Higher Posttraumatic Stress Symptoms Research Articles

P0726 The Moderating Role of Adverse Childhood Experiences in the Relationship between Crohn's Disease Activity and the Development of PTSD Symptoms

Abstract Background Crohn's disease (CD) is a type of inflammatory bowel disease (IBD) characterized by transmural granulomatous inflammation, skip lesions, and a relapsing-remitting course, potentially affecting the entire gastrointestinal tract. Patients with chronic illness are at an increased risk for traumatic stress because of the medical trauma. Previous evidence suggests that many patients perceive the chronic nature of the disease and related diagnostics and therapeutic procedures as traumatic events. Initial studies on post-traumatic stress (PTS) in patients with IBD have found that approximately one-third of patients may experience significant PTS symptoms, including flashbacks, nightmares, hypervigilance, disrupted sleep, and low mood, potentially leading to the development of post-traumatic stress disorder (PTSD). This study aims to explore the moderating role of adverse childhood experiences (ACEs) in the link between CD activity and PTSD symptoms. Methods In a cross-sectional design, the revised Impact of Event Scale (IES-R) and the ACEs Questionnaire were administered to consecutive CD outpatients at Policlinico A. Gemelli in Rome. Disease activity was assessed with the Harvey-Bradshaw Index (HBI). Data were analyzed using Pearson correlation coefficients and moderated regression models in SPSS (version 27). Results A total of 172 CD patients were included in the study, of whom 152 completed the IES and 148 also completed the ACEs questionnaire. Forty-eight patients (31.2%) exhibited a score of 33 or more on the IES-R, suggestive of PTSD. Correlation analyses revealed that ACEs scores correlated significantly with all subscales of the IES-R: intrusion (r=.405, p< .001), avoidance (r=.348, p< .001), and hyperarousal (r= .363, p< .001). Moreover, patients with higher ACEs had significantly more severe disease activity (r= .272, p< .001). Notably, the highest scores of ACEs were observed for the items related to feeling undervalued and ignored by one’s family. Further results from a hierarchical regression analysis demonstrated that the relationship between CD activity and the overall IES- R score was significantly stronger among patients with high ACEs scores (b= .21, p < .001) compared to those with medium (b= .12, p= .005) or low scores (b=.06, p =.291). Conclusion Our study revealed that ACEs play a moderating role in the relationship between CD disease activity and the development of PTS symptoms. Patients with higher PTS symptoms and more ACEs are less likely to achieve remission and may require increased use of gastroenterology services. These findings underscore the importance of a psychological assessment to enhance the management of these patients. Intervention trials to mitigate PTS symptoms in patients with IBD are warranted.

Mediator role of psychological resilience between post-traumatic stress symptoms and burnout in academicians affected by the earthquakes in Türkiye.

This study aims to investigate the mediator role of psychological resilience in the relationship between post-traumatic stress and burnout symptoms in academicians affected by two earthquakes that occurred on February 6, 2023, affecting 11 provinces of Türkiye. The research sample consisted of 175 academicians affected by these earthquakes. Each academician completed an online survey consisting of a sociodemographic form, the PTSD Checklist for DSM-5 (PCL-5), the Brief Psychological Resilience Scale, and the Burnout Syndrome Inventory-Short Version. Negative relationships were found between the post-traumatic stress symptom and burnout levels of academicians and their psychological resilience levels. Psychological resilience had a partial mediating role in the relationships of post-traumatic stress symptoms (reexperiencing, avoidance, and hyperarousal) and burnout. It can be said that higher post-traumatic stress symptoms' severity is associated with higher levels of burnout, and psychological resilience has a mediator role in the relationship between post-traumatic stress and burnout in earthquake-affected academicians.

Post-traumatic stress disorder and symptoms in paediatric cancer survivors and their family nucleus: systematic review, meta-analysis and meta-regression.

