Posttraumatic Stress Disorder Symptoms Of Avoidance Research Articles

Altered functional connectivity between cortical networks associated with inhibitory control in trauma-exposed females

Post-traumatic stress disorder (PTSD) is associated with impaired inhibitory control and alterations in large-scale brain network connectivity. However, few studies to date have examined the construct of inhibitory control as it relates to resting-state functional connectivity (rsFC) in a population with PTSD or trauma-exposure. The present study investigated the relationship between impaired inhibitory control and rsFC within the default mode network (DMN), central executive network (CEN), and salience network (SN) in a sample of females exposed to interpersonal trauma with and without PTSD (n = 67). Participants completed a classic Color-Word Stroop task as a measure of inhibitory control and two resting-state fMRI scans. We conducted voxelwise rsFC analyses with seed regions in the DMN, CEN, and SN and voxelwise linear regression analyses to examine the relationship between inhibitory control and rsFC of these networks across the sample. Better Stroop performance was negatively associated with total self-reported PTSD symptoms. An analysis of PTSD symptom clusters indicated that better Stroop performance was also associated with re-experiencing and hyperarousal symptoms, but not avoidance PTSD symptoms. Decreased coupling between the CEN and the DMN was associated with better inhibitory control in this sample of trauma-exposed females. These findings lend support to the hypothesis that efficient switching between these networks may contribute to better performance on cognitive and attentional tasks in trauma-exposed individuals.

Specifying the Relations among PTSD Symptom Clusters and Parenting Stress in Mothers Engaged in Substance Use Treatment

Introduction Parenting stress is often heightened in mothers receiving treatment for substance use. Experiences of trauma are commonly seen in this population, which may give rise to Posttraumatic Stress Disorder (PTSD) symptoms, including intrusion, avoidance, negative cognition and mood, and affective arousal. While past research has demonstrated a significant relation between PTSD symptoms and parenting stress, no studies have examined the relative contributions of these symptoms to parenting stress in mothers engaged in substance use treatment. Methods Seventy-four mothers attending outpatient substance use treatment who were parenting children aged 0–3 years completed measures of parenting stress, PTSD, substance use, and depression symptoms. Results A canonical correlation analysis indicated two canonical variates accounting for significant variance between PTSD symptom clusters and parenting stress measures. The first canonical variate, primarily reflecting depressive and PTSD cognition and mood symptoms, was predominantly related to the parental distress aspect of parenting stress (40%). The second canonical variate, primarily reflecting intrusion and avoidance PTSD symptoms, was associated with increased parental perceptions of their child as difficult (10%). Conclusion Future research directions and clinical implications of these results are discussed for designing parenting interventions with mothers attending substance use treatment who present with PTSD symptoms.

Acting with awareness and distress tolerance relate to PTSD symptoms among women with substance use disorder.

Women with a history of trauma exposure and substance use disorder (SUD) are more likely to report co-occurring post-traumatic stress disorder (PTSD) symptoms than the general population. However, cognitive factors such as increased distress tolerance and mindfulness disposition might be especially protective against PTSD symptoms for women with SUD. We examined the associations of distress tolerance and mindfulness disposition as potential resilience factors to PTSD symptoms in a sample of women receiving residential treatment for SUD (N = 237, M AGE = 32.34, 56.96% Hispanic). PTSD symptoms were divided into the clusters of Reexperiencing, Avoidance, Dysphoria and Arousal. Regression models revealed that distress tolerance and the mindfulness facet of acting with awareness are negatively and incrementally associated with total, dysphoria and arousal PTSD symptom severity, while non-reactivity has a significant negative relationship with avoidance PTSD symptoms. Only distress tolerance emerged to be negatively related to PTSD reexperiencing symptom severity. Our findings show that the ability to tolerate distress, as well as specific mindfulness skills, might protect against specific severe PTSD symptoms among women with SUD. Future research should examine whether targeting both of these facets is necessary for achieving favorable clinical outcomes on PTSD in this population.

