Negative Alterations In Cognitions Research Articles

Are There Differences Among Evidence-Based Psychotherapies for Treating Different DSM-5 PTSD Symptom Clusters? A Systematic Review and Meta-analysis of Controlled Clinical Trials.

Posttraumatic stress disorder (PTSD) is a heterogeneous disease defined by four Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) symptom clusters: reexperiencing, avoidance, negative alterations in cognitions and mood, and hyperarousal. There are effective evidence-based psychotherapies (EBPs) for PTSD. However, given the variety of PTSD clinical presentations, we conducted the first meta-analysis investigating whether DSM-5 PTSD symptom clusters show different responses to EBPs. We systematically reviewed the literature for controlled clinical trials in five databases, performed a meta-analysis, and evaluated the methodological quality of the studies. We screened 633 studies and included seven. Three showed high risk, two showed some concerns, and one showed a low risk of bias. The symptom clusters do not seem to respond differently to EBPs (SMD cluster B: -0.40; 95% confidence interval [CI], -0.87 to 0.08; cluster C: -0.49; 95% CI, -0.90 to -0.08; cluster D: -0.44; 95% CI, -0.94 to 0.05; cluster E: -0.54; 95% CI, -1.07 to -0.0), even when analyzed by the therapeutic focuses. The findings dovetail nicely with the network theory of PTSD symptom, as although it is a heterogeneous disorder, the EBPs seem to promote a kind of cascade of symptom improvement.

A panel network analysis of posttraumatic stress disorder and obsessive-compulsive disorder symptoms across the perinatal period.

The perinatal period is marked by a higher risk of experiencing depressive, anxiety, and/or trauma-related symptoms, a phenomenon that affects millions of individuals each year. Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) symptoms commonly co-occur but have rarely been examined together beyond prevalence estimates in the perinatal period. Our study aimed to explore patterns of associations among OCD and PTSD symptoms to elucidate within- and between-person effects and how these effects may change over time. Participants (N = 270) were recruited during pregnancy from an academic medical center affiliated with a midwestern university. PTSD, OCD, and depressive symptoms were assessed at pregnancy, 4, 8, and 12 weeks postpartum. A panel graphical vector autoregression model was used to estimate networks. The temporal network provided information regarding directed predictive effects between symptoms, and hyperarousal, neutralizing, and ordering were the most stable and predictive symptoms across time. The contemporaneous network, which yields undirected partial correlations between symptoms at a given moment, indicated that there were positive associations between intrusions and avoidance, hyperarousal and negative alterations in cognitions and mood, as well as between hyperarousal and dysphoria. This study identified hyperarousal and neutralizing as the PTSD and OCD symptoms with the strongest stability, predictive power, and association with other symptoms. Clinically, this indicates that screening for hyperarousal and neutralizing symptoms may identify individuals who could maximally benefit from treatment in the perinatal period. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A Combined Kundalini Yoga and Cognitive Behavioral Therapy Program for Posttraumatic Stress Disorder: A Pilot Study.

Cognitive behavioral therapy (CBT) is one of the standard conventional treatments for posttraumatic stress disorder (PTSD). However, recent studies have reported the benefits of yoga for reducing PTSD symptoms including a Kundalini Yoga (KY) intervention. The purpose of this study was to test the efficacy of a novel combined 8-week CBT and KY program for treating PTSD symptoms and improving sleep quality in a single group trial of 26 adults with PTSD. PTSD symptoms (PTSD checklist-5) and sleep quality (Pittsburgh Sleep Quality Index) were assessed at baseline, post intervention, and at 2-month follow-up. Both CBT and yoga homework compliance were also measured. Total PTSD symptom scores as well as the cluster symptoms (intrusion, avoidance, arousal/reactivity, and negative alterations in cognitions and mood) were significantly improved following the program, all p < .01. The improvements in total PTSD scores, intrusion, avoidance, arousal/reactivity were maintained at follow-up, with all values still less (p < .01) than baseline. The negative alterations in cognitions and mood symptom cluster continued to improve further at follow-up compared to post-intervention values (p < .05). Total sleep score (p < .05) and the subscales of sleep disturbance (p < .01), daytime dysfunction (p < .05), and sleep quality (p < .01) were significantly improved after the program and these improvements were maintained at follow-up compared to baseline. Sleep medication use was decreased (p < .05) and sleep latency was improved (p < .01) at follow-up only compared to baseline. There was a significant positive correlation (p < .05) between the completion of the yoga home practice and post change in total sleep scores. These results show that a combined KY and CBT intervention resulted in decreased PTSD symptoms and improved sleep quality and suggest this program may constitute an additional treatment option for PTSD.

