Role Of Posttraumatic Stress Symptoms Research Articles

Unpacking the Links Between Community Violence, Delinquency, and Illicit Substance Use Among College Students: The Role of PTSS and Code of the Streets

ABSTRACT Community violence (CV) is a serious public health concern. To date, most of the existing research has focused on youth of color living in high-risk environments. The prior literature has shown that CV-exposed youth are at risk for post-traumatic stress symptoms (PTSS), delinquency, and substance use. CV has also been tied to beliefs about violence being an acceptable way of resolving conflict, referred to as the Code of the Streets (COS). It is unclear how the trajectories of other CV-exposed populations may differ from vulnerable youth, including college students who are in a developmental period associated with high-risk for violence exposure. The study objectives were therefore to: 1) examine the relations between CV and delinquency (i.e. gang involvement, arrest, weapon ownership) and illicit substance use, as well as 2) investigate whether there are indirect effects between CV and both delinquency and illicit substance use through PTSS and COS beliefs among college students. The sample included 547 students from two universities (M age = 20.31, SD = 2.08, Range = 18–28; 80.8% female; 57.8% White). CV was associated with delinquency and illicit substance use. COS beliefs had an indirect effect on the relation between CV and delinquency, but PTSS did not. Conversely, PTSS had an indirect effect on the link between CV and illicit substance use, but COS did not. College students are at risk for CV exposure and adverse outcomes. Interventions addressing PTSS and COS beliefs may be central to mitigating delinquent behaviors and illicit substance use in this population.

The Role of Post-Traumatic Stress Symptoms and Post Migration Life Difficulties for Future Aspirations of Iraqi and Syrian Asylum Seekers

The majority of asylum seekers experience some kind of traumatic events before or during their flight and their challenging experiences do not end after resettlement. Still, they need to envision and build their future life in the host country. Moreover, asylum seekers’ future aspirations need to be differentiated from the satisfaction of essential needs. We (1) measured future aspirations (FA); (2) explored whether FA and post-migration life difficulties (PMLD) differ between asylum seekers with high and low levels of post-traumatic stress symptoms (PTSS); and (3) examined whether PTSS, PMLD, gender, age, and length of stay are associated with different types of FA. In total, 139 Iraqi and Syrian asylum seekers (55 female, 83 male) aged 18 to 67 years ( M = 34.03, SD = 10.35) participated. A four-factor structure of FA was confirmed by confirmatory factor analysis (CFA). Participants with high levels of post-traumatic stress symptoms reported higher levels of PMLD and lower levels of FA related to their home country. FA related to the host country and FA related to occupation were predicted by lower levels of post-traumatic stress symptoms, while future aspirations related to the home country were predicted by higher levels of PMLD. Results indicate that asylum seekers who experienced more traumatic events before they migrated are more reluctant to return to these places in the future. Treating the psychological impairments of this highly vulnerable group and relaxing the manifold structural barriers are crucial to foster their construction of a future life.

Posttraumatic stress and probable post traumatic stress disorder as it relates to smoking behavior and beliefs among trauma exposed hispanic persons who smoke.

There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p < .008) and a severity of problems when trying to quit (p < .001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology.

Effets médiateurs de la symptomatologie de stress post-traumatique et des symptômes de dissociation somatoforme sur la relation entre l’attachement et la qualité de vie liée à la santé après un infarctus du myocarde

