Higher Posttraumatic Stress Research Articles

Anxiety Buffer Disruption: Self-Evaluation, Death Anxiety, and Stressor Appraisals Among Low and High Posttraumatic Stress Symptom Samples

Objective: Research driven by terror management theory suggests sociocultural anxiety-buffer systems typically protect against existential anxiety, whereas anxiety buffer disruption theory suggests traumatic experiences may disrupt that process. Method: Following posttraumatic stress (PTS) symptom screening (n = 4097), individuals with low (n = 149) and high (n = 120) PTS engaged in either negative or positive self-evaluations, then reported death anxiety and appraised life's stressors as negative/threatening or positive/challenging. Results: When low PTS participants contemplated their worst (vs. best) selves, they experienced moderately heightened death anxiety yet appraised life's stressors as more positive/challenging than harmful/threatening, reflecting effective existential anxiety buffers. However, high PTS participants reported high death anxiety in both the best-self and worst-self conditions—indicating anxiety buffer disruption—and the worst-self (vs. best self) prompt increased their appraisal of life's stresses as a harmful threat and decreased appraisal as positive/challenging opportunities for growth and well-being. Discussion: Theoretical and clinical implications are discussed.

The social cognitive appraisal of trustworthiness in individuals with dimensional levels of post-traumatic stress symptoms: a translational study

ABSTRACT Background: Misappraisals in evaluating the trustworthiness of others may be one mechanism contributing to the interpersonal difficulties individuals with posttraumatic stress disorder (PTSD) face. Objective: This study used a translational experimental design to examine the behavioural and neural correlates underlying the appraisal of facial stimuli morphed on dimensions of trustworthiness across three groups: individuals with high posttraumatic stress symptoms (HPTS), low posttraumatic stress symptoms (LPTS), and healthy controls (HC). Methods: Participants (N = 70) rated how trustworthy to untrustworthy they perceived three facial morphs (trustworthy, neutral, and untrustworthy) while undergoing electroencephalography (EEG). Results: Behavioural results showed that the HPTS group rated the untrustworthy morph as more untrustworthy than the HC group (β = 0.20, SE = .07, 95% CI [0.06, 0.33], z = 2.88, p = .004). The HPTS group also showed no variation in response time across morphs ((2) = 0.92, p = 0.63), while the LPTS and HC groups did ((2) = 9.60, p = .008; (2) = 23.62, p < .001). EEG data revealed significant group by morph interactions at the N170 latency and the Vertex Positive Potential (VPP): the HPTS and LPTS identified the untrustworthy morph faster than the HCs, but diverged to the degree to which they encoded each facial morph. Conclusions: Taken together our results suggest that HPTS individuals demonstrate an early attentional avoidance of faces morphed on dimensions of trustworthiness. This early, preconscious, avoidance may be one mechanism contributing to the miscalculations individuals with PTSD make in interpersonal situations.

Aggravating factors and assessment tools for Posttraumatic Stress Disorder in children after hospitalization.

Posttraumatic stress disorder (PTSD) is a mental disorder caused by several distressing events that are related with psychotrauma. It is very frequent in childhood and untreated traumatic stress symptoms in children and adolescents often result in debilitating consequences on development with increased risks for a variety of physical and mental disorders. Ιt has been found that PTSD symptoms are reduced as soon as therapeutic interventions have been applied. The aim of the present review was to summarize the available literature regarding aggravating factors associated with the development of PTSD in children after hospitalization and assessment tools for a quick and reliable screening of children who are at risk for developing PTSD. A review of published papers was conducted until April 10, 2019 to identify articles that discuss the aggravating factors and the assessment tools for PTSD in children after hospitalization published in English, German or Greek language. Search was performed on PubMed with the following combination of key-words: "PTSD" and "children" and "hospitalization", using the filters ''human'' and "Publication date from 30/11/2007 to 09/04/2019" and choosing "all fields'' in PubMed Advanced Search Builder. Of the 115 articles reviewed, 16 relevant articles were included, 10 of them referred to the aggravating factors and the remaining 6 were related to the assessment tools. Significant aggravating factors associated with the development of PTSD were: traumatic injuries and illness/ medical-related hospital admission, previous health problems, Pediatric Intensive Care Unit (PICU) hospitalization, attendance at a hospital for child and adolescent psychiatry, female gender and psychotherapy and initial high Posttraumatic Stress Symptoms (PTSS) in parents. As for assessment tools, it was observed that the Child Trauma Screening Questionnaire (CTSQ)-Heart Rate (HR), the alternative PTSD algorithm (PTSD-AA), the Child Stress Disorders Checklist-Short Form (CSDC-SF), the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) model for PTSD symptom categories, the Posttraumatic Stress Disorder Semi-Structured Interview (PTSDSSI), the Preschool Children's Assessment of Stress Scale (PCASS) and the diagnostic interview for children and adolescents (DICA-P) led to the identification of children who were likely to develope or had already developed PTSD symptoms, in the study population wherein each was implemented. The greatest limitation - but also a significant finding - of this review is the scarceness of published studies on this topic. Overall, there is a variety of aggravating factors associated with the development of PTSD in children after hospitalization. Assessment tools should be able to identify immediately the children who are likely to or have already developed PTSD symptoms.

