were obtained. For symptoms of posttraumatic stress, large effects were found for associations with rumination (r = .52) and experiential avoidance (r = .48), whereas a medium effect size was found for thought suppression (r = .29). With respect to different PTSD symptom clusters, associations ranged between r = .35 and r = .41 for associations with intrusive re-experiencing, between r = .39 and r = .41 for associations with avoidance, between r = .50 and r = .53 for associations with alterations in cognitions and mood and between r = .41 and r = .45 for associations with alterations in arousal and activity. Few available studies provide some evidence that associations might be somewhat reduced but still substantial in longitudinal compared to cross-sectional studies. These findings provide valuable targets for future investigations with the long-term goal of improving targeted interventions for the prevention and treatment of PTSD symptoms.

Inhibition Predicts the Course of Depression and Anxiety Symptoms Among Adolescents: The Moderating Role of Familial Risk

ABSTRACT

Numerous theoretical models suggest that inhibition difficulties-the inability to moderate automatic responses-contribute to the onset and/or maintenance of internalizing symptoms. Inhibition deficits and internalizing disorders run in families and share overlapping genetic risk factors, suggesting that inhibition deficits may be particularly prognostic of internalizing symptoms in those with high familial risk. This study tested this hypothesis in a longitudinal sample during the transition from adolescence to early adulthood. As hypothesized, prospective associations between inhibition and anxiety and depressive symptoms 8 years later were moderated by familial risk for depression. Specifically, poorer inhibition prospectively predicted greater anxiety and depressive symptoms in those at high (but not low) familial risk for major depressive disorder. These findings provide preliminary support for impaired inhibition as an indicator of risk for later internalizing symptoms in those at high familial risk.

The effectiveness of mindfulness-based interventions for ruminative thinking: A systematic review and meta-analysis of randomized controlled trials

OBJECTIVE

To systematically evaluate the effectiveness of mindfulness-based interventions for ruminative thinking.

METHODS

Cochrane Library, Web of Science, Embase, EBSCO, PubMed and Science Direct databases were searched to include randomized controlled trials of mindfulness-based interventions for rumination that met the criteria. The Rumination scale was used as the primary outcome indicator, and the secondary outcome indicator included the Mindfulness scale. An evaluation of bias risk was conducted to identify possible sources of bias based on methodological and clinical factors. Stata 16.0 software was used to perform meta-analysis, subgroup analysis, sensitivity analysis, meta-regression analysis and publication bias detection of the extracted data.

RESULTS

A total of 61 studies with 4229 patients were included. Meta-analysis results revealed a significant intervention effect on ruminative thinking (SMD = -0.534, 95 % CI = [-0.675, -0.394], z = -7.449, P < 0.001). However, there was no significant difference between mindfulness-based interventions and CBT (SMD = 0.009, 95%CI = [-0.239, 0.258], z = 0.073, P = 0.941). Meta-analysis showed that mindfulness-based interventions significantly enhanced the level of mindfulness (SMD = 0.495, 95 % CI = [0.343, 0.647], z = 6.388, P < 0.001), while it was not significant compared to CBT (SMD = 0.158, 95%CI = [-0.087, 0.403], z = 1.266, P = 0.205). The two subgroups with >65 % (SMD = -0.534, 95%CI = [-0.681, -0.386], z = -7.081, P < 0.001) and 80 % (SMD = -0.462, 95%CI = [-0.590, -0.334], z = -7.071, P < 0.001) of females showed significant improvement in ruminative thinking. There were significant intervention effects for depression, students, cancer, healthy adults, and clinical patients. Significant intervention effects were demonstrated for various participant ages and intervention periods.

CONCLUSION

This study confirmed the feasibility of mindfulness-based interventions in improving ruminative thinking and enhancing the level of mindfulness. However, the effectiveness of mindfulness-based interventions was not significant compared to CBT. The two subgroups with a higher proportion of females showed a more significant improvement in ruminative thinking, whereas there were no significant differences in participant characteristics, age, and the duration of intervention.