Various studies have highlighted the increased incidence and symptoms of depression and anxiety in paediatric cancer survivors (PCS). Yet no meta-analysis has focused on post-traumatic stress disorder (PTSD) or post-traumatic stress symptoms (PTSS) in PCS and their family nucleus. To evaluate the overall risk of PTSD and severity of PTSS in PCS and their family nucleus. Secondary objectives include identifying potential risk factors of PTSD and high PTSS. We systematically searched PubMed, Embase and PsycINFO for studies comparing the risk of PTSD and PTSS severity among PCS, their family nucleus and non-cancer controls. PRISMA reporting guidelines were followed. Random effects meta-analyses and meta-regressions were conducted. From 1089 records, we included 21 studies. PCS have an increased risk of PTSD (risk ratio 2.36, 95% CI 1.37-4.06) and decreased PTSS severity (standardised mean difference -0.29, 95% CI -0.50 to -0.08). Subgroup analyses of other categorical study-level characteristics revealed that female PCS who were older at diagnosis and data collection had a significantly higher risk of PTSD. Meta-regression were insignificant. Family nucleus did not show a significantly increased risk of PTSD (risk ratio 1.13, 95% CI 0.59-5.00) and PTSS severity (standardised mean difference 0.53, 95% CI -0.00 to 1.06). Systematically reviewing studies on the family nucleus found that the majority reported a significantly increased risk of psychological trauma compared with the comparator. Lower education, income and social status were also risk factors. Timely identification and interventions are imperative for policy makers and healthcare providers to prevent trauma from worsening in this population group.

COVID-19 Personal Experiences and Posttraumatic Stress in National Guard Service Members.

The National Guard (NG) was an important component of the U.S. emergency response for the coronavirus (COVID-19) pandemic. Understanding how the personal COVID-19 experiences of NG members may be associated with posttraumatic stress symptoms (PTSS) and disorder (PTSD) can inform approaches to identifying and sustaining service members' mental health. We surveyed 3,993 NG service members (75% Army; 79% enlisted; 33% 30-39 years old; 81% male) during the pandemic. Forty-six percent of participants were activated in response to COVID-19. Surveys were administered between August and December 2020. We defined personal COVID-19 experiences as having COVID-19, a family member(s) having COVID-19, and/or having a close relationship with someone who died from COVID-19. In addition, using a 4-item form of the PTSD Checklist for DSM-5 (PCL-5), current posttraumatic stress symptoms (PTSS) and probable PTSD were assessed. Linear and logistic regression analyses were conducted to examine the relationship of COVID-19 experiences to PTSS and probable PTSD, respectively. Approximately 32% of participants reported at least one personal COVID-19 experience. Univariable linear regression analyses indicated that NG service members who had a personal COVID-19 experience reported more PTSS than those with no personal experience (B = 0.53, SE = 0.12, P < .001). After adjusting for demographics and service-related characteristics, having a personal COVID-19 experience continued to be associated with higher PTSS (B = 0.48, SE = 0.12, P < .001). When examining the relationships of distinct types of personal COVID-19 experiences to PTSS and PTSD together in multivariable models, those who had a close relationship with someone who died from COVID-19 had higher levels of PTSS (B = 1.31, SE = 0.22, P < .001) and were almost 3 times more likely to have PTSD (OR = 2.94[95%CI = 1.93-4.47], P < .001). Personal COVID-19 experiences are associated with increased PTSS and PTSD risk in NG service members. Such knowledge may aid in selection of service members for activation and identifying those in need of care.

Latent trajectories of anxiety and depression among women during subsequent pregnancy following pregnancy loss.

