Negative Alterations In Cognitions Research Articles

The effects of partner perceptions on the relationship between posttraumatic stress disorder symptoms and aspects of parenting.

Posttraumatic stress disorder (PTSD) is associated with parenting difficulties, but the role of partner perceptions in this relationship is unclear. The present study aimed to (a) examine the links between partner perceptions, three PTSD symptom clusters (i.e., avoidance, negative alterations in cognitions and mood, changes in arousal and reactivity), and aspects of parenting (i.e., support, satisfaction, involvement) and (b) determine if partner perceptions moderate these relationships. In total, 225 trauma-exposed parents (M = 36.87, SD = 8.32, 64% female, 52.9% White) were assessed via self-report measures. As expected, the negative alterations in cognitions and mood and arousal and reactivity clusters were negatively associated with partner perceptions (r = -.17 and -.24, respectively) and all three parenting indices (rs = -.15 to -.35). Avoidance symptoms were unrelated to partner perceptions but were tied to parental support and satisfaction (rs = -.15). Partner perceptions moderated the relationships between negative alterations in cognitions and mood and support and satisfaction (βs = .02), as well as changes in arousal and reactivity and support (β = .02). Parents with negative alterations in cognitions and mood and arousal and reactivity symptoms who perceive their partners negatively may be at higher risk for experiencing lower levels of parental support or satisfaction. Additionally, the negative links between the aforementioned symptom clusters and parenting disappeared in the context of positive partner perceptions, indicating a potential protective factor. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Prevalence and Related Factors of Post-Traumatic Stress Disorder in Emergency Medical Technicians; a Cross-sectional Study.

Introduction:Ongoing exposure to a variety of Pre-hospital Emergencies (PE) has placed Emergency Medical Technicians (EMTs) at serious psychiatric compromise such as Post-Traumatic Stress Disorder (PTSD). The present study aimed to evaluate the prevalence and associated factors of PTSD among EMTs.Methods:This prospective cross-sectional study was conducted on EMTs in the Emergency Medical Services (EMS) in west of Iran. A baseline information questionnaire including personal work-related characteristics and the PTSD checklist of DSM-5 (PCL-5) were used for data collection. Non-parametric tests and multivariate linear regression were used to evaluate the associated factors of PTSD in these participants. Results:Among the participants, 22% of technicians had PTSD-diagnostic criteria. The mean total PCL-5 score was 21.60 ± 11.45, while the scores were 38.02 ± 6.08 and 17.47 ± 8.36 in the PTSD-diagnosed and undiagnosed groups, respectively. The most common symptom of the clusters was negative alterations in cognition with a mean score of 7.42 ± 4.63. After adjusting confounders, the number of missions (t= 2.50, P= 0.013), work experience (t= -3.24, P= 0.001) and number of shifts (t: 26.38, P < 0.001) were significantly corelated with PCL-5 score.Conclusion: The results indicated that the prevalence of PTSD among EMTs personnel of Hamedan province is high. EMTs with the age of ≤ 30 years, work experience of ≤ 10 years, married status, informal employment, emergency medical technician's degree, and more than 8 shifts per month, as well as no previous training history had a higher total PCL-5 score.

The structure of peritraumatic reactions and their relationship with PTSD among disaster survivors.

Peritraumatic reactions such as fear, psychic and somatoform dissociation, tonic immobility, data-driven processing, and mental defeat are important in the etiology of posttraumatic stress disorder (PTSD). However, current measures of such reactions overlap conceptually and do not clearly identify distinct peritraumatic processes. It is not known which processes are uniquely associated with PTSD. We investigated the factor structure of six standard peritraumatic measures and their relationship with the four Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) PTSD symptom clusters. Measures were administered to 308 earthquake survivors with high levels of exposure to traumatic events. Items comprising the six measures were investigated using exploratory structural equation modeling, which identified five peritraumatic response factors. Items from most measures loaded on multiple factors. Mental defeat and somatoform dissociation significantly predicted all PTSD symptom clusters. Cognitive overload significantly predicted intrusions, avoidance, and alterations in arousal and reactivity. Immobility significantly predicted intrusions and avoidance, whereas distress significantly predicted negative alterations in cognition and mood and alterations in arousal and reactivity. Because of the key role such reactions play in the development of PTSD, the findings are likely to benefit the study of etiological mechanisms, the prediction of those at greatest risk, and the design of preventative interventions. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Trauma-Related Psychopathology in Iraqi Refugee Youth Resettled in the United States, and Comparison With an Ethnically Similar Refugee Sample: A Cross-Sectional Study.

