Objective: Trauma researchers have recently begun using Amazon's Mechanical Turk (MTurk) as a data collection platform that is both time- and cost-efficient. Research is needed to determine the ...utility, generalizability, and validity of MTurk as a recruitment source for trauma-exposed samples. Method: Data were collected from 266 trauma-exposed MTurk participants on several clinical and psychological constructs relevant to trauma research. The mean scores, prevalence rates, and correlation strengths of the MTurk sample were compared to those reported in previously published studies of undergraduate, community, and treatment-seeking samples. Results: Findings indicated that prevalence rates of posttraumatic stress disorder (PTSD) and depression were not significantly different from comparison samples, but prevalence rates of generalized anxiety were significantly higher than that of a community sample. The MTurk sample showed significantly lower mean scores of PTSD, depression, and generalized anxiety symptoms than all comparison samples. Correlations were examined to determine whether established relationships between common trauma-related constructs were correlated for MTurk participants as they were in other samples. Correlations between PTSD symptom severity, posttraumatic cognitions (PTCs), and trauma coping self-efficacy (CSE-T) in the MTurk sample were not significantly different from the correlations observed in all comparison samples. Finally, MTurk participants who met criteria for probable PTSD scored significantly higher on measures of depression, generalized anxiety, and PTCs, and lower on CSE-T, than those without probable PTSD. Conclusions: Future trauma researchers utilizing MTurk should consider potential similarities and differences between MTurk samples and community, clinical, and undergraduate samples when interpreting the generalizability of findings.
Clinical Impact Statement
Findings from the present study may be relevant to researchers interested in using MTurk to study clinical phenomena related to trauma. Recruitment sources may lead to differences in the clinical symptoms reported by research participants after trauma exposure, which researchers should consider when making inferences about the clinical application of their findings. However, the present study also supports that MTurk participants' self-report data are similar in important ways to the data provided by participants recruited from more traditional sources. Utilizing MTurk more frequently could increase the rate at which clinical research is conducted and the findings applied to real-world settings.
ABSTRACTA constellation of psychosocial factors contributes to the complex trauma symptoms that survivors of torture may experience. We examined the roles of pretrauma, peritrauma, and postmigration ...factors as predictors of posttraumatic stress disorder, depression, and anxiety in a sample of 101 culturally heterogeneous torture survivors residing in the United States. Predictors included demographic variables (sex, education, marital status), peritrauma torture type variables generated by principal components analysis (PCA), and postmigration variables (employment status, legal immigration status, and family separation). Of the torture factors identified through PCA (torture inflicted on the self and torture inflicted on family members), torture inflicted on the self significantly predicted anxiety. Undocumented legal status and female sex were related to poorer psychological outcomes. Results highlight the importance of considering postmigration factors, specifically legal status, rather than elements of the torture experience itself, in the delivery of trauma-informed psychological interventions and policy development for survivors of torture.
Objectives
Maternal posttraumatic stress disorder (PTSD) is a risk factor for negative child adjustment, but it is unclear whether this association is direct (e.g., a mother's PTSD symptoms are ...observed, learned, and internalized by children which results in behavioral and emotional problems) or indirect, through parent–child relationship difficulties or parenting stress. We hypothesized that parenting stress and maternal emotional availability would exhibit indirect effects on relationships between maternal PTSD and children's functioning.
Method
Participants were 52 trauma‐exposed mothers and their children (aged 7–12 years). Mothers completed measures of PTSD and parenting stress and reported on their children's functioning. Emotional availability was assessed through observer‐rated mother–child interactions.
Results
Emotional availability was not related to PTSD or child outcomes. Parenting stress had a substantial indirect effect on the relationships between maternal PTSD and child emotion regulation, internalizing, and externalizing behaviors.
Conclusions
Results highlight the need to target parenting stress in interventions with trauma‐exposed families.
Objective
This study explored risk and resilience factors of mental health functioning during the coronavirus disease (COVID‐19) pandemic.
Methods
A sample of 467 adults (M age = 33.14, 63.6% female) ...reported on mental health (depression, anxiety, posttraumatic stress disorder PTSD, and somatic symptoms), demands and impacts of COVID‐19, resources (e.g., social support, health care access), demographics, and psychosocial resilience factors.