To determine the longitudinal trajectories of anxiety and depression among pregnant women who have experienced pregnancy loss, and to explore the association between post-traumatic stress symptoms (PTSS) related to pregnancy loss and these trajectories. A prospective longitudinal study. Between October 2022 and August 2023, pregnant women with a history of pregnancy loss were recruited from four hospitals in Guangdong Province, China. Eligible participants were screened for PTSS related to pregnancy loss upon enrolment. Anxiety and depression symptoms were assessed in early, mid and late pregnancy using the Pregnancy-related Anxiety Questionnaire-Revised 2 and the Patient Health Questionnaire-9, respectively. Latent class growth analysis was employed to categorize anxiety and depression trajectories, and multinomial logistic regression analysis was conducted to examine the association between PTSS and these trajectories. Of the 388 participants included in the analysis, 158 individuals (40.7%) reported high PTSS scores. The best-fitting models identified three trajectories for both anxiety and depression: low (anxiety: 35.6%, depression: 48.7%), moderate (anxiety: 44.8%, depression: 40.5%) and high (anxiety: 19.6%, depression: 10.8%). Pregnant women with high PTSS levels were significantly more likely to experience moderate-to-high trajectories of anxiety and depression compared to those with low PTSS levels. Pregnant women who have experienced pregnancy loss exhibit higher incidences of elevated anxiety and depression trajectories. Screening for PTSS and targeted supportive care are recommended to alleviate anxiety and depressive symptoms in this population. This study underscores the importance of early psychological screening and tailored interventions for pregnant women with a history of pregnancy loss. Trauma-informed care should be prioritized to mitigate anxiety and depression trajectories in this vulnerable population. There was no patient or public involvement.

Disclosure and concealment in military couples: A dyadic study.

Disclosure of deployment-related experiences among military couples is generally beneficial to mental health and relationship adjustment. Yet, disclosure by the spouse is rarely studied, as are the dyadic associations between disclosure and outcomes in both partners. The present study used a dyadic approach to study the relationship between disclosure or concealment on one hand and mental health and relationship adjustment on the other hand among Israeli military couples. Sixty-three Israel Defense Force (IDF) combat veterans (all male) and their spouses (all female; N = 126) completed self-report questionnaires about disclosure and concealment of deployment-related experiences to their partner; relationship adjustment; depression; and posttraumatic stress symptoms (PTSS). Six Actor-Partner Interdependence Models (APIM) were used for dyadic analysis. We found lower disclosure and higher concealment of deployment-related experiences by veterans compared to spouses. The veteran's concealment of deployment-related experiences was associated with lower relationship adjustment for both partners and with the veteran's own higher PTSS. The spouse's concealment was associated with greater depression for both partners and with the spouse's own higher PTSS. Neither actor nor partner effects were found for disclosure regarding all three outcomes. Concealment of deployment-related experiences among military couples may have detrimental implications on the mental health and relationship adjustment of both the concealer and their partner. The spouse's concealment of their experience was as related to mental health and relationship adjustment as the veteran's concealment. The findings highlight the need to address communication about deployment-related experiences by both partners among military couples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Role of distress tolerance, meaning in life and social support in the relationship between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among Nigerian cancer patients

We examined the moderating roles of distress tolerance, meaning in life, and social support in the relationship between posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG) among cancer patients. Participants included 301 cancer outpatients randomly selected from the oncology unit of a tertiary healthcare institution in Nigeria (female = 60.1%%; age range = 21 to 85 years, mean age = 52.30 years, SD = 12.64 years). They completed self-report measures on distress tolerance, meaning in life, social support, posttraumatic stress symptoms (PTSS), and PTG. Following series of moderation analysis using Hayes PROCESS macro for SPSS Model 1, results showed that higher PTSS was associated with lower PTG at low and moderate, but not at high levels of distress tolerance. Moreover, meaning in life and social support moderators the PTSS and PTG relationship for higher PTG. Therefore, intervention programmes to promote PTG among cancer patients should consider meaning in life, and social support for their protective potentials in improving positive posttraumatic outcome and recovery with distress tolerance.