Myocardial infarction (MI) is a particularly frequent coronary disease: the number of new cases of MI recorded each year amounts to nearly 90,000 in France and nearly 790,000 in the United States. Over the past 15 years, the number of people who can survive this major cardiac event has substantially increased, as a result of advances in medical treatment and a reduction in delay to intervention. However, patients often report a decrease in their health-related quality of life following myocardial infarction. In other words, some patients perceive that the disease negatively affects various aspects of their daily lives, including physical functioning, emotional state, social relationships, and overall well-being. Furthermore, studies have shown that health-related quality of life is a prognostic indicator of the evolution of patients’ health status: the more health-related quality of life is reduced, the greater the risk of all-cause mortality, recurrence of cardiovascular events, and re-hospitalization for heart disease. In view of these elements, the identification of potentially modifiable factors, and in particular psychological factors, having an impact on health-related quality of life is particularly relevant. More specifically, insecure attachment, post-traumatic stress symptomatology and somatoform dissociation symptoms could have an impact on the health related-quality of life of people who have experienced a major cardiac event. ObjectivesThe objective of this study was to investigate the mediating role of posttraumatic stress symptoms and somatoform dissociative symptomatology in the relationship between insecure attachment and health related-quality of life after a myocardial infarction. Materials and methodsA total of 73 participants, having suffered a myocardial infarction and participating in a cardiovascular rehabilitation program, completed questionnaires to assess the degree of insecurity of their attachment (Experiences in Close Relationship Scale-12; ECR-12), the severity of post-traumatic stress symptoms (Post-Traumatic Stress Disorder Checklist Scale; PCL-5) and somatoform dissociation symptoms (Somatoform Dissociation Questionnaire; SDQ-20), and their health related-quality of life (MacNew Heart Disease-Health Related Quality of Life; MacNew). Mediation analyses were conducted according to the recommendations formulated by Baron and Kenny. ResultsOur results showed that only anxious attachment was positively and significantly associated with the severity of posttraumatic stress symptomatology, whereas such a link was not observed for avoidant attachment. The importance of posttraumatic symptomatology fully explained why individuals with high levels of fear of abandonment also have the poorest emotional, physical, and social quality of life after myocardial infarction. The importance of dissociative somatoform symptomatology partially explained why individuals with an insecure attachment style characterized by a high level of abandonmen were also those with the poorest health-related quality of life following myocardial infarction. ConclusionsThe results of this study tend to demonstrate the importance of taking into account the specificities of attachment, posttraumatic stress symptoms and somatoform dissociation phenomena in the context of interventions aimed at improving the health related-quality of life of people after a myocardial infarction. Insofar as secure attachment appears to be a protective factor against the risk of developing posttraumatic stress disorder, a psychotherapeutic approach aimed at promoting this form of attachment seems to be well justified. Specifically, it may be helpful to provide patients with a psychotherapeutic framework that takes into account their attachment experiences to allow them to change their beliefs about themselves and others, while helping them develop coping strategies appropriate to the stress. Psychotherapeutic interventions aimed jointly at increasing of the degree of attachment security and reducing the symptoms of posttraumatic stress and somatoform dissociation could be relevant to improve the health-related quality of life after a myocardial infarction.

Associations among sexual assault, posttraumatic stress, drinking to cope with anxiety, and alcohol use based on gender identity and sexual orientation.

Sexual assault (SA) is experienced by a substantial proportion of emerging adult college students and is associated with elevated rates of posttraumatic stress disorder (PTSD) and alcohol use. This study examines the mediating role of posttraumatic stress symptoms (PTSS) in the associations among SA severity, drinking to cope with anxiety, and average weekly drinks while considering the moderating roles of gender identity and sexual orientation. A total of 2160 college students who were diverse in gender (cisgender women, 64.4%; cisgender men, 30.6%, and transgender and gender diverse [TGD] individuals = 4.9%) and sexual orientation (heterosexual = 68.0%, LGBQ+ = 32.0%) completed measures of SA severity, PTSS, drinking to cope with anxiety motives, and average weekly drinks. The mediation model for the full sample indicated significant indirect effects of SA severity on drinking to cope with anxiety through PTSS, but not on average weekly drinks. Moderation analyses revealed differential relationships between the variables based on both gender identity and sexual orientation. For instance, the association between SA severity and PTSS was stronger for cisgender women and TGD individuals than cisgender men, and for LGBQ+ individuals than heterosexual individuals. While the association between PTSS and average weekly drinks was only significant for cisgender men, the association between PTSS and drinking to cope with anxiety was significant for both cisgender men and women but not TGD individuals. Furthermore, the association between SA severity and drinking to cope with anxiety was stronger for cisgender women than cisgender men. Findings from this study demonstrate sexual orientation and gender identity differences and similarities in the associations of SA severity, PTSS, drinking to cope with anxiety, and alcohol use. Results are discussed in relation to the self-medication hypothesis and tailoring interventions for diverse groups.

