Posttraumatic Reactions Research Articles

The Role of Objective and Subjective Experiences, Direct and Media Exposure, Social and Organizational Support, and Educational and Gender Effects in the Prediction of Children Posttraumatic Stress Reaction One Year after Calamity.

Eighty-three students and one teacher died when a powerful earthquake hit eastern Turkey at 3:27 in the morning. The boarding school at which they were residents was destroyed. The purpose of this study was to test the direct, indirect, objective, and subjective exposure effect on the development of Post Traumatic Stress Disorder (PTSD). The impact of social and organizational support, as well as age and gender factors, were examined in relationship to the development of PTSD in this group. Participants included 270 disaster survivor elementary and secondary school students. One year after the disaster, each participant filled out a Children’s Post-Traumatic Stress Disorder Reaction Index (CPTSD), trauma exposure, trauma experiencing, social support, and organizational support scale. Contributing factors were predicted with a stepwise regression analysis. A combination of direct, indirect, objective exposure scores, subjective exposure scores, gender, age, organizational and social support variables accounted for 17% of the PTSD scores. Direct exposure accounted for 6%, subjective exposure 5.4%, age 2%, food shortage 1%, and having a friend moving away after the disaster contributed 2.6% of the total variance. Subjective exposure (fear) and direct exposure appeared to be the most significant predictors. However, inconsistent with previous research studies, media exposure, gender, and physical exposure seemed to be especially poor contributors. Neither school nor home damage, the death of relatives or friends, or gas, water, and electric shortages contributed significantly to the results. However, fear experienced during the disaster, food shortages and the loss of a friend who moved away after the earthquake were all powerful predictors. Protective factors, which can strengthen or modify the individual's ability to cope, include healthy family functioning, support from peers and family members, organizing a social network, and the utilization of civil organizations. Thus, researcher and practitioner should pay attention to those predictive and protective factors.

The relationship between post-traumatic stress and depressive symptoms in children: A two-year longitudinal study

Studies have shown that children and adolescents exposed to natural disasters could be at high risk of mental health problems. Post-traumatic stress disorder (PTSD) is now well established as the most common psychopathological outcome of trauma. Studies have shown that PTSD often co-occurs with depression. The comorbidity of PTSD and depression adversely affects the hospitalization of patients. The high prevalence of PTSD and depression poses challenges for accurate diagnosis and treatment. Therefore, the potential mechanism of the comorbidity of PTSD and depression deserves attention. Researchers have proposed several models of comorbidity, such as the “demoralization model,” which indicates that the initial PTSD symptoms may cause subsequent depression. Conversely, the “depressogenic effect model” suggests that the initial depression may cause the subsequent PTSD. However, the “synchronous change model” posits that PTSD and depression occur at the same time and are independent of each other. Clearly, a consistent conclusion has not been reached. Therefore, the relationship between PTSD and depression should be further explored. Moreover, there are some limitations in previous studies. For example, the majority of these studies have focused on PTSD symptoms as a whole, without distinguishing PTSD symptom clusters (such as re-experiencing, avoidance, and hyperarousal) with depression over time. In addition, the most recent studies focused on adults. Children and adolescents are in the developmental stage of cognitive nervous system and emotional regulation and lack the coping mechanism for adaptation and recovery from a disaster. Therefore, they may be vulnerable to environmental changes and negative life events. In view of this, the comorbidity of PTSD and depression needs to be explored in children. The present study investigates the relationship between depressive symptoms and PTSD and differences between the relationships of PTSD clusters and depression among children who survived the Zhouqu debris flow. PTSD was measured with the University of California at Los Angeles Post-traumatic Stress Disorder Reaction Index for DSM-IV, and depressive symptoms were measured with the Children’s Depression Inventory. Participants were assessed at 3, 15, and 27 months after the Zhouqu debris flow. The sample consisted of 1070 adolescents (aged 13.90±1.33), among which 452 (42%) were male and 618 (58%) were female. A cross-lagged analysis revealed bidirectional associations between PTSD and depressive symptoms from T1 to T2, and only depressive symptoms predicted PTSD significantly from T2 to T3. The relationships between depressive symptoms and three PTSD clusters were also different. From T1 to T3, depressive symptoms predicted three PTSD clusters continuously. However, avoidance had no predictive effect on depression from T1 to T3, re-experiencing predicted depressive symptoms from T1 to T2, and hyperarousal demonstrated a continuous predictive effect on depression from T1 to T3. Our study suggested that the relationship between depressive symptoms and PTSD may change over time and the relationships between the three clusters of PTSD and depression may be different. Psychological therapy should focus on different symptoms based on the trauma stage. Future studies should compare the relationships between depressive symptoms and PTSD across different courses after trauma, trauma types, genders, and age stages.