Anxiety buffer disruption: Worldview threat, death thought accessibility, and worldview defense among low and high posttraumatic stress symptom samples.

Decades of research suggest that people are able to function effectively in the world and maintain mental health and well-being, at least in part, by relying on effective sociocultural anxiety buffer systems to shield against the awareness of death. However, according to anxiety buffer disruption theory, posttraumatic stress reflects anxiety buffer disruption, signaling that sociocultural belief systems have been rendered unable to buffer the individual against death awareness. As such, we would not expect to see the normal responses to death awareness meant to bolster and defend those belief systems in participants with posttraumatic stress. To test these hypotheses, we screened for posttraumatic stress in U.S. participants (n = 4,150) and recruited individuals with low (n = 193) and high (n = 205) posttraumatic stress symptoms. Each group was randomly assigned to a worldview-threat or -support condition, followed by a standardized measure of death-thought accessibility (DTA) and worldview defense. In the nonthreat (worldview-support) condition, individuals with high (vs. low) posttraumatic stress had elevated DTA. Further, among individuals with low posttraumatic stress, worldview threat (vs. -support) increased DTA, which in turn mediated an increase in worldview defense; however, among those with high posttraumatic stress, worldview threat did not increase DTA and its effect on worldview defense was substantially reduced. These findings supported the present hypotheses derived from anxiety buffer disruption theory, are important for understanding the existential dimension of posttraumatic stress, and may have implications for mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Pain in the Acute Aftermath of Stalking: Associations With Posttraumatic Stress Symptoms, Depressive Symptoms, and Posttraumatic Cognitions.

This longitudinal study examined whether posttraumatic stress and depressive symptoms, posttraumatic cognitions, and ongoing cyberstalking exposures were independently associated with changes in pain outcomes among 82 young adult women with recent exposure to stalking. Multilevel models indicated that higher sensory pain intensity and pain-related interference were associated with more negative cognitions about the self. Higher affective pain intensity was associated with higher posttraumatic stress and depressive symptoms. Cyberstalking exposures were not associated with pain intensity or pain-related interference. Results reveal persistent pain complaints in recent stalking victims and highlight distinct psychological risk factors for pain intensity and pain-related interference.

Anxiety Buffer Disruption: Relationship Threat, Death Anxiety, and Coping Appraisals Among Low and High Posttraumatic Stress Symptom Samples

Objective: Prior work suggests that people function effectively in the world, in part, by relying on sociocultural anxiety-buffer systems to protect against death anxiety. However, traumatic experiences may overwhelm and disrupt those systems, and this work tests whether posttraumatic stress symptoms reflect a vulnerability to death anxiety and risk of coping failure.Method: Following posttraumatic stress screening (n = 4129), individuals with low (n = 187) and high (n = 186) posttraumatic stress symptoms engaged in either an anxiety-buffer stressor task (contemplating relationship problems) or control task. Participants subsequently reported death anxiety and made coping appraisals.Results: Results supported four key hypotheses. Among individuals with low posttraumatic stress: (1) death anxiety was low under control conditions but moderately increased after contemplating relationship problems; and (2) perceived coping ability remained high in both conditions. However, among those with high posttraumatic stress: (3) death anxiety was exceptionally high in both the relationship problems prime and the control conditions—indicating anxiety buffer disruption; and (4) perceived coping ability was low in the control condition, and even lower after contemplating relationship problems.Conclusions: These findings support the hypotheses and make novel contributions, in that prior research on the existential implications of PTSD have not considered that anxiety buffer disruption may be associated with failure to cope with new challenges after traumatic experiences. Future research should determine whether therapies can improve the core dimensions of functional worldviews, a sense of meaning and self-esteem, and whether such improvements result in improvements to perceived coping abilities.