The role of strength-based parenting, posttraumatic stress, and event exposure on posttraumatic growth in flood survivors.

The present study examined the role of posttraumatic stress symptoms (PTSS), strength-based parenting (SBP), and event exposure on posttraumatic growth (PTG) in Peruvian flood survivors. After contacting local authorities, 1,077 adult participants were surveyed 1 year after the flood. Correlation, moderation, and mediation analyses were conducted to determine relationships between variables. Flood survivors experienced both PTSS and PTG. Additionally, event exposure directly facilitated PTG. Further, SBP influenced PTG both directly and by its role in reducing PTSS. Finally, higher levels of SBP aided individuals in converting PTSS into PTG. Favorable psychological outcomes following floods are not uncommon even for those with high levels of stress or exposure. Individual- and community-level interventions should leverage facilitating factors such as SBP to promote growth outcomes such as PTG. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The relationship between combat exposure and suicide risk in U.S. military veterans: Exploring the role of posttraumatic stress symptoms and religious coping

BackgroundRising suicide rates in the U.S. veteran population are a growing concern. Combat exposure has been identified as a potential predictor of suicide risk, but factors that may mediate the relation between combat exposure and suicide risk, and the role of potential coping mechanisms remain largely understudied. To address this gap, this study examined the association between lifetime combat exposure and current suicide risk; whether this association is mediated by posttraumatic stress disorder (PTSD) symptoms; and whether direct and/or indirect associations with combat exposure are moderated by organizational, non-organizational, and intrinsic religiosity. MethodsData were analyzed from the National Health and Resilience in Veterans Study (2019–2020; n = 3843). Ordinary least squares and conditional process analyses were conducted to evaluate the conditional direct and indirect predictors of suicide risk. ResultsPTSD symptoms significantly mediated the association between combat exposure and suicide risk. Intrinsic religiosity showed significant moderation and reduced the coefficient of PTSD symptoms predicting suicide risk but increased the coefficient of combat exposure predicting PTSD symptoms. LimitationsIn this cross-sectional, observational study, no conclusions can be made regarding causality. ConclusionsResults of this study suggest a multifaceted relationship between combat exposure, PTSD, religiosity/spirituality, and suicide risk in U.S. veterans, and underscore the importance of PTSD and religious coping as part of ongoing suicide prevention efforts in this population.

The mediating role of posttraumatic stress symptoms on somatization in adolescents: A two-wave longitudinal study.

Trauma as well as adverse childhood experiences (ACEs) have been associated with increased rates of later somatization symptoms. Some evidence has proposed that posttraumatic stress symptoms (PTSS) can mediate this relationship. However, most data come from adult samples. This two-wave longitudinal study aimed to investigate the relationship between cumulative adversity (total amount of adverse and traumatic experiences), PTSS and somatization symptoms in adolescents. The sample included 150 adolescents, mean age of 16 years old (M = 15.99, SD = 1.25) with 67 (44.7%) males and 83 (55.3%) females. All were exposed to at least one traumatic event or one childhood adversity. The interval time between the two assessments was about 1 year. The results showed that the PTSS Cluster E, alterations in arousal and reactivity, partially mediated the relationship between cumulative adversity and somatization symptoms (B = .09, BSE = .03, CI [.01, .15]). However, the effect size of the mediation was medium, while the direct effect was large (B = .34, BSE = .08, CI [.18, .50]). While arousal and reactivity symptoms seem to play a key role in adolescents suffering from somatization symptoms, cumulative adversity have their own direct and strong contribution. Clinicians should consider assessing PTSS and cumulative adversity when caring for adolescents suffering with somatic symptoms to better deliver intervention plans. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Early Child Adversity and Delinquent Behavior in Foster Care Youth: Do Future Expectations and Sexual Identity Moderate the Mediating Role of Posttraumatic Stress?