BackgroundConflict in Iraq has displaced millions of refugee youth. Warzone exposure and forced migration have unique acute and chronic impacts on youth, yet effects of exposure may not be universal across diverse refugee groups. Understanding how youth from various refugee groups are differentially affected by stress and trauma is critical to allocate resources and implement screening measures with the goal of providing early intervention.MethodTo identify the effects of warzone exposure and forced migration, a convenience sample of 48 Iraqi refugee youth ages 6–17 was assessed within the first month of arrival to the United States. Youth provided self-reported severity of posttraumatic stress and anxiety symptoms; symptom severity was then compared with an existing sample of 135 Syrian refugee youth to explore whether refugee youth of different nationalities experience the same effects of warzone exposure and forced migration. These data are the baseline for a longitudinal developmental study of refugee health, which also includes parental data.ResultsSeverity of separation anxiety and negative alterations in cognition and mood were the greatest symptomatic concerns in Iraqi refugee youth. Thirty-eight percent of responding Iraqi youth showed possible indication of an anxiety disorder. Severity of posttraumatic stress symptoms was lower in Iraqi youth compared to Syrian youth. For both Iraqi and Syrian refugee youth, separation anxiety was the most significant concern, with more than 80% of both samples showing a possible indication of clinically significant separation anxiety.ConclusionThe present observational study indicated that Iraqi refugee youth experience a range of anxiety and posttraumatic stress symptoms following warzone exposure and forced migration; posttraumatic stress symptoms were less severe in Iraqi versus Syrian youth. Comparing refugee youth of different nationalities is of particular importance, as our results demonstrate that findings from one refugee population cannot easily be generalized to another. Clinical and research efforts should prioritize interventions to address separation anxiety in refugee youth, which was of concern in both samples.

Posttraumatic Distress and Treatment Barriers Among Former Gang Members: Implications for Improving Access to Traumatic Stress Resources in Marginalized Populations.

Limited research has examined the links among violent victimization, mental health, and service utilization among gang-involved individuals. This mixed-methods preliminary study examined narratives of psychiatric distress, current psychiatric morbidity, and mental health treatment experiences among a sample of former gang members (N = 32; M age = 44.4 years, 87.5% male; 56.3% Hispanic or Latino, 31.3% African American). Participants completed online questionnaires to assess trauma exposure and current psychiatric symptoms as well as a semistructured interview to examine histories of psychiatric distress and mental health treatment. Participants reported exposure to an average of 10.2 discrete traumatic events (range: 3-21). On average, participants reported exposure to five to six community violence-related events, ranging from never or one time up to monthly and weekly exposure. Participants generally described histories of depression, anxiety, posttraumatic stress disorder (PTSD), and substance abuse, although a thematic analysis revealed PTSD symptoms predominated the psychiatric distress described, including symptoms related to intrusions, avoidance, negative alterations in cognitions and mood, and alterations in arousal. Grounded theory analysis revealed barriers to traditional models of mental health treatment included self-isolation, gang rules, and social stigma, especially in the context of interpersonal disconnect with providers. Given conditions of limited resources to access treatment, participants engaged in peer support services, which may have reduced their psychiatric distress to currently low levels. Implications for understanding these notable findings of recovery and resilience for some individuals and building trauma-informed communities that improve access to traumatic stress resources for marginalized populations are discussed.

Posttraumatic stress disorder symptoms and trauma-informed care in higher levels of care for eating disorders.

The purpose of the current study was to examine the prevalence and trajectory of posttraumatic stress disorder (PTSD) symptoms among patients with eating disorders (EDs) in higher level of ED care with trauma-informed components, but without a formal evidence-based trauma intervention. Participants were 613 adults diagnosed with EDs receiving treatment at inpatient, residential, or partial hospitalization levels of care. Participants completed the PTSD Checklist-5 (PCL-5) at admission and discharge. Over half of patients scored above the cutoff of 33 on the PCL-5 at admission, suggestive of PTSD symptoms characteristic of a formal PTSD diagnosis. The average PCL-5 score significantly decreased for every ED diagnostic category, and there was a significant reduction in the proportion of patients above the PCL-5 cutoff score at discharge. PCL-5 subscales measuring PTSD criteria B (intrusions) and C (avoidance) improved with modest effect sizes, whereas PCL-5 subscales D (negative alterations in cognitions and mood) and E (alterations in arousal and reactivity) improved with larger effect sizes. PTSD symptoms are prevalent among patients with EDs seeking higher levels of care. Despite not offering evidence-based trauma-specific interventions, PTSD symptoms decreased over the course of treatment. However, improvements cannot definitely be attributed to trauma-informed care.