Male and female impairments in odor span are observed in a rat model of PTSD

Posttraumatic stress disorder (PTSD) is associated with neural and behavioral alterations in response to trauma exposure, including working memory impairments. Rodent models of PTSD have not fully investigated chronic or reactive working memory deficits, despite clinical relevance. The present study uses footshock to induce a posttraumatic stress state in male and female rats and evaluates the effect of footshock and trauma-paired odor cues on working memory performance in the odor span task. Results demonstrate the emergence of chronic deficits in working memory among animals exposed to footshock by 3 wk after traumatic stress. The presentation of a trauma-paired odor cue was associated with further decrement in working memory performance for male animals. Furthermore, anxiety-like behaviors associated with the PTSD-like phenotype could predict the degree of working memory impairment in response to the trauma-paired odor cue. This study enhances validation of an existing rodent model of PTSD through replication of the clinical observations of working memory deficits associated with PTSD and provides novel insight into effects in female rodents. This will facilitate work to probe underlying mechanistic dysregulation of working memory following footshock trauma exposure and future development of novel treatment strategies.

Empathy and depression among a Chinese sample: The moderating role of rumination and attentional shift

Background

Although previous studies have explored the moderating role of emotional regulation strategies in the relationship between empathy and depression, no studies have studied the moderating role of attentional control in the relationship between empathy and depression. To address this research gap, the present study investigated the moderating roles of rumination and attentional control in the relationship between empathy and depression.

Methods

423 participants filled out questionnaires anonymously, including Interpersonal Reactivity Index, Attention Control Scale, Self-rating Depression Scale, and Rumination Response Scale. PROCESS macro for SPSS was used for moderating effect analysis.

Results

Rumination and attentional shift moderated the relationship between emotional empathy and depression. Specifically, the lower rumination or the higher attentional shift, the stronger the negative association between emotional empathy and depression. Attentional shift moderated the relationship between cognitive empathy and depression, and cognitive empathy was significantly associated with depression only among participants whose attentional shift is high.

Conclusion

The study showed that rumination and attentional shift play important roles in the relationship between empathy and depression. The findings implicated that the positive role of good emotional regulation strategies and executive function for individuals in the relationship between empathy and depression.

Lessons unlearned: A conceptual review and meta-analysis of the relationship between the Attention Control Scale and Objective Attention Control

Attention control is central to many models of emotion. Among the most common measures of attention, control is the Attention Control Scale (ACS), which has exerted considerable influence in terms of the volume and breadth of research findings, with its use in cognitive-experimental research continuing to increase in recent years. However, there are growing concerns about whether the ACS genuinely indexes attention control. The present paper considers the context and development of the ACS, reviews and meta-analyses the available evidence regarding its association with objective measures of attention control. Meta-analytic results from nine studies (total n = 1274) indicated that the full-scale ACS was not significantly associated with behavioural measures of attentional control (r = .067, p = .093, N = 1274, 95% CI: -.011, .145). Findings indicated likely missing studies with lower correlations suggesting the true association may be smaller. Limited evidence of shared variance between subjective and objective measures of attention control contrasts with considerable evidence that the scale is closely correlated with dispositional traits (e.g. anxiety, agreeableness) that could plausibly influence responding. Thus, on the balance of current findings, we conclude that there is little compelling evidence that responding on the ACS reflects genuine attention control abilities.

Factors associated with post-traumatic stress disorder among bereaved family members and surviving students two and half years after the Sewol ferry accident in South Korea

BACKGROUND

The Sewol ferry accident was a human-made disaster that caused the death of 250 high school students on board the ferry. Post-traumatic stress disorder (PTSD) is one of the most serious mental health sequela among those exposed to disasters. Therefore this study assessed the PTSD symptoms among bereaved family members and surviving students after the disaster, along with associated risk factors.

METHODS

Bereaved family members (N = 80) and surviving students (N = 48) of the disaster were assessed by self-reported questionnaires 2.5 years after the disaster. Sociodemographic and psychological variables (i.e., PTSD, depression, embitterment, rumination, and others) were obtained. Multivariable Poisson regression analyses were conducted to identify the factors associated with PTSD symptoms.