The long-term effects of early-life trauma on psychological, physical and physiological health among the elderly: the study of Holocaust survivors

Objectives: To study post-traumatic stress symptoms and post-traumatic growth and heart rate variability among elderly Holocaust survivors and a matched comparison group and the mediational effect of post-traumatic stress symptoms and post-traumatic growth on the association between Holocaust experience and heart rate variability.Method: 159 Holocaust survivors and 87 matched participants without Holocaust experience answered post-traumatic stress symptoms and post-traumatic growth questionnaires. Heart rate variability time and frequency parameters were measured for a subsample of N = 133.Results: Holocaust survivors reported higher levels of post-traumatic stress symptoms and post-traumatic growth. Most heart rate variability measures were similar in the two groups, except for better heart rate variability measured by the ratio of low frequency/high frequency among Holocaust survivors. Structural equation modeling showed that belonging to the Holocaust survivor group was associated with higher post-traumatic stress symptoms and higher post-traumatic growth, as well as better heart rate variability scores (standard deviation of normal to normal R-R intervals, high frequency and the ratio of low frequency/high frequency) through the mediation of post-traumatic stress symptoms and post-traumatic growth.Conclusions: The study emphasized the duality of the association between post-traumatic stress symptoms and post-traumatic growth and their integrated effect on heart rate variability.

Supplemental Material for Anxiety Buffer Disruption: Worldview Threat, Death Thought Accessibility, and Worldview Defense Among Low and High Posttraumatic Stress Symptom Samples

Supplemental Material for Anxiety Buffer Disruption: Worldview Threat, Death Thought Accessibility, and Worldview Defense Among Low and High Posttraumatic Stress Symptom Samples

Longitudinal Factors Associated With Increased Alcohol and Tobacco Use in Fukushima Nuclear Power Plant Workers 32 Months After the Nuclear Disaster: The Fukushima News Project Study.

The aim of this study was to predict increased alcohol and tobacco use in Fukushima nuclear power plant (NPP) workers 3 years after a nuclear disaster. Surveys were conducted in two postdisaster waves (Wave 1: 2 to 3 months; Wave 2: 32 months). Adjusted risk ratio (aRR) was computed to assess the covariates of increased alcohol and tobacco use in Wave 2. Increased alcohol use was associated with age of 29 years or less [aRR (95% confidence interval (95% CI): 1.26 (1.01 to 1.57)], major property loss [1.25 (95% CI 1.02 to 1.55)], and high posttraumatic stress responses (PTSRs) [1.34 (95% CI 1.08 to 1.67)] in Wave 1. Increased tobacco use was associated with age of 29 years or less [1.46 (95% CI 1.12 to 1.90)] and high PTSR [1.62 (95% CI 1.25 to 2.10)] in Wave 1 (P < 0.05). The workers' increased alcohol and tobacco use were predicted by major property loss (alcohol), age of 29 years or less, and high PTSR (alcohol/tobacco) in Wave 1.

Posttraumatic stress, alcohol use, and alcohol use reasons in firefighters: The role of sleep disturbance

BackgroundFirefighters are at elevated risk for posttraumatic stress and alcohol use, with research indicating that individuals with posttraumatic stress are likely to use alcohol as a coping strategy. A behavioral mechanism of clinical relevance to these associations is sleep disturbance. Thus, it was hypothesized that higher posttraumatic stress and sleep disturbance would be associated with higher alcohol use and alcohol use coping reasons; and sleep disturbance would moderate the association between posttraumatic stress and alcohol use and alcohol use coping reasons. ProcedureParticipants included 639 urban career firefighters (93.6% male; 77.9% White; Mage = 38.5). Covariates included fire department years and occupational stress. Structural equation models were tested. ResultsPosttraumatic stress severity was significantly, positively associated with alcohol use severity and alcohol use coping reasons. Similarly, sleep disturbance severity was significantly, positively associated with alcohol use severity and alcohol use coping reasons. After accounting for covariates and main effects, the interaction of PTSD severity and sleep disturbance was significantly associated with alcohol use severity, with the model accounting for 23.6% of variance, and alcohol use coping reasons, with the model accounting for 37.6% of variance. As predicted, the interaction of posttraumatic stress severity and sleep disturbance was not significantly associated with alcohol use enhancement, conformity, or social reasons. ConclusionThese findings indicate that posttraumatic stress severity is related to heightened alcohol use severity and alcohol use coping reasons, and this association is markedly stronger when firefighters' levels of sleep disturbance are heightened. Clinical and research implications are to be discussed.