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

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

Trauma-Related Sleep Problems and Associated Health Outcomes in Police Officers: A Path Analysis.

Police officers are frequently exposed to two different types of potentially traumatic events: one dealing with physical threats to self and the other involving the witnessing of harm to others. These different types of traumatic experiences are thought to produce various posttraumatic reactions. Furthermore, sleep problems are also reported as a hallmark of posttraumatic stress disorder. There is evidence, however, that sleep problems may mediate the relationship between posttraumatic stress disorder symptoms and health outcomes, especially physical health and depression. Previous research has shown this to be the case among officers from large urban agencies. The purpose of the present study was to test a model involving a pathway from trauma type and posttraumatic stress disorder symptoms to physical health and depression that is mediated by sleep quality in officers (N = 193) using data from small- to mid-size police agencies. Results revealed that sleep problems served as a mediator between posttraumatic stress disorder hyperarousal and avoidance symptoms and health outcomes, that the trauma types are related to different posttraumatic stress disorder symptoms, and that complicated relationships exist between the study variables. In addition, the results indicated that approximately 25% of our sample displayed probable partial posttraumatic stress disorder or probable full posttraumatic stress disorder, causing substantial functional impairment. Suggestions for improving officer health and performance in the field are provided. Specifically, it appears that interventions designed to address posttraumatic stress disorder hyperarousal symptoms related to personal life threat and the posttraumatic stress disorder avoidance symptoms related to the witnessing of human suffering may maximize officer sleep quality and ultimately overall wellness. In particular, mindfulness-based interventions are well suited for addressing these symptom clusters.

Adipose-Derived Mesenchymal Stem Cell Application Combined With Fibrin Matrix Promotes Structural and Functional Recovery Following Spinal Cord Injury in Rats.

The use of stem and progenitor cells to restore damaged organs and tissues, in particular, the central nervous system, is currently considered a most promising therapy in regenerative medicine. At the same time, another approach aimed at stimulating regeneration with the use of stem cells encapsulated into a biopolymer matrix and capable of creating a specific microenvironment for the implanted cells similar to the natural extracellular matrix is under active development. Here, we study effects of the application of adipose-derived mesenchymal stem cells (AD-MSCs) combined with a fibrin matrix on post-traumatic reactions in the spinal cord in rats. The AD-MSC application is found to exert a positive impact on the functional and structural recovery after spinal cord injury (SCI) that has been confirmed by the results of behavioral/electrophysiological and morphometric studies demonstrating reduced area of abnormal cavities and enhanced tissue retention in the site of injury. Immunohistochemical and real-time PCR analyses provide evidence that AD-MSC application decreases the GFAP expression in the area of SCI that might indicate the reduction of astroglial activation. Our results also demonstrate that AD-MSC application contributes to marked upregulation of PDGFβR and HSPA1b mRNA expression and decrease of Iba1 expression at the site of the central canal. Thus, the application of AD-MSCs combined with fibrin matrix at the site of SCI during the subacute period can stimulate important mechanisms of nervous tissue regeneration and should be further developed for clinical applications.

A Comparison of Psychological Symptoms in Survivors of Sex and Labor Trafficking

ABSTRACTHuman trafficking is a form of interpersonal trauma that has significant mental health impacts on survivors. This study examined psychological symptoms in 131 survivors of sex and labor trafficking, including people trafficked into or within the United States. High rates of depression (71%) and posttraumatic stress disorder (PTSD) (61%) were identified. Two thirds of survivors also met criteria for multiple categories of Complex PTSD (C-PTSD), including affect dysregulation and impulsivity; alterations in attention and consciousness; changes in interpersonal relationships; revictimization; somatic dysregulation; and alterations in self-perception. Although there were not significant differences in the prevalence rates of diagnoses of PTSD or depression between survivors of sex and labor trafficking, important group differences were identified. Compared to survivors of labor trafficking, sex trafficking survivors had higher prevalence rates of pre-trafficking childhood abuse and a higher incidence of physical and sexual violence during trafficking. They reported more severe post-trauma reactions than labor trafficking survivors, including more PTSD and C-PTSD symptoms. They were also more likely to meet criteria for comorbid PTSD and depression, while labor trafficking survivors were more likely than sex trafficking survivors to meet criteria for depression alone. An analysis of gender differences found that trafficking survivors who identified as transgender endorsed more PTSD and C-PTSD symptoms, than male or female survivors. Childhood abuse exposure was linked to PTSD and C-PTSD in trafficking survivors, and trafficking type was predictive of the number of trauma-related symptoms beyond the role of pre-trafficking child abuse. Implications for assessment and intervention with trafficking survivors are discussed.