A Network Analysis of Symptoms of Post-Traumatic Stress Disorder and Facets of Mindfulness

Post-traumatic Stress Disorder (PTSD) is a mental health concern impacting a large proportion of the population. There is a growing interest in mindfulness-based treatments for PTSD. However, some individuals with PTSD do not respond to treatment. Identifying factors that may provide a more precise treatment approach has the potential to enhance response. Network analysis is a data-driven methodology that has been used to suggest specific targets for treatment. To date, there has not been a network analysis examining the interrelation between PTSD symptoms and trait mindfulness. The current study is an exploratory analysis of N = 214 adults from a non-clinical sample who endorsed a Criterion A traumatic event and completed the PTSD Checklist for DSM-5 and the Five Facet Mindfulness Questionnaire. Both undirected and directed networks were generated to identify links between PTSD symptom clusters and the facets of mindfulness. Both networks highlighted the connection between the PTSD symptom cluster Alterations in Arousal and Reactivity and the Awareness facet of mindfulness; and the PTSD symptom cluster Negative Alterations in Cognitions and Mood with the Non-judging facet of mindfulness. Taken together, these findings provide further evidence that greater mindfulness is generally associated with lower PTSD symptoms. Importantly, the findings highlight Non-judgement and Awareness as facets that might warrant further investigation in the context of mindfulness-based treatment efforts for PTSD.

Psychometric Evaluation of the Persian Version of the Post-Traumatic Symptom Scale: Exploratory and Confirmatory Factor Analysis

Background: Iranian youth encounter numerous stressors, including accidents, suicide, and unemployment, heightening their risk for posttraumatic stress disorder (PTSD). It's crucial to assess, diagnose, and treat PTSD in this demographic. Objectives: This study aimed to evaluate the factor structure and validate the Post-Traumatic Symptom Scale (PTSS). Methods: A cross-sectional approach was employed for the validation of the PTSS in Bandar Abbas, 2022, with a sample of 901 young residents selected via random cluster sampling. Data were gathered using the PTSS and the Mississippi Scale for Posttraumatic Stress Disorder (MSPSS). Validation of the scale encompassed content validity, concurrent validity, and factor analysis. Reliability assessments included internal consistency, test-retest, and split-half reliability. The optimal cut-off point was identified through receiver operating characteristic (ROC) curve analysis and the Youden Index. Results: The PTSS demonstrated robust face and content validity, evidenced by impact factor (1.6 &lt; impact factor &lt; 3.6), content validity ratio (CVR = 0.68 to 0.91), and Content Validity Index (CVI = 0.70 to 0.94). The PTSS's concurrent validity with the MSPSS was positively strong (r = 0.64, P &lt; 0.001). Factor analyses, both exploratory (EFA) and confirmatory (CFA), substantiated a four-factor model of the PTSS, accounting for 56.288% of the variance (19% for arousal and reactivity, 14% for negative alterations in cognitions and mood, 11% for avoidance, and 11% for intrusion). The scale's overall Cronbach's alpha was 0.87, with subscales ranging from 0.77 to 0.88. Test-retest reliability stood at 0.81 (P &lt; 0.01), and split-half reliability at 0.81. The PTSS's optimal cut-off for PTSD diagnosis was 60, delivering a sensitivity of 0.70, specificity of 0.99, and Youden Index of 0.69. Conclusions: The PTSS proves to be a reliable and valid instrument for assessing posttraumatic stress symptoms among young Iranians, offering a useful resource for researchers and practitioners in the prevention and treatment of PTSD.

Comparing diagnostic criteria for posttraumatic stress disorder in a diverse sample of trauma-exposed youth.

