Trauma-exposed Community Sample Research Articles

Participant, rater, and computer measures of coherence in posttraumatic stress disorder.

We examined the coherence of trauma memories in a trauma-exposed community sample of 30 adults with and 30 without posttraumatic stress disorder. The groups had similar categories of traumas and were matched on multiple factors that could affect the coherence of memories. We compared the transcribed oral trauma memories of participants with their most important and most positive memories. A comprehensive set of 28 measures of coherence including 3 ratings by the participants, 7 ratings by outside raters, and 18 computer-scored measures, provided a variety of approaches to defining and measuring coherence. A multivariate analysis of variance indicated differences in coherence among the trauma, important, and positive memories, but not between the diagnostic groups or their interaction with these memory types. Most differences were small in magnitude; in some cases, the trauma memories were more, rather than less, coherent than the control memories. Where differences existed, the results agreed with the existing literature, suggesting that factors other than the incoherence of trauma memories are most likely to be central to the maintenance of posttraumatic stress disorder and thus its treatment.

Emotional Distress Intolerance, Experiential Avoidance, and Anxiety Sensitivity: The Buffering Effect of Attentional Control on Associations with Posttraumatic Stress Symptoms

A number of individual difference factors, including emotional distress intolerance (EDI), experiential avoidance (EA), and anxiety sensitivity (ASI), have been implicated in the development and maintenance of posttraumatic stress (PTS) symptomatology. Attentional control (AC) has been shown to serve as a protective factor against the development of maladaptive psychological outcomes across a number of studies, even among those with outcome-specific vulnerabilities. The purpose of the present study was to examine AC as a moderator of the relations between three constructs pertaining to the way that people relate to their internal experiences (i.e., EDI, EA, AS) and PTS symptoms among a trauma exposed community sample (N = 903). As predicted, AC moderated the relations between each individual difference factor and PTS symptoms, such that as attentional control decreased, the strength of the association between each individual difference factor and PTS symptoms increased. Study results suggest that AC abilities may be one factor that differentiates those who recover from trauma from those who do not, even among those who may be vulnerable for developing PTS symptomatology. Clinical implications and results of a PTS cluster level analysis will be discussed.

The effects of positive patient testimonials on PTSD treatment choice

Despite the existence of effective treatment options for PTSD, these treatments are failing to reach those that stand to benefit from PTSD treatment. Understanding the processes underlying an individual's treatment seeking behavior holds the potential for reducing treatment-seeking barriers. The current study investigates the effects that positive treatment testimonials have on decisions regarding PTSD treatment. An undergraduate (N = 439) and a trauma-exposed community (N = 203) sample were provided with videotaped treatment rationales for prolonged exposure (PE) and sertraline treatments of PTSD. Half of each sample also viewed testimonials, detailing a fictional patient's treatment experience. All participants then chose among treatment options and rated the credibility of – and personal reactions toward – those options. Among treatment naïve undergraduates, testimonials increased the proportion choosing PE alone; and among treatment naïve members of the trauma-exposed community sample, testimonials increased the proportion choosing a combined PE plus sertraline treatment. These effects were not observed for those with prior history of either psychotherapeutic or pharmacological treatment. Major barriers exist that prevent individuals with PTSD from seeking treatment. For a critical unreached treatment sample, those who are treatment naïve, positive patient testimonials offer a mechanism in which to make effective treatments more appealing and accessible.

Posttraumatic stress and alcohol use coping motives among a trauma-exposed community sample: The mediating role of non-judgmental acceptance

The current investigation evaluated (1) the incremental predictive validity of non-judgmental acceptance in terms of alcohol use coping motives and (2) the mediating role of non-judgmental acceptance in the association between posttraumatic stress symptom severity and alcohol use coping motives. Participants included 153 (79 women) adults who reported exposure to at least one DSM-IV PTSD Criterion A traumatic life event and alcohol use in the past month. Non-judgmental acceptance emerged as a significant incremental predictor of alcohol use coping motives. Furthermore, non-judgmental acceptance partially mediated the association between posttraumatic stress symptom severity and alcohol use coping motives. Theoretical and clinical implications of the findings are discussed with regard to better understanding the co-occurrence of posttraumatic stress and alcohol use disorders.