Post-traumatic Reactions and Their Predictors among Workers Who Experienced Serious Violent Acts: Are There Sex Differences?

Serious violent acts (e.g. physical violence, robbery, sexual aggression and death threats) are among the most visible and notable examples of workplace violence. Although women are commonly found to be at higher risk for post-traumatic reactions following workplace violence, little is known as regards sex differences concerning the types of post-traumatic reactions and their predictors. This study aimed to describe sex differences in the post-traumatic reactions of serious violent acts and the predictors of such reactions. The study was conducted among a convenience sample of 2889 French-speaking workers from Quebec, Canada by using a self-administrated survey. Linear regression modelings and post-hoc comparisons of coefficients according to the sex of the respondents were used to achieve the objective. Preliminary results confirmed that while men are more exposed to violence at work, women experience a greater number of post-traumatic reactions. Women were more affected by flashbacks, avoidance, and hypervigilance than men. The results also showed that being victimized by a male aggressor was associated with a greater number of post-traumatic reactions for women, whereas being victimized by an insider (e.g. colleague, supervisor, employee) was associated with a greater number of post-traumatic reactions for both sexes. These findings highlight the necessity to better consider sex as a potential determinant of mental health in studies on workplace violence.

Healing stories: An expressive-narrative intervention for strengthening resilience and survival skills in school-aged child victims of war and political violence in the Gaza Strip.

Within a preventive framework, we outline a school-based intervention aimed at strengthening skills of survival and psychological functioning in children who have experienced war and political violence in the Gaza Strip. In accordance with a socio-ecological perspective on wellbeing and resilience, the pilot study aimed at evaluating the outcomes of a psychosocial narrative school-based intervention with a group of school-aged children in the aftermath of war. The intervention was oriented at empowering positive emotions, life satisfaction, and optimism in children as protective factors in preventing posttraumatic reactions after war. Findings showed the efficacy of the intervention in favoring life satisfaction in different ecological domains. Children in the intervention group showed greater appreciation for friends, school, family, themselves, and their living environment. At the end of the activity, children were increased the level of positive emotions, but negative feelings were stronger than before the narrative intervention. Clinical implications and future direction or community work are, then, discussed.

Children's emotional and behavioral problems in the shadow of terrorism: The case of Israel

This research investigates the well-being of children subjected to prolonged exposure to missile attacks. A study of post-traumatic symptoms, emotional stress, and behavioral problems among 152 children from southern Israel, an area prone to missile attacks, was conducted. Post-traumatic symptoms were assessed by a self-reported version of the Post-traumatic Stress Disorder Reaction Index for Children (CPTS-RI). Emotional and behavioral problems were assessed by the Child Behavioral Checklist (CBCL), which was completed by the children's mothers. The mothers were asked to answer the CBCL regarding their children's behavior both in the present and prior to the missile attacks. CBCL results were then compared with those of comparable children (n = 125) living in central Israel who were not exposed to missile attacks and whose mothers were asked to answer a similar questionnaire. The results indicated that prolonged exposure to security threats did not result in high levels of posttraumatic symptoms. However, according to the mothers the emotional and behavioral states of the children deteriorated. This was found also when their current emotional and behavioral state was compared to similar children in central Israel. The complex effect of prolonged exposure to security threats is discussed.

The dissociative post-traumatic stress disorder (PTSD) subtype: A treatment outcome cohort study in veterans with PTSD.