Feasibility of a trauma-focused internet- and mobile-based intervention for youth with posttraumatic stress symptoms

ABSTRACT Background: Many youth with posttraumatic stress symptoms (PTSS) do not receive evidence-based care. Internet- and Mobile-Based Interventions (IMIs) comprising evidence-based trauma-focused components can address this gap, but research is scarce. Thus, we investigated the feasibility of a trauma-focused IMI for youth with PTSS. Methods: In a one-arm non-randomized prospective proof-of-concept study, 32 youths aged 15–21 years with clinically relevant PTSS (CATS ≥ 21) received access to a trauma-focused IMI with therapist guidance, comprising nine sessions on an eHealth platform accessible via web-browser. We used a feasibility framework assessing recruitment capability, sample characteristics, data collection, satisfaction, acceptability, study management abilities, safety aspects, and efficacy of the IMI in PTSS severity and related outcomes. Self-rated assessments took place pre-, mid-, post-intervention and at 3-month follow-up and clinician-rated assessments at baseline and post-intervention. Results: The sample mainly consisted of young adult females with interpersonal trauma and high PTSS levels (CATS, M = 31.63, SD = 7.64). The IMI sessions were found useful and comprehensible, whereas feasibility of trauma processing was perceived as difficult. Around one-third of participants (31%) completed the IMI’s eight core sessions. The study completer analysis showed a significant reduction with large effects in self-rated PTSS at post-treatment [t(21) = 4.27; p < .001; d = 0.88] and follow-up [t(18) = 3.83; p = .001; d = 0.84], and clinician-rated PTSD severity at post-treatment [t(21) = 4.52; p < .001; d = 0.93]. The intention-to-treat analysis indicated significant reductions for PTSS at post-treatment and follow-up with large effect sizes (d = −0.97– –1.02). All participants experienced at least one negative effect, with the most common being the resurfacing of unpleasant memories (n = 17/22, 77%). Conclusion: The study reached highly burdened young adults. The IMI was accepted in terms of usefulness and comprehensibility but many youths did not complete all sessions. Exploration of strategies to improve adherence in trauma-focused IMIs for youth is warranted, alongside the evaluation of the IMI's efficacy in a subsequent randomized controlled trial.

Filial piety as a beneficial factor for posttraumatic adjustment in the context of adverse childhood experiences among Taiwanese young adults

Introduction: Adverse childhood experiences (ACEs) increase posttraumatic stress symptoms (PTSS) after exposure to later trauma, but in Chinese society some cultural factors such as filial piety can be perceived as a protector buffering the negative results of ACEs on early adulthood adaptation. Method: This study used a longitudinal design to investigate whether dual filial piety—reciprocal filial piety (RFP: affection/gratitude) and authoritarian filial piety (AFP: role obligation/hierarchy)—are protective factors against PTSS and facilitate posttraumatic growth (PTG) following trauma among Taiwanese young adults. The final sample comprised 246 participants aged 18-25 years old who reported experiencing at least one type of trauma in their history of ACEs, RFP, AFP, PTSS, and PTG at Time 1. One (Time 2) and seven (Time 3) months later, 98 and 60 of the original respondents completed follow-up assessments. Results: Results showed that ACEs were significantly associated with higher PTSS, and both RFP and AFP significantly related to lower PTSS and higher PTG at Time 1 and Time 2. Furthermore, RFP mediated the relationship between ACEs and PTSS such that individuals with higher RFP reported lower PTSS across time. Discussion: These findings suggest that filial piety may serve as a protective factor against PTSS and facilitate PTG among traumatized Taiwanese individuals with a history of ACEs. The study implies that future research should explore the mechanisms underlying these relationships and consider how cultural factors may influence the role of filial piety in posttraumatic adjustment.

A Study to Assess the Post Traumatic Stress Symptoms (PTSS) and Anxiety among patients after transfer out from Intensive Care Unit at Shri Vinoba Bhave Civil Hospital, Silvassa.

