Self-Disgust Is Associated With Loneliness, Mental Health Difficulties, and Eye-Gaze Avoidance in War Veterans With PTSD

Is self-disgust an implicit or explicit emotional schema?

Self-disgust, a negative self-conscious emotional schema that is associated with mental health difficulties in both clinical and non-clinical populations, is typically assessed with self-reported measures that target physical and behavioural aspects of the self. The aim of the present research was to develop and validate a novel implicit self-disgust measure (ISDM) using an Implicit Association Task (IAT) paradigm, across three studies. Study 1 developed a list of disgust-related and positive words that were rated for emotional valence and arousal and informed the content of the ISDM. Study 2 developed and examined the ISDM using the single-target IAT in a non-clinical population and showed that scores in the ISDM were significantly associated with self-reported self-disgust. Study 3 partly replicated the findings of Study 2 among participants with trauma-related experiences and following a mood induction paradigm, showing a significant association between the ISDM and the physical aspect of self-reported self-disgust. These findings are significant because they have implications about the automaticity of self-disgust in people with traumatic experiences which can further inform clinical practice and interventions targeting self-disgust.

Post-traumatic Stress Disorder in Veterans: A Concept Analysis

Post-traumatic stress disorder (PTSD) occurs when an individual experiences a traumatic event that exceeds the limits of psychological endurance. Many veterans experience PTSD. PTSD can negatively impact veterans' quality of life, functioning, life satisfaction, and overall well-being. It is important to analyze the concept of PTSD in the veteran population. This concept analysis aimed to investigate the defining attributes, a model case, antecedents, consequences, and empirical referents related to the concept of PTSD among veterans. Walker and Avant's method was used to guide this concept analysis of PTSD. The results showed that three attributes were determined from the analysis: intrusive memories of traumatic events, feelings of isolation and estrangement, and negative cognitions. PTSD is conceptualized as a collection of symptoms that arise from highly traumatic experiences. The military environment predisposes veterans to traumatic events that should be identified or acknowledged. A better understanding of the concept of PTSD can facilitate the development of effective interventions for the veteran population and enhance their mental health.

(No) Effects of a Self-Kindness Intervention on Self-Esteem and Visual Self-Perception: An Eye-Tracking Investigation on the Time-Course of Self-Face Viewing

Previous research has suggested a favorable impact of self-kindness on subjective well-being. The present experiment investigated the effects of an app-assisted self-kindness intervention for increasing self-esteem and self-face gaze, and for decreasing depression. We explored self-face processing via a time-course analysis of eye-tracking data. Eighty participants (56 female, 24 male; mean age: 23.2 years) were randomly allocated to one of two intervention groups, each receiving daily instructions to enhance either self-kindness or relaxation (active control). Following a one-week intervention period, both groups reported improved self-esteem (p = .035, ηpart2 = .068) and reduced depression (p < .001, ηpart2 = .17). The duration of self-face gaze increased in both groups (p < .001, ηpart2 = .21). Self-face processing was characterized by an early automatic attention bias toward the self-face, with a subsequent reduction in self-face bias, followed in turn by an attentional self-face reapproach, and then a stable self-face bias. We thus identified a complex temporal pattern of self-face inspection, which was not specifically altered by the intervention. This research sheds light on the potential for app-assisted interventions to positively impact psychological well-being, while also highlighting the complexity of self-face processing dynamics in this context. In the future, we propose the inclusion of personalized self-kindness statements, which may amplify the benefits of these interventions.

Loneliness in Posttraumatic Stress Disorder: A Neglected Factor in Accelerated Aging?

Prior research suggests that people with Posttraumatic Stress Disorder (PTSD) may experience a form of accelerated biological aging. In other populations, loneliness has been shown to elevate risk for many of the same components of accelerated biological aging, and other deleterious outcomes, as seen in people with PTSD. Although standard diagnostic criteria for PTSD include "feelings of detachment or estrangement from others", the relationship of such feelings to the concept of loneliness remains uncertain, in par potentially due to a failure to distinguish between loneliness versus objective social isolation. In order to catalyze wider research attention to loneliness in PTSD, and the potential contribution to accelerated biological aging, the present paper provides three components: (1) a conceptual overview of the relevant constructs and potential interrelationships, (2) a review of the limited extant empirical literature, and (3) suggested directions for future research. The existing empirical literature is too small to support many definitive conclusions, but there is evidence of an association between loneliness and symptoms of PTSD. The nature of this association may be complex, and the causal direction(s) uncertain. Guided by the conceptual overview and review of existing literature, we also highlight key areas for further research. The ultimate goal of this line of work is to elucidate mechanisms underlying any link between loneliness and accelerated aging in PTSD, and to develop, validate, and refine prevention and treatment efforts.

