Lower Posttraumatic Stress Symptoms Research Articles

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.

Psycho-emotional intervention with parents of very preterm babies during the first year: A single-arm pilot study.

Studies of intervention programs that aim to improve the emotional state of parents of children admitted to the neonatal intensive care units (NICU) are scarce in Spain. The aims of this single-arm pilot study are to get to know the emotional profile of parents of high-risk preterm newborns, and to explore parents' patterns of emotional well-being before and after a psychological program called the Parental Empowerment Program, to increase parental readiness levels. The sample was made up of 100 parents (50 couples) who participated in the program. Measurements were taken of post-traumatic stress, depression, and resilience at 1 month and 12 months. Repeated measurements and dyadic data analyses were performed. One month after the birth of the baby and prior to the start of the program, mothers show more symptoms of stress and depression than fathers. After the intervention, both parents experienced improvements in their mood levels. The evidence obtained seems to show that high resilience levels and low post-traumatic stress symptoms are associated with reduced depression levels after implementing the program. However, the heterogeneity of the responses obtained, the observed associations between stress, resilience, and maternal depression, along with the reciprocal influence between maternal and paternal depression 1 year after the intervention, highlight the need for a more in-depth exploration of the interplay between risk and protective factors in this population. Despite the identified potential threats to validity, further work in this direction is recommended, including the implementation of clinical trials to demonstrate intervention efficacy. The adaptation of the parents' mutual emotional adjustment at each stage would allow them to participate more actively in the baby's care.

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, & 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 & clinical variables and PTSS & 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.

The day-to-day relationship between posttraumatic stress symptoms and social support after sexual assault

ABSTRACT Background: Experiencing sexual assault is associated with a significant increase in risk for developing posttraumatic stress disorder and related concerns (e.g. alcohol misuse). Cross-sectional and longitudinal evidence suggests that social support may be both broadly protective against and eroded by posttraumatic stress symptoms. However, little is known about how different aspects of social support and posttraumatic stress symptoms influence each other in the weeks and months immediately following sexual assault, when posttraumatic stress (PTS) symptoms first emerge. Objective: The present study assessed the day-to-day relationship between social support and PTS in a sample of distressed, alcohol-using, recently-assaulted female survivors participating in a clinical trial of an app-based intervention (N = 41). Method: Participants completed 3 weeks of daily diaries starting within 10 weeks of sexual assault. Mixed-effects models were used to examine prior-day and same-day relationships between PTS and four social support constructs (social contact, emotional support, pleasantness of social interactions, and talking about sexual assault). Results: Results indicate that higher quantity and pleasantness of social interactions over the full sampling period was associated with lower PTS symptoms on any given day. Experiencing better-than-typical social interactions on one day was associated with lower than typical PTS symptoms on that day and the next day. On days when participants discussed their sexual assault with others, they tended to be having higher than usual PTS symptoms. Conclusions: Findings suggest that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms. Trial registration: ClinicalTrials.gov identifier: NCT03703258.

Risk factors for intimate partner violence victimization across 8 years: Contributions of the posttraumatic stress symptom domains.

Although much remains unknown about what creates risk for women's intimate partner violence (IPV) victimization across time, trauma exposure and mental health are likely contributors. Specifically, posttraumatic stress (PTS) is a risk factor for IPV victimization, yet we know less about the unique contributions of PTS symptom domains to IPV risk. Identification of PTS symptom domains that confer risk for IPV has the potential to inform novel targets of intervention. This study follows women with children (N = 118) across 8 years to identify the trauma exposure, mental health, and sociodemographic factors that contribute to IPV victimization risk using longitudinal multilevel modeling. Higher levels of PTS symptoms were associated with initially greater number of IPV victimization acts experienced (i.e., "IPV victimization"). However, across time, women with higher PTS symptoms decreased more quickly in IPV victimization than those with lower PTS symptoms. Higher levels of PTS arousal and reexperiencing were each associated with initially higher levels of IPV victimization. In addition, higher levels of PTS reexperiencing and arousal remained associated with higher levels of IPV victimization across time. Women's age was inversely related to IPV victimization over time only when accounting for the PTS symptom domains. Findings are that collapsing PTS symptoms into an overall construct may be too imprecise to identify key mechanisms for IPV victimization risk. IPV prevention should prioritize addressing reexperiencing and arousal symptoms to curb future IPV victimization. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Post-traumatic-stress in the context of childhood maltreatment: pathways from attachment through mentalizing during the transition to parenthood.