BACKGROUND: Critical illness can expose patients to traumatic stressors that are caused by both Intensive Care intervention techniques and life threatening experiences. For the last ten years, there has been an increasing interest and attention regarding psychological consequences related to surviving critical illness. This patient population were found to have both Post Traumatic Stress Symptoms and Anxiety. OBJECTIVE: To assess the Post Traumatic Stress Symptoms (PTSS) and Anxiety among patients after transfer out from the ICU, to correlate the relationship between PTSS and Anxiety and find the association between Post Traumatic Stress Symptoms and Anxiety with selected demographic and clinical variables METHODOLOGY: A time series design was adopted and 200 samples were selected by non-purposive sampling technique. Sociodemographic and clinical variables data was collected using the self-administered questionaries’ and PTSS was assessed by using Impact Event Scale Revised and Anxiety was assessed by Anxiety Assessment Scale once the patient is transfer from ICU.Follow up interview was done on 7, 14, 30 day. RESULT: The study findings suggest that Out of 200 samples (patients), 77% of patient were having moderate anxiety, 13% were having severe anxiety, 9.5% were having mild anxiety, &amp; 0.5% were having no anxiety on 0 day. On day 30 62.5% were having moderate anxiety, 33.5% were having mild anxiety, 2% each were having severe and no anxiety So people in the moderate group reduced to 62% and an increment is found in the mild group percentage as 33.5%. On day 0, 51% were having moderate PTSS, 47.5% were having low PTSS and 3% were having high PTSS, none of the patient was having severe PTSS. On day 30, 97.5% were having low PTSS and 7.5% were having moderate PTSS, none of the patient was having high or severe PTSS. This shows a remarkable improvement on day 30 with 92.5% low PTSS. There is no correlation between PTSS and anxiety of patients on 0, 7, 14, 30 day. There was no association between demographic &amp; clinical variables and PTSS &amp; anxiety scores. CONCLUSION: Technological advancements in health care setting has reduce mortality rate of human beings but their emotional consequences also need to be conducted.

Protective Factors in the Context of Childhood Bereavement: Youth Gratitude, Future Orientation, and Purpose in Life.

The objective of the study was to examine potential associations between positive youth development constructs (gratitude, future orientation, purpose in life) and psychological functioning (posttraumatic stress symptoms, depressive symptoms, maladaptive grief reactions) among bereaved youth and test whether these associations vary by age. A diverse sample of 197 clinic-referred bereaved youth (56.2% female; M = 12.36, SD = 3.18; 36.1% Hispanic, 23.7% White, 20.1% Black, 11.9% Multiracial, and 8.2% another race/ethnicity) completed self-report measures of psychological functioning and positive youth development constructs. Linear regression models indicated that gratitude and purpose were associated with lower posttraumatic stress and depressive symptoms among bereaved youth. Future orientation was associated with higher posttraumatic stress symptoms. Results were consistent across age. If replicated longitudinally, gratitude and purpose may be important protective factors against negative mental health outcomes in the aftermath of losing a loved one.

Perceived life threat in children during the COVID-19 pandemic: associations with posttraumatic stress, anxiety, and depressive symptoms.

Defining children's "trauma exposure" in the context of the COVID-19 pandemic has been a source of debate. Children were exposed to threatening messaging about COVID-19 but might interpret this information differently than adults. Perceived life threat (PLT), the belief that one's life is in danger, has been identified as a robust predictor of posttraumatic stress symptoms (PTSS), and may be a better predictor of PTSS than actual life threat (ALT). This study investigated parent reports of children's self-PLT (belief that they might die from COVID-19) and family-PLT (belief that a family member might die from COVID-19). The aims were to compare PLT to ALT, evaluate their associations with children's psychological functioning, and identify risk factors associated with PLT. We hypothesized an association between PLT and children's psychological functioning in the context of the COVID-19 pandemic. Parents (N = 140) reported on their child's (M age = 9.81years, 47% female) pandemic experiences, psychological functioning, and both self-PLT and family-PLT. Results revealed self-PLT for 10% of the children and family-PLT for 43% of the children, yet only 6% experienced ALT (i.e., they or their parent tested positive for COVID-19). Children with reported self- or family-PLT had higher PTSS, depressive symptoms, anxiety symptoms, and functional impairment compared to children without these reported beliefs. PLT, but not ALT, was associated with psychological outcomes. Children with only PLT had greater PTSS and impairment than children with ALT. There were differences in parental functioning and pandemic-related information/media exposure between children with and without PLT. Children's perceptions, rather than objective experiences, may be more central to their psychological functioning. This has implications for screening for pandemic-related symptomatology in children as traditional trauma exposure measures may not adequately identify distressed children.