Divergent conceptualization of posttraumatic stress disorder (PTSD) within the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) and International Statistical Classification of Diseases and Related Health Problems (11th ed..; ICD-11) significantly confounds both research and practice. Using a diverse sample of trauma-exposed youth (N = 1,542, age range: 8-20 years), we compared these two diagnostic approaches along with an expanded version of the ICD-11 PTSD criteria that included three additional reexperiencing symptoms (ICD-11+). Within the sample, PTSD was more prevalent using the DSM-5 criteria (25.7%) compared to the ICD-11 criteria (16.0%), with moderate agreement between these diagnostic systems, κ =.57. The inclusion of additional reexperiencing symptoms (i.e., ICD-11+) reduced this discrepancy in prevalence (24.7%) and increased concordance with DSM-5 criteria, κ =.73. All three PTSD classification systems exhibited similar comorbidity rates with major depressive episode (MDE) or generalized anxiety disorder (GAD; 78.0%-83.6%). Most youths who met the DSM-5 PTSD criteria also met the criteria for ICD-11 PTSD, MDE, or GAD (88.4%), and this proportion increased when applying the ICD-11+ criteria (95.5%). Symptom-level analyses identified reexperiencing/intrusions and negative alterations in cognition and mood symptoms as primary sources of discrepancy between the DSM-5 and ICD-11 PTSD diagnostic systems. Overall, these results challenge assertions that nonspecific distress and diagnostically overlapping symptoms within DSM-5 PTSD inflate comorbidity with depressive and anxiety disorders. Further, they support the argument that the DSM-5 PTSD criteria can be refined and simplified without reducing the overall prevalence of psychiatric diagnoses in youth.

Randomized controlled trial of two internet-based written therapies for world trade center workers and survivors with persistent PTSD symptoms

Posttraumatic stress disorder (PTSD) remains prevalent among individuals exposed to the 9/11 World Trade Center (WTC) terrorist attacks. The present study compared an Internet-based, therapist-assisted psychotherapy for PTSD to an active control intervention in WTC survivors and recovery workers with WTC-related PTSD symptoms (n = 105; 75% syndromal PTSD). Participants were randomized to integrative testimonial therapy (ITT), focused on WTC-related trauma, or modified present-centered therapy (I-MPCT), each comprising 11 assigned written narratives. The primary outcome was baseline-to-post-treatment change in PTSD symptoms on the PTSD Checklist for DSM-5 (PCL-5). Secondary measures included PTSD symptom clusters, depressive/anxiety symptoms, functioning, and quality of life. A significant main effect of time was observed for the primary outcome (average “large” effect size improvement, d = 1.49). Significant and “moderate-to-large” main effects of time were also observed for all PTSD symptom clusters, depressive symptoms, quality of life, and mental health-related functioning (d range=0.62–1.33). Treatment and treatment-by-time interactions were not significant. In planned secondary analyses incorporating 3-month follow-up measures, ITT was associated with significantly greater reductions than I-MPCT in PTSD avoidance and negative alterations in cognitions and mood, anxiety, and mental health-related functioning. Both therapies significantly lowered PTSD symptoms, suggesting they may benefit hard-to-reach individuals with chronic WTC-related PTSD symptoms.

Systematic Review of Dispositional Mindfulness and Posttraumatic Stress Disorder Symptomology: A Targeted Examination of Avoidance.

High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope.

An investigation of laboratory-based positive and negative emotional suppression in relation to posttraumatic stress disorder symptom clusters.

Emotional suppression is a clinically significant aspect of emotion regulation with robust associations to psychopathology, including posttraumatic stress disorder (PTSD). Despite the fast-growing body of literature highlighting the role of positive emotion regulation difficulties in the development and maintenance of PTSD, extant work on emotional suppression and PTSD has almost exclusively focused on the role of negative emotions. The present study aimed to advance this literature by examining the associations between PTSD symptom clusters and participants' use of state emotional suppression during a laboratory task designed to elicit negative or positive emotions. Participants were 108 community women (Mage = 39.55; 33% Black/African American) currently experiencing intimate partner violence (IPV) by a male partner and using substances. Participants were interviewed using a structured diagnostic assessment for PTSD and reported on state emotional intensity and emotional suppression following idiographic negative or positive emotion inductions. Results of the moderation analyses showed that, when controlling for state emotional intensity, women experiencing clinical levels of PTSD symptom Clusters B (intrusive recollections), D (negative alterations in cognitions and mood), and E (alterations in arousal and reactivity) were significantly more likely to utilize emotional suppression, but only in the context of positive-not negative-emotions. Findings provide evidence for a link between PTSD and positive emotional suppression among women currently experiencing IPV by a male partner and using substances, highlighting positive emotional suppression as a potential target in PTSD treatment for IPV populations with comorbid substance use concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