Posttraumatic Stress and Alcohol Use Motives

This investigation first examined the incremental validity of distress tolerance in terms of alcohol use coping motives within a trauma-exposed community sample of adults, beyond the variance contributed by posttraumatic stress symptom severity, difficulties in emotion regulation, alcohol consumption, and other (noncriterion) alcohol use motives. Secondly, the potential mediating role of distress tolerance in the association between posttraumatic stress symptom severity and alcohol use coping motives was tested. Participants were 83 community-recruited individuals (63.8% women; M(age) = 22.98, SD = 9.24) who endorsed exposure to at least one traumatic life event and past-month alcohol use. Participants were assessed using structured diagnostic interviews and a series of self-report inventories. Results were consistent with hypotheses, because distress tolerance was significantly and incrementally associated with alcohol use coping motives; and distress tolerance at least partially mediated the association between posttraumatic stress and alcohol use coping motives. Theoretical and clinical implications as well as future directions regarding the association between distress tolerance and alcohol use motives among trauma-exposed persons are discussed.

Multimethod study of distress tolerance and PTSD symptom severity in a trauma‐exposed community sample

Despite initial evidence linking distress tolerance to posttraumatic stress disorder (PTSD) symptom severity, there is a need for the investigation of interrelations among multiple measures of distress tolerance and PTSD symptom severity. Therefore, the present study investigated concurrent relations among multiple measures of distress tolerance, as well as the relations between these measures and PTSD symptom severity, within a trauma-exposed community sample. The sample consisted of 81 trauma-exposed adults (63.1% women). Results indicated that Distress Tolerance Scale (Simons & Gaher, 2005) scores, but no other measures of distress tolerance were significantly related to PTSD symptom severity above and beyond the variance accounted for by number of traumas, trait-level neuroticism, and participant sex. Implications and future directions are discussed.

Posttraumatic Stress Symptom Severity and Marijuana Use Coping Motives: A Test of the Mediating Role of Non-Judgmental Acceptance within a Trauma-Exposed Community Sample

We examined the role of non-judgmental acceptance in the relation between posttraumatic stress symptom severity and marijuana use coping motives. These relations were examined among 97 (46 women) adults (M age = 21.57 years, SD = 6.32) who met DSM-IV-defined PTSD Criterion A for at least one traumatic event exposure and reported using marijuana in the past 30 days. Consistent with expectation, greater levels of posttraumatic stress symptom severity were associated with greater levels of coping-oriented marijuana use motives, as well as lower levels of non-judgmental acceptance. Furthermore, non-judgmental acceptance was inversely associated with coping-oriented marijuana use motives. Finally, non-judgmental acceptance was found to partially mediate the association between posttraumatic stress symptom severity and marijuana use coping motives. Results are discussed in terms of better understanding the role of non-judgmental acceptance in coping-oriented marijuana use among trauma-exposed populations.

Are expressive suppression and cognitive reappraisal associated with stress-related symptoms?

Emotion dysregulation is thought to be critical to the development of negative psychological outcomes. Gross (1998b) conceptualized the timing of regulation strategies as key to this relationship, with response-focused strategies, such as expressive suppression, as less effective and more detrimental compared to antecedent-focused ones, such as cognitive reappraisal. In the current study, we examined the relationship between reappraisal and expressive suppression and measures of psychopathology, particularly for stress-related reactions, in both undergraduate and trauma-exposed community samples of women. Generally, expressive suppression was associated with higher, and reappraisal with lower, self-reported stress-related symptoms. In particular, expressive suppression was associated with PTSD, anxiety, and depression symptoms in the trauma-exposed community sample, with rumination partially mediating this association. Finally, based on factor analysis, expressive suppression and cognitive reappraisal appear to be independent constructs. Overall, expressive suppression, much more so than cognitive reappraisal, may play an important role in the experience of stress-related symptoms. Further, given their independence, there are potentially relevant clinical implications, as interventions that shift one of these emotion regulation strategies may not lead to changes in the other.