Self-labeling as a survivor predicts perceived posttraumatic growth

Event centrality, the extent to which a traumatic event becomes a reference point for understanding the world and one's role in it, is related to both posttraumatic stress (PTS) symptoms and posttraumatic growth (PTG). Given that higher event centrality is associated with both of these seemingly disparate postevent trajectories, research on potential moderators of these relationships is needed to better understand the conditions under which event centrality relates to one or both outcomes. Maladaptive metacognitive beliefs (i.e., beliefs about thinking, Wells & Matthews, 1994, 1996) might be one individual difference factor that influences the degree to which event centrality is related to PTS symptoms and PTG. In a laboratory session, undergraduate students (N = 149) completed self-report measures of event centrality, maladaptive metacognitive beliefs (negative and positive), PTS symptoms, and PTG. Analyses were conducted using structural equation modeling in order to account for shared variance between PTS symptoms and PTG. As predicted, the positive relationship between event centrality and PTS symptoms became increasingly stronger as maladaptive metacognitive beliefs increased (i.e., both positive and negative metacognitive beliefs). The positive relationship between event centrality and PTG was stronger as maldaptive negative, but not positive, metacognitive beliefs decreased. Study findings suggest that treatments designed to reduce maladaptive metacognitive beliefs could lead to reductions in PTS symptoms and increased opportunity for PTG among those with highly central traumatic events. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objectives This study attempted to examine the mediating effect of mentalization on the relationship between centrality of event and posttraumatic stress symptoms, posttraumatic growth. Methods An online/offline questionnaire was conducted targeting 596 students enrolled in domestic universities, and 596 cases were used for the analysis, excluding 217 cases who responded insincerely or answered that their subjective pain level was below normal. Data were collected from 596 university students using the self-rated mentalization Questionnaire, the trauma event inventory questionnaire, centrality of event scale-korean version, the korean version of impact of event scale-revised, and the korean version of the posttraumatic growth inventory. The collected data were analyzed using descriptive statistics, correlation analysis, and structural equations. Results First, centrality of event had a negative relationship with mentalization, and centrality of event had a positive relationship with posttraumatic stress symptoms and posttraumatic growth. Mentalization had a negative relationship with posttraumatic stress symptoms, and mentalization had a positive relationship with posttraumatic growth. Second, mentalization partially mediated the relationship between centrality of event and posttraumatic stress symptoms, centrality of event and posttraumatic growth. Thrid, centrality of event had direct effect on posttraumatic stress symptoms and posttraumatic growth. Conclusions The results of this study confirmed the role of mentalization in the process of event centrality affecting post-traumatic stress symptoms and post-traumatic growth. Through this, it was confirmed that mentalization can help clients who are struggling with traumatic events in the counseling scene.

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected college students’ mental health and caused post-traumatic stress symptoms (PTSS). Event centrality is thought to play a key role in the development of PTSS, but it is not yet clear by what mechanism. Theoretically, event centrality may affect the retrieval of traumatic memories and further prompt post-traumatic cognitions to understand events, and so may in turn be associated with PTSS in college students. However, few empirical studies have examined the mediating role of post-traumatic cognitions in the relationship between event centrality and PTSS, especially among college students during the COVID-19 pandemic. Objectives: The objective of this study was to examine the mediating roles of post-traumatic cognitive factors (e.g. attention to negative information, catastrophizing, and rumination) in the relationship between event centrality and PTSS among college students during the COVID-19 pandemic. Methods: We recruited 1153 college students who completed the pandemic experiences scale, the centrality of event scale, the attention to positive and negative information scale, the cognitive emotion regulation questionnaire, and the PTSD Checklist for DSM-5 during the COVID-19 pandemic in May 2020. Results: In this sample of college students, event centrality directly predicted PTSS, and PTSS was also indirectly predicted by event centrality through attention to negative information, catastrophizing, and rumination. Conclusions: These findings support the existing literature on the relationship between event centrality, proposed cognitive variables, and PTSS, and shed light on the mechanisms underlying PTSS. Our findings also highlight the importance and applicability of targeted cognitive interventions for PTSS in college students during the COVID-19 pandemic. HIGHLIGHTS The COVID-19 pandemic has caused post-traumatic stress symptoms among college students. Event centrality is a risk factor of post-traumatic stress symptoms among college students during the COVID-19 pandemic. Attention to negative information, catastrophizing and rumination mediate the relationship between event centrality and post-traumatic stress symptoms.