Results
Depression, anxiety, and PTSD rates were 44%, 36%, and 23%, respectively. Supervised machine learning models identified psychosocial factors as the primary significant predictors across outcomes. Greater trauma coping self‐efficacy and forward‐focused coping, but not trauma‐focused coping, were associated with better mental health. When accounting for psychosocial resilience factors, few external resources and demographic variables emerged as significant predictors.
Conclusion
With ongoing stressors and traumas, employing coping strategies that emphasize distraction over trauma processing may be warranted. Clinical and community outreach efforts should target trauma coping self‐efficacy to bolster resilience during a pandemic.
Recent studies have found a significant association between PTSD and low heart rate variability (HRV), a biomarker of autonomic dysregulation. Research indicates that respiratory sinus arrhythmia ...(RSA) biofeedback increases HRV while reducing related pathological symptoms. This controlled pilot study compared RSA biofeedback to progressive muscle relaxation (PMR) as adjunctive interventions for 38 persons with PTSD symptoms in a residential treatment facility for a substance use disorder. Both groups were assessed at pre-intervention and 4-week post-intervention. Group × time interactions revealed significantly greater reductions in depressive symptoms and increases in HRV indices for the RSA group. Both groups significantly reduced PTSD and insomnia symptoms and a statistical trend was observed for reduced substance craving for the RSA group. Increases in HRV were significantly associated with PTSD symptom reduction. Overall, these results provide preliminary support for the efficacy of RSA biofeedback in improving physiological and psychological health for individuals with PTSD.
Objective
Posttraumatic stress disorder (PTSD) is associated with somatic and cognitive changes, which may be magnified when accompanied by persistent pain. The mechanisms of somatic sensation ...processing may extend to cognitive symptoms, revealing a potential generalization of impairment across cognitive and somatic domains in PTSD. We hypothesized that somatic burden would mediate relationships between PTSD, pain, and perceived cognitive impairment.
Methods
Two samples—360 trauma‐exposed college students and 268 mechanical Turk users—completed self‐report measures.
Results
Both samples revealed similar findings. There was a significant indirect effect of PTSD and pain on perceived cognitive problems through somatic burden. There remained a direct effect of PTSD symptoms. These findings indicate that in trauma‐exposed samples with pain, somatic burden rather than pain severity accounts for perceived cognitive problems.
Conclusion
High somatic burden may reflect an underlying appraisal about somatic cues, which extend in part to interpretation of cognitive cues.
Declarative memory dysfunction is associated with post-traumatic stress disorder (PTSD). This paper reviews this literature and presents two frameworks to explain the nature of this dysfunction: that ...memory deficits are a product of neurobiological abnormalities caused by PTSD and/or that pre-existing memory deficits serve as a risk factor for the development of PTSD following trauma exposure. Brain regions implicated in declarative memory deficits include the hippocampus and prefrontal cortex, and imaging and biochemistry studies as they relate to memory dysfunction are described. Prospective and twin studies provide support for a risk factor model.
•Both cognitive training and psychoeducation resulted in PTSD symptom reduction.•Change in appraisals of cognitive functioning predicted PTSD improvement.•Effectiveness of cognitive remediation for ...PTSD is infrequently studied.•Modifying patients’ cognitive appraisals may elicit clinical benefits.
Patients with PTSD often voice concern over their perceived change in cognitive functioning. However, these negative appraisals do not always align with objective neuropsychological performance, yet are strongly predictive of PTSD symptom severity and self-reported functional impairment.
The present study involves a secondary analysis examining the role of appraisals of a subsample of 81 adults with full or subthreshold PTSD on treatment outcomes in a randomized controlled trial investigating the effectiveness of a cognitive rehabilitation treatment, Strategic Memory and Reasoning Training (n = 38), compared to a psychoeducation control arm, the Brain Health Workshop (n = 43). Neither condition addressed PTSD symptoms, focusing instead on cognitive skills training and psychoeducation about the brain.
Intent-to-treat models showed statistically significant improvements for both groups on composite scores of executive functioning and memory. Additionally, both groups experienced clinically significant reductions in PTSD symptoms (assessed via the Clinician-Administered PTSD Interview) and the SMART group showed