Objective:
Sexual assault is associated with higher rates of posttraumatic stress disorder (PTSD) than other traumas, and the course of PTSD may differ by trauma type. However, the course of PTSD ...after sexual assault has not been summarized. The aim of this meta-analysis was to identify the prevalence and severity of PTSD and changes to the average rate of recovery in the 12 months following sexual assault.
Method:
Authors searched four databases for prospective studies published before April 2020 and sought relevant unpublished data. Eligible studies assessed PTSD in at least 10 survivors of sexual assault in at least two time points, starting within 3 months postassault. Random effects linear-linear piecewise models were used to identify changes in average recovery rate and produce model-implied estimates of monthly point prevalence and mean symptom severity.
Results:
Meta-analysis of 22 unique samples (N = 2,106) indicated that 74.58% (95% confidence interval CI: 67.21, 81.29) and 41.49% (95% CI: 32.36, 50.92) of individuals met diagnostic criteria for PTSD at the first and 12th month following sexual assault, respectively. PTSD symptom severity was 47.94% (95% CI: 41.27, 54.61) and 29.91% (95% CI: 23.10, 36.73) of scales’ maximum severity at the first and 12th month following sexual assault, respectively. Most symptom recovery occurred within the first 3 months following sexual assault, after which point the average rate of recovery slowed.
Conclusions:
Findings indicate that PTSD is common and severe following sexual assault, and the first 3 months postassault may be a critical period for natural recovery.
Background
There has been widespread concern that the COVID‐19 pandemic may be a high‐risk time for alcohol use among heavy drinking populations such as college students. Initial efforts to evaluate ...changes in college drinking have not yet accounted for typical drinking patterns within a semester.
Methods
To fill this gap, we evaluated how college student drinking patterns changed with the onset of restrictions related to the COVID‐19 pandemic during spring 2020 relative to spring 2018 and 2019. Participants were 1,365 college students aged 19 and older, including 895 students who reported past‐month alcohol use. Daily drinking data were extracted from an online Timeline Followback survey.
Results
Negative binomial hurdle models revealed that, with the onset of the COVID‐19 pandemic in spring 2020, college student drinkers did not increase their drinking frequency as was typical in late spring semester, and the number of drinks per occasion declined substantially (28% reduction), greater than the change observed from early to late spring 2018 (3% reduction) or spring 2019 (8% increase). This reduction in drinking quantity in spring 2020 was larger for college student drinkers who moved residences because of the pandemic (49% reduction) than students who did not move (21% reduction). Perceptions in pandemic‐related changes in drinking also revealed that 83.5% of college student drinkers self‐reported that their drinking stayed the same or decreased.
Conclusions
Findings suggest that, on average, college students drank less—not more—during the onset of the COVID‐19 pandemic and highlight the importance of living situation in college student drinking behavior. More research is needed to assess alcohol use in other universities, as this information could be utilized in norms‐based interventions to further reduce drinking in students who remain at risk.
To evaluate changes in college student drinking during the onset of the COVID‐19 pandemic, we examined alcohol use patterns among three cohorts of US college students (N = 1,365). Although drinking frequency increased from early to late spring in 2018 and 2019, no such increase was observed in 2020. Whereas drinking quantity remained relatively stable from early to late spring in both 2018 and 2019, the number of drinks consumed per occasion decreased by 28% in 2020.
•College students (N = 989) from 4 universities completed a survey in spring 2021.•Three in ten participants (29%) were hesitant to receive the COVID-19 vaccine.•Explicit reasons for hesitancy were ...varied, including safety concerns and distrust.•Perceived descriptive and injunctive norms were related to vaccine hesitancy.•Correcting misperceived norms may increase young adults’ vaccine uptake.