Delinquency in youth is a significant public health concern for individuals who experienced adversity and complex trauma as children. The present study explored the longitudinal associations between adverse child experiences and future engagement in delinquent behavior. Using a sample of 1,245 foster youth who are aging out of the child welfare system, mediation, moderation, and moderated mediation analysis was used to test the mechanistic role of post-traumatic stress symptoms and the moderating role of sexual identity and positive future expectations on engagement in delinquent behavior. Results showed a positive and significant association between adverse child experiences and engagement in delinquent behavior. Post-traumatic stress symptoms partially mediated the ACEs-delinquency relationship. In addition, sexual minority youth and youth who were less optimistic about the future, but who experienced more ACEs, were at risk for heightened levels of post-traumatic stress. Interventions that promote positive future outlooks may minimize the psychological sequelae of early child adversity and delinquent behavior particularly when tailored to the needs of sexual minority youth.

Role of Posttraumatic Stress Symptoms, Psychological Resilience and Hope in Posttraumatic Growth in Individuals with Novel Coronavirus Disease (Covid-19)

The aim of this research is to examine the role of post-traumatic stress symptoms, resilience and hope in post-traumatic growth in individuals who have overcome the novel coronavirus disease (Covid-19). The study group of the research consisted of 454 participants aged between 18 and 72. The mean age of the participants was 32.91, and the standard deviation was 11.18. Participants answered the demographic information form, Post Traumatic Growth Inventory, Trait Hope Scale, Post Traumatic Stress Diagnostic Scale, and Adult Resilience Scale. The results showed that posttraumatic growth levels of women were significantly higher than men's posttraumatic growth levels. Moreover the post-traumatic growth levels of those who had the disease severely were higher than the post-traumatic growth levels of those who had the disease mildly and moderately. According to the recovery time from the disease, the post-traumatic growth levels of those who had the disease for a long time were found to be higher than the post-traumatic growth levels of those who had the disease in a short time. Post-traumatic stress symptoms, resilience and hope were found to be positive and significant predictors of post-traumatic growth. Post-traumatic stress symptoms, psychological resilience and hope-focused psychosocial interventions by mental health professionals and healthcare professionals during the epidemic may help people to endure an unknown disease and cope with the trauma that this disease has created in their lives, thus increasing their post-traumatic growth levels.

The Role of Post-Traumatic Stress Symptoms and Psychological Distress on Quality of Life of COVID-19 Survivors

This study aims to examine the relationship of posttraumatic stress symptoms, psychologicaldistress, and quality of life in Covid-19 survivors. Participants were N=120 Corona survivors(MA = 29.03; SD = 10), where 56.7 % were males and 43.3% were females from Lahore,Pakistan. The sample was collected using purposive and convenience sampling technique. Inorder to gather data, Depression Anxiety and Stress Scale (DASS) (Lovibond &amp; Lovibond,1996), PTSD Checklist for DSM-5(PSL-5) (Weather et al., 2013), World Health OrganizationsQuality of Life (WHOQOL) BREF (Whoqol Group, 1998) and Demographic form wereadministered. Correlation research design was employed. Data was analyzed using PearsonProduct Moment Coefficient of Correlation and Multiple Linear Regression. Results indicatedmoderate to severe levels of depression, anxiety and distress symptoms with significant scores of53.3%, 56.6% and 39.1% respectively. Moreover, common symptoms reported by survivorsincluded fever (68.3%), dry cough (54.2%), headache (49.2%), loss of sense of smell (39.2%)and taste (37.5%). Results revealed a significant relation between the study variables, whereaspsychological distress and post-traumatic stress symptoms significantly predicted lower qualityof life. The findings of the present study have implications for psychologists, psychiatrists,mental health professionals and social workers the results also provide concrete bases in formingand implementing mental health intervention policies to cope with post Covid-19 challengeseffectively. The psychological interventions and mental health strategies provide psychologicalsupport and guidance that will contribute to mental health well-being, and improve the quality oflife and coping strategies.

Has the COVID-19 Pandemic Traumatized Us Collectively? The Impact of the COVID-19 Pandemic on Mental Health and Sleep Factors via Traumatization: A Multinational Survey.