Criterion A and Non-Criterion A Racial Discrimination Experiences, Posttraumatic Stress Symptoms, and Posttraumatic Cognitions Among Black or African Americans.

Racial discrimination is an unfortunately common experience for Black Americans with detrimental physical and mental health consequences. Prior research has established an association between discrimination and posttraumatic stress symptoms (PTSS); yet, trauma-related cognitions have not been studied. The majority of the existing empirical work in this area has not examined specific forms of discrimination experiences, despite potential key differences in these adversities. Relatedly, some forms of discrimination constitute "traumatic" events as defined by Criterion A for PTSD in the DSM-5 while others do not, and these distinctions have also been overlooked. Thus, the present study aimed to (a) examine discrimination, including specific types, in relation to PTSS and posttraumatic cognitions and (b) investigate whether Criterion A and non-Criterion A discrimination experiences were tied to PTSS and trauma-related thoughts. Participants were 172 undergraduate students who identified as Black or African American (Mage = 25.11, SD = 8.25, range = 18-56; 84.9% female). Results indicated that while cumulative trauma was unrelated to PTSS, discrimination experiences were linked with higher PTSS and negative posttraumatic cognitions. Specifically, avoidance discrimination experiences were associated with both outcomes. Criterion A discrimination events were not tied to PTSS. These findings support previous research showing a link between racial discrimination and trauma-related outcomes. In addition, the results suggest that avoidance discrimination, while not classified as "traumatic," may have an important contribution to PTSS and posttraumatic cognitions among Black individuals. The study underscores the need to address racial discrimination experiences, including microaggressions, within a traumatic stress context.

Unraveling the relations between post-traumatic stress symptoms, neurocognitive functioning, and limbic white matter in pediatric brain tumor patients.

Pediatric brain tumor patients are at risk of developing neurocognitive impairments and associated white matter alterations. In other populations, post-traumatic stress symptoms (PTSS) impact cognition and white matter. This study aims to investigate the effect of PTSS on neurocognitive functioning and limbic white matter in pediatric brain tumor patients. Sixty-six patients (6-16 years) completed neuropsychological assessment and brain MRI (1-year post-diagnosis) and parents completed PTSS proxy questionnaires (CRIES-13; 1-3 months and 1-year post-diagnosis). Mean Z-scores and percentage impaired (>1SD) for attention, processing speed, executive functioning, and memory were compared to normscores (t-tests, chi-square tests). Multi-shell diffusion MRI data were analyzed for white matter tractography (fractional anisotropy/axial diffusivity). Effects of PTSS on neurocognition and white matter were explored with linear regression models (FDR correction for multiple testing), including age at diagnosis, treatment intensity, and tumor location as covariates. Neurocognition and limbic white matter associations were explored with correlations. Attention (M = -0.49, 33% impaired; P < .05) and processing speed (M = -0.57, 34% impaired; P < .05) were significantly lower than healthy peers. PTSS was associated with poorer processing speed (β = -0.64, P < .01). Treatment intensity, age at diagnosis, and tumor location, but not PTSS, were associated with limbic white matter metrics. Neurocognition and white matter metrics were not associated. Higher PTSS was associated with poorer processing speed, highlighting the need for monitoring, and timely referrals to optimize psychological well-being and neurocognitive functioning. Future research should focus on longitudinal follow-up and explore the impact of PTSS interventions on neurocognitive performance.