Among US adults, the highest rates of hesitancy to receive the COVID-19 vaccine are among young adults aged 18 to 25. Vaccine hesitancy is particularly concerning among young adults in college, where social interactions on densely populated campuses can lead to substantial community spread. Given that many colleges have opted not to mandate vaccines, identification of modifiable predictors of vaccine hesitancy – such as perceived social norms – is key to informing interventions to promote vaccine uptake. To address this need, we examined predictors of and explicit reasons for vaccine hesitancy among 989 students aged 18 to 25 recruited from four geographically diverse US universities in the spring of 2021. At the time of the survey, 57.3% had been vaccinated, 13.7% intended to be vaccinated as soon as possible, and 29.0% were vaccine hesitant. Common reasons for hesitancy were wanting to see how it affected others first (75.2%), not believing it was necessary (30.0%), and other reasons (17.4%), which were examined via content analysis and revealed prominent safety concerns. Despite these varied explicit reasons, logistic regressions revealed that, when controlling for demographics and pandemic-related experiences, perceived descriptive and injunctive social norms for vaccine uptake were each significant predictors of vaccine hesitancy (ORs = 0.35 and 0.78, respectively). When both norms were entered into the same model, only perceived descriptive norms uniquely predicted vaccine hesitancy (OR = 0.37; 95% CI: 0.29 – 0.46). Findings suggest perceived social norms are strongly associated with vaccine-related behavior among young adult college students. Correcting normative misperceptions may be a promising approach to increase vaccine uptake and slow the spread of COVID-19 among young adults.
Objective: On October 15, 2017, Alyssa Milano encouraged anyone who had been sexually harassed or assaulted to respond on Twitter with the phrase, #MeToo. Millions responded and a cultural reckoning ...ensued. Anecdotally, the #MeToo movement appears to have affected survivors' acceptance and acknowledgment of their own sexual assault experiences, but empirical evidence is lacking. To address this gap, the aim of this study was to examine associations between behavioral and labeled reports of sexual assault and time since the #MeToo movement began. Methods: Participants were 2,566 college students who completed a sexual assault survey over the course of 3 years, overlapping with the onset of the #MeToo movement. Results: Regarding our hypothesis that the prevalence of sexual assault-indicated by standardized behaviorally specific questions-would be relatively constant over time after controlling for demographics, a Bayesian logistic regression model yielded inconclusive results. However, among the 596 students who endorsed behaviorally specific screeners for sexual assault, a Bayesian linear regression model revealed that, after controlling for demographics and characteristics of the assault, participants were increasingly likely to label the experience a "sexual assault" with more time post-#MeToo. Conclusions: Overall, findings revealed no evidence for or against changes in the prevalence of sexual assault, but suggested there were associations between the #MeToo movement and greater recognition of past unwanted sexual experiences as "sexual assault" over time. These findings highlight the importance of considering the social context in research examining sexual assault survivors' cognitions.
Institutional Review Boards (IRBs) are sometimes hesitant to approve trauma-related research due to concerns that asking participants about traumatic experiences will induce extreme distress. Despite ...the growing empirical literature examining participants' reactions to trauma-related research, no quantitative reviews have been conducted. The present multilevel meta-analysis was undertaken to quantify: (1) how participants react to trauma-related research overall; (2) to what extent reactions to trauma-related research differ by participant characteristics, including personal history of trauma, PTSD symptoms, and gender; and (3) to what extent (a) type of traumatic experience and (b) mode of administration moderate these effects. Studies examining adult participants' reactions to trauma assessments in the context of research were included. Results from 73,959 participants across 70 samples suggest that although trauma-related research can lead to some immediate psychological distress, this distress is not extreme. This distress is greater for individuals with a trauma history or PTSD, particularly in studies involving interviews. However, individuals generally find research participation to be a positive experience and do not regret participation, regardless of trauma history or PTSD. There were no gender differences in reactions. Present findings, which suggest that trauma-related research can continue without harming participants, may help inform IRB decisions on trauma research.
•IRBs often raise concerns about asking participants to report on prior traumas.•Meta-analyses were used to examine adult participants' reactions to trauma research.•Participants reported some distress, but also found participation to be beneficial.•Trauma history and PTSD symptoms were associated with more distress.•Implications for ethical conduct of trauma research are discussed.
Alongside the SARS-CoV-2 virus, the COVID-19 pandemic is associated with several secondary health effects. There is concern for increased substance use motivated by coping with stress, anxiety, ...depression, and boredom–all of which may be elevated during the pandemic. The current study examined intraindividual changes (from pre-COVID to during COVID) in young adults’ alcohol and marijuana use, perceptions of peers’ use (i.e., norms), and motives for use.