Network Analysis of Posttraumatic Stress and Eating Disorder Symptoms in a Community Sample of Adults Exposed to Childhood Abuse.

Posttraumatic stress disorder (PTSD) and eating disorders (EDs) are individually debilitating and highly comorbid conditions. Childhood abuse is a prominent risk factor for PTSD and ED symptoms both individually and as a comorbid syndrome (PTSD-ED). There may be a functional association between comorbid PTSD-ED symptoms whereby disordered eating behaviors are used to avoid trauma-related thoughts and feelings. The current study used a network analytic approach to examine key associations between PTSD and ED symptom subscales (i.e., PCL-5 and EPSI, respectively) in a community sample of 120 adults who endorsed at least one experience of childhood abuse (i.e., physical, sexual, or emotional abuse; witnessing domestic violence). Participants completed an anonymous online survey using Amazon's Mechanical Turk Prime. We used three network analysis indices (i.e., strength centrality, key players, and bridge symptoms) to identify symptoms that may maintain the comorbid PTSD-ED network. The results indicated that reexperiencing symptoms had the highest strength centrality in the PTSD-ED network and bridged the PTSD and ED clusters. For ED, cognitive restraint was a bridge to all PTSD symptoms. Hyperarousal, negative alterations in cognitions and mood (NACM), and purging were key players, indicating they are integral to the network structure. If replicated in prospective studies, these results may indicate that reexperiencing and cognitive restraint are core drivers of PTSD-ED comorbidity, whereas hyperarousal, NACM, and purging may be downstream consequences maintaining the comorbid condition. Concurrent treatments that address PTSD and ED symptoms simultaneously may result in the best outcomes.

Post-Traumatic Stress Disorder in Intensive Care Unit Nurses: A Concept Analysis.

Intensive care unit (ICU) nurses are at an increased risk of post-traumatic stress disorder (PTSD) due to their stressful work environment. Using the Walker and Avant conceptual analysis method, we sought to review the literature to better understand PTSD as it pertained to ICU nurses and its impact on their lives, patient care, and health care organizations. For the review, we searched the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, and PsycINFO. The keyword searches included the terms "post-traumatic stress disorder" AND "psychological stress" AND "intensive care unit nurses." Abstract and full text reviews were conducted. Ten articles met our inclusion criteria of being published in the past 10 years (2010-2020), peer reviewed, written in English, and referred specifically to PTSD and psychological stress in ICU nurses. Antecedents for PTSD in ICU nurses are their stressful work environment, where exposure to traumatic events is experienced, and a lack of support from their manager, coworkers, and organization. Defining attributes for ICU nurses with PTSD included reexperiencing, avoidance, negative alterations in cognition and mood, and hyperarousal. Consequences identified included burnout, job dissatisfaction, and the intention to leave their job. The conceptual definition of PTSD in ICU nurses was illustrated by the attributes, antecedents, consequences, model case, empirical referents, and by the negative impact on the nurse, patients, and the health care organization. Hospital administrators, nurse managers, and occupational health nurses should ensure that policies and interventions are in place to recognize and reduce the risk of PTSD among ICU nurses.

An Examination of Chronic Pain Indices and the Updated Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental-Disorders-Fifth Edition.