Post-traumatic stress symptoms in family caregivers of intensive care unit patients: A longitudinal study

ObjectivesTo describe the prevalence and trajectory of family caregivers’ post-traumatic stress symptoms during the first year after a patient’s admission to the intensive care unit and identify associations between family caregivers’ background characteristics, hope and post-traumatic stress symptoms. Research methodology/designsFamily caregivers of intensive care unit patients (n = 211) completed questionnaires at patient admission to the intensive care unit and thereafter at 1, 3, 6, and 12 months. Mixed-model analyses were performed. SettingFour intensive care units in a university hospital in Norway. Main outcome measuresImpact of Event Scale—Revised and Herth Hope Index. ResultsOn admission, 54% of family caregivers reported high post-traumatic stress symptom levels, which decreased during the first six months after patient discharge. Lower levels of hope, being younger, having more comorbidities and being on sick leave were associated with higher post-traumatic stress symptom levels. Being the parent of the patient was associated with decreased post-traumatic stress symptom levels. ConclusionsFamily caregivers of intensive care unit patients report high levels of post-traumatic stress symptoms. Higher levels of hope were associated with fewer post-traumatic stress symptoms.

Sex differences in posttraumatic stress and depressive symptoms in police officers following exposure to violence in Ferguson

PurposeWomen comprise a significant and growing proportion of the law enforcement population. Despite this, their potentially unique reactions to job-related posttraumatic stress symptoms (PTSS) and depression have been underrepresented in the relevant literature, particularly within the context of exposure to community violence. Also understudied is the role of empathy in the development of post-trauma reactions, which has been a risk factor for the development of posttraumatic distress in previous studies. With the recent endorsement of empathy training by the President’s Task Force on 21st Century Policing, it is important to examine ways in which empathy may contribute to differences in PTSS and depression for male and female officers. The paper aims to discuss this issue.Design/methodology/approachMale and female police officers (n=189) exposed to violence during the 2014 Ferguson protests completed a battery of measures designed to assess demographic information, prior trauma history, and mental health outcomes.FindingsModeration analyses showed that empathy moderated the relationships between exposure and PTSS and exposure and depression in female officers, such that exposure was associated with higher posttraumatic stress and depressive symptoms only for female officers with high levels of empathy. These relationships were not found for men.Originality/valueThis study is the first to examine sex differences and the role of empathy in the mental health effects of law enforcement secondary to violence during community protests against policing.

The Psychological Impact of the Great East Japan Earthquake on Japan Ground Self-Defense Force Personnel: A Three-Wave, One-Year Longitudinal Study

Objective: Approximately 70,000 Japan Ground Self-Defense Force (JGSDF) personnel were dispatched in the wake of the 2011 Great East Japan Earthquake and the tsunami and nuclear disaster that followed. This study was conducted to evaluate the mental health of the JGSDF personnel and the correlates. Methods: Data collected from 56,753 participants at three time points (one, six, and 12 months after mission completion) were analyzed. Those who scored 25 or more points on the Impact of Events Scale–Revised (IES-R) and the Kessler Psychological Distress Scale (K10) were allocated into the high posttraumatic stress response (high-PTSR) group, and the high general psychological distress (high-GPD) group, respectively. Results: The multiple logistic regression analysis identified the following factors as the significant risk factor related to high-PTSR or high-GPD status, with odds ratios of 2.0 or higher: deployment length of three or more months, being personally affected by the disaster, and being overworked continuously for three or more months after mission completion. No significant association was observed for duties with radiation exposure risk. Conclusions: Our findings suggest that disaster workers may be able to conduct disaster relief activities more safely with mission-related considerations of shorter deployment length and recognizing the effects on personnel personally affected by the disaster, in addition to avoiding overworking personnel after mission completion.

