Associations of past-year overall trauma, sexual assault and PTSD with social support for young adult sexual minority women

Background: Young adult sexual minority women (SMW) are at elevated risk for sexual assault (SA), posttraumatic stress disorder (PTSD), and inadequate social support. While SA and PTSD can lead to reductions in social support from close significant others, the impact of SA and PTSD on SMWs' social support has not previously been assessed.Objective: This study examined the associations of past year SA and PTSD with SMW's social support from intimate partners, family, and friends. It was hypothesized that SA and PTSD would be negatively associated with support from partners, family and friends, and that PTSD would moderate the effect of SA on support in early adulthood.Method: Young adult SMW in the United States (N = 235) who were M = 23.93 (SD = 2.15) years old, primarily lesbian or bisexual (n = 186, 79.1%) and White (n = 176, 74.9%) completed measures on past year exposure to SA and non-SA trauma, PTSD, and social support from intimate partners, family and friends.Results: PTSD was associated with less social support from partners, (b  = -0.06, SE = 0.02, p = .010, R2change = .02), family, (b  = -0.06, SE = 0.03, p = .025, R2change = .02), and friends, (b  = -0.07, SE = 0.02, p = .008, R2change = .02). There was a significant interaction between PTSD and SA on social support from partners (b  = -0.01, SE = 0.01, p = .047, R2change = .01). Neither non-SA nor SA trauma was associated with support from family or friends.Conclusions: Results underscore the potential impact of recent SA on intimate partnerships for young adult SMW with more severe PTSD. Future work should explore how addressing PTSD and improving social support quality may help SMW recover from traumatic experiences and ameliorate the effects of SA on intimate partnerships.

A preliminary evaluation of the supportive other experiences questionnaire: Integrating the perspectives of SS providers after traumatic injury

BACKGROUND

Social support is a protective factor against the development of Posttraumatic Stress Disorder (PTSD). However, examinations of the social support after trauma have relied primarily on the self-reports of trauma survivors to the exclusion of their support providers. A new measure, the Supportive Other Experiences Questionnaire (SOEQ) was adapted from a well-established behavioral coding schema of support behaviors to capture social support experiences from the support provider perspective.

METHOD

513 Concerned Significant Others (CSOs) recruited on MTurk who had served as support providers to a traumatically injured romantic partner were recruited to respond to SOEQ candidate items and other relevant measures of psychopathology and relational factors. Factor analytic, correlational and regression analyses were conducted.

RESULTS

Confirmatory factor analytic results of SOEQ candidate items provide evidence for three support types (i.e., informational, tangible, and emotional) and two support processes (i.e., frequency, difficulty), producing a final 11-item version of the SOEQ. Evidence of convergent and discriminant validity provide good psychometric support for the measure. Evidence of construct validity was derived from support for two hypotheses: (1) difficulty providing social support is negatively associated with CSO perceptions of trauma survivor recovery, (2) social support provision frequency is positively associated with relationship satisfaction.

LIMITATIONS

Though factor loadings for support types were significant, several were small, limiting interpretability. Cross-validation in a separate sample is needed.

CONCLUSIONS

The final version of the SOEQ demonstrated promising psychometric properties, and can provide key information one the experiences of CSOs as social support providers for trauma survivors.

The Enduring Importance of Parenting: Caregiving Quality and Fear-Potentiated Startle in Emerging Adults With a Child Maltreatment History

Background: The transition to adulthood is a period of increased risk for emergent psychopathology; emerging adults with a childhood maltreatment history are at risk for poor outcomes. Method: Using a multi-measure, transdisciplinary, cross-sectional design, this study tested whether participant-reported positive parenting, a potential resilience-promoting factor, moderated the association between clinician-rated PTSD symptom severity and a transdiagnostic maladjustment biomarker, fear-potentiated startle (FPS), in a sample of 66 emerging adults (Myears = 18.83, SD = 0.89) with a maltreatment history. We hypothesized that characteristics of effective parenting would moderate the relation between PTSD symptoms and FPS. Results: Results indicated that elevated PTSD, as measured by the CAPS, was associated with a more severe startle reaction. The magnitude of the increase in startle reactivity was moderated by parenting such that those with more positive parenting (Accepting [relative to rejecting]: b = -0.42, p < .001; Psychologically-controlling [relative to autonomy-promoting]: b = 2.96, p = .004) had significantly less reactivity across the task at higher levels of PTSD symptoms. Conclusions: Emerging adults with childhood maltreatment histories, high levels of PTSD symptoms, and who perceive present-day high-quality caregiver support may cope better with novel stressors relative to youth lacking that support, potentially translating to better psychological outcomes.