This study aimed to clarify the role of mentalizing in pathways from attachment to Post Traumatic Stress Symptoms (PTSS) in survivors of childhood maltreatment (CM). We focused on the transition to parenting, a critical period for reworking parenting representations to reduce intergenerational maltreatment cycles. Study participants included 100 pregnant CM survivors. We assessed PTSS with the SCID and attachment and mentalizing with the Adult Attachment Interview (AAI), which was rated for Attachment and Reflective Functioning (RF). Regarding Re-experiencing trauma symptoms, the results of the path analysis were consistent with mediation. CM survivors' mentalizing about their early relationships with their parents (RF-Other) directly impacted Re-experiencing trauma symptoms, and attachment had an effect on Re-experiencing trauma symptoms through mentalizing (RF-Other). Regarding Arousal/Reactivity symptoms, the results of the pathways analysis were consistent with partial mediation by mentalizing about early relationships with parents (RF-Other). In addition to the pathway from attachment via mentalizing (RF-Other) to Arousal/Reactivity, the pathway between attachment and Arousal/Reactivity also remained significant. This study provides new evidence of a mentalizing and attachment model of PTSS in CM survivors. The findings indicate that increased mentalizing about early relationships with parents is an important process associated with lower PTSS. Finally, we discuss the implications of developing interventions for CM survivors to reduce PTSS. Scaffolding the development of mentalizing regarding attachment relationships in which CM occurred may help CM survivors reduce the intrusion of traumatic memories and decrease trauma-related arousal and reactivity symptoms. Interventions to help CM survivors mentalize regarding parents and attachment relationships in which trauma occurred may be particularly important during the transition to parenting when activation of representations of parenting can trigger PTSS.

Posttraumatic Stress Symptom Trajectories in Family Caregivers of Patients With Acute Cardiorespiratory Failure

Overall, 1 in 3 family caregivers of patients who require intensive care unit (ICU) admission will experience significant posttraumatic stress symptoms (PTSSs), but little is known about how PTSSs evolve over time. Measuring PTSS trajectories could facilitate the development of targeted interventions to improve mental health outcomes for family caregivers of critically ill patients. To measure 6-month PTSS trajectories among caregivers of patients with acute cardiorespiratory failure. This prospective cohort study was conducted in the medical ICU of a large academic medical center among adult patients requiring (1) vasopressors for shock, (2) high-flow nasal cannula, (3) noninvasive positive pressure ventilation, or (4) invasive mechanical ventilation. Each patient was enrolled along with their primary caregiver, ie, the unpaid individual who provided the most physical, emotional, or financial support prior to ICU admission. Family caregiver PTSSs were assessed using the Impact of Events Scale-Revised within 48 hours of ICU admission, following ICU discharge, and 3 and 6 months after enrollment. Latent class growth analysis was used to measure PTSS trajectories. Preselected patient and caregiver characteristics measured at ICU admission were analyzed for association with trajectory membership. Six-month patient and caregiver outcomes were analyzed by caregiver trajectory. Overall, 95 family caregivers were enrolled and provided baseline data; mean (SD) age was 54.2 (13.6) years, 72 (76%) were women, 22 (23%) were Black individuals, and 70 (74%) were White individuals. Three trajectories were identified: persistently low (51 caregivers [54%]), resolving (29 [31%]), and chronic (15 [16%]). Low caregiver resilience, prior caregiver trauma, high patient severity of illness, and good patient premorbid functional status were associated with the chronic trajectory. Caregivers with the chronic PTSS trajectory had worse 6-month health-related quality of life (mean [SD] total 36-item Short Form Survey score, persistently low trajectory: 104.7 [11.3]; resolving trajectory: 101.7 [10.4]; chronic trajectory: 84.0 [14.4]; P < .001) and reduced effectiveness at work (mean [SD] perceived effectiveness at work score, persistently low trajectory: 86.0 [24.2]; resolving trajectory: 59.1 [32.7]; chronic trajectory: 72.3 [18.4]; P = .009). In this study, 3 distinct PTSS trajectories among ICU family caregivers were observed, with 16% of caregivers experiencing chronic PTSSs over the subsequent 6 months. Family caregivers with persistent PTSS had lower resilience, prior trauma, higher patient severity of illness, and higher baseline patient functional status compared with family caregivers with persistently low PTSS, with adverse effects on quality of life and work. Identifying these caregivers is an essential first step to develop interventions tailored to those with the greatest need for support.