Insomnia and posttraumatic stress symptoms: Evidence of shared etiology

Posttraumatic stress disorder (PTSD) and insomnia are comorbid clinical conditions that are thought to result from genetic and environmental effects. Though studies have established the heritability of these disorders independently, no study to date has examined the genetic contributions to the relation between insomnia and PTSD symptoms (PTSS). The present study assessed this gap in the literature using a behavioral genetics approach to symptom dimensions. The sample consisted of 242 twin pairs who endorsed lifetime trauma exposure. Insomnia symptoms were assessed with the Women's Health Initiative Survey, and intrusion and avoidance PTSS were assessed with the Impact of Events Scale. Structural equation modeling was then employed to test the relative contributions of genetic, shared environmental, and nonshared environmental components to the relations between insomnia symptoms and intrusions and avoidance. Results indicated a significant association between insomnia symptoms and intrusions (r = 0.33, p < 0.01) and insomnia symptoms and avoidance (r = 0.20, p < 0.01), and 36–44% of phenotypic variance was accounted for by genetic contributions. These findings highlight a significant role for genetic factors in the mechanisms underlying the comorbidity between insomnia and PTSS. The implications for current etiological models of PTSD and insomnia are discussed.

Trajectories of academic burnout in adolescents after the Wenchuan earthquake: A latent growth mixture model analysis

Changes in academic burnout in adolescents have attracted much research attention; however, most studies assume that adolescent academic burnout is characterized by overall homogenous change and overlook the heterogeneity of burnout change. To address this issue, this study examined distinct latent trajectories of academic burnout in adolescents following the Wenchuan earthquake, China. Adolescents were surveyed at 1 (T1), 1.5 (T2), 2 (T3), and 2.5 years (T4) after the earthquake. Self-reported questionnaires were administered to 391 participants aged 12- to 19-years-old. The results identified three academic burnout trajectories: Increasing (3.9%), low (85.4%), and decreasing (10.7%). Additionally, intrusive post-traumatic stress disorder (PTSD) symptoms were more likely in the increasing group, avoidance PTSD symptoms were more likely in the decreasing group, and PTSD hyperarousal symptoms were more likely in the decreasing group, but less likely in the increasing group. These findings indicate that adolescents experienced heterogeneous academic burnout changes following the earthquake.

Using art therapy to overcome avoidance in veterans with chronic post-traumatic stress disorder

ABSTRACTAvoidance can be a significant barrier to engaging in trauma-focused treatment for post-traumatic stress disorder (PTSD), as well as being a mechanism that creates restrictions that can seriously impact functioning and wellbeing. Following an outpatient study with veterans that indicated art therapy might assist the overcoming of avoidance, a group of veterans was offered an art therapy-focused, short-stay, inpatient admission at the veterans’ mental health charity Combat Stress to explore this potential outcome. Participants were able to use the art therapy process to express and tolerate painful thoughts and emotions, and to consider the effects of rigid perceptions. The group dynamic between the veterans created a strong container for this process. Consequently, this study suggests that art therapy can be constructively employed in assisting veterans to overcome avoidance PTSD symptoms and as a means of opening up new ways of perceiving, interpreting, and responding to situations. It is proposed that the non-verbal operations of art therapy enable this process through the use of imagination and creativity.

Chronic posttraumatic stress disorder and family functioning of Vietnam veterans and their partners.

This study examines the association between posttraumatic stress disorder (PTSD), in terms of the three main symptom clusters (intrusion, avoidance and arousal), and the self-report of family functioning of Vietnam veterans and the self-report of family functioning of their partners. A second objective was to determine if depression, anger and alcohol abuse mediated between PTSD symptoms and family functioning. Vietnam veterans and their partners completed a series of questionnaires as part of their participation in the inpatient and outpatient PTSD treatment program, in the Veterans Psychiatry Unit, at the Austin and Repatriation Hospital. Data from 270 veterans and partners were used in the final analyses. The PTSD subscales were initially correlated with family functioning for veterans and family functioning for partners. Then two path diagrams were constructed and analyzed using the statistical program AMOS to test for mediating effects between PTSD symptoms and family functioning. For veterans there were significant initial correlations with all three subscales of the PTSD measure. In the path analysis when the mediating variables were included only the avoidance subscale of the PTSD measure remained directly associated with family functioning. The arousal PTSD subscale was mediated by anger. The measures of depression and anger were significantly associated with poor family functioning and the anger and the avoidance subscales were significantly associated with depression. In the second set of analyses conducted on data from partners, the PTSD symptoms of avoidance and arousal were initially correlated with family functioning. When the test for mediation was conducted none of the PTSD subscales remained associated with partners' self-report of family functioning. Posttraumatic stress disorder arousal and alcohol abuse were mediated by anger for partners' self-report of family functioning. Posttraumatic stress disorder symptoms of avoidance for veterans, and comorbid symptoms of anger and depression for veterans, and anger on its own for partners appear to be important in the self-report of family functioning. These findings suggest that veterans and their partners have similar difficulties as couples with distressed relationships in the community.