Dissociation is a prevalent phenomenon among veterans with post-traumatic stress disorder (PTSD) that may interfere with the effectiveness of treatment. This study aimed to replicate findings of a dissociative PTSD subtype, to identify corresponding patterns in coping style, symptom type, and symptom severity, and to investigate its impact on post-traumatic symptom improvement. Latent profile analysis (LPA) was applied to baseline data from 330 predominantly (97%) male treatment-seeking veterans (mean age 39.5years) with a probable PTSD. Multinomial logistic models were used to identify predictors of dissociative PTSD. Eighty veterans with PTSD that commenced with psychotherapy were invited for a follow-up measure after 6months. The majority (n=64, 80% response rate) completed the follow-up measure. Changes in post-traumatic stress between baseline and follow-up were explored as a continuous distal outcome. Latent profile analysis revealed four distinct patient profiles: 'low' (12.9%), 'moderate' (33.2%), 'severe' (45.1%), and 'dissociative' (8.8%) PTSD. The dissociative PTSD profile was characterized by more severe pathology levels, though not post-traumatic reactions symptom severity. Veterans with dissociative PTSD benefitted equally from PTSD treatment as veterans with non-dissociative PTSD with similar symptom severity. Within a sample of veterans with PTSD, a subsample of severely dissociative veterans was identified, characterized by elevated severity levels on pathology dimensions. The dissociative PTSD subtype did not negatively impact PTSD treatment. The present findings confirmed the existence of a distinct subgroup veterans that fit the description of dissociative PTSD. Patients with dissociative PTSD subtype symptoms uniquely differed from patients with non-dissociative PTSD in the severity of several psychopathology dimensions. Dissociative and non-dissociative PTSD patients with similar post-traumatic severity levels showed similar levels of improvement after PTSD treatment. The observational design and small sample size caution interpretation of the treatment outcome data. The IES-R questionnaire does not assess all PTSD DSM-IV diagnostic criteria (14 of 17), although it is considered a valid measure for an indication of PTSD.

КОГНІТИВНО-ОСОБИСТІСНІ ОСОБЛИВОСТІ ПЕРЕЖИВАНЬ ДОРОСЛИХ З ПРИВОДУ ЗДОРОВ’Я

The cognitive-personal features of patients diagnosed with breast cancer were studied, i.e. the degree of severity of post-traumatic reactions, the level of actual and personal anxiety, basic personal attitudes relating to the self-image and the surrounding world; the presence of depressive symptoms. As a result, individual post-traumatic stress reactions were highlighted, with distress reaching the level corresponding to the clinical picture of post-traumatic stress disorder. Subjects were registered with subdepression, i.e. pessimistic assessment of events and the self, the reduction of working capacity. Most patients have high rates of situational anxiety. At the same time, the overwhelming majority of patients do not exhibit high levels of personal anxiety. Methodology used: Mississippi Scale (MS, Mississippi Scale, Keane et al., 1988); Spalberger-Khanin's Scale of Situational and Personality Anxiety; Scale of basic beliefs (World Assumption Scale, WAS, Janoff-Bulman, 1982); Beck Depression Inventory (Depression Inventory, BDI, Beck & Steer, 1987). The results demonstrated that basic beliefs of patients have the following specificity: predominantly negative image of the self and the world, confidence in their own failure, inability to control the occurring events. Women suffer from decreasing sense of the value and significance of their selves. The world and surrounding people are perceived as unfriendly, dangerous and untrustworthy, probably due to the quality of social support and the attitude of others as a result of the disease. Thus, the variability of the psychological consequences of the disease and peculiarities of individual responses to the stress is most likely related not to the effectiveness of the treatment (all women in these sample have successfully completed the treatment), but rather to the personal and cognitive characteristics of patients, their basic beliefs and conceptions.

Validation Study of a Korean Version of the Abbreviated University of California, Los Angeles, PTSD Reaction Index (Abb-UCLA-PTSD RI) for Adolescents.