Doomscrolling during COVID-19: The negative association between daily social and traditional media consumption and mental health symptoms during the COVID-19 pandemic

OBJECTIVE

Consumption of traditional and social media markedly increased at the start of the COVID-19 pandemic as new information about the virus and safety guidelines evolved. Much of the information concerned restrictions on daily living activities and the risk posed by the virus. The term doomscrolling is used to describe the phenomenon of elevated negative affect after viewing pandemic-related media. The magnitude and duration of this effect, however, is unclear. Furthermore, the effect of doomscrolling likely varies based on prior vulnerabilities for psychopathology, such as a history of childhood maltreatment. It was hypothesized that social and traditional media exposure were related to an increase in depression and PTSD and that this increase was moderated by childhood maltreatment severity.

METHOD

Participants completed a baseline assessment for psychopathology and 30 days of daily assessments of depression, PTSD, and pandemic-related media use.

RESULTS

Using multilevel modeling, social media exposure was associated with increased depression and PTSD. This association was stronger for those with more severe maltreatment histories. Furthermore, those with more severe baseline psychopathology used more social media during this period. These relations were not observed for traditional media sources.

CONCLUSIONS

These results suggest that regular viewing of pandemic-related social media is associated with increases in psychopathology for those with existing vulnerabilities. Those with such vulnerabilities should adopt strategies to limit social media consumption. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Crowdsourcing Trauma: Psychopathology in a Trauma-Exposed Sample Recruited via Mechanical Turk

Although crowdsourcing websites like Amazon's Mechanical Turk (MTurk) allow researchers to conduct research efficiently, it is unclear if MTurk and traditionally recruited samples are comparable when assessing the sequela of traumatic events. We compared the responses to validated self-report measures of posttraumatic stress disorder (PTSD) and related constructs that were given by 822 participants recruited via MTurk and had experienced a DSM-5 Criterion A traumatic event to responses obtained in recent samples of participants recruited via traditional methods. Results suggested that the rate of PTSD in the present sample (19.8%) was statistically higher than that found in a recent systematic review of studies that used only traditional recruitment methods. The severity of PTSD reported in the MTurk sample was significantly greater than that reported in a college sample, d = 0.24, and significantly less than that reported in a veteran sample, d = 0.90. The factor structure of PTSD found in the MTurk sample was consistent with prevailing models of PTSD. Findings indicate that crowdsourcing may improve access to this hard-to-reach population.

An Examination of Social Support and PTSD Treatment Response During Prolonged Exposure

OBJECTIVE

Posttraumatic stress disorder (PTSD) results from exposure to traumatic events. Social support is negatively related to PTSD symptoms in cross-sectional and longitudinal studies. It is unclear, however, if social support is associated with treatment response for PTSD. The current study evaluated the extent to which social support was associated with PTSD treatment response among treatment-seeking veterans receiving prolonged exposure (PE). It was hypothesized that social support would improve PTSD treatment response and that PTSD symptom reduction would improve social support.

METHOD

A total of 123 veterans were recruited from a Veterans Affairs Medical Center and evaluated for PTSD, diagnostic-related symptoms, and social support. All participants received PE. Data were analyzed using mixed-effects models.

RESULTS

Findings suggested that elevated social support during treatment was associated with greater reductions in PTSD symptoms during treatment. Social support also increased during treatment. Increases in social support were not moderated by PTSD symptoms during treatment.