Background: Potentially traumatic events (PTEs) are unfortunately common experiences among children and adolescents. Approximately one quarter of US children are exposed to a PTE before the age of four, with rates increasing to 60% by 16 years of age (Briggs-Gowan, Ford, Fraleigh, McCarthy, & Carter, 2010; Copeland, Keeler, Angold, & Costello, 2007). Exposure to PTEs during childhood is associated with a wide range of negative emotional, behavioral, and physical health consequences over the life course (Anda et al., 2006; Felitti et al., 1998; Gilbert et al., 2009; Shonkoff et al., 2012). Emerging research suggests that childhood trauma may also increase susceptibility to the development of chronic pain in adolescence and adulthood (Boey & Goh, 2001; Davis, Luecken, & Zautra, 2005; Larsson & Sund, 2007; Liakopoulou-Kairis et al., 2002; Mulvaney, Lambert, Garber, & Walker, 2006). However, most investigations of the link between childhood trauma and chronic pain have focused on adults with history of maltreatment. As a result, the contribution of other PTEs to the development of chronic pain among children and adolescents is poorly understood. Additionally, prior research has largely emphasized the prevalence of comorbid chronic pain and posttraumatic stress disorder (PTSD) diagnoses, rather than closely examining the associations between specific posttraumatic stress symptoms (PTSS), pain severity, and functional impairment. As such, much remains unknown regarding the interplay between exposure to PTEs, PTSS, and chronic pain in youth. Aims: The current study aimed to investigate the relationships between quantity and timing of PTEs, pain severity, and pain-related functional impairment among children with amplified musculoskeletal pain syndromes (AMPS). Additionally, this investigation examined the relationships between indices of PTSD symptomatology (i.e., overall symptom severity and symptom clusters) and pain. Finally, this study explored whether potential associations between childhood trauma and pain outcomes were moderated by anxiety, depression, PTSS, and family functioning. Methods: This study employed a cross-sectional design. Participants included 76 children ages 8-17 years (M = 14.08, SD = 2.14) diagnosed with AMPS and their caregivers presenting to the CHOP Center for Amplified Musculoskeletal Pain Syndromes. Participants completed assessments of childhood trauma history, family functioning, and child anxiety, depression, and PTSS online within two weeks before or after their initial consultation appointment. Medical records were reviewed to obtain information about demographic characteristics, pain severity, and pain-related functional disability from measures administered as part of routine clinical care. Results: While total quantity of PTEs was not associated with pain, PTEs reported during the first five years of life significantly predicted pain-related disability. This relationship varied as a function of both child depression and perceptions of family functioning, such that children who endorsed higher current depression and family functioning exhibited the strongest relationship between early trauma and disability. Total PTSS severity and specific symptom clusters were not associated with pain outcomes and did not moderate the relationship between early childhood PTEs and pain-related disability. Conclusions: Early childhood may be a sensitive period for the effects of PTEs on risk for functional disability in youth with AMPS. Additional research utilizing prospective and longitudinal designs is needed to better understand the biopsychosocial mechanisms underlying the relationship between early childhood trauma and pediatric chronic pain.

The connection between stress and skin disease has been extensively documented; however, there are no empirical studies investigating the incidence of traumatic event exposure and posttraumatic stress (PTS) symptoms among dermatology patients. To address this gap in the literature and begin to understand the associations between PTS symptoms and skin disease symptoms, this study used a sample of adults with self-reported skin disease symptoms to examine: (1) rates of potentially traumatic event (PTE) exposure and PTS symptoms; and (2) the association between PTS symptoms and skin-related quality of life, controlling for relevant covariates. Data were collected online through Cloud Research, and participants completed a battery of self-report measures. The sample included 310 participants (68.4% female) who endorsed current skin disease symptoms. Results indicated that 47.1% of participants endorsed clinical levels of PTS symptoms. Consistent with hypotheses, greater levels of PTS symptoms were associated with worse skin-related quality of life, and this association was particularly robust for arousal-related symptoms. Results shed light on the occurrence of trauma-related experiences among individuals with self-reported skin disease and indicate a link between PTS symptoms and the perceived burden of skin disease symptoms on daily living. However, this study was cross-sectional and relied on self-report measures; therefore, findings should be interpreted with caution, particularly since diagnoses could not be verified. Replication of this work in dermatology patients is needed to further understand these connections.