Chronic pain and post-traumatic stress disorder (PTSD) comorbidity is prevalent among veterans and is associated with increased levels of pain severity and pain-related disability. An improved understanding of the relationship between these co-occurring disorders, in addition to effective integrated treatments, will develop by considering the changes to the PTSD diagnostic criteria in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5). The current study examined the relationship between the revised PTSD Checklist for DSM-5 (PCL-5) symptom clusters (i.e., intrusion, avoidance, negative alterations in cognition and mood [NACM], and arousal) and chronic pain measurements (i.e., pain severity, interference, and disability). Participants included 103 veterans (ages 26-70, mean = 45.33) participating in a randomized clinical trial examining the efficacy of an interdisciplinary pain management program for chronic musculoskeletal pain. The study was approved by a university system Institutional Review Board and affiliated healthcare system. The participants with a provisional PTSD diagnosis based on PCL-5 responses (N = 76) had significantly greater pain severity, interference, and disability than the participants without a provisional diagnosis (N = 23). Correlations between symptom clusters and pain measurements were mostly significant and positive with varying strengths. The avoidance symptom cluster, however, had relatively weaker correlations with pain measurements and was not significantly associated with the numeric rating scale of pain severity. Path analyses revealed that, after controlling for avoidance symptoms, significant associations remained between NACM and all the pain measurements. After controlling for NACM symptoms, however, there were no significant associations between avoidance symptoms and pain measurements. The current study highlights a need to re-examine the leading theories about the mutual maintenance of these disorders in order to develop effective integrative treatment approaches. PTSD-related avoidance may have a relatively weaker role in co-occurring chronic pain than the other symptom clusters and may have a qualitatively different role than chronic pain-related avoidance. Future research should explore the relationship between the avoidance in PTSD and the avoidance in chronic pain as well as identify which chronic pain measurements are the most useful when examining the relationship between PTSD and chronic pain. The potential impact of trauma-related cognition and mood on chronic pain indicates that this is an important area for intervention and should be considered in the development of integrated treatments for chronic pain and PTSD among veterans.

PTSD is associated with increased DNA methylation across regions of HLA-DPB1 and SPATC1L

Posttraumatic stress disorder (PTSD) is characterized by intrusive thoughts, avoidance, negative alterations in cognitions and mood, and arousal symptoms that adversely affect mental and physical health. Recent evidence links changes in DNA methylation of CpG cites to PTSD. Since clusters of proximal CpGs share similar methylation signatures, identification of PTSD-associated differentially methylated regions (DMRs) may elucidate the pathways defining differential risk and resilience of PTSD. Here we aimed to identify epigenetic differences associated with PTSD. DNA methylation data profiled from blood samples using the MethylationEPIC BeadChip were used to perform a DMR analysis in 187 PTSD cases and 367 trauma-exposed controls from the Grady Trauma Project (GTP). DMRs were assessed with R package bumphunter. We identified two regions that associate with PTSD after multiple test correction. These regions were in the gene body of HLA-DPB1 and in the promoter of SPATC1L. The DMR in HLA-DPB1 was associated with PTSD in an independent cohort. Both DMRs included CpGs whose methylation associated with nearby sequence variation (meQTL) and that associated with expression of their respective genes (eQTM). This study supports an emerging literature linking PTSD risk to genetic and epigenetic variation in the HLA region.

Latent structure of secondary traumatic stress, its precursors, and effects on people working with refugees.

The study aims to examine the latent structure of secondary traumatic stress (STS), its precursors, and the psychological effects of it on the population of service providers working with refugees passing through the Balkan route. A total of 270 service providers (57% female) of different professional backgrounds working directly with refugees took part in the study. Participants were assessed for STS using the Secondary Traumatic Stress Scale, the extent of secondary exposure to trauma (i.e., clients’ traumatic experiences from the countries of origin and travel that were communicated to them directly), depression, anxiety, and quality of life. Comparisons of several confirmatory factor analyses following prominent PTSD conceptualizations showed that the model with three relatively distinct but highly correlated factors–intrusion, avoidance, and the blend of negative alterations in cognitions, mood, and reactivity (NACMR), had the best fit. STS has been shown to be positively correlated both with the amount of different traumatic experiences that were communicated to them as well as with the specific content of those experiences. Path analysis showed that the amount of secondary exposure to the clients’ traumatic experiences during travel, but not in the country of origin, had exclusive relationships with all three factors of STS. NACMR demonstrated direct effects on anxiety and depression symptoms, while intrusions exhibited a direct effect on anxiety-related symptomatology only. The avoidance factor did not have any independent direct effects on anxiety or depression. Finally, the effects of STS factors on quality of life were fully mediated by an increase of depression-related symptomatology. Results provide evidence on the latent structure of the STS which partially deviates from the prominent models of PTSD thus questioning the isomorphism of two constructs on the empirical level. Additionally, findings provide insights on the cascade of events that make professionals working with traumatized people especially vulnerable to STS and broader psychological distress.