A community sample of young adults (N = 572; Mage= 25.14; 60.8% women) was recruited in Washington State. By using a repeated-measures design, data were collected prior to the COVID-19 pandemic (January 2020) and again during the initial acute phase of the pandemic (April/May of 2020).
Young adults, on average, increased alcohol use frequency but decreased the amount consumed per drinking occasion. No changes in marijuana use were identified. Young adults (on average) perceived that peers had increased the frequency and total amount of alcohol use and perceived that peers were engaging in heavier marijuana use than prior to COVID-19. For alcohol use motives, there was a significant increase in depression coping motives and significant decreases in social, enhancement, and conformity motives. Boredom motives for marijuana use significantly increased, while celebration motives decreased.
Using a prospective design with a sample initially recruited in Washington State, these data indicate that (a) young adults’ patterns of alcohol use may have changed, (b) young adults tend to think that peers are engaging in heavier alcohol/marijuana use than before the pandemic, and (c) motives for using alcohol/marijuana may have changed during the pandemic.
One victimization experience can increase the risk for subsequent victimization, which is known as revictimization. The aims of this study were to build on sexual revictimization research by (a) ...broadening the understanding of revictimization to interpersonal (and potentially noninterpersonal) trauma generally and (b) gaining specificity in the mechanisms that underlie revictimization. Using a prospective multisite design, an ethnically and racially diverse sample of 453 young women from the community (age range: 18–25 years, 60.7% European American) completed an initial survey and at least one follow‐up survey within the subsequent year. Participants completed self‐report measures of trauma history, posttraumatic stress symptoms, and maladaptive posttraumatic cognitions. Structural equation models revealed that interpersonal revictimization was observed when controlling for past noninterpersonal trauma, odds ratio (OR) = 2.27, 95% CI 1.23, 4.18, and supported the role of posttraumatic stress symptoms as a mechanism underlying such revictimization, 95% CI of indirect effect (IE) 0.08, 0.51. Additionally, a history of noninterpersonal trauma (controlling for past interpersonal trauma) increased risk of subsequent interpersonal victimization via posttraumatic stress symptoms, 95% CI of IE 0.01, 0.38. Notably, however, when maladaptive cognitions were included as mediators in addition to posttraumatic stress symptoms, the only unique indirect effect was for the association between interpersonal trauma and risk of revictimization specifically through perceived threat of harm, 95% CI of IE 0.05, 0.20. These findings suggest that efforts to reduce interpersonal revictimization should target maladaptive posttraumatic cognitions, particularly perceptions of threat in the environment.
Resumen
Spanish s by Asociación Chilena de Estrés Traumático (ACET)
Riesgo de revictimización luego de trauma interpersonal y no interpersonal: Aclarando el rol de los Síntomas de Estrés postraumático y las Cogniciones relacionadas con el Trauma
REVICTIMIZACIÓN, TEPT Y COGNICIONES
Una experiencia de victimización puede aumentar el riesgo de una subsiguiente victimización, conocida como revictimización. Los objetivos de este estudio fueron desarrollar una investigación sobre la revictimización sexual mediante (a) una comprensión más amplia de la revictimización al trauma interpersonal (y potencialmente no interpersonal) en general, y (b) la obtención de especificidad en los mecanismos que subyacen a la revictimización. Utilizando un diseño multisitio prospectivo, una muestra étnica y racialmente diversa de 453 mujeres jóvenes de la comunidad (rango de edad: 18–25 años, 60.7% europeo‐estadounidense) completaron una encuesta inicial y al menos una encuesta de seguimiento dentro del año siguiente. Las participantes completaron medidas de auto reporte del historial de traumas, síntomas de estrés postraumático y cogniciones postraumáticas no adaptativas. Los modelos de ecuaciones estructurales revelaron que se observó una revictimización interpersonal al controlar traumas no interpersonales pasados, odds ratio (OR) = 2.27, IC 95% 1.23, 4.18, y apoyaron el rol de los síntomas de estrés postraumático como un mecanismo subyacente a dicha revictimización, IC del 95% de efecto indirecto (IE) 0.08, 0.51. Además, un historial de trauma no interpersonal (controlando el trauma interpersonal pasado) incrementó el riesgo de subsecuente victimización interpersonal mediante síntomas de estrés postraumático, IC del 95% de IE 0.01, 0.38. Sin embargo, notablemente, cuando se incluyeron las cogniciones no adaptativas como mediadores además de los síntomas de estrés postraumático, el único efecto indirecto fue la asociación entre el trauma interpersonal y el riesgo de revictimización, específicamente a través de la percepción de la amenaza de daño, IC del 95% de IE 0.05, 0.20. Estos hallazgos sugieren que los esfuerzos para reducir la revictimización interpersonal deben dirigirse a las cogniciones postraumáticas no adaptativas, en particular las percepciones de amenaza en el medio ambiente.