BackgroundWe aimed to verify a Korean version of the Abbreviated University of California, Los Angeles, Post-Traumatic Stress Disorder Reaction Index (Abb-UCLA-PTSD RI-Korean version) among Korean adolescents to assess post-traumatic stress in this population.MethodsWe recruited 1,254 adolescents who completed the Abb-UCLA-PTSD RI-Korean version scale, the Child Report of Post-Traumatic Symptoms (CROPS), the Lifetime Incidence of Traumatic Events (LITE), and the Children's Depression Inventory (CDI). Test-retest reliability was computed for a randomly selected 314 participants. Among all the students, 765 were included in the analysis because 143 students were classified in the normative group (LITE 1) and 622 were in the traumatized group (LITE 4).ResultsThe internal consistencies of the nine-item and eight-item versions of the Abb-UCLA PTSD RI-Korean version were found to be high (Cronbach's α = 0.843 and 0.842, respectively). The criterion-related validity was based on comparison of the Abb-UCLA PTSD RI total scores between the normative and trauma groups. For the eight-item version, the normative group (4.6 ± 4.6) and the traumatized group (8.8 ± 6.0) demonstrated better criterion-related validity than those in the nine-item version (4.5 ± 4.3 and 8.5 ± 5.0, respectively). The test-retest reliability of the eight-item version was better than the nine-item version (r = 0.85 vs. 0.77). A two-factor model with eight items (two items regarding sleep, and the other six items made up the second factor) showed the best fit.ConclusionOur results indicate that the eight-item Abb-UCLA PTSD RI-Korean version is a useful screening tool for post-traumatic stress in Korean adolescents.

Диагностическая и экспертная оценка психологических последствий сексуального насилия и злоупотребления в отношении девочек

The article presents the results of a comprehensive psychological and psychiatric examination of 200 minors victims of sexual violence and abuse. A set of methods was used, including the methodology of life quality research, maps of disadaptation assessment, a set of techniques used in the production of cspe, methods of mathematical statistics and data analysis. Depending on the mental state of the victim, the psychological consequences of sexual violence and clinical and psychological abuse were identified. Described 4 types of consequences that vary in severity: psychogenic condition in the form of the disorder (1) and psychogenic condition in the form of reaction (2) (clinical level); adverse psychological condition (3) and minimal negative psychological condition (4) (psychological level). It is established that with the aggravation of the mental state of the victims, from the minimum unfavorable to the psychogenic state in the form of a disorder, the coverage of the spheres of mental activity, the number and severity of signs of post-traumatic reactions expands. The psychological effects demonstrated by mentally healthy victims indicate a decline in their quality of life.

Hair cortisol concentrations in war-affected adolescents: A prospective intervention trial

Temporal examinations of the biological signature of stress or trauma in war-affected populations are seldom undertaken. Moreover, few studies have examined whether stress biomarkers track biological sensitivity to brief interventions targeting the improvement of psychosocial wellbeing. Our study is the first to prospectively examine, in war-affected adolescents, the associations between hair cortisol concentrations (HCC) and self-reports of stress, insecurity, posttraumatic reactions, and lifetime trauma. We conducted a randomized controlled trial to test the impact of an 8-week intervention based on profound stress attunement. We collected data for a gender-balanced sample of 733 Syrian refugee (n = 411) and Jordanian non-refugee (n = 322) adolescents (12–18 years), at three time-points. We used growth mixture models to classify cortisol trajectories, and growth models to evaluate intervention impact on stress physiology. We observed three trajectories of HCC: hypersecretion, medium secretion, and hyposecretion (9.6%, 87.5% and 2.9% of the cohort, respectively). For every one percent increase in levels of insecurity, adolescents were 0.02 times more likely to have a trajectory of hypersecretion (95% CI: 1.00, 1.03, p = 0.01). For each additional symptom of posttraumatic stress reported, they were 0.07 times less likely to show hyposecretion (95% CI: 0.89, 0.98, p = 0.01). Indeed, stronger posttraumatic stress reactions were associated with a pattern of within-individual cortisol dysregulation and medium secretion. Overall, HCC decreased by a third in response to the intervention (95% CI: −0.19, −0.03, p = 0.01). While the intervention decreased HCC for youth with hypersecretion and medium secretion, it increased HCC for youth with hyposecretion (95% CI: 0.22, 1.16, p = 0.004), relative to controls. This suggests a beneficial regularization of cortisol levels, corroborating self-reports of improved psychosocial wellbeing. We did not find evidence to suggest that gender, resilience, or posttraumatic stress disorder influenced the strength or direction of responses to the intervention. This robust impact evaluation exemplifies the utility of biomarkers for tracking physiological changes in response to interventions over time. It enhances the understanding of trajectories of endocrine response in adverse environments and patterns of stress responsivity to ecological improvement.

Complex regional pain syndrome-up-to-date.