The Role of Experiential Avoidance and Emotion Regulation in DSM-5 Posttraumatic Stress Symptomatology

Purpose The present study expanded previous research examining how experiential avoidance and PTSD symptoms of hyperarousal impact negative alterations of cognition and mood according to DSM-5 PTSD criteria. Methods: Mediation analyses examined if experiential avoidance accounted for relationships between emotional suppression and PTSD symptom clusters. Results: Hyperarousal accounted for significantly more variance than experiential avoidance in negative cognitions and mood. Mediations revealed experiential avoidance partially mediated the relationship between emotional suppression and hyperarousal, and negative alterations in cognition and mood. A full mediation of experiential avoidance was found between emotional suppression and intrusions and avoidance. Conclusion: Clinical implications are discussed.

Post-Traumatic Stress Disorder and Associated Factors Among Traumatic Patients Attended in Four Government Hospitals, West Ethiopia

Background: Posttraumatic Stress Disorder is exposure to actual or threatened death that leads to negative alterations in cognitions and mood, and marked change in arousal and reactivity. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. Patients’ quality of life decreases in almost every dimension after severe trauma. Objective: This study aims to assess the prevalence of post-traumatic stress disorder and its associated factors among fifteen years and above aged patients with traumatic history for more than one month who attended four government hospitals in East Wollega Zone, West Ethiopia. Methods: An institutional based cross-sectional study was employed using an interviewer-administered questionnaire. Post-trauma stress disorder symptoms scale was employed to assess the prevalence of post-trauma stress disorder and its associated factors among fifteen years and above aged patients. Study populations were those who had a history of a traumatic injury and attended four government hospitals in East Wollega Zone, West Ethiopia, for more than one month. Study participants were, consecutively, recruited from January to February 2018. Results: One hundred ninety-three traumatic patients participated in this study. Male participants accounted for 119 (61.7%) and 82 (42.5%) of respondents aged between 15-26 years. The prevalence of Posttraumatic Stress Disorder in this study was 33 (17.1%). Female traumatic patients were 2.727 times more likely to develop post-traumatic stress disorder than male respondents (AOR= 2.727, 95% CI: 0.431-4.227). Similarly, participants who were found to be involved in substance abuse were 1.65 times (AOR= 1.65, 95% CI: 0.926-2.782) more likely to develop post-traumatic stress disorder than their counterparts. Also, daily laborers were 4.05 times (AOR= 4.05, 95% CI: 0.89-8.76) more likely to develop post-traumatic stress disorder than government employees. Conclusion: The prevalence of post-traumatic stress disorder, in this study, was 17.1%. Psychological counseling services offered to female patients, daily laborers, and substance abusers can benefit them as they were significantly associated with the post-traumatic stress disorder.

Neurological Soft Signs and Post-Traumatic Stress Disorder: A Biomarker of Severity?

BackgroundThe psychophysiological changes for individual suffering from chronic post-traumatic stress disorder (PTSD) raise to the questions of how facilitate recovery and return to work. Negative alterations in neuro-cognition remain a complaint for patients and participate to long-term functional impairments. Neurological soft signs (NSSs) appear as a candidate for better understanding these complaints. They have been reported in several mental disorders. They are found in several behavioral and/or neurocognitive disorders and are taken into account by psychiatric rehabilitation programs to support recovery. As few studies evaluate NSSs in PTSD, our exploratory study aims to assess NSSs in chronic PTSD and their relationships with PTSD severity.MethodTwenty-two patients with a clinical diagnosis of chronic PTSD were evaluated in terms of PTSD severity (post-traumatic checklist scale, PCL5), NSSs (NSSs psychomotor skills scale, PASS), and well-being upon arrival to the hospital and compared with 15 healthy subjects. Statistical non-parametric analyses assessed the relationships between these variables.ResultsPTSD subjects exhibited higher NSSs compared with healthy subjects. NSSs were positively associated with PTSD severity, with negative alterations in cognition and mood, and with impairment in well-being. They were higher in women compared with men. No impact of age was found. Three groups were identified based on the severity of the PTSD. Severe PTSD exhibited NSSs characterized by motor integration alterations.ConclusionsThis pilot study suggests that NSSs might be a biomarker of PTSD severity. This proof of concept highlights the need for further research for better evaluating the clinical neuro-functional impairment. This will be helping for defining neurological remediation for promoting PTSD recovery.