PPTSD Portrait Due to Childhood Trauma to Ellice in the All Her Little Secrets Novel

Almost everyone has experienced traumatic events that lead to trauma. Trauma is a form of psychological experience that has a serious impact on mental health. The impact of trauma itself can vary, such as anxiety, depression, dissociation, and PTSD. In the novel All Her Little Secrets, Ellice, the main character, is described as suffering from PTSD due to childhood trauma. This study aims to determine how the character Ellice is described as suffering from PTSD and what trauma she has experienced. This research uses a qualitative descriptive method referring to two types of data, namely primary data and secondary data. Primary data were taken from the All Her Little Secrets novel in the form of narrative, dialogue and monologue. Meanwhile secondary data were taken from journals, books and articles related to the research topic. Several steps were taken to obtain data, namely reading the novel repeatedly and carefully, identifying data, classifying data, and reducing power. The results of this study concluded that Ellice as a PTSD sufferer was described through the symptoms she experienced. Ellice's PTSD symptoms include re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal. Meanwhile, the forms of childhood trauma that Ellice experienced included bullying, child maltreatment, and exposure to domestic and community violence

Dyadic Investigation of Posttraumatic Stress Symptoms and Daily Sleep Health in Patients With Cancer and Their Caregivers.

Cancer can be a traumatic experience affecting multidimensional aspects of sleep among patients and caregivers. This study examined the differential associations of cancer-related posttraumatic stress symptoms (PTSS) with various sleep markers in this population. Patients newly diagnosed with colorectal cancer ( n = 138, mean age = 56.93 years, 31.88% female, 60.14% Hispanic, 6.53 months after diagnosis) and their sleep-partner caregivers ( n = 138, mean age = 55.32 years, 68.12% female, 57.97% Hispanic) completed questionnaires assessing the four PTSS clusters (intrusion, avoidance, alterations in arousal and reactivity, negative alterations in cognitions and mood). Participants also completed daily sleep diaries for 14 consecutive days, from which sleep onset latency (SOL), wake after sleep onset (WASO), and sleep duration were derived. Actor-partner interdependence model revealed that caregivers' greater alterations in arousal and reactivity were associated with their own longer SOL ( b = 15.59, p < .001) and their patients' longer sleep duration ( b = 0.61, p = .014), whereas patients' arousal and reactivity were associated with their caregivers' shorter SOL ( b = -8.47, p = .050). Patients' and caregivers' greater negative alterations in cognitions and mood were associated with patients' longer SOL ( b = 9.15, p = .014) and shorter sleep duration ( b = -0.41, p = .050), respectively. Caregivers' greater intrusion was related to their own shorter SOL ( b = -10.14, p = .004). The four PTSS clusters, particularly arousal and reactivity and negative cognitions and mood, have distinct associations with sleep markers individually and dyadically in patients and caregivers affected by cancer. Investigations of psychosocial and biobehavioral pathways underlying these relations are warranted. Tailored trauma treatments and sleep interventions may improve the well-being of this population.

A network analysis of Hurricane Maria-related traumatic stress and substance use among Puerto Rican youth.

Youth exposed to natural disasters are at risk of developing trauma-related symptoms as well as engaging in substance use. Although previous research has established associations between disaster-related stressors and substance use in youth, less has focused on how symptoms of posttraumatic stress disorder (PTSD) may underpin this association. The current study used network analysis to identify specific PTSD symptoms associated with substance use following a natural disaster. Participants were 91,732 youths (Grades 3-12) from across Puerto Rico who completed a needs assessment 5-9 months after Hurricane Maria made landfall in September 2017. We examined associations between PTSD symptoms and substance use, identified clusters of symptoms and bridges between them, and explored age- and binary gender-related differences in associations between specific PTSD symptoms and substance use. Analyses identified two symptom communities: (a) arousal and reactivity, negative alterations in cognition and mood, and substance use, and (b) avoidance and intrusion. Broader findings suggested that substance use was most strongly associated with PTSD-related irritability and angry outbursts among youths. Surrounding nodes explained only 4.1% of the variance in substance use, but this was higher among youths who reported not having a supportive adult, R2 = 8.5; friend, R2 = 7.9; or teacher/counselor, R2 = 7.7, in their life. The bridge symptoms of sleep disruption and physiological reactivity were identified as potentially critical intervention targets for disrupting PTSD symptom networks after a natural disaster. Implications for triaged mental health care following natural disasters and directions for future research are discussed.