Does gender moderate resiliency variables and posttraumatic stress symptoms in informal caregivers of neurocritical care patients? An exploratory study

ABSTRACT We examined gender differences between resiliency factors (i.e. mindfulness, self-efficacy, coping, intimate care, and caregiver preparedness) and posttraumatic stress symptoms (PTSS) in informal caregivers of patients in the neuroscience intensive care unit (Neuro-ICU). Ninety-two informal caregivers were enrolled during patients’ hospitalization and completed resiliency measures at baseline, and a PTSS measure at baseline, 3 and 6 months. We conducted five ANCOVAs to explore gender and resiliency on PTSS. No significant main effects of gender on PTSS were observed across time points. However, main effects were seen for resiliency on PTSS at baseline for informal caregivers with high (vs. low) mindfulness, coping, and self-efficacy. Gender moderated the association between mindfulness and PTSS (i.e. high mindfulness at baseline was associated with lower PTSS in males compared to females at 3 months) and intimate care and PTSS (high intimate care at baseline was associated with lower PTSS in males than females at 6 months; high intimate care at baseline for females was associated with lower PTSS at 6 months than females with low intimate care). Overall, we observed associations among informal caregivers’ gender, resiliency, and PTSS, with males particularly benefitting from mindfulness and intimate care. These findings hold value for future inquiry into gender differences in this population with possible clinical implications.

Exploring the Impact of Racism on Black Youth: A Multidimensional Examination of Discriminatory Experiences Across Place and Time

PurposeCommunity violence disproportionally impacts Black youth. Experiences of racism and discrimination may create additional challenges for youth recovering from violence exposure. This study used ecological momentary assessment to elucidate how perceptions of racism and social support influence health and safety outcomes among Black youth following violence exposure. MethodsTwenty-five Black youth (14–19 years old, 60% female) who had witnessed violence within the past three months completed a baseline survey that assessed discrimination experiences, social support, post-traumatic stress symptoms (PTS), and perceived safety. Youth completed ecological momentary assessments three times daily for two weeks about the place they were in, people they were with, their current emotional state, and in-the-moment racism perceptions. Multilevel models estimated the relationship between overall and time-varying perceptions of racism and social support, PTS symptoms, and perceived safety. ResultsOverall, 76% of youth reported at least one discrimination experience at baseline. Prior discrimination was associated with higher PTS (B = 1.86, p = .001) and depressive symptoms (B = 0.13, p = .013) at baseline. Youth who reported higher overall perceptions of racism in-the-moment reported higher PTS (B = 0.50, p = .002) and lower perceived safety (B = −0.53, p = .001). In-the-moment perceptions of racism were associated with lower perceived safety in that place (B = −0.09, p < .01). Emotional and instrumental support were associated with lower PTS and higher perceived safety (p < .05). DiscussionExperiences of racism and being in discriminatory places impacted youth’s depressive symptoms, PTS symptoms, and perceived safety. Interventions attuned to in-the-moment experiences of racism, and that leverage social support, are needed to support Black youth exposed to violence and discrimination.