The development of posttraumatic stress symptoms (PTSS) can occur following a traumatic injury, which may include an increase in negative cognitions. One cognitive construct shown to be associated with the development of PTSS is event centrality, or the degree to which an individual views a traumatic experience as central to their life story. Although cross-sectional work has demonstrated a robust connection between event centrality and PTSS, the directionality of this association remains unclear. Most previous work has investigated centrality as a predictor of PTSS, although one recent study suggests that PTSS may, in fact, predict event centrality. The current longitudinal study enrolled adult civilian participants (N = 191) from a Level 1 trauma center following a traumatic injury and assessed both event centrality and PTSS at three points posttrauma (3, 12, and 18 months). A time-constrained random intercept cross-lagged panel analysis showed that PTSS predicted event centrality over the 18-month follow-up period, B = 0.16, p = .021, but event centrality did not predict PTSS, B = -0.27, p = .340. These findings suggest that the development of PTSS following trauma exposure may lead to the perception of the traumatic event as central to an individual's story over time. Further longitudinal research is necessary to determine what variables may influence the connection between PTSS and event centrality.

Background: Research on bullying and child PTSD has traditionally been conducted separately. This study examines the association between bullying and posttraumatic stress symptoms (PTSS) in three international samples, comparing its impact to other potentially traumatic events (PTEs) and assessing whether bullying predicts PTSS when controlling for other PTEs. Method: We analyzed three large clinical samples of children and adolescents referred for mental health care in Norway (N = 3370, 63.4% female, Mage = 14.0), the Netherlands (N = 952, 68.7% female, Mage = 15.57), and Germany (N = 707, 39.0% female, Mage = 13.25), using the Child and Adolescent Trauma Screen (CATS or CATS-2) to measure bullying, PTEs, and PTSS. Two linear regression models were compared per sample: one with variable regression weights and one with constrained weights. We also evaluated unique R² shares to determine the distinct variance each PTE contributed to PTSS. Results: Bullying was reported by 56.2% (Norway), 53.2% (the Netherlands), and 52.6% (Germany); cyberbullying was reported by 17.0% (Germany). Moderate correlations with PTSS severity were found (r = .17–.37 for bullying; r = .36 for cyberbullying). Clinically elevated PTSS were reported by 57.4%–73.1% of those bullied and 78.3% of cyberbullied youth. Bullying remained a significant predictor of PTSS, explaining 3.8% to 22.9% of variance after controlling for other PTEs, age, and gender. Conclusions: From a socio-emotional developmental perspective, bullying is a significant risk factor for child PTSS. This association was stronger when bullying items included threat-based language. Specifying the nature of bullying is crucial in determining whether it meets trauma criteria.

Cross-lagged associations between posttraumatic stress symptoms and coping self-efficacy in long-term recovery: A four-wave comparative study

Background Exposure to potentially traumatic events (PTEs) at work can have a negative impact on the psychological health and work life of child protection workers (CPWs). The most common form of work-related PTE experienced by CPWs consists of aggressive behaviours from the youths or their parents. Objective This study aims to identify modifiable work-related variables that might influence the probability of experiencing impaired mental health and professional adjustment following a PTE. Method The participants were CPWs from two youth social services organizations in Canada. A survey was administered to CPWs within one month of a work-related PTE (Time 1; n = 176), two months after the PTE (Time 2; n = 168), six months after the PTE (Time 3; n = 162), and 12 months after the PTE (Time 4; n = 161). Lagged linear mixed models allowed for the independent variables measured at Time 1, Time 2, and Time 3 to predict the outcome variables as measured on the next assessment (Time 2, Time 3, and Time 4, respectively). The outcomes of interest were insomnia symptoms, depressive symptoms, anxiety symptoms, and post-traumatic stress symptoms, as well as presenteeism (inadequate work performance) and professional quality of life. Results Confidence in one’s own ability to cope with service user aggression negatively predicted depressive, anxiety, and post-traumatic stress symptoms as well as presenteeism, and positively predicted professional quality of life. The perception of job safety negatively predicted depressive, anxiety, and post-traumatic stress symptoms, and positively predicted professional quality of life. Finally, psychological demands from work positively predicted all mental health outcomes as well as presenteeism, and negatively predicted professional quality of life. Conclusions This study identified work-related variables that could be modified in an attempt to prevent the negative impacts of exposure to work-related PTEs, especially, aggressive behaviours from the service users.