抽象
Traditional and Simplified Chinese s by the Asian Society for Traumatic Stress Studies (AsianSTSS)
簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯
Risk for Revictimization Following Interpersonal and Noninterpersonal Trauma: Clarifying the Role of Posttraumatic Stress Symptoms and Trauma‐Related Cognitions
Traditional Chinese
標題: 經歷人際及非人際創傷後再次受害的風險:釐清創傷後壓力症狀與創傷相關認知的影響
撮要: 經歷一次受害༌有可能提升其後受害(即再次受害)的風險。本研究旨在對性侵犯再次受害作進一步研究༌將(a) 透過檢視普遍的人際(及潛在非人際)創傷༌加深對再次受害的理解;及(b) 取得更多有關再次受害背後機制的特殊資訊。研究採用前瞻性多站點設計༌多元的種族樣本由社區內453名年輕女性組成(年齡值域: 18–25 歲, 60.7% 歐洲裔美國人)。樣本起初接受了一次訪問༌並在接著的一年內接受至少一次跟進調查。她們完成以下方面的自評測量:過往的創傷歷史、創傷後壓力症狀、適應不良的創傷後認知。結構性方程模型反映༌當對過往的非人際創傷作對照後༌樣本有人際再次受害(勝算比 (OR) = 2.27, 95% CI 1.23, 4.18)༌並反映創傷後壓力症狀屬於導致這種再次受害背後的機制(間接效應(IE)的95% CI 0.08, 0.51)。此外༌過往曾遭受非人際創傷(對過往的人際創傷作對照後)༌會透過創傷後壓力症狀༌提升其後遭受人際受害的風險(IE 的 95% CI 0.01, 0.38)。然而༌假若我們在創傷後壓力症狀外༌亦視適應不良的認知作為中介因素的話༌那麼唯一的獨特間接效應則見於透過傷害感知所產生的、人際創傷與再次受害風險的關連中(IE 的 95% CI 0.05, 0.20)。結果反映༌為減少人際再次受害༌我們應針對改善適應不良的創傷後認知༌尤其是對環境威脅的感知。
Simplified Chinese
标题: 经历人际及非人际创伤后再次受害的风险:厘清创伤后压力症状与创伤相关认知的影响
撮要: 经历一次受害༌有可能提升其后受害(即再次受害)的风险。本研究旨在对性侵犯再次受害作进一步研究༌将(a) 透过检视普遍的人际(及潜在非人际)创伤༌加深对再次受害的理解;及(b) 取得更多有关再次受害背后机制的特殊信息。研究采用前瞻性多站点设计༌多元的种族样本由小区内453名年轻女性组成(年龄值域: 18–25 岁, 60.7% 欧洲裔美国人)。样本起初接受了一次访问༌并在接着的一年内接受至少一次跟进调查。她们完成以下方面的自评测量:过往的创伤历史、创伤后压力症状、适应不良的创伤后认知。结构性方程模型反映༌当对过往的非人际创伤作对照后༌样本有人际再次受害(胜算比 (OR) = 2.27, 95% CI 1.23, 4.18)༌并反映创伤后压力症状属于导致这种再次受害背后的机制(间接效应(IE)的95% CI 0.08, 0.51)。此外༌过往曾遭受非人际创伤(对过往的人际创伤作对照后)༌会透过创伤后压力症状༌提升其后遭受人际受害的风险(IE 的 95% CI 0.01, 0.38)。然而༌假若我们在创伤后压力症状外༌亦视适应不良的认知作为中介因素的话༌那么唯一的独特间接效应则见于透过伤害感知所产生的、人际创伤与再次受害风险的关连中(IE 的 95% CI 0.05, 0.20)。结果反映༌为减少人际再次受害༌我们应针对改善适应不良的创伤后认知༌尤其是对环境威胁的感知。
Sexual assault (SA) often occurs in the context of substances, which can impair the trauma memory and contribute to negative cognitions like self‐blame. Although these factors may affect ...posttraumatic stress disorder (PTSD) treatment, outcomes for substance‐involved SA have not been evaluated or compared with other types of SA. As such, we conducted a secondary analysis of a dismantling trial for cognitive processing therapy (CPT), focusing on 58 women with an index trauma of SA that occurred since age 14. Women who experienced a substance‐involved SA (n = 21) were compared with those who experienced a non–substance‐involved SA (n = 37). Participants were randomized to CPT, CPT with written account (CPT+A), or written account only (WA). Regressions controlling for pretreatment symptom levels revealed no differences by SA type in PTSD severity at posttreatment. At 6‐month follow‐up, substance‐involved SA was associated with more severe residual PTSD severity than non–substance‐involved SA, with no significant differences by treatment condition. Among participants in the substance‐involved SA group, the largest effect for reduced PTSD symptom severity from pretreatment to follow‐up emerged in the CPT condition, d = −2.02, with reductions also observed in the CPT+A, d = −0.92, and WA groups, d = −1.23. Although more research in larger samples is needed, these preliminary findings suggest that following substance‐involved SA, a cognitive treatment approach without a trauma account may facilitate lasting change in PTSD symptoms. We encourage replications to better understand the relative value of cognitive and exposure‐based treatment for PTSD following substance‐involved SAs.