Managing Bipolar Disorder patients during COVID‐19 outbreak

On February 20, 2020 the first case of coronavirus disease (COVID-19) has been diagnosed in Italy. In a few weeks the Policlinico A. Gemelli Hospital in Rome has become a so called "COVID Hospital", so its structure has changed and consequently also the organization of the clinical activities of the Psychiatric Unit. In particular, outpatients' services (ambulatory and day hospital) have guaranteed the management of emergencies, the administration of oral and long acting drug therapies, the assistance of patients with severe mental illness by means of telephone checks.

Interpersonal Trauma and Sexual Function and Satisfaction: The Mediating Role of Negative Affect Among Survivors of Military Sexual Trauma.

Healthy sexual function among women service members/veterans (SM/Vs) is associated with higher quality of life, lower incidence and severity of mental health diagnoses, higher relationship satisfaction, and less frequent suicidal ideation. Although trauma exposure has been established as a predictor of poor sexual function and satisfaction in women SM/Vs, no study to date has examined whether specific trauma types, such as military sexual trauma (MST), increase risk for sexual issues. Moreover, the possible mechanisms of this association have not been explored. The current study examined whether posttraumatic stress disorder (PTSD) and depression symptom clusters mediated the association of trauma type and sexual function and satisfaction in 426 trauma-exposed women SM/Vs. Two hundred seventy participants (63.4%) identified MST as their index trauma. Path analyses demonstrated that MST was related to poorer sexual function and lower satisfaction relative to the other traumas (χ2[28, N = 426] = 43.3, p = 0.03, CFI = 1.00, TLI = 0.99, and RMSEA = 0.04), and this association was mediated by higher non-somatic depressive symptoms and PTSD symptom clusters of anhedonia and negative alterations in cognition and mood (NACM). Causality cannot be inferred due to the cross-sectional nature of the data. However, our findings suggest that interventions aimed at decreasing sexual issues among female SM/Vs with MST should target depressogenic symptoms, whether the origin is depression or PTSD. Longitudinal research exploring the etiological processes that contribute to sexual dysfunction among those with MST is needed.

Understanding the impact of attachment insecurity on PTSD symptoms among male Veterans and military personnel

ABSTRACT Attachment insecurity (i.e., attachment anxiety and attachment avoidance) has been found to contribute to PTSD symptom severity in Veterans. However, little is known of the unique contribution of attachment insecurity on individual PTSD symptom clusters. In a community sample of 106 combat-deployed Veterans, active duty service members, and reservists, this study examined: (1) the relationships between childhood family experience, combat experience, attachment insecurity, and PTSD symptom clusters, and (2) the influence of attachment insecurity on PTSD symptom clusters. Results revealed significant correlations between attachment anxiety and all PTSD symptom clusters (rs = .22 –.43) and attachment avoidance and PTSD symptom clusters, except the avoidance cluster (rs = .21 −.36). Four multiple regression analyses were employed to address the second study aim. Childhood family experiences predicted negative alterations in cognitions and mood (β = –.30) and alterations in arousal and reactivity (β = –.20). Further, combat experience significantly predicted each symptom cluster of PTSD (βs = .03 –.44). In the second step, attachment anxiety and attachment avoidance were added to each model. Attachment anxiety and attachment avoidance predicted negative alterations in cognitions and mood (βs = .22 and .35) and alterations in arousal and reactivity (βs = .27 and .17). Inconsistent with previous research, attachment insecurity did not predict symptoms of avoidance. These results highlight the impact of attachment among a diverse sample of trauma exposed individuals and may provide insights for clinical implications and therapeutic approaches when working with Veterans and military personnel high in attachment insecurity.

Sexual Assault, Posttraumatic Stress Symptoms, and Indices of Aggression Among Women.