Self-affirmation attenuates death-thought accessibility after mortality salience, but not among a high post-traumatic stress sample.

According to anxiety buffer disruption theory (ABDT), people function effectively in the world, in part, by relying on anxiety-buffer systems to protect against death awareness; however, traumatic experiences can overwhelm and disrupt those anxiety-buffer systems, leaving people unprotected from death awareness and at increased risk for the major symptom clusters of posttraumatic stress disorder (PTSD). Based on that idea, it was hypothesized that (a) when posttraumatic stress symptoms are low, self-affirmation (a known worldview/self-esteem based anxiety-buffer) should prevent mortality reminders from causing increased death-thought accessibility (DTA); but that (b) when posttraumatic stress symptoms are high (indicating anxiety-buffer disruption), self-affirmation should fail to prevent mortality reminders from increasing DTA. To test these hypotheses, participants identified in a general population prescreen assessment as "low posttraumatic-stress symptom" (n = 222) and "high posttraumatic-stress symptom" (n = 210) were reminded of death (vs. control topic), prompted to engage in a self-affirmation (vs. nonself-affirmation) task, and then asked to complete a standard assessment of death-thought accessibility (DTA). The hypotheses were confirmed, revealing that posttraumatic stress symptoms were associated with the ineffectiveness of anxiety-buffer system in protecting against increased death awareness. The present findings support of a foundational concept of ABDT, and point to new insights about the nature of PTSD and its treatment, because failure to manage death awareness is known to cause anxiety and exacerbate anxiety-related disorders (e.g., PTSD). (PsycINFO Database Record

Эмоционально-личностные особенности пациентов с диагнозом менингиома при выраженном посттравматическом стрессе

The results of the study on post-traumatic stress rates and individual indicators arising in response to the diagnosis of a life-threatening disease are being analyzed. The participants of the study are the patients of Burdenko National Medical Research Center of Neurosurgery, Ministry of Health of the Russian Federation (n = 25) diagnosed with meningioma. It has been shown that one of the psychological consequences of the diagnosis of “meningioma” is post-traumatic stress of different intensity rates. Increased depression, shyness and emotional lability are associated with high post-traumatic stress rates. The comparison of the triad of emotional-personal characteristics, social support indicators (according to the Psychological Safety Questionnaire) and basic assumptions (according to the World Assumptions Scale) made it possible to verify the research hypothesis. It has been revealed that high rates on depression and shyness scales (according to the Freiburg Personality Inventory) do not reflect the tendency to avoid social contact, but indirectly indicate the presence of auto-aggression or introverted orientation directed to oneself in people diagnosed with this disease.

Communication Quality Predicts Psychological Well-Being and Satisfaction in Family Surrogates of Hospitalized Older Adults: An Observational Study.

Many hospitalized older adults require family surrogates to make decisions, but surrogates may perceive that the quality of medical decisions is low and may have poor psychological outcomes after the patient's hospitalization. To determine the relationship between communication quality and high-quality medical decisions, psychological well-being, and satisfaction for surrogates of hospitalized older adults. Observational study at three hospitals in a Midwest metropolitan area. Hospitalized older adults (65+ years) admitted to medicine and medical intensive care units who were unable to make medical decisions, and their family surrogates. Among 799 eligible dyads, 364 (45.6%) completed the study. Communication was assessed during hospitalization using the information and emotional support subscales of the Family Inpatient Communication Survey. Decision quality was assessed with the Decisional Conflict Scale. Outcomes assessed at baseline and 4-6weeks post-discharge included anxiety (Generalized Anxiety Disorder-7), depression (Patient Health Questionnaire-9), post-traumatic stress (Impact of Event Scale-Revised), and satisfaction (Hospital Consumer Assessment of Healthcare Providers and Systems). The mean patient age was 81.9 years (SD 8.32); 62% were women, and 28% African American. Among surrogates, 67% were adult children. Six to eight weeks post-discharge, 22.6% of surrogates reported anxiety (11.3% moderate-severe anxiety); 29% reported depression, (14.0% moderate-severe), and 14.6% had high levels of post-traumatic stress. Emotional support was associated with lower odds of anxiety (adjusted odds ratio [AOR]=0.65, 95% CI 0.50, 0.85) and depression (AOR=0.80, 95% CI 0.65, 0.99) at follow-up. In multivariable linear regression, emotional support was associated with lower post-traumatic stress (β=-0.30, p=0.003) and higher decision quality (β=-0.44, p<0.0001). Information was associated with higher post-traumatic stress (β=0.23, p=0.022) but also higher satisfaction (β=0.61, p<0.001). Emotional support of hospital surrogates is consistently associated with better psychological outcomes and decision quality, suggesting an opportunity to improve decision making and well-being.

