Infusing community-level risk factors into traumatic stress research can broaden intervention targets. The Neighborhood Deprivation Index (NDI) and the Index of Concentration at the Extremes (ICE) ...are two common community-level risk factors derived from U.S. census data. We provide R scripts facilitating the computation of these risk factors and demonstrate their relationship with PTSD symptomatology in 74 injury survivors assessed at 2-weeks, 6-weeks, and 3-months post-injury. The NDI and the ICE were computed using the Census Data Application Programming Interface, then matched to participants’ census tracts using their residential addresses. Results indicated that after controlling for person-level characteristics, both risk factors were associated with PTSD symptom severity at follow up time points (Cohen’s f2 =0.011,.14). This study provides an easy method for computing the NDI and ICE, demonstrates the increased mental health risk that they convey in the aftermath of injury, and highlights their value in intervention efforts.
•Infusing community-level risk factors into trauma research broadens intervention targets.•Census data can be used to compute community-level risk factors.•Community-level risk factors predict elevated PTSD symptoms across the acute post-injury period.
Objective:
The present study documented, compared, and contrasted the test-retest reliabilities of the victimization and perpetration forms of a Tactic-First Sexual Experiences Survey (T-SES) and the ...Post-Refusal Sexual Persistence Scales (PRSPSs).
Methods:
Two hundred and forty-three Mechanical Turk Workers (116 women, 124 men) completed 4 questionnaires in a randomized order via anonymous web survey at Time 1 and approximately 1 week later at Time 2.
Results:
There were consistent gender differences in test-retest estimates. When assessing a history of victimization in women, both the T-SES and the PRSPS demonstrated evidence of minimal to good reliability (κ > .61, ICC = .86-92) while for men the PRSPS (κ = .64) was more consistent than the T-SES (κ = .59). When assessing a history of perpetration, there were fewer gender differences although post hoc analyses suggest potential gender differences in assessing substance use facilitated perpetration (κ = .48-.83) but were limited by few cases. Continuous scoring approaches were the most reliable, dichotomous scores were mostly reliable, and categorical scores generally did not meet minimal acceptable standards. For the rape victimization acknowledgment items, we found strong evidence of reliability for women (κ = .89, n = 31) and suggestive evidence of reliability for men (n = 7). There were few differences in reliability between standard and extended versions of the questionnaires.
Conclusions:
All four questionnaires exhibited good evidence of 1-week test-retest reliability when scored continuously. Evidence of reliability was strongest with the populations and constructs most well studied-victimization history among women and perpetration history among men.
Although cortisol alterations have been associated with posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS), the direction of association is mixed. Cortisol which is measured in blood, ...saliva, or urine is subject to transient factors that may confound results. Recent advances in cortisol sampling techniques provide novel opportunities to address these inconsistencies. Hair cortisol sampling is a non-invasive method for the retrospective assessment of long-term integrated cortisol, yet its utility at predicting PTSS has not been assessed in acute injury victims.
The aim of this prospective study was to examine whether higher levels of hair cortisol concentrations (HCC) were associated with increases in PTSS following traumatic physical injury.
From January 2012 to May 2013, injury victims admitted to a level-1 Midwestern trauma center were recruited during their routine trauma clinic appointment within 30-days post-injury. Thirty participants had sufficient hair length to obtain 3-cm hair samples for cortisol assay. These participants completed PTSS assessments in relation to their recent injury at both the baseline and follow-up assessments (within 30- and 60-days post-injury, respectively).
Hierarchical regression analyses – which controlled for baseline PTSS, age, and sex – revealed that higher HCC predicted significant increases in overall PTSS at follow-up. Higher HCC also predicted increases in the avoidance/numbing subscale symptoms of PTSS. Dividing the avoidance symptoms and numbing symptoms into two separate clusters (consistent with the 4-factor DSM-5 model of PTSD) revealed that HCC was only marginally associated with numbing, but not with avoidance symptoms.
Hair sampling is a feasible method for assessing integrated cortisol levels soon after traumatic physical injury. This study suggests that elevated HCC may serve as a biomarker of risk for the development of posttraumatic symptomatology, and identifies specific symptoms that may be targeted for intervention in those with high HCC in the aftermath of injury.
•Hair cortisol is non-invasive and is a feasible method for use in injury victims.•Hair cortisol may serve as a biological risk factor for posttraumatic consequences.•Elevated hair cortisol (within 30-days of injury) is linked to increased PTSS risk.