Associations between posttraumatic stress disorder and eating disorder symptoms among women veterans

Recent research suggests high rates of posttraumatic stress disorder (PTSD) and eating disorder (ED) comorbidity in women veterans. This study aims to expand the literature by examining associations between PTSD and ED diagnoses and symptoms in this population. We assessed probable PTSD diagnosis and symptom clusters (intrusion, avoidance, arousal and reactivity, and negative alterations in cognition and mood [NACM]), as well as probable Binge Eating Disorder (BED) diagnosis and ED subscales (dietary restraint, shape/weight overvaluation, and body dissatisfaction) in a sample of women veterans (N = 371). We investigated significance at the standard p < .05, and the Bonferroni-corrected p < .005 cut-off to adjust for experiment-wise error. Overall, we found that probable PTSD was associated with provisional BED (p < .001) using logistic regression at both cut-offs. Probable PTSD was associated with all ED subscales (all p's < 0.003) using linear regression models also at both cut-offs. Provisional BED was associated with NACM at p < .05 (p = .046), though it did not meet significance at our conservative cut-off. NACM was also associated with shape/weight overvaluation (p = .02) and a global ED score (p = .01) at p < .05, but not at our conservative cut-off; arousal was associated with shape/weight overvaluation (p = .04) and the global ED score (p = .02) at p < .05, but not at our conservative cut-off. Our findings may further guide how ED-related topics can be integrated in PTSD treatment for women veterans with comorbid PTSD and ED.

Sexual Objectification Racial Microaggressions Amplify the Positive Relation Between Sexual Assault and Posttraumatic Stress Among Black Women

Black women report higher rates of adult sexual assault (ASA) and sexual objectification compared to White women. Sexual objectification serves as a reminder that Black women's bodies are viewed as sexual objects based on racist/sexist ideologies, though trauma research rarely includes race-specific stressors. In this study, we examined sexual objectification racial microaggressions as a moderator of the relation between ASA severity and posttraumatic stress disorder (PTSD) symptoms among Black women. Data were collected from 129 Black college and community women ( Mage = 33.84). ASA severity was associated with greater overall PTSD symptoms and symptom clusters. The interaction between ASA severity and sexual objectification microaggressions was associated with greater PTSD symptoms and the PTSD symptom cluster, negative alterations in cognition and mood. ASA severity was associated with PTSD at mean and high sexual objectification racial microaggressions but not low levels. Associations with other PTSD symptom clusters were not significant. Findings suggest sexual objectification racial microaggressions amplify the positive relation between ASA and PTSD symptoms, specifically symptoms related to cognition and mood. It is essential that clinicians assess for race-specific stressors during trauma interventions to help reduce mental health disparities. Post-assault interventions should be tailored with multiculturally sensitive practices to address the ways racial discrimination can exacerbate trauma symptoms.

The development and initial validation of the Trauma-Related Alcohol Use Coping Measure (TRAC).