CONCLUSIONS

These findings suggest that social support and PTSD symptoms are related throughout treatment. Social support moderated the change in PTSD symptoms, whereas PTSD symptoms did not moderate changes in social support.

mHealth solutions for early interventions after trauma: improvements and considerations for assessment and intervention throughout the acute post-trauma period

Interventions administered shortly after a traumatic event have the potential to prevent posttraumatic stress disorder (PTSD) and related mental health conditions. A key challenge in delivering such interventions is understanding how PTSD symptoms develop in the acute post-trauma period, defined as the first 30 days after a trauma. Mobile devices have the potential to transform the way symptoms are assessed and how treatment is delivered in that they can capture the dynamic and nuanced nature of symptom progression after trauma. Symptoms can be assessed through active strategies that require user input, such as self-report, or through passive strategies, such as location information. Adaptive mobile interventions can be tailored to target PTSD symptoms as they appear and ultimately prevent more chronic courses of illness. Considerations for how such mobile strategies should be implemented are discussed.

An exploratory study of mobile messaging preferences by age: Middle-aged and older adults compared to younger adults

Introduction

Mobile technologies, such as short message service or text messaging, can be an important way to reach individuals with medical and behavioral health problems who are homebound or geographically isolated. Optimally tailoring messages in short message service interventions according to preferences can enhance engagement and positive health outcomes; however, little is known about the messaging preferences of middle-aged and older adults.

Methods

Utilizing secondary data, global messaging preferences were examined to inform the development of short message service interventions for adults of all ages. Two hundred and seventy-seven adults were recruited through an online labor market. They completed an online survey by evaluating message dyads in 22 content groupings. Dyads were identical in subject matter but structurally or linguistically varied. Participants selected the message in each dyad they would prefer to receive when attempting to meet a self-selected personal goal. Preferences were tested for two age groups ≤50 and 51 and older.

Results

Findings reveal adults 51 and older have clear messaging preferences that differ significantly from the younger group for only two content groupings; specifically, they prefer no emoticon to a smiley face emoticon and “you” statements rather than “we” statements.

Conclusion

Recommendations for optimizing messaging for older adults are reviewed.

The intervening role of urgency on the association between childhood maltreatment, PTSD, and substance-related problems

A range of risk factors lead to opioid use and substance-related problems (SRP) including childhood maltreatment, elevated impulsivity, and psychopathology. These constructs are highly interrelated such that childhood maltreatment is associated with elevated impulsivity and trauma-related psychopathology such as posttraumatic stress disorder (PTSD), and impulsivity-particularly urgency-and PTSD are related. Prior work has examined the association between these constructs and substance-related problems independently and it is unclear how these multi-faceted constructs (i.e., maltreatment types and positive and negative urgency) are associated with one another and SRP. The current study used structural equation modeling (SEM) to examine the relations among childhood maltreatment, trait urgency, PTSD symptoms, and SRP in a sample of individuals with a history of opioid use. An initial model that included paths from each type of childhood maltreatment, positive and negative urgency, PTSD and SRP did not fit the data well. A pruned model with excellent fit was identified that suggested emotional abuse, positive urgency, and negative urgency were directly related to PTSD symptoms and only PTSD symptoms were directly related to SRP. Furthermore, significant indirect effects suggested that emotional abuse and negative urgency were related to SRP via PTSD symptom severity. These results suggest that PTSD plays an important role in the severity of SRP.

Characteristics of online treatment seekers interested in a text messaging intervention for problem drinking: adults 51 and older versus middle-aged and younger adults

According to the Institute of Medicine, the vast older adult population is estimated to have mental health and substance use disorders at unprecedented rates and will place high demand on an unprepared healthcare system. Online and mobile health interventions, such as text messaging, could provide an alternative form of frontline intervention that could alleviate some of the burden on the healthcare system; however, it remains unknown what are characteristics of adults over 50 who might be interested in a mobile health behavioral intervention and how they may differ from their younger counterparts. To explore the characteristics of those interested in a text messaging intervention by age, we examined screening data for a randomized controlled trial testing a text messaging intervention to reduce drinking among 1,128 hazardous and problem drinkers, aged 21-30, 31-50, and 51 and older. Participants were recruited online through website advertising on alcoholscreening.org and moderationmanagement.org. Results demonstrated that over a quarter of individuals pursuing online and/or text messaging treatment were 51 and older. These participants reported heavy drinking, with significantly greater number of days drinking and binge drinking than the younger groups, but with fewer consequences. Across age groups, a vast majority of participants were female. Findings demonstrate that a group of adult heavy drinkers 51 and older already pursue online treatment and are interested in using a text messaging intervention to help them reduce drinking, suggesting an avenue to engage this population using an alternative frontline treatment.