Supplemental Material for Self-Affirmation Attenuates Death-Thought Accessibility After Mortality Salience, But Not Among A High Post-Traumatic Stress Sample

Supplemental Material for Self-Affirmation Attenuates Death-Thought Accessibility After Mortality Salience, But Not Among A High Post-Traumatic Stress Sample

Comparing Neural Correlates of High Sensory Processing Sensitivity and Post-Traumatic Stress Disorder

Many reported features of high sensory processing sensitivity (SPS), an overarching trait exhibited by highly sensitive persons (HSPs), resemble features of post-traumatic stress disorder (PTSD). This article compares results from imaging studies in order to identify potential commonalities and differences between PTSD and high SPS. Notably there is some resemblance between high SPS and dissociative post-traumatic stress symptoms described by Lanius et al. in the early 2000s, for example in terms of heightened activation of right-hemisphere regions responsive to emotional cues.

Assessing the Impact of Post-Traumatic Stress Symptoms on the Resting-State Default Mode Network in a Military Chronic Mild Traumatic Brain Injury Sample.

The relationship between post-traumatic stress disorder (PTSD) and chronic symptoms of mild traumatic brain injury (mTBI) is difficult to discern and poorly understood. An accurate differential diagnosis, assessment, and treatment of mTBI and PTSD are challenging due to significant symptom overlap and the absence of clearly established biomarkers. The objective of this work is to examine how post-traumatic stress influences task-free default mode network in chronic mTBI subjects. Control subjects (N = 44) were compared with chronic mTBI subjects with low (N = 58, PTSD Checklist-Civilian Version [PCL-C] total < 30), medium (N = 124, PCL-C total = 31-49), and high (N = 105, PCL-C total ≥ 60) post-traumatic stress symptoms (PTSS). The results indicate significant differences in Brodmann area 10 for all mTBI subject groups, indicating potential mTBI-related disruptions with regulation of emotions and decision-making. The effects of PTSS were observed in the anterior cingulate and parahippocampus, suggesting possible disruptions pertaining to memory regulation, encoding, and retrieval. The overall results indicate the presence of aberrant connectivity patterns between controls and chronic mTBI subjects with low, medium, and high PTSS. Furthermore, the findings suggest a disruption in attention relating to a network of brain regions involved with emotional regulation and memory coding, rather than a fear-related response. Taken together, the results suggest these regions form a network that could be a target for future research pertaining to PTSD and chronic mTBI. Furthermore, the use of clinical measures, task-based imaging studies, or multimodal imaging could help further elucidate specific neural correlates of PTSS and mTBI.

The effects of living environment on disaster workers: a one-year longitudinal study.

BackgroundDefense Force workers engaged in disaster relief activities might suffer from strong psychological stress due to the tasks that they had been involved. We evaluated how living environments, work environments, and individual factors psychologically affect those who engaged in disaster relief activities.MethodData generated with 1506 personnel engaged in the Great East Japan Earthquake relief activity were analyzed. Those who scored ≥25 points on the Impact of Events Scale-Revised and the Kessler Psychological Distress Scale (K10) were allocated into the high post-traumatic stress response (high-PTSR) group, and the high general psychological distress (high-GPD) group, respectively.ResultsThe multiple logistic regression analysis extracted living environment (camping within the shelter sites) as the significant risk factor for both high-PTSR (OR = 3.39, 95 % CI 2.04–5.64, p < 0.001) and high-GPD (OR = 3.35, 95 % CI 1.77–6.34, p < 0.001) groups.ConclusionIt is desirable for disaster workers to have a living environment in which they can keep an appropriate distance from the victims.