PurposeThe COVID-19 pandemic affects mental health and sleep, resulting in frequent nightmares. Therefore, identifying factors associated with nightmare frequency is important, as it can indicate mental health issues. The study aimed to investigate increases in nightmare frequency comparing the pre-pandemic and pandemic period, and identify its risk factors. Further, the mediating role of post-traumatic stress disorder symptoms between the pandemic and nightmares is explored.Patients and MethodsFor this cross-sectional survey data were obtained via self-rating online survey (ICOSS: details in Partinen et al, 2021), which was open to anyone older than 18 years. The final volunteer sample consisted of 15,292 participants, divided according to their nightmare frequency (high: ≥1–2 nights/week; low: <1–2 nights/week). A total of 9100 participants were excluded if answers on variables of interest were missing or receiving rewards for participation. Chi-square tests identified changes of nightmare frequency. Predictors of high nightmare frequency were assessed using logistic regression and presented as Odds Ratios. Post-hoc mediation models were used to investigate the role of post-traumatic stress symptoms (PTSS).ResultsThe mean age was 41.63 (SD=16.55) with 64.05% females. High nightmare frequency increased significantly from 13.24% to 22.35% during the pandemic. Factors associated with it included self-reported PTSS (OR=2.11), other mental disorders and various sleep disorders or problems. Financial burden due to the pandemic, confinement, having had COVID-19, and work situation during the pandemic were associated with nightmare frequency, those relations were partly mediated through PTSS.ConclusionOur results display the pandemic influence on nightmare frequency, which in turn connects to multiple mental health and sleep factors. These relations were partly mediated through PTSS. The COVID-19 pandemic appears to have caused traumatization of a substantial proportion of society. Health care workers should consider nightmares in their screening routines, as it might indicate PTSS and/or other mental and sleep disorders.

The Role of Posttraumatic Stress Symptoms on Pain Catastrophizing among Acutely Injured Patients

Posttraumatic symptom severity (PTSS) conveys amplified vulnerability to the development of chronic pain-related processes after physical injury, namely pain catastrophizing (PC) (e.g., magnification of threat, helplessness, and rumination). Yet, early relationships between PTSS and PC in the aftermath of injury remain relatively unexplored. We examined the role of PTSS on PC among emergency department (ED) patients following motor vehicle crash (MVC). Sixty-three injured patients (63% female; 57% nonwhite; average age = 37) with moderate pain (≥ 4 out of 10) were recruited in the EDs of two Level-1 trauma centers within 24 hours post-MVC. In the ED, participants completed assessments regarding pre-injury PTSS and PC (T1PC); acute PTSS stemming from the injury was assessed at 30-days post-injury (T2) and PC was assessed again at 90-days post-injury (T3PC). This study represents secondary data analysis of a randomized clinical trial (NCT03247179) testing whether a smartphone app ("PTSD Coach") may prevent post-injury PTSS; we controlled for group assignment (PTSD Coach vs. standard of care) in all analyses. Most participants (84.1%) had mild injuries and did not require hospitalization. T3PC was higher among non-White versus White subjects. After adjusting for race, sex, group assignment, baseline pain and T1PC, pre-injury PTSS uniquely predicted higher levels of total T3PC (β = 0.50; p < 0.001) and T3PC subscales (magnification of threat, helplessness, and rumination) (ps < 0.01). Similarly, acute PTSS stemming from the MVC uniquely predicted total and subscale T3PC scores (β = 0.64; p < 0.001), even beyond controlling for pre-injury PTSS. These findings extend prior work by highlighting that both pre-injury and acute PTSS are robust predictors of post-injury PC. PTSS can be briefly assessed in the ED to identify high-risk patients, and both PTSS and PC are amenable to intervention; these findings inform early intervention strategies to improve recovery. This work was supported by the Virginia Kaufman Endowment Fund and the University of Pittsburgh Clinical and Translational Science Institute (The Pain Research Challenge Award 2017), and the National Institute of Arthritis and Musculoskeletal Skin Diseases (1 K01 AR073300-01A1).