Posttraumatic stress disorder (PTSD) symptoms and alcohol use commonly co-occur and present a prevalent clinical comorbidity. The self-medication/coping model has been applied most consistently to understand the PTSD-alcohol use association. However, there is a relative paucity of self-report measures designed to assess motivations for alcohol use, specifically for coping with PTSD symptoms. The goals of the present study were to develop and validate a measure that assesses the use of alcohol to cope with specific facets of PTSD symptomatology across two independent samples. Two samples were evaluated: a university-based sample (N = 617; 77.0% women; Mage = 22.3; SD = 5.20) composed of racially diverse trauma-exposed students and a nationally representative sample (N = 510; 52.5% women; Mage = 39.5; SD = 10.9) of trauma-exposed adults who endorsed PTSD symptoms and past-year hazardous drinking. Both samples completed identical online questionnaire batteries. A Trauma-Related Alcohol Use Coping (TRAC) measure was developed and validated across both samples. Confirmatory factor analysis was used to support the latent, hierarchical structure of the TRAC measure (total score; coping with intrusion, avoidance, negative alterations in cognitions and mood, and arousal/reactivity symptoms) and supported an 18-item version of the TRAC measure (university-based sample [N = 617]: RMSEA = 0.047, 90% CI [.04, .05]; SRMR = 0.043; CFI = 0.95; TLI = 0.95; nationally representative sample [N = 510]: RMSEA = 0.045, 90% CI [.04, .05]; SRMR = 0.021; CFI = 0.98; TLI = 0.97). The TRAC measure demonstrated excellent internal consistency, convergent, and discriminant validity with well-established measures of mental health, known-groups validity, and incremental validity relative to non-PTSD coping-motivated drinking. Overall, the TRAC measure can be used to assess the extent to which alcohol use is related to coping with PTSD symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Factor structure and factorial invariance of the PTSD checklist for DSM-5 in public safety personnel: Results from a large and diverse sample.

Public safety personnel (PSP; e.g., correctional workers, firefighters, paramedics, and police officers) are frequently exposed to potentially psychologically traumatic events (PPTEs) and report posttraumatic stress disorder (PTSD) difficulties more frequently than the general population. The PTSD checklist for DSM-5 (PCL-5) is a commonly used measure to screen PSP for PTSD. A single previous study assessed PCL-5 factorial invariance among PSP but used a small homogenous sample. The current study evaluated factorial invariance with a large (n = 5,855) and diverse PSP sample. Multigroup confirmatory factor analyses (mCFAs; n = 98) were conducted using six competing factor models of the PCL-5 across seven PSP sectors, five age groups, and two gender groups. The seven-factor hybrid model of PTSD (i.e., reexperiencing, avoidance, negative alterations in cognitions and mood, hyperarousal, intrusion, emotional numbing, dysphoria, dysphoric arousal, anxious arousal, anhedonia, negative affect) produced consistently superior fit across all sectors assessed and produced marginally better absolute values than the six-factor anhedonia model, supporting PCL-5 factorial invariance among PSP. The current study is the first to use a large and diverse PSP sample to assess PCL-5 factorial invariance. The results support the PCL-5 as invariant across PSP sectors, age groups, and men and women. Consistent with other studies, the seven-factor hybrid model of PTSD produced the best fit, followed closely by the six-factor anhedonia model. Future research could use structured clinical interviews to further investigate the factorial structure and invariance of PTSD symptoms among PSPs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Exploring gender differences in the relationships among childhood maltreatment, PTSD, and depression in young adults through network analysis

Background and objectivesCollege students who have experienced childhood maltreatment commonly exhibit adverse psychological consequences such as post-traumatic stress disorder (PTSD) and depression. The aim of this study is to use network analysis to investigate the gender differences in complex connections among various types of childhood maltreatment, PTSD, and depression. MethodsThis study involved 481 participants (M = 19.25 years, 54.5 % female) who were selected from a larger sample of 5231 college students. These participants had experienced childhood maltreatment and exhibited significant clinical symptoms of PTSD and depression. The participants completed validated measures that assessed childhood trauma, PTSD, and depression. ResultsThe network analysis performed on the entire sample revealed robust connections among various types of childhood maltreatment, symptom clusters of PTSD, and depression. The most central symptom that emerged was negative alterations in cognitions and mood (NACM), with emotional abuse displaying the highest centrality measure among the various types of childhood maltreatment. Upon comparing the subnetworks, the centrality analysis identified significant gender differences in nodes such as sexual abuse, physical neglect, emotional neglect, and avoidance. ConclusionsThe study's findings confirm that various forms of childhood abuse have intricate and multifaceted connections with depression and PTSD symptoms in adulthood. The study suggests that NACM could be the most significant symptom, and emotional abuse may play a vital role in adverse psychological outcomes. Furthermore, notable gender discrepancies were identified in the relationship between various forms of maltreatment and psychopathological symptoms.

Negative emotion differentiation in trauma-exposed community members: Associations with posttraumatic stress disorder symptoms in daily life.