Patterns and predictors of perinatal posttraumatic stress symptoms: A latent transition analysis

BackgroundPregnancy is a time of increased risk for intimate partner violence (IPV), yet there is a dearth of prospective research examining the relationship between IPV and posttraumatic stress symptoms (PTSS) in the perinatal period. Further, relationships among different types of IPV and perinatal PTSS remain understudied. MethodsLatent class and transition analyses were used to examine classes of PTSS in pregnancy and postpartum, the longitudinal patterns of transitions across these classes, and the role of IPV types, childhood adversity, and depressive symptoms in PTSS presentation. Participants (N = 238) were drawn from two longitudinal studies of high-risk perinatal women. ResultsFour latent PTSS classes emerged: High, Avoidant, Hypervigilant, and Low. Childhood adversity (χ2(3) = 13.09, p = .004), prenatal depression (χ2(3) = 17.58, p = .001), and psychological IPV (χ2(3) = 10.51, p = .01) were associated with membership in High, Avoidant, and Hypervigilant classes. Women with low prenatal PTSS continued to have low levels at postpartum. Women in higher severity classes during pregnancy tended to transition into classes with adjacent, and often lower, levels of symptom severity postpartum. Women in the High PTSS class in pregnancy with elevated levels of depression were significantly more likely to remain in the High PTSS class or transition into the Avoidant class at postpartum, compared to the Low PTSS class, χ2(3) = 11.84, p = .008. LimitationsRelatively modest sample size precluded examination of a broader range of symptoms consistent with PTSD. ConclusionsFindings highlight the importance of individualized approaches to assessing, monitoring, and treating perinatal PTSS.

Traumatic childbirth during COVID-19 triggers maternal psychological growth and in turn better mother-infant bonding

BackgroundAlthough posttraumatic psychological growth (PTG) occurs following stressful events, knowledge of maternal psychological growth as a result of giving birth during the novel coronavirus (COVID-19) pandemic is lacking. MethodsWe assessed PTG associated with recent childbirth (Posttraumatic Growth Inventory) in a sample of 2205 women who gave birth during the pandemic and 540 who gave birth before. They also provided information about birth-related traumatic stress (Peritraumatic Distress Inventory; PTSD Checklist), mother-infant bonding (Maternal Attachment Inventory), and breastfeeding. ResultsClose to two thirds (60.45 %) of participants reported childbirth-related PTG with greater appreciation of life endorsed most frequently. No group differences in PTG prevalence were noted between deliveries during or before COVID-19 (χ2 = 0.35, p = 0.84). A multigroup mediation model revealed that in deliveries during the pandemic, childbirth-related acute stress was linked with elevated PTG (β = 0.07, p < 0.01); in turn, PTG was associated with lower posttraumatic stress symptoms (β = −0.06, p < 0.05) and better mother-infant bonding (β = 0.22, p < 0.001). These indirect paths via PTG were not significant in deliveries before the pandemic. LimitationsReliance on a convenient sample, self-reports, and cross-sectional design may introduce bias. ConclusionsPerceived positive maternal psychological changes as a result of childbirth are endorsed by a significant portion of women during the pandemic and can ensue in response to traumatic childbirth. Maternal growth is further implicated in successful postpartum adjustment and positive mother-infant interactions during an important period. Hence, directing clinical attention to opportunities of maternal psychological growth may have benefits especially for women at risk for the adverse outcomes of exposure to traumatic experiences of childbirth.

Stress, anxiety, and depression: A comparative study of perceptions of patients in the ICU, other wards and their family caregivers in a low middle income country

Developed countries report higher ICU-related mental-health complications. The absence of non-ICU comparators limits interpretation and comparability across socioculturally diverse populations. Having found low levels of mental health complications in our ICU patients, we compared anxiety, depression, posttraumatic stress symptoms (PTSS), quality of life (QOL), and self-reported stressors in ICU (n ​= ​28), ward (n ​= ​34) patients and family caregivers (n ​= ​30) in a cross-sectional study in a tertiary teaching hospital. Hospital Anxiety and Depression Scale (HADS), Impact of Events revised IES-R, European Quality of Life 5 Dimensions 3 levels (EQ5D 3L) were used. Clinically relevant anxiety, depression (HADS ≥8), and PTSS (IES-R ≥30) were comparable amongst the ICU patients (46.4%, 46.4%, 10.7%), ward patients (53.3%, 30.0%, 6.7%), and caregivers (55.9%, 29.4%, 0%) respectively. Avoidance as PTSS subgroup was significantly higher in ICU patients and caregivers. IES-R scores were significantly less when only the ICU experiences were considered. QOL was significantly worse in ICU patients. Self-reported stressors were comparable in the groups; however after correcting baseline factors, unemployment contributed significantly to higher PTSS, anxiety and depression. While the rates of anxiety/depression were similar, lower PTSS in comparison to reports from developed countries suggest future studies to focus ICU experience, confounding non-clinical stressors and cultural issues. 1. Anxiety, depression, and stress of caregivers, ICU and ward patients were similar. 2. Avoidance was significantly higher in ICU patients and caregivers. 3. Quality of life was significantly worse in ICU patients. 4. Nonclinical factors contributed significantly to stress, anxiety and depression. 5. Indian sample had lower posttraumatic stress compared to the developed countries.