RESULTS

Sixty-seven (83.8%) of the bereaved family members and three (6.3%) of the surviving students were suffering from probable PTSD. Depression and embitterment were associated with PTSD symptoms in both groups. Social support and meaning in life were related to PTSD symptoms only in the surviving students, while intrusive rumination and posttraumatic growth were related to PTSD symptoms only in the bereaved family members.

CONCLUSIONS

These findings may help identify high-risk groups for PTSD and aid the development of psychological interventions to ameliorate PTSD symptoms of those affected by disasters.

Rumination in posttraumatic stress disorder: A systematic review

Initial models and empirical investigations of rumination in the clinical literature were predominantly in the domain of depression. However, rumination is now well-established as a transdiagnostic cognitive process, including in the context of posttraumatic stress. To clarify the current understanding of rumination in posttraumatic stress, we conducted a systematic review of the empirical literature on rumination in posttraumatic stress disorder (PTSD). Six sub-groups of studies on this topic were identified; these addressed: (i) the frequency and nature of rumination, (ii) cross-sectional relationships between rumination and PTSD symptoms, (iii) the capacity of rumination to predict PTSD longitudinally, (iv) other processes associated with rumination, (v) neurobiological correlates of rumination, and (vi) whether treating PTSD reduces rumination. This review synthesizes these domains of research and identifies key methodological limitations which limit causal inferences, and points to important areas of future research to advance knowledge on rumination in PTSD.

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

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

Prevalence of Mental Health Problems and Willingness to Participate in a Mindfulness Treatment: An Examination among Veterans Injured in Combat

Numerous studies have demonstrated that combat-exposed military veterans are at risk for numerous psychiatric disorders and rates of comorbid mental health and substance use disorders are high. Veterans wounded in combat are a particularly high-risk group of military veterans, however treatment services are often underutilized among this group and it is unclear whether an online treatment program that targets emotional and physical distress (including mental health symptoms and substance use disorders) would be appealing to Veterans wounded in combat. The goal of the current study was to conduct formative research on whether veterans wounded in combat would be interested in an online mindfulness-based treatment to help them cope with emotional and physical discomfort. We recruited Veterans from Combat Wounded Coalition (n = 163; 74.2% non-Hispanic White; 95.7% male) to complete an online survey of mental health and substance use disorder symptoms and willingness to participate in mindfulness treatment. The majority of participants reported significant mental health symptoms and indicated that they would be willing to participate in mindfulness treatment, either at the VA (54.0%) or online (59.5%). Those with problems in multiple health domains and lower self-compassion were significantly more likely to express interest in treatment and likely to represent a very high need group of veterans. The development of a mindfulness-based treatment for this group of individuals could be very helpful in reducing mental health symptoms and improving quality of life among wounded warriors.

An Examination of the Role of Difficulties Regulating Positive Emotions in Posttraumatic Stress Disorder

Emotion regulation difficulties have been theoretically and empirically linked to posttraumatic stress disorder (PTSD). Previous research, however, has focused almost exclusively on difficulties regulating negative emotions. In this study, we explored the nature of difficulties regulating positive emotions in PTSD. Participants were women who had experienced domestic violence (N = 210; 48.6% African American; M_age = 36.14 years). Higher levels of nonacceptance of positive emotions, difficulties engaging in goal-directed behaviors when experiencing positive emotions, and difficulties controlling impulsive behaviors when experiencing positive emotions were related to a higher level of PTSD symptom severity overall and for the intrusion, avoidance/emotional numbing, and hyperarousal clusters, rs = .24-.37. The presence (vs. absence) of a probable PTSD diagnosis was related to greater difficulties engaging in goal-directed behaviors, d = 0.54, and controlling impulsive behaviors, d = 0.34, when experiencing positive emotions. Results suggest the potential utility of assessing and treating difficulties regulating positive emotions among domestic violence-victimized women with PTSD.