Relationship of Cosmetic Disfigurement to the Severity of Posttraumatic Stress Disorder in Burn Injury or Digital Amputation

Background: The purpose of this study was to examine the relationships of physical factors including physical functioning and cosmesis to posttraumatic stress disorder (PTSD) symptoms in patients with burn injury and in patients with digital amputation. Methods: Subjects were 56 patients with burn injury and 26 patients with digital amputation. In addition to assessments of physical factors, psychiatric interviews were administered to examine mental disorders including PTSD and major depression. Results: The prevalence rates of PTSD and major depression were 33.9 and 7.1% in burn-injured patients and 18.5 and 7.4% in patients with digital amputation respectively. Multivariate analysis of variance (MANOVA) revealed that, regardless of the severity of burn injury such as percentage of total body surface burned, female victims with cosmetic disfigurement (i.e., facial burn) exhibited PTSD symptoms, in particular PTSD symptoms of avoidance and emotional numbing. For subjects with digital amputation, MANOVA indicated that, regardless of the degree of physical functioning after replantation, female victims with cosmetic disfigurement exhibited PTSD symptoms. Discussion: These findings suggest that, in female victims with burn injury and/or digital amputation, the degree of cosmetic disfigurement is related to the manifestation of PTSD symptoms of avoidance and emotional numbing.

Posttraumatic stress disorder and its related factors in burn injury and digit amputation

This study examined the relationship of physical factors including physical functioning and cosmesis to posttraumatic stress disorder (PTSD) symptoms in patients with burn injury and in patients with digit amputation; posttraumatic stress symptoms and depression in mothers of children with burn injuries from falling into bathtubs of hot water. The study comprised 56 patients with burn injury and 26 patients with digit amputation, and 16 children with burn injury and their mothers. Prevalence rates of PTSD and major depression were 33.9 and 7.1%, respectively, in burn‐injured patients and 18.5 and 7.4%, respectively, in patients with digit amputation. Regardless of the severity of the burn injury, such as percentage of total body surface burned, females with cosmetic disfigurement exhibited PTSD symptoms, in particular avoidance and emotional numbing. For digit amputation, regardless of the degree of physical functioning after replantation such as motion and sensation, females with cosmetic disfigurement exhibit PTSD symptoms, in particular avoidance and emotional numbing. These findings suggest that in female victims the degree of cosmetic disfigurement is related to the manifestation of PTSD symptoms of avoidance and emotional numbing. Prevalence rates of PTSD and major depression were 6.3 and 0%, respectively, in children with burn injury and 12.5 and 18.8%, respectively, in their mothers. For three PTS symptoms (i.e. intense distress at a similar event, restricted range of affect, and hypervigilance), prevalence rates were significantly higher for mothers than for children. The three PTS symptoms of their mothers were significantly and positively correlated with severity of guilt feelings. Compared with burn‐injured children, the mothers are prone to PTS symptoms mixed with guilt feelings.

Emotional disturbances in trauma patients during the rehabilitation phase: Studies of posttraumatic stress disorder and alexithymia

Recent studies have shown a partial similarity between posttraumatic stress disorder (PTSD) and alexithymia. In this study, the authors examined the relationship between PTSD and alexithymia in two samples of 26 patients with burn injury and 27 patients with digit amputation during rehabilitation. The prevalence rates of DSM-III-R PTSD and alexithymia assessed by the Toronto Alexithymia Scale (TAS) were significantly higher for injury patients than for healthy volunteers. The rate of PTSD symptoms of avoidance and emotional numbing was significantly and positively correlated with the TAS scores in injury patients. The PTSD symptoms of avoidance and emotional numbing had a significant relationship with function after digit replantation. Alexithymia also had a similar relationship with physical conditions. These results suggest that 1) in some cases, alexithymia may be evident when PTSD emotional symptoms appear in injury patients, and 2) emotional disturbances (i.e., PTSD symptoms of avoidance and emotional numbing and alexithymia) may be influenced by the level of functional recovery after digit replantation.

Effects of the Persian Gulf War on Veterans with Combat-Related Post-Traumatic Stress Disorder

The authors prospectively studied 32 male veterans with combat-related post-traumatic stress disorder (PTSD) during the Persian Gulf War. The veterans were enrolled in a Veterans Affairs mental health clinic and met the DSM-III-R criteria for PTSD. The purpose of the study was to evaluate exacerbation and reactivation of PTSD symptomatology utilizing the Mississippi Scale and the Impact of Event Scale, two widely used self-report inventories for assessment of PTSD symptoms. Results did not support an increase in the PTSD symptoms of avoidance and intrusion during the actual combat period. Possible reasons for this finding are discussed.