Biological studies of posttraumatic stress disorder (PTSD) have found alterations of physiological stress pathways sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis ...soon after trauma in individuals who have subsequently developed PTSD, leading researchers to hypothesize that pharmacological manipulation of stress hormone levels may aid in preventing the development of post-traumatic distress. The present paper first reviews the current understanding of the neurobiology of PTSD development and then provides the rationale and evidence for early pharmacological strategies to prevent/reduce post-traumatic distress in at-risk trauma victims. Emphasis is placed on those interventions targeting the SNS and the HPA axis. Furthermore, in light of recent calls to move away from categorical diagnostic outcomes, we discuss how examining post-traumatic distress from a transdiagnostic viewpoint may inform novel chemoprophylactic approaches (intervening pharmacologically after trauma to prevent post-traumatic distress). Current evidence is suggestive for medications, such as propranolol, hydrocortisone, morphine, and oxytocin, impacting early stress hormone levels and subsequent risk for post-traumatic distress; however, future research is needed prior to adapting recommendations for widespread use of any chemoprophylactic treatments.
ObjectivesThe aim of this project was to test the efficacy of a brief and novel online ambulatory intervention aimed at supporting psychological health and well-being for medical personnel and first ...responders during the COVID-19 pandemic.MethodsInterested participants, n=28, actively employed as medical personnel, support staff and emergency responders, in the Midwestern USA in May–June of 2020, provided informed consent and were randomised to complete either low-dose or high-dose intervention, one time daily for 1 week via smartphone application. Each daily intervention included expressive writing, adaptive emotion regulation activity and (one vs two) positive emotion-generation activities, lasting 3–6 min a day. Ratings of negative and positive emotion were provided before and after each activity daily. Analyses tested compliance, acceptability, as well as efficacy at increasing positive emotion and decreasing negative emotion with each use and across time.ResultsThe results indicated a 13% increase in positive emotion, t(25)=2.01, p=0.056; and decrease in negative emotion by 44%, t(25)=−4.00, p=0.001 across both doses. However, there was a clear advantage for individuals in the high-dose condition as daily boosts in positive emotion were significantly greater (an additional 9.4%) B=0.47, p=0.018. Overall, compliance was good. Acceptability ratings were good for those who completed the follow-up assessment.ConclusionFront-line personnel, including medical staff and emergency responders, are experiencing unprecedented psychological stress during the COVID-19 pandemic. This investigation suggests both feasibility and efficacy for a brief, daily, ambulatory intervention which could provide essential psychological support to individuals at risk in the workplace.
Background: Emotional abuse is associated with an increased risk for substance use disorders (SUDs) as well as with negative urgency and posttraumatic stress disorder (PTSD) following a subsequent ...trauma. Both negative urgency and PTSD are key contributors to the relationship between emotional abuse and SUDs when examined separately. A comprehensive model including both factors can inform models of PTSD-SUD comorbidity. Furthermore, the comparison of these mechanistic roles in emotional versus other types of abuse can shed light on the specificity of these effects. Objectives: The present study tested whether negative urgency and PTSD symptom severity serially mediated the relationship between emotional abuse and substance use across two separate samples. Method: Participants were recruited from a detoxification center and completed a battery of surveys examining abuse history, PTSD symptom severity, and impulsivity measures including negative urgency and substance use history during the last 3 months. The samples consisted of predominantly (59% and 62%) males with an average age of 35 (age range: 18-65). The majority of participants (90% and 93%) were Caucasian. Results: Study 1 (N = 368) and Study 2 (N = 274) both found that negative urgency and PTSD symptom severity serially mediated the relationship between emotional abuse and substance use. When comparing indirect effects, both contributed equally. Conclusion: These findings suggest that negative urgency and PTSD symptom severity together account more for the link between emotional abuse and SUDs than either alone and argue for the inclusion of negative urgency in models of PTSD-SUD comorbidity.
Celotno besedilo
Dostopno za:
DOBA, FSPLJ, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Estimates of the rate of sexual victimization in college men vary wildly, likely because of the lack of validated measures. This study provides psychometric data on the Sexual Experiences ...Survey-Short Form Victimization (SES-SFV) and basic descriptive characteristics of sexual victimization of college men via the SES-SFV. Participants (n = 405) completed a web survey containing the study measures; a subset of 69 participants completed the SES-SFV again 1-3 weeks later. Convergent validity correlations were consistent but modest in size. Two-week test-retest reliability estimates varied widely by the type of sexual victimization assessed and scoring format used; dichotomous scores were the most reliable and category scores the worst. More than 1 in 4 participants (28%) reported experiencing sexual victimization at Time 1; most reported victimization frequencies greater than 1 (22.8% of sample). Using behaviorally specific items, 1 in 7 reported experiencing rape (14.1%). The most common type of sexual victimization experienced was unwanted sexual contact. Rape acknowledgment among men who experienced rape (12.2%) was much lower than has been observed in women. Our results indicate mixed evidence for the reliability and validity of the SES-SFV in college men, highlight important characteristics of sexual victimization in college men, and demonstrate the need for further research on the best strategies for the assessment of sexual victimization in college men.