To compare a Posttraumatic Stress Disorder (PTSD) treatment (Cognitive Processing Therapy; CPT), an Alcohol Use Disorder (AUD) treatment (Relapse Prevention; RP), and assessment-only (AO) for those ...meeting diagnostic criteria for both PTSD and AUD.
Participants with current PTSD/AUD (N = 101; mean age = 42.10; 56% female) were initially randomized to CPT, RP, or AO and assessed post-treatment or 6-weeks post-randomization (AO). AO participants were then re-randomized to CPT or RP. Follow-ups were at immediate post-treatment, 3-, and 12-months. Mixed effects intent-to-treat models compared conditions on changes in PTSD symptom severity, drinking days, and heavy drinking days.
At post-treatment, participants assigned to CPT showed significantly greater improvement than those in AO on PTSD symptom severity (b = -9.72, 95% CI -16.20, -3.23, d = 1.22); the RP and AO groups did not differ significantly on PTSD. Both active treatment conditions significantly decreased heavy drinking days relative to AO (CPT vs. AO: Count Ratio CR = 0.51, 95% CI 0.30, 0.88; RP vs. AO: CR = 0.34, 95% CI 0.19, 0.59). After re-randomization both treatment conditions showed substantial improvements in PTSD symptoms and drinking between pre-treatment and post-treatment over the 12-month follow-up period, with RP showing an advantage on heavy drinking days.
Treatments targeting one or the other aspects of the PTSD/AUD comorbidity may have salutary effects on both PTSD and drinking outcomes. These preliminary results suggest that people with this comorbidity may have viable treatment options whether they present for mental health or addiction care.
The trial is registered at clinicaltrials.gov (NCT01663337).
Top-down prefrontal cortex inputs to the hippocampus have been hypothesized to be important in memory consolidation, retrieval, and the pathophysiology of major psychiatric diseases; however, no such ...direct projections have been identified and functionally described. Here we report the discovery of a monosynaptic prefrontal cortex (predominantly anterior cingulate) to hippocampus (CA3 to CA1 region) projection in mice, and find that optogenetic manipulation of this projection (here termed AC-CA) is capable of eliciting contextual memory retrieval. To explore the network mechanisms of this process, we developed and applied tools to observe cellular-resolution neural activity in the hippocampus while stimulating AC-CA projections during memory retrieval in mice behaving in virtual-reality environments. Using this approach, we found that learning drives the emergence of a sparse class of neurons in CA2/CA3 that are highly correlated with the local network and that lead synchronous population activity events; these neurons are then preferentially recruited by the AC-CA projection during memory retrieval. These findings reveal a sparsely implemented memory retrieval mechanism in the hippocampus that operates via direct top-down prefrontal input, with implications for the patterning and storage of salient memory representations.
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