Long-term post-traumatic stress symptoms in COVID-19 survivors and its risk factors: a two-year longitudinal cohort study

The COVID-19 pandemic has led to widespread mental health problems, necessitating the investigation of longitudinal mental health changes, associated risk factors, and neural mechanisms in survivors. We recorded demographics, mental health, social support, and potential exposures in survivors at 3 months (n = 189), 6 months (n = 47), and 2 years (n = 69) post-discharge and collected brain imaging data at the second timepoint. Control groups included non-COVID-19 locals (3 months: n = 188, 6 months: n = 42, 2 years: n = 71). Results indicated that female survivors exhibited higher post-traumatic stress symptoms (PTSS) and depression levels than female controls for up to 2 years, along with higher anxiety level for up to 6 months. Male survivors had higher PTSS, depression, and anxiety levels than male controls at 2 months. Moreover, COVID-related trauma and low social support were risk factors for PTSS and negative emotions in survivors. Neuroimaging revealed increased amygdala activity in male survivors and correlations between hippocampus activity and depression symptoms as well as between right hippocampus activity and social support. Our study emphasized the importance of monitoring mental wellness in COVID-19 survivors and underscored the crucial role of social support in mitigating mental health problems.

Minority stress and mental health in lesbian, gay, bisexual, transgender, and queer survivors of sexual assault.

Extant research has shown that sexual violence disproportionately affects lesbian, gay, bisexual, transgender, and queer (LGBTQ+) individuals, conferring risk for the development of posttraumatic stress symptoms (PTSS) and related mental health conditions. However, little research has focused on specific vulnerabilities among LGBTQ+-identified sexual assault (SA) survivors (e.g., minority stress) and their associations with post-SA psychopathology. To address this gap, we examined associations between experiences of minority stress and post-SA psychopathology in a sample of LGBTQ+ individuals who experienced SA (N = 92) and completed a battery of self-report measures. Results revealed significant differences in internalized stigma, community connectedness, alcohol use, and cannabis use across sexual orientation and gender modality groups, ηp 2 = .08-11. Additionally, regression analyses indicated that experiences of violence and victimization were significantly associated with higher PTSS, β = .31, p = .020; anxiety, β = .39, p = .003; and alcohol use severity, β = .31, p = .027, over and above other experiences of minority stress and psychopathology risk factors. Internalized stigma was significantly associated with cannabis use severity, β =.34, p = .011. Finally, community connectedness was significantly associated with lower anxiety symptom severity, β = -.42, p = .001. Although longitudinal work is needed, findings indicate that experiences of minority stress may serve as risk or maintenance factors for post-SA psychopathology. These results offer important considerations for future treatment approaches tailored to LGBTQ+ survivors of SA.

Use of religious and spiritual responses after trauma to prevent posttraumatic stress symptoms and suicidality: The role of meaning in life.

The present study examined the relationship between religious/spiritual (R/S) responses to trauma, meaning in life, and psychopathology among US veterans (n = 729). Participants (66.7% male and 83.2% White) completed study questionnaires assessing positive religious coping, divine spiritual struggle, meaning in life, posttraumatic stress symptoms (PTSS), and suicidality severity. Assessments were conducted via telephone interviews at baseline (T1), 3 months (T2) and 6 months (T3). Divine spiritual struggle was associated with lower meaning in life, higher suicidality and higher PTSS at all time points. Positive religious coping was associated with higher meaning in life at all time points and lower suicidality at T2. Meaning in life fully mediated relationships between divine spiritual struggle and both PTSS and suicidality. While higher levels of T1 positive religious coping predicted increased T3 PTSS when controlling for T1 PTSS, meaning in life partially mediated this relationship, with a negative indirect effect. Meaning in life also fully mediated the relationship between positive religious coping and later suicidality, with a negative indirect effect. These findings suggest that divine spiritual struggle consistently predicts both higher PTSS and suicidality. Further, a sense of meaning plays a large role in linking R/S responses to trauma and psychological outcomes. It holds promise as a means through which positive religious coping may exert beneficial effects. Clinicians should be particularly mindful of negative R/S responses after trauma as a risk factor for adverse psychological outcomes. Future research should examine whether meaning-based interventions are beneficial after trauma.