The role of posttraumatic stress symptoms on memory complaints and performance in active-duty service members

Objective: Memory complaints are the most common form of cognitive limitation reported by military service members, but prior research suggests that posttraumatic stress symptoms (PTSS) may account for the link between subjective cognitive complaints and objective cognitive performance. The mechanisms underlying this relationship are largely unknown, including whether the finding applies to memory complaints and performance, which clinical dimensions are involved, and how the association varies when memory complaints are non-credible. Method: Using a sample of 196 US military service members, the present study aims to address these gaps by modeling the relationship between objective memory performance and plausible/implausible subjective memory complaints, then evaluating how the association is influenced by PTSS and clinical traits commonly found within PTSS (e.g. depression, anxiety, and somatic concerns). Results: Overall memory complaints were associated with immediate and delayed recall, but both associations were fully mediated by PTSS (95% CI −0.14, −0.01; 95% CI −0.14, −0.02, respectively). Implausible memory complaints, however, were inconsistently linked to memory performance, and no PTSS mediation was observed. Of the clinical traits, only depression moderated the impact of PTSS, specifically by influencing the link between PTSS and overall memory complaints (β = −0.02, SE = 0.004, p < .001). Conclusions: These results corroborate the importance of assessment for PTSS and depression in service members who report subjective memory complaints and highlight how targeted intervention for these conditions may play a key role in the management of memory complaints.

The Role of Posttraumatic Stress Symptoms and Negative Affect in Predicting Substantiated Intimate Partner Violence Incidents Among Military Personnel

Increasing rates of posttraumatic stress disorder (PTSD) in military populations during recent conflicts have sparked concerns regarding the incidence of other commonly associated problems, such as intimate partner violence (IPV). From a clinical perspective, it is important to understand patterns of PTSD symptomology that may indicate heightened risk for such aggression. To address this, among a longitudinal cohort of U.S. military personnel, we evaluated the association of PTSD symptom clusters and comorbid conditions as predictors of any subsequent Department of Defense Family Advocacy Program incidents of IPV meeting full definitional criteria for physical or psychological abuse. Results suggested that general symptoms of negative affect common in PTSD (e.g., anger/irritability, sleep disruption) and comorbid alcohol dependence were stronger predictors of IPV than trauma-specific PTSD symptomology (e.g., reexperiencing, hypervigilance). Clinical implications and recommendations for future research are discussed.

Self-Rated Health Among Patients With Severe Traumatic Brain Injury and Their Close Relatives: The Role of Posttraumatic Stress Symptoms.

Severe traumatic brain injury (sTBI) is accompanied by significant declines in self-rated health (SRH). Although such deteriorations in SRH are related to various consequences of sTBI, the effect of posttraumatic reactions (i.e., posttraumatic stress [PTS] symptoms) has been tested insufficiently to date, especially among civilians. The present investigation is based on Trajectories of Recovery After Severe Traumatic brain injury-Matters In families (TRAST-MI), a unique study among civilians with sTBI and their families. Previous research revealed that civilian sTBI has effects beyond the injured patient, influencing their close relatives as well. The aim of this study was to assess the association between PTS symptoms and SRH among patients with civilian sTBI and their close relatives. Patients with sTBI (assessed by an Abbreviated Injury Scale of the head region score >3) and their close relatives participated in TRAST-MI. One hundred twenty-six patient-relative dyads were assessed at 3, 6, and 12 months after the injury. Multilevel modeling revealed that patients' PTS symptoms were associated with consequent SRH (slope = 0.42; p < .001), and relatives' PTS symptoms were associated with their respective SRH (slope = 0.2; p = .012). The findings of this study reveal that SRH of both patients with sTBI and their relatives are negatively affected by their own PTS symptoms. These findings underline the understanding that sTBI is not merely a medical trauma but rather a comprehensive psychosocial trauma, which has consequences for the whole family system.