Tracking post-trauma psychopathology using mobile applications: A usability study

Trauma exposure markedly increases risk for psychopathology including posttraumatic stress disorder (PTSD). Understanding the course by which PTSD develops after a traumatic event is critical to enhancing early intervention. Although prior work has explored the course of PTSD symptoms in the subsequent months, relatively few studies have explored the course of symptoms in the acute post-trauma period, defined as the 30 days after a traumatic event. A key challenge to conducting such studies is the lack of efficient means to collect data that does not impose significant burden on the participant during this time. The present study evaluated the use of a mobile phone application to collect symptom data during the acute post trauma period. Data was obtained from 23 individuals who experienced a Criterion A traumatic event and were recruited from the Emergency Department of a Level 1 Trauma Center. Participants completed 44.93% of daily assessments across a 30-day period. Responses rates were uncorrelated with PTSD symptoms or depression symptoms at 1-month and 3-month posttrauma. Participants reported that the surveys were moderately helpful and posed minimal burden. These findings suggest that mobile applications can be used to learn about the course of post-trauma recovery.

A Randomized Controlled Pilot Trial of Different Mobile Messaging Interventions for Problem Drinking Compared to Weekly Drink Tracking

INTRODUCTION

Recent evidence suggests that text messaging may help to reduce problem drinking as an extension to in-person services, but very little is known about the effectiveness of remote messaging on problem drinking as a stand-alone intervention, or how different types of messages may improve drinking outcomes in those seeking to moderate their alcohol consumption.

METHODS

We conducted an exploratory, single-blind randomized controlled pilot study comparing four different types of alcohol reduction-themed text messages sent daily to weekly drink self-tracking texts in order to determine their impact on drinking outcomes over a 12-week period in 152 participants (≈ 30 per group) seeking to reduce their drinking on the internet. Messaging interventions included: weekly drink self-tracking mobile assessment texts (MA), loss-framed texts (LF), gain-framed texts (GF), static tailored texts (ST), and adaptive tailored texts (TA). Poisson and least squares regressions were used to compare differences between each active messaging group and the MA control.

RESULTS

When adjusting for baseline drinking, participants in all messaging groups except GF significantly reduced the number of drinks consumed per week and the number of heavy drinking days compared to MA. Only the TA and GF groups were significantly different from MA in reducing the number of drinking days. While the TA group yielded the largest effect sizes on all outcome measures, there were no significant differences between active messaging groups on any outcome measure. 79.6% of individuals enrolled in the study wanted to continue receiving messages for an additional 12 weeks at the end of the study.

DISCUSSION

Results of this pilot study indicate that remote automated text messages delivered daily can help adult problem drinkers reduce drinking frequency and quantity significantly more than once-a-week self-tracking messages only, and that tailored adaptive texts yield the largest effect sizes across outcomes compared to MA. Larger samples are needed to understand differences between messaging interventions and to target their mechanisms of efficacy.

Investigation of abbreviated 4 and 8 item versions of the PTSD Checklist 5

Posttraumatic stress disorder (PTSD) is a significant public health concern associated with marked impairment across the lifespan. Exposure to traumatic events alone, however, is insufficient to determine if an individual has PTSD. PTSD is a heterogeneous diagnosis such that assessment of all 20 symptoms is problematic in time-limited treatment settings. Brief assessment tools that identify those at risk for PTSD and measure symptom severity are needed to improve access to care and assess treatment response. The present study evaluated abbreviated measures of PTSD symptoms derived from the PTSD Checklist for DSM-5 (PCL-5) - a 20-item validated measure of PTSD symptoms - across two studies. In the first, using a community sample of adults exposed to a traumatic event, 4-and 8-item versions of the PCL-5 were identified that were highly correlated with the full PCL-5. In the second, using a sample of combat veterans, the 4-and 8-item measures had comparable diagnostic utility to the total-scale PCL-5. These results provide support for an abbreviated measure of the PCL-5 as an alternative to the 20-item total scale.