Complex regional pain syndrome (CRPS) was described for the first time in the 19th century by Silas Weir Mitchell. After the exclusion of other causes, CRPS is characterised by a typical clinical constellation of pain, sensory, autonomic, motor, or trophic symptoms which can no longer be explained by the initial trauma. These symptoms spread distally and are not limited to innervation territories. If CRPS is not improved in the acute phase and becomes chronic, the visible symptoms change throughout because of the changing pathophysiology; the pain, however, remains. The diagnosis is primarily clinical, although in complex cases further technical examination mainly for exclusion of alternative diagnoses is warranted. In the initial phase, the pathophysiology is dominated by a posttraumatic inflammatory reaction by the activation of the innate and adaptive immune system. In particular, without adequate treatment, central nociceptive sensitization, reorganisation, and implicit learning processes develop, whereas the inflammation moderates. The main symptoms then include movement disorders, alternating skin temperature, sensory loss, hyperalgesia, and body perception disturbances. Psychological factors such as posttraumatic stress or pain-related fear may impact the course and the treatability of CRPS. The treatment should be ideally adjusted to the pathophysiology. Pharmacological treatment maybe particularly effective in acute stages and includes steroids, bisphosphonates, and dimethylsulfoxide cream. Common anti-neuropathic pain drugs can be recommended empirically. Intravenous long-term ketamine administration has shown efficacy in randomised controlled trials, but its repeated application is demanding and has side effects. Important components of the treatment include physio- and occupational therapy including behavioural therapy (eg, graded exposure in vivo and graded motor imaging). If psychosocial comorbidities exist, patients should be appropriately treated and supported. Invasive methods should only be used in specialised centres and in carefully evaluated cases. Considering these fundamentals, CRPS often remains a chronic pain disorder but the devastating cases should become rare.

A longitudinal study of psychological distress and exposure to trauma reminders after terrorism.

The aim of this study was threefold: (1) to examine the type and frequency of trauma reminders reported by survivors 2.5 years after a terrorist attack; (2) to examine whether frequency of exposure to trauma reminders is associated with psychological distress and level of functioning; and (3) to compare the worst trauma reminders reported by the same survivors at 2 different time points. Participants were 261 survivors (52.1% male; Mage = 22.1 years, SD = 4.76) of the 2011 massacre on Utøya Island, Norway, who were interviewed face-to-face 14-15 and 30-32 months postterror. Participants were asked how often they had experienced various trauma reminders in the past month, which reminder was the worst, and how distressing it was. Current posttraumatic reactions were measured using the University of California at Los Angeles PTSD Reaction Index and an 8-item version of the Hopkins Symptom Checklist-25. Auditory reminders were most frequently encountered and the most distressing. Frequency of exposure to trauma reminders was positively correlated with symptoms of posttraumatic stress disorder (PTSD), anxiety, and depression, as well as negatively correlated with level of functioning, over time. Almost 20% of the survivors reported being very distressed by their worst reminder 2.5 years postterror. Less than half reported the same worst reminder at both time points. Trauma reminders, especially auditory reminders, are prevalent and distressing for years after a terrorist attack. Exposure to reminders may be important not only in the development and maintenance of PTSD but also in a broader conceptualization of posttraumatic reactions and functioning. Which reminder survivors appraise as the worst may fluctuate over time. It is important to help survivors identify and cope with reminders. (PsycINFO Database Record

Intergenerational transmission of captivity trauma and posttraumatic stress symptoms: A twenty three-year longitudinal triadic study.

The aversive, long-term toll of war captivity and fathers' combat-induced posttraumatic stress disorder symptoms (PTSS) on adult offspring's mental health has been recently exemplified. However, studies that have examined the implication of PTSS of both fathers and mothers in the intergenerational transmission of trauma to offspring are still lacking. This prospective study assessed the unique and combined effects of former prisoners of war (ex-POWs) fathers' and mothers' PTSS in adult offspring's PTSS. A sample of 123 Israeli father-mother-offspring triads (79 ex-POW triads and a comparable group of 44 veteran triads) completed self-report measures. Following the 1973 Yom Kippur War, fathers participated in 3 waves of measurements (1991, 2003, 2008), mothers participated in 2 waves of measurements (2004, 2011), while offspring took part in 2014. Both fathers' and mothers' PTSS were positively related to offspring's PTSS. Among ex-POW triads, fathers' PTSS in 2003 and 2008 and mothers' PTSS in 2004 predicted offspring's PTSS in 2014. Interestingly, serial multiple mediation model results showed that mothers' PTSS in 2004 mediated the link between fathers' PTSS in 1991 and offspring's PTSS in 2014. Furthermore, fathers' PTSS in 2008 mediated the link between mothers' PTSS in 2004 and offspring's PTSS in 2014. Over time, both ex-POWs fathers' and mothers' PTSS are implicated in their offspring's PTSS. However, both direct and indirect effects of both parents' posttraumatic reactions contribute to the intergenerational transmission of captivity related trauma. (PsycINFO Database Record