Background and Objectives: Repetitive thought (RT) strategies have been linked to a range of negative outcomes following traumatic interpersonal events but are proposed to serve an adaptive function under particular circumstances. This study examined outcomes following RT within a transdiagnostic framework, and explored the potentially adaptive nature of trait-like and event-related RT. Design: The centrality of a traumatic event to one's identity was explored as a context under which the adaptive nature of RT might change. Young adults with interpersonal violence experiences (N = 163) reported use of trait-like and event-related RT, centrality of the event, depressive, anxious, and posttraumatic stress symptoms (PTSS), posttraumatic depreciation and posttraumatic growth. Methods: Hierarchical multiple regression analyses were used to examine main and moderating effects of four types of RT and event centrality on outcome variables. Results: Centrality positively predicted depressive symptoms and PTSS, depreciation, and growth. Brooding RT positively predicted all negative outcomes. Reflecting RT positively predicted anxious symptoms and PTSS and depreciation. Only deliberate RT positively predicted growth. Centrality did not moderate any examined relationships. Conclusions: Findings highlight the importance of addressing specific types of RT in interventions with survivors and of considering centrality as a robust contributor to outcomes following interpersonal violence.

We conducted a cross-sectional study involving completion of self-report measures. Individuals who acquire a spinal cord injury (SCI) face numerous physical and psychological challenges, with the former receiving considerable less attention during the rehabilitation process. In this article, we examined event centrality as a unique predictor of psychological outcomes in a sample of individuals receiving rehabilitation for SCI. Event centrality refers to the extent to which individuals construe a stressful experience as a core part of their identity. In samples of individuals exposed to psychological traumas (for example, sexual assault or military combat), event centrality has emerged as a consistent and powerful predictor of posttraumatic stress symptoms (PTSSs). This is the first study to examine event centrality in an SCI sample. Inpatient rehabilitation program in a large urban city in the Southwestern United States. A sample of 55 participants in rehabilitation for a recent SCI completed measures of event centrality, PTSS, depressed mood and perceived disability. Event centrality was significantly related to perceived disability (r=0.48) and PTSS (r=0.31) and accounted for unique variance in these two outcomes after controlling for demographics and depressed mood. Event centrality is common among individuals with SCI and may be a unique contributor to worse psychological and functional outcomes. We hope our findings will alert health-care professionals to the importance of event centrality. This study was supported by a grant from the Danish National Research Foundation (DNRF89).

Relationship between ways of coping and posttraumatic stress symptoms in firefighters compared to the general population in South Korea

Posttraumatic stress and medication adherence in pediatric transplant recipients

Receiving a diagnosis of HIV can be challenging. People with HIV (PWH) can experience high levels of distress, as well as some positive psychological changes associated with post-traumatic growth. However, the mechanisms which underlying the association of a highly stressful event (i.e., being diagnosed with HIV) and posttraumatic growth (PTG) and posttraumatic stress symptoms (PTSS) are under-explored, and this is the focus of the study. Cross-sectional survey data were provided by 77 PWH living in New Zealand. An analysis examined the roles of deliberate rumination and coping strategies as serial mediators of the associations between event centrality and PTG and PTSSs. The relationships between event centrality and PTG and PTSSs were found to be sequentially mediated by deliberate rumination and avoidance coping, but not by deliberate rumination and active coping. Further analyses explored active coping and deliberate rumination as parallel mediators, with avoidance coping as a subsequent mediator, between event centrality and PTG and PTSSs. However, these analyses were not supported. The findings indicate that the more participants appraised the HIV diagnosis as central, the greater PTG they perceived; however, the more they deliberately ruminated on it, and the more avoidance coping they adopted, the less PTG and greater PTSSs they perceived. Future studies need to explore the relationships of event centrality and coping and their associations with PTG and PTSSs.

To assess and compare the (independent) predictive value of trauma-related coping self-efficacy (CSE) for posttraumatic stress symptoms (PTSS) among a treatment sample and a comparison group of nontreatment seeking victims. Both the treatment (N = 54) and comparison group (N = 144) were exposed to potentially traumatic events (PTEs), experienced a heightened level of PTSS (IES > = 19), and were matched on work status and time between PTE and first measurement (T1). Respondents completed both baseline (T1) and follow-up measures (T2) approximately 8 months after T1. Multiple regression analyses among the treatment sample showed that neither PTSS at T1 (start of treatment) nor CSE levels at T1 predicted PTSS at T2 among the treatment group. Among the comparison group, higher CSE levels at T1 and younger age were significantly associated with lower PTSS at T2. In both the treatment group and the comparison group PTSS levels were significantly lower at T2 than at T1. As expected, treatment seeking victims have higher PTSS and lower CSE levels than nontreatment seeking victims. Pretreatment CSE did not affect recovery during treatment: higher pretreatment CSE perceptions do not give treated individuals an advantage while CSE is predictive of PTSS among untreated victims.