Sexual assault is associated with many adverse outcomes, including a higher risk for developing posttraumatic stress symptoms (PTSS). Although nonsexual trauma exposure has been linked to aggression, the associations between sexual assault and aggression are understudied. Further, the DSM-5 conceptualization of posttraumatic stress disorder (PTSD) includes a symptom related to aggression, and associations between symptom clusters and aggression with regard to the new criteria are underexplored. The present study aimed to (a) examine the relations between sexual assault and indices of aggression (i.e., physical/verbal aggression, anger, and hostility) after accounting for PTSS and (b) investigate PTSD symptom clusters in relation to aggression among 263 women (Mage = 29.03years, SD = 11.71; 67.6% white). Path analysis revealed that sexual assault was unrelated to indices of aggression, βs = .003-.08; however, PTSS was consistently linked with increased aggression, βs = .22-.49. Results indicated specificity in the associations between the symptom clusters and aspects of aggression. Negative alterations in cognitions and mood corresponded with increased physical aggression, β = .28, and hostility, β = .38, and avoidance was related to verbal aggression, β = .19. Hyperarousal was also tied to higher levels of anger, hostility, and verbal aggression, βs = .21-.33. Nonetheless, lower levels of intrusion symptoms were associated with increased anger and hostility, β = -.26. With regard to understanding women's risk for aggression, PTSS may be more relevant than sexual assault. Further, there may be specificity related to the type of PTSD symptoms and aspects of aggression.

PostTraumatic Stress Symptoms And Beliefs Regarding Parenting And Children’s Development Among Trauma-Exposed Parents

ABSTRACT Posttraumatic stress symptoms (PTSS) have been associated with increased risk for parenting difficulties; however, cognitive factors related to parenting, such as parenting perceptions and beliefs regarding children’s development, remain unexplored. This is problematic as negative and unrealistic beliefs regarding parenthood and children may be a key mechanism by which PTSS increases vulnerability for adverse parenting outcomes. The aims of the study were to examine whether PTSS and the specific posttraumatic stress disorder (PTSD) symptom clusters were related to more negative parenting perceptions and to more unrealistic beliefs regarding children’s development among 212 trauma-exposed parents (Mage = 36.68 SD = 7.38; 60.9% female; 54.3% White). Higher levels of PTSS corresponded with more negative parenting perceptions and more unrealistic expectations of children. Intrusion, avoidance, and negative alterations in cognitions and mood were not associated with parenting perceptions. Trauma-related alterations in arousal and reactivity were related to more negative parenting-related beliefs regarding one’s child and oneself. PTSS, particularly trauma-related changes in arousal and reactivity symptoms, may be relevant in understanding perceptions of parenthood and beliefs regarding children’s development. These symptoms may be targeted via trauma-focused treatments to increase adaptive parenting outcomes for parents who have experienced trauma.

Exploring mood symptoms overlap in PTSD diagnosis: ICD-11 and DSM-5 criteria compared in a sample of subjects with Bipolar Disorder

BackgroundThe latest edition of the ICD (ICD-11) introduced relevant modifications to Post-traumatic Stress Disorder (PTSD) diagnostic criteria with respect to those of the DSM-5, including the exclusion of DSM-5 symptoms that potentially overlapped with mood disorders. To date, no study has yet investigated the differences in PTSD and its related symptoms, according to the two diagnostic systems in subjects with mood disorders. The aim of the present study was to compare the DSM-5 and ICD-11 diagnostic criteria for PTSD in a sample of patients with Bipolar Disorder (BD). MethodsAn overall sample of 210 in-patients with BD completed the Trauma and Loss Spectrum-Self Report, assessing post-traumatic stress symptoms, to compare symptomatological PTSD diagnosis according to either the DSM-5 or the ICD-11 criteria. ResultsDSM-5 PTSD was detected in 41% of the whole sample, whereas ICD-11 PTSD in 31.8%. The two diagnostic systems showed good concordance (Cohen's k = 0.643), whereas the concordance of re-experiencing and arousal criteria were moderate (Cohen's k = 0.578) and good (Cohen's k = 0.791), respectively. Almost all the subjects with a diagnosis of ICD-11 PTSD (92.5%) endorsed the “negative alterations in cognitions and mood” DSM-5 criterion. LimitationsThe small size, the use of a self-report instrument. ConclusionOur findings show high rates of PTSD and post-traumatic stress symptoms among subjects with BD according to both DSM-5 and ICD-11 criteria, despite significantly lower with the latter. However, potentially DSM-5 mood overlapping symptoms appear to be significantly higher among bipolar patients with ICD-11 PTSD with respect to those without.