Trajectories of resilience and posttraumatic stress in childhood cancer: Consistency of child and parent outcomes.

Childhood cancer represents a potentially traumatic experience for both patients and caregivers. We examined trajectories of posttraumatic stress symptoms (PTSS) across a 5-year period in children with a history of cancer and their parents/caregivers. Medical, demographic, and dispositional variables were examined as predictors of PTSS trajectories. Using a longitudinal design, children with cancer history (n = 254, age 8-17 years at baseline) and one parent or caregiver (n = 255) completed measures of PTSS at baseline, and 1-, 3-, and 5-years poststudy entry. Children and caregivers completed dispositional measures including optimism, positive or negative affect, and Five-Factor Inventories. Latent class growth analysis (LCGA) was used to identify latent trajectories of PTSS, and univariate logistic regression models were conducted to predict LCGA class membership from medical, demographic, and disposition factors Results: Very similar trajectories were observed in children and caregivers, with two-class solutions providing the best fit: a "resilient" class, with low PTSS at baseline, which declined significantly over time (83.5% in children; 71.5% in parents), and an "elevated PTSS" class, which was moderately high at baseline and increased significantly over time. There was a small, but significant relationship between child and caregiver trajectories. Latent trajectories observed in children and parents were more strongly associated with dispositional variables than medical factors. Resilience, depicted by low PTSS, is by far the most common outcome observed in both children and caregivers. However, the smaller subset with elevated PTSS do not show recovery over time, and are identified as a group in need of targeted interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Exploring Posttraumatic Stress Symptoms and Posttraumatic Growth among Children Living beyond Cancer and Their Parents Using an Actor-Partner Interdependence Model.

Simple SummaryA diagnosis of childhood cancer, and its subsequent treatment, initiates a difficult and long-lasting experience for families which can result in posttraumatic stress symptoms. However, positive change, such as growth, may also occur. The relationship between posttraumatic stress symptoms and growth in the wake of childhood cancer is poorly understood. We sought to better understand the relationships between children’s posttraumatic stress symptoms and growth and those of their parents via a survey. The results from our study showed that the children and parents in our study were faring relatively well, reporting low levels of posttraumatic stress symptoms and moderate levels of growth. The children’s posttraumatic stress symptom score was not related to, nor did it predict their growth. The same was true for their parents wherein their posttraumatic stress symptom score was not related to, nor did it predict their growth. Notably, lower posttraumatic stress symptom scores among children were associated with greater growth in their parents, and vice versa, but the parents’ posttraumatic stress symptom score was not associated with the children’s growth.There is a growing focus on describing both negative and positive outcomes in the wake of childhood cancer. The purpose of this study was to describe and explore the relationships between posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among children living beyond cancer and one of their parents. As part of a larger online survey, 113 children (Mage at time of study = 15.82 (SD = 4.81); Mage at diagnosis = 5.86 (SD = 4.66)) and one of their parents completed questionnaires assessing PTSS and PTG. Descriptive statistics were used to describe the sample and levels of PTSS and PTG. Data were z-transformed and analyzed using bivariate correlations and t-tests. An actor–partner interdependence model (APIM) was used to test whether children’s and their parents’ PTSS was associated with their own PTG (actor effect) and the others’ PTG (partner effect). PTSS was low and PTG was moderate in this sample relative to scale ranges. There were no significant differences between the children’s and their parents’ PTSS (p = 0.535) or PTG (p = 0.534). Results from the APIM showed no significant actor effects (p = 0.185). A significant overall partner effect (p = 0.020) emerged. Lower PTSS for children was associated with greater PTG for their parents (b = −0.29, p = 0.018), but parent’s PTSS was not associated with children’s PTG (p = 0.434). This sample reported similar levels of PTSS and PTG to that which has been reported in the literature. Children and their parents’ scores on PTSS and PTG measures were not significantly different from one another. Children’s PTSS was negatively associated with their parents PTG, illuminating the ways in which PTSS and PTG may be related in the context of childhood cancer. Exploring family-based strategies to reduce PTSS and enhance PTG may be warranted, though further studies are required.