Adverse Childhood Experiences (ACEs) and Internalizing Mental Health, Pain, and Quality of Life in Youth With Chronic Pain: A Longitudinal Examination

The aims of this longitudinal study were to 1) identify categories of adverse childhood experiences (ACEs) (ie, neglect, abuse, household dysfunction in childhood) that increase risk for internalizing mental health problems, pain-related impairment, and poorer quality of life and 2) examine the moderating role of posttraumatic stress symptoms (PTSS) in these associations, in a clinical sample of youth with chronic pain. At 2 timepoints, youth (N = 155; aged 10–18 years) completed measures of exposure to ACEs, PTSS, depressive and anxiety symptoms, pain intensity, pain interference, and quality of life. Multivariate analyses of variance, linear mixed modeling, and moderation analyses were conducted. Results from cross-sectional and longitudinal analyses were similar; youth with a history of 3+ ACEs reported significantly higher PTSS, depressive and anxiety symptoms, and poorer quality of life than youth with no ACE history. Results also revealed differences in functioning between youth exposed to different types of ACEs (ie, maltreatment only, household dysfunction only, both, none). Finally, PTSS was found to moderate the association between ACEs and anxiety and depressive symptoms. Findings underscore the influence that ACEs can have on the long-term functioning of youth with chronic pain as well as the important role of current PTSS in this association. PerspectiveThis study found that the risk of poorer outcomes imposed by ACEs at baseline remains longitudinally and that posttraumatic stress symptoms (PTSS) moderate the relationship between ACEs and anxiety and depressive symptoms in youth with chronic pain. These results underscore the importance of assessing for ACEs and PTSS alongside chronic pain in youth.

The Development of Post-traumatic Stress Symptoms among Adolescents Who Experience Cyber and Traditional Victimization over Time.

Adolescents' experiences of bullying victimization are positively associated with their post-traumatic stress symptoms. The development of these symptoms alongside experiences of bullying victimization over time, however, are not well understood. The current study used a transactional theory of development to examine the bidirectional associations between adolescents' post-traumatic stress symptoms and experiences of cyber and traditional victimization across three academic years. Participants were 510 Canadian students in grade 7 or 10 (Mage = 13.7, 61.6% girls) who completed surveys annually. The findings show that adolescents' concurrent experiences of cyber and traditional victimization were uniquely associated with their post-traumatic stress symptoms. Over time, greater post-traumatic stress symptoms were associated with more experiences of cyber and traditional victimization among adolescent boys and girls. Prevention and intervention efforts must address the role of post-traumatic stress symptoms that may limit adolescents' ability to develop or maintain healthy relationships.

Traumatic brain injury and its effect on mental and physical health of close relatives: The role of posttraumatic stress symptoms

Traumatic brain injury and its effect on mental and physical health of close relatives: The role of posttraumatic stress symptoms

Physical and Mental Health and Functioning Among Traumatic Brain Injury Close Relatives: The Role of Posttraumatic Stress Symptoms.

Severe Traumatic brain injury (sTBI) often instigates widespread long-lasting disability and is accompanied by extensive rehabilitation. Unsurprisingly, sTBI also holds malignant consequences for patients' close relatives. The burden caused by the injury and its severity explains some of the ramifications for the relatives. Additionally, some findings demonstrate that patients with sTBI and their relatives develop posttraumatic stress (PTS) symptoms. However, although the link between PTS symptoms and physical and mental health is well-documented in literature, the effect of PTS symptoms on relatives of patients with sTBI has barely been examined. This study examines the influence of PTS symptoms of patients with sTBI and their relatives on the physical and mental health and functioning of the relatives. Patients who sustained a severe sTBI (Abbreviated Injury Scale of the head region>3) and close relatives were included in a multi-center, prospective cohort study (TRAST-MI). One-hundred patients and their relatives were assessed at 2, 6, and 12months post injury. Outcome variables included health-related quality of life (SF-12) as well as emotional, cognitive, interpersonal, and total functioning (PCRS). Relatives' physical health was predicted by relatives' PTS symptoms (Slope=-1.76; p=.043), and mental health was predicted by both patients' (Slope=-2.77; p=.034) and relatives' (Slope=-6.59; p<.001) PTS symptoms. Functioning level was only predicted by patients' PTS symptoms (Slope=-.25; p< .001). The findings emphasize that TBI should be considered a comprehensive traumatic experience reaching further than mere physical damage to the brain and its direct consequences, affecting the injured individual and close relatives.