The ability to make fine-grained distinctions between discrete negative emotions-termed negative emotion differentiation (NED)-is important for emotion regulation and psychological well-being. Posttraumatic stress disorder (PTSD) is associated with elevated trauma-related negative emotions (e.g., fear, anger, guilt, shame) and self-reported difficulty identifying feelings, suggesting that low NED may be a feature of PTSD. PTSD is also characterized by overreliance on avoidance as an emotion regulation strategy-a characteristic that could be influenced by low NED. Here, we examined whether NED is reduced in PTSD and the role NED plays in the association between trauma-related avoidance and other PTSD symptoms (traumatic reexperiencing, negative alterations in cognition and mood, alterations in arousal and reactivity). Hypotheses were tested using 3 days of ecological momentary assessment (up to 17 prompts per day) in 80 trauma-exposed participants (39 with PTSD, 41 without PTSD; total completed surveys = 2,158). NED was reduced and self-reported difficulty identifying feelings was elevated in those with PTSD, and both predicted PTSD severity (Clinician-Administered PTSD Scale-5 score) and momentary PTSD symptoms. Furthermore, low NED, but not difficulty identifying feelings, predicted a stronger association between momentary trauma-related avoidance and PTSD symptoms. Results suggest that NED is involved in the emotional processing of trauma by decreasing the negative impact of avoidance behavior on other PTSD symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining specific and non-specific symptoms of the best-fitting posttraumatic stress disorder model in conflict-exposed adolescents

BackgroundThe 5th revision of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) construes PTSD symptoms into 4 clusters (intrusion, avoidance, negative alterations in cognitions and mood, alterations in arousal and reactivity; Model 1). However, recent literature has shown that this symptom structure does not best represent PTSD. Unfortunately, the findings of studies investigating the proposed alternative models are from consensus. Adding to the complexity of the issue of symptom-grouping models is the identification of specific and non-specific symptoms of PTSD. The present study aims to address these gaps by identifying the best-fitting PTSD model and subsequently examining what symptoms are considered specific and non-specific to PTSD in adolescent-survivors of armed political conflict and violence.MethodsThe study utilized a sample of 641 adolescent victim survivors. We conducted CFA analyses and compared nested models through the scaled χ2 difference test, while comparison of non-nested models was done using the Bayesian information criterion (BIC). The best-fitted model was used in the consequent analysis, where we statistically controlled for the effect of non-specific psychological distress on PTSD by comparing the factor loadings and factor correlations before and after accounting for distress using the Aroian z-test.ResultsThe results provide support for the 7-factor hybrid model of PTSD over other proposed models for the current sample. Moreover, the data reveal that only 7 items could be construed as core symptoms, while the rest of the symptoms can be considered non-PTSD specific.ConclusionsOverall, the findings provide support for the validity of the hybrid PTSD model among political conflict-exposed adolescents. The results also show that the DSM-5 PTSD has both specific and non-specific features in the present sample of conflict-exposed adolescents. This has potential implications for theory, practice, and treatment of the disorder.

Differential Associations Between Posttraumatic Cognitions, Posttraumatic Stress Disorder Symptoms, and Race Among Black and White Veterans Seeking Treatment for Assaultive Military Sexual Trauma.

Past research supports the role of negative posttraumatic cognitions (NPCs) in the development and maintenance of posttraumatic stress disorder (PTSD). The relationship between NPCs and PTSD may be uniquely impacted by racial status and experiences of military sexual trauma (MST), both of which may have a unique impact on one's understanding of self, others, and the world. We explored racial differences in the association between NPCs and PTSD symptom clusters in a sample of veterans endorsing MST (N = 139; 74.8% White, 25.2% Black). A path model was created and analyzed both with the full sample and separately by racial group. In the full sample, NPCs about the self and world were significantly associated with intrusion, negative alterations in cognitions and mood (NACM), and arousal, but not avoidance. Self-blame was not a significant predictor of negative alterations in cognition in mood. This model was consistent in the White veteran model, whereas only negative cognitions about the self were associated with NACM in the Black veteran path model. NPCs about the self and world appear important to non-avoidance PTSD symptomatology related to MST and thus should be targeted in treatment. For Black veterans endorsing distress related to NACM symptoms, negative beliefs about the self should be specifically considered for intervention.