Exploring the association between forgiveness, meaning-making, and post-traumatic stress symptoms: The case of Hurricane Maria in Puerto Rico

Prior research suggests that meaning-making and forgiveness are associated with lower post-traumatic stress symptoms (PTSS) following exposure to trauma. Few studies have examined these factors in the aftermath of natural disasters. This study therefore aimed to investigate the relationship between meaning-making and forgiveness, and their association with PTSS after the 2017 Hurricane Maria in Puerto Rico. Bivariate correlations and hierarchical regression analyses indicated that meaning-making and forgiveness were negatively correlated with PTSS. Higher levels of “presence of meaning,” “self-forgiveness,” “forgiveness of others,” and “feeling forgiven by God” were significantly associated with lower levels of PTSS. Conversely, “search for meaning” was positively associated with PTSS. The results suggest the importance of meaning-making and forgiveness education for building and promoting well-being in the face of extreme stressors.

Affective dynamics among veterans: Associations with distress tolerance and posttraumatic stress symptoms.

We tested a dynamic structural equation model (DSEM; Asparouhov, Hamaker, & Muthén, 2018) of positive and negative affect in 254 veterans with approximately 1.5 years of experience sampling data. The analysis provided estimates of several aspects of veteran's emotional experience including "trait" positive and negative affect (i.e., mean levels), inertia (i.e., tendency for emotions to self-perpetuate), innovation variance (conceptualized as lability, reactivity, or exposure to stressors), and cross-lagged associations between positive and negative affect. Veterans with higher trait negative affect had more negative affect inertia and innovation variance. This suggests a pattern whereby the veteran has more negative reactions, and negative emotions, in turn, tend to maintain themselves, contributing to higher trait negative affect. In contrast, veterans with higher trait positive affect exhibited more positive affect innovation variance (e.g., positive reactivity). Although veterans showed some consistency in dynamics across emotions (e.g., positive and negative reactivity were positively correlated), trait positive and negative affect were not significantly associated. Veterans with higher posttraumatic stress symptoms (PTSS) at baseline exhibited higher reactivity to negative events, less positive affect, and more negative affect during the follow-up. Veterans with higher distress tolerance reported not only lower PTSS but also a more adaptive pattern of affective experience characterized by lower inertia and reactivity in negative affect and more positive lagged associations between negative affect and subsequent positive affect. The results demonstrated that distress tolerance and PTSS in veterans were associated with dynamics of positive and negative emotion over time, suggesting specific differences in affect regulation processes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Profiles of home violence and posttraumatic stress symptoms among young adults: Distinguishing between trauma and adversity using latent class analysis.

Home violence exposure (HVE) varies by type and frequency of exposure, which can lead to uncertainty when determining what is traumatic and what is not, particularly when assessing posttraumatic stress symptoms (PTSS) and disorder (PTSD). The current study examined whether specific types of HVE were associated with specific types of PTSS to help determine what experiences may rise to the level of trauma. Participants included 988 racially and ethnically diverse college students (74.1% women). Two latent class analyses were performed, examining types of HVE and types of PTSS to determine how classifications of HVE were associated with classifications of PTSS. Four classifications of HVE were identified: high exposure (21.7%), vicarious exposure (28.9%), victimization (10.5%), and low exposure (38.9%). Four classifications of PTSS were also identified: high PTSS (20.9%), dysphoric arousal (17.4%), anxious arousal (21.3%), and low PTSS (40.4%). Even when considering other potentially traumatic events, participants with experiences of victimization were 2.55 times more likely than those with low exposure to meet criteria for PTSD. Victimization was uniquely associated with dysphoric arousal as well as all other PTSS. High exposure was associated with high PTSS and anxious arousal, with vicarious exposure associated only with anxious arousal. Findings provide unique evidence for the potentially traumatic effects of victimization in the home. Frequent and cumulative effects of HVE that do not meet DSM criteria for a potentially traumatic event may be associated with elevated PTSS, particularly symptoms of anxious and dysphoric arousal. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Secondary posttraumatic stress symptom trajectories and perceived health among spouses of war veterans: a 12-year longitudinal study