Longitudinal and bidirectional associations between posttraumatic stress disorder and emotional support among disaster-affected men and women.

Research has demonstrated a negative association between social support and symptoms of posttraumatic stress disorder (PTSD). This has been interpreted as a protective influence of social support against the development of posttraumatic stress symptoms (PTSS). Research on the opposite association is more limited, but findings suggest that PTSS have a negative impact on social support. There is conflicting evidence that these effects are moderated by gender. Few studies have assessed both associations and gender moderation in a postdisaster context. We examined the longitudinal and bidirectional effects of emotional support and PTSS and whether gender moderates these effects among U.S. survivors of the 2017-2018 season. Participants (N = 1,347) were assessed at four time points over 1 year. Bidirectional effects were assessed using cross-lagged, autoregressive analyses with the combined sample (Model 1) and grouped by gender (Model 2) to assess gender moderation. The results supported small bidirectional negative effects of social support and PTSS on one another from one assessment point (e.g. Wave 1) to the subsequent point (e.g., Wave 2) for all waves, βs = -.07-.15, p < .001-p = .040. Multigroup analyses suggested the effects were not significantly different by gender. Overall, the results suggest that social support and PTSS may mutually diminish one another. Such effects may result in a positive or negative cascade wherein high PTSS may lead to lower social support and, therefore, even higher PTSS and vice versa. These findings support the importance of including social support in interventions to promote PTSS prevention and recovery.

Resource loss, gain, and traumatic stress in couples during COVID-19.

This study was designed to understand how resource losses and gains during the early months of COVID-19 pandemic-related shutdowns in the United States longitudinally predicted variation in posttraumatic stress symptoms (PTSS) in couples by examining actor and partner effects. A dyadic sample was recruited through the panelist company "Forthright" to complete an online survey asking about experiences with COVID-19 and PTSS. The sample included 535 heterosexual couples from several U.S. states who responded to the survey in April, July, and October of 2020. Actor-partner interdependence modeling (Kenny et al., 2006) was used to explore longitudinal associations within and between partners. Results showed that higher PTSS at Wave 1 significantly, positively predicted both loss and gain at Wave 2 within and between partners. Loss at Wave 2 was a significant predictor of PTSS at Wave 3 within partners. Furthermore, indirect actor and partner effects from Wave 1 to Wave 3 PTSS are discussed. Greater loss, within and between partners, was a predictor of greater posttraumatic stress over time in this study. Further, PTSS were connected over time across partners. While gains have an important role in understanding the effects of the pandemic, loss may be pivotal for clinical focus in addressing posttraumatic stress in dyadic treatment. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Hypervigilance or shutdown? Electrophysiological processing of trauma-unrelated aversive stimuli after traumatic life events.

Post-Traumatic Stress Disorder (PTSD) research indicates that hyper-reactivity to trauma-related stimuli reflects reduced prefrontal cortex (PFC) modulation of amygdala reactivity. However, other studies indicate a dissociative "shutdown" reaction to overwhelming aversive stimuli, possibly reflecting PFC over-modulation. To explore this, we used an Event-Related Potential (ERP) oddball paradigm to study P3 responses in the presence of the following: 1. Trauma-unrelated morbid distractors (e.g., "injured bear") related to the Rorschach inkblot test, and 2. Negative distractors (e.g., "significant failure"), among participants with high post-traumatic stress symptoms (PTS; n = 20), low PTS (n = 17), and controls (n = 15). Distractors were presented at 20% frequency amongst the more frequent (60%) neutral standard stimuli (e.g., "desk lamp") and the equally frequent (20%) neutral trauma-unrelated target stimulus ("golden fish"). P3 amplitudes were high in the presence of morbid distractors and low in the presence of negative distractors only amongst the control group. Possible mechanisms underlying the lack of P3 amplitude modulation after trauma are discussed.