Exploring the Role of Social Connection in Interventions With Military Veterans Diagnosed With Post-traumatic Stress Disorder: Systematic Narrative Review

Background

It has been identified that military veterans have distinct experiences of loneliness and social isolation and, when comparing this community to other client groups with a PTSD diagnosis, veterans respond less favorably to treatment. However, the link between PTSD and loneliness for veterans remains insufficiently researched and it is unclear if there are effective interventions tackling this distinct experience of loneliness.

Aims

This systematic narrative review aimed to synthesize existing evidence incorporating elements of social connection, social isolation, and loneliness within interventions for military veterans with a diagnosis of PTSD, consequently aiming to examine the impact of such interventions upon this community.

Methods

Six databases were searched, utilizing relevant search criteria, with no date restrictions. Articles were included if they involved intervention or treatment for military veterans with PTSD and considered elements of social connection, social isolation, and/or loneliness. The initial search returned 202 papers. After exclusions, removal of duplications, and a reference/citation search, 28 papers remained and were included in this review.

Results

From the 28 studies, 11 directly addressed social isolation and two studies directly addressed loneliness. Six themes were generated: (i) rethinking the diagnosis of PTSD, (ii) holistic interventions, (iii) peer support, (iv) social reintegration, (v) empowerment through purpose and community, and (vi) building trust.

Conclusions

A direct focus upon social reintegration and engagement, psychosocial functioning, building trust, peer support, group cohesiveness and empowerment through a sense of purpose and learning new skills may mitigate experiential loneliness and social isolation for veterans with PTSD. Future research and practice should further explore the needs of the PTSD-diagnosed veteran community, seek to explore and identify potential common routes toward the development of PTSD within this community and consider bespoke interventions for tackling loneliness.

Loneliness is not a homogeneous experience: An empirical analysis of adaptive and maladaptive forms of loneliness in the UK

Understanding loneliness is pivotal to informing relevant evidence-based preventive interventions. The present study examined the prevalence of loneliness in the UK, during the COVID-19 pandemic, and the association between loneliness, mental health outcomes, and risk and protective factors for loneliness, after controlling for the effects of social isolation. It was estimated that 18.1% of the population in our study experienced moderately high to very high loneliness. We also found that loneliness was positively associated with self-disgust and social inhibition, and negatively associated with trait optimism and hope. Cluster analysis indicated that two distinct groups emerged among those experiencing higher levels of loneliness: "adaptive" and "maladaptive" loneliness groups. The maladaptive loneliness group displayed psychological characteristics like self-disgust and social inhibition including symptoms of depression and anxiety that can potentially undermine their ability to connect with others and form meaningful social relationships. These findings suggest that not all people experience loneliness in the same way. It is possible that a one-size-fit-all approach to reducing loneliness, may be less effective because it does not take into account the differential psychological profiles and characteristics of lonely people, relevant to their capacity to connect with others.

Effects of Self-Esteem on Self-Viewing: An Eye-Tracking Investigation on Mirror Gazing

While some people enjoy looking at their faces in the mirror, others experience emotional distress. Despite these individual differences concerning self-viewing in the mirror, systematic investigations on this topic have not been conducted so far. The present eye-tracking study examined whether personality traits (self-esteem, narcissism propensity, self-disgust) are associated with gaze behavior (gaze duration, fixation count) during free mirror viewing of one's face. Sixty-eight adults (mean age = 23.5 years; 39 females, 29 males) viewed their faces in the mirror and watched a video of an unknown person matched for gender and age (control condition) for 90 s each. The computed regression analysis showed that higher self-esteem was associated with a shorter gaze duration for both self-face and other-face. This effect may reflect a less critical evaluation of the faces.