Objective: War-related trauma may indirectly affect veterans’ spouses both in terms of secondary posttraumatic stress symptoms (PTSS) and negative perceived health. The present study aimed to examine trajectories of secondary PTSS over a twelve-year period and its association with various measures of subjectively perceived health, among spouses of war veterans. Methods: Spouses of war veterans (n = 155) were assessed prospectively 30 (T1, 2003), 37 (T2, 2010), and 42 (T3, 2015) years after the 1973 Yom Kippur War. Participants completed self-report questionnaires of PTSS (PTSD inventory) in all three measurement waves, while perceived health measures (Short-Form Health Survey-SF-36) were assessed only at T3. Results: Most spouses were classified to the ‘resilient’ trajectory with low and stable secondary PTSS over time, followed by recovered, chronic, and delayed onset PTSS trajectories. Importantly, spouses in the ‘chronic’ and ‘delayed’ secondary PTSS trajectories reported a higher severity of general negative subjective health perceptions and health-related social malfunctioning. Conclusion: Veterans’ spouses who were grouped in the ‘chronic’ and ‘delayed’ PTSS trajectories are to be considered as at-risk populations for both PTSS and negative perceived health perceptions. Mental health professionals as well as family physicians should be aware of the ongoing nature of secondary PTSS which might negatively affect veterans’ spouses medical conditions and ability to cope with the aging process.

World assumptions and post-traumatic growth among older adults: The case of Holocaust survivors.

Traumatic events may lead to post-traumatic growth (PTG). Nevertheless, little is known about the mechanisms leading to PTG, especially among older adults. This study sought to examine the direct relationship between world assumptions and PTG and the indirect relationship between them via two possible mediation pathways: post-traumatic stress symptoms (PTSS) and meaning in life. One hundred fifty-nine Holocaust survivors participated in the study (mean age = 82.34, SD = 5.81). Participants completed questionnaires of world assumptions, meaning in life, PTSS and PTG. The findings showed that world assumptions were positive and were positively associated with meaning in life and PTG and negatively associated with PTSS. The results of the multiple mediation model suggest that meaning in life and PTSS partially mediated the relations between world assumptions and PTG. Positive world assumptions were associated with higher meaning in life, which was associated with higher PTG. In contrast, despite the direct association between PTSS and PTG, the mediating effect of PTSS was negative, thus the more positive the world assumptions, the higher the PTG mediated by lower PTSS. The results suggest that the relationship between world assumptions and PTG may be direct and indirect. These findings suggest possible mechanisms underlying PTG, especially in old age.

Hidden wounds of violence: Abnormal motor oscillatory brain activity is related to posttraumatic stress symptoms

Victims of urban violence are at risk of developing Posttraumatic Stress Disorder (PTSD), one of the most debilitating consequences of violence. Considering that PTSD may be associated with inefficient selection of defensive responses, it is important to understand the relation between motor processing and PTSD. The present study aims to investigate the extent to which the severity of posttraumatic stress symptoms (PTSS) is related to motor preparation against visual threat cues in victims of urban violence. Participants performed a choice reaction time task while ignoring a picture that could be threating or neutral. The EEG indices extracted were the motor-related amplitude asymmetry (MRAA) in the alpha frequency range, and the lateralized readiness potential (LRP). We observed a linear relation between longer LRP latency and a slower reaction time, selectively during threat processing (compared to neutral) in low PTSS, but not in high PTSS participants. Alpha MRAA suppression and the PTSS were also linearly related: the smaller the alpha MRAA suppression in the threat condition relative to neutral, the greater the PTSS. These results provide evidence that threatening cues affect motor processing that is modulated by the severity of PTSS in victims of urban violence.