Posttraumatic Growth in Case of Internal Displacement

Most of the empirical research in trauma psychology focuses on posttraumatic reactions, rather than on positive outcomes besides increased attention to contributing factors to the concept of posttraumatic growth. The study presented in this paper investigates the role of religious commitment on the one hand and religious and nonreligious coping on the other as contributing factors to posttraumatic growth among Internally Displaced Persons (IDPS) in Georgia. Based on data from N = 190 IDPS, Structural Equation Modeling (SEM) was used to understand posttraumatic growth and the role of religiosity as a coping resource and strategy. Results indicate that religious commitment is not directly related to areas of posttraumatic growth but it has a positive impact on posttraumatic growth when it fosters religious and non-religious ways of coping. Each and every component has shown to have unique contribution to the outcome variable. Finally, implications of the practical value and for the field in general are discussed.

Parental Post-traumatic Stress Disorder Symptoms Are Related to Successful Aging in Offspring of Holocaust Survivors.

A fascinating, yet underexplored, question is whether traumatic events experienced by previous generations affect the aging process of subsequent generations. This question is especially relevant for offspring of Holocaust survivors (OHS), who begin to face the aging process. Some preliminary findings point to greater physical dysfunction among middle-aged OHS, yet the mechanisms behind this dysfunction need further clarification. Therefore, the current studies assess aging OHS using the broad-scoped conceptualization of successful aging, while examining whether offspring successful aging relates to parental post-traumatic stress disorder (PTSD) symptoms and offspring’s secondary traumatization symptoms. In Study 1, 101 adult offspring (mean age = 62.31) completed measures of parental PTSD, secondary traumatization, as well as successful aging indices – objective (medical conditions, disability and somatic symptoms) and subjective (perceptions of one’s aging). Relative to comparisons and OHS who reported that none of their parents suffered from probable PTSD, OHS who reported that their parents suffered from probable PTSD had lower scores in objective and subjective measures of successful aging. Mediation analyses showed that higher level of secondary traumatization mediated the relationship between parental PTSD and less successful aging in the offspring. Study 2 included 154 dyads of parents (mean age = 81.86) and their adult offspring (mean age = 54.48). Parents reported PTSD symptoms and offspring reported secondary traumatization and completed measures of objective successful aging. Relative to comparisons, OHS whose parent had probable PTSD have aged less successfully. Once again, offspring secondary traumatization mediated the effect. The findings suggest that parental post-traumatic reactions assessed both by offspring (Study 1) and by parents themselves (Study 2) take part in shaping the aging of the subsequent generation via reactions of secondary traumatization in the offspring. The studies also provide initial evidence that these processes can transpire even when offspring do not have probable PTSD or when controlling offspring anxiety symptoms. Our findings allude to additional behavioral and epigenetic processes that are potentially involved in the effect of parental PTSD on offspring aging, and further imply the need to develop interdisciplinary interventions aiming at promoting successful aging among offspring of traumatized parents.

The Role of Environmental Factors in the Aetiology of Social Anxiety Disorder: A Review of the Theoretical and Empirical Literature

Social anxiety disorder (SAD) is characterised by a marked and persistent fear of social/performance situations, and a number of key environmental factors have been implicated in the aetiology of the disorder. Hence, the current article reviews theoretical and empirical evidence linking the development of SAD with parenting factors, traumatic life events, and aversive social experiences. Specifically, research suggests that the risk of developing SAD is increased by over-controlling, critical and cold parenting, an insecure attachment style, aversive social/peer experiences, emotional maltreatment, and to a lesser extent other forms of childhood maltreatment and adversity. Moreover, these factors may lead to posttraumatic reactions, distorted negative self-imagery, and internalised shame-based schemas that subsequently maintain SAD symptomatology. However, further research is necessary to clarify the nature, interactions, and relative contributions of these factors. It is likely that SAD develops via a complex interplay of biological and environmental factors, and that multiple aetiological pathways underlie the development of the disorder.