Examination of the interrelations between the factors of PTSD, major depression, and generalized anxiety disorder in a heterogeneous trauma-exposed sample using DSM 5 criteria

Exposure to traumatic events places individuals at high risk for multiple psychiatric disorders, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). The high rates of comorbidity among these conditions merit evaluation in order to improve diagnosis and treatment approaches. The current study evaluated the association between PTSD, MDD, and GAD factors as presented in the DSM 5. 602 trauma-exposed individuals who experienced an event that met Criterion A for the DSM 5 PTSD diagnosis were recruited through Amazon.com, Inc.'s Mechanical Turk (MTurk) to complete an assessment of the impact of stressful events on their lives. High interrelations were detected among the 4 PTSD factors, 2 MDD factors that corresponded to somatic and affective symptoms, and the single GAD factor. The affective factor of MDD was most strongly related to the emotional numbing factor of PTSD, whereas the somatic factor of MDD was most strongly related to the hyperarousal factor of PTSD. The GAD factor was most strongly related to the hyperarousal factor of PTSD, relative to the other PTSD factors. The strength of the interrelations between factors of the three disorders is largely a function of the overlap in symptoms and calls into question the uniqueness of negative affective symptoms of PTSD, MDD and GAD. Results suggest that improved understanding of the trauma reaction requires a focus on the unique presentation of each individual and assessment of multiple disorders.

Understanding text-based persuasion and support tactics of concerned significant others

The behavior of concerned significant others (CSOs) can have a measurable impact on the health and wellness of individuals attempting to meet behavioral and health goals, and research is needed to better understand the attributes of text-based CSO language when encouraging target significant others (TSOs) to achieve those goals. In an effort to inform the development of interventions for CSOs, this study examined the language content of brief text-based messages generated by CSOs to motivate TSOs to achieve a behavioral goal. CSOs generated brief text-based messages for TSOs for three scenarios: (1) to help TSOs achieve the goal, (2) in the event that the TSO is struggling to meet the goal, and (3) in the event that the TSO has given up on meeting the goal. Results indicate that there was a significant relationship between the tone and compassion of messages generated by CSOs, the CSOs’ perceptions of TSO motivation, and their expectation of a grateful or annoyed reaction by the TSO to their feedback or support. Results underscore the importance of attending to patterns in language when CSOs communicate with TSOs about goal achievement or failure, and how certain variables in the CSOs’ perceptions of their TSOs affect these characteristics.

Understanding messaging preferences to inform development of mobile goal-directed behavioral interventions

Background

Mobile messaging interventions have been shown to improve outcomes across a number of mental health and health-related conditions, but there are still significant gaps in our knowledge of how to construct and deliver the most effective brief messaging interventions. Little is known about the ways in which subtle linguistic variations in message content can affect user receptivity and preferences.

Objective

The aim of this study was to determine whether any global messaging preferences existed for different types of language content, and how certain characteristics moderate those preferences, in an effort to inform the development of mobile messaging interventions.

Methods

This study examined user preferences for messages within 22 content groupings. Groupings were presented online in dyads of short messages that were identical in their subject matter, but structurally or linguistically varied. Participants were 277 individuals residing in the United States who were recruited and compensated through Amazon’s Mechanical Turk (MTurk) system. Participants were instructed to select the message in each dyad that they would prefer to receive to help them achieve a personal goal of their choosing.

Results

Results indicate global preferences of more than 75% of subjects for certain types of messages, such as those that were grammatically correct, free of textese, benefit-oriented, polite, nonaggressive, and directive as opposed to passive, among others. For several classes of messages, few or no clear global preferences were found. There were few personality- and trait-based moderators of message preferences, but subtle manipulations of message structure, such as changing “Try to…” to “You might want to try to…” affected message choice.

Conclusions

The results indicate that individuals are sensitive to variations in the linguistic content of text messages designed to help them achieve a personal goal and, in some cases, have clear preferences for one type of message over another. Global preferences were indicated for messages that contained accurate spelling and grammar, as well as messages that emphasize the positive over the negative. Research implications and a guide for developing short messages for goal-directed behaviors are presented in this paper.