Symptoms of depression, anxiety, and stress in pregnant women are generally highest in the first trimester and then decrease throughout pregnancy, reaching their lowest point in the postpartum ...period. Pregnant women are a high-risk population for mortality and mental health symptoms due to COVID-19. However, the extent to which the chronic stress of the COVID-19 pandemic alters the trajectory of depression, anxiety and stress symptoms in pregnant/postpartum women is unknown.
Women (N=127) who were pregnant or who had given birth less than one month prior were recruited via online advertising during the COVID-19 pandemic. Participants were assessed up to three times during the pregnancy and at 1-month postpartum for depression (Edinburgh Postnatal Depression Scale), anxiety, and stress (Depression, Anxiety, and Stress Scale-21). Random intercepts models examined symptom change over time as well as predictors of elevated postpartum psychopathology.
On average, women completed their surveys at 8.5 weeks (first trimester), 21 weeks (second trimester), 32 weeks (third trimester) and 7-weeks postpartum. Women reported mild-moderate levels of depression, anxiety, and stress throughout pregnancy. There was a significant change in symptoms of depression and anxiety over time which was best represented by a quadratic rather than linear trajectory: symptoms increased until week 23–25 and then decreased. Stress levels remained consistently elevated over time. Higher symptom levels at 1-month postpartum were predicted by younger age, lower social support, and worry about going to a healthcare facility. Change in routine due to COVID-19 was not predictive of symptom trajectory from pregnancy to postpartum.
During COVID-19, symptoms of depression and anxiety increased from early to mid-pregnancy but then declined slightly while stress levels remained elevated. Observed reductions in symptoms were small. Given the substantial persistent impact of perinatal distress and poor mental health on maternal and fetal health, providers should be aware of heightened levels of these symptoms in pregnant women during large-scale external health stressors such as COVID-19, and should implement screening procedures to identify and appropriately intervene with at-risk women.
Social support confers a protective effect against elevated PTSD symptomatology following injury. However, little is known about the mechanisms through which social support conveys this protective ...mental health effect in injury survivors. Coping self-efficacy is linked to both social support and PTSD symptomatology but has not been examined.
To test coping self-efficacy as a mechanism for the relationship between social support and PTSD symptom severity among injury survivors.
Participants consisted of 61 injury survivors (62.3% male, 72.1% White) admitted to a Level-1 Trauma Center. Social support was assessed at 2-weeks post-injury; coping self-efficacy at 6-weeks post-injury; and PTSD symptom severity at 3-months post-injury.
A statistically significant indirect effect was found for the social support - coping self-efficacy - PTSD symptomatology pathway, providing evidence of mediation even after controlling for age, sex, race, and education (B = −0.51, SE = 0.18, CI = −0.92, −0.20).
Social support may exert an effect on PTSD symptom severity post-injury through its connection with coping self-efficacy. Coping self-efficacy represents an important intervention target following injury for those survivors with lower social support who are at risk for elevated PTSD symptom severity levels.
Research examining the comorbidity of posttraumatic stress disorder (PTSD) and alcohol-use disorder (AUD) suggests that individuals experiencing PTSD symptoms (PTSS) often drink alcohol as a means to ...self-medicate their trauma symptoms; however, little attention has been given to moderating variables that may make this association more likely. The stressor vulnerability model proposes that being male, relying on maladaptive forms of coping, and holding positive alcohol-outcome expectancies predispose individuals to engage in alcohol use when experiencing psychological distress. In the current study, sex, avoidance coping (AVC), tension-reduction expectancies (TRE), and emotional-relief drinking-refusal self-efficacy (ERDRSE) were examined as moderators of the relationship between PTSS and alcohol-related problems in a sample of 144 undergraduates. Results indicated that males reporting high levels of TRE exhibited a stronger positive relationship between PTSS and alcohol-related problems than was present for males reporting low levels of TRE and for females reporting either high or low levels of TRE. In addition, a significant positive relationship between PTSS and alcohol-related problems was observed for individuals reporting high levels of TRE and low levels of ERDRSE, but not for individuals reporting high levels of TRE and high levels of ERDRSE, low TRE-low ERDRSE, or low TRE-high ERDRSE. Assessment of these vulnerability factors in traumatized youth and young adults may serve as a useful means of identifying individuals at risk for the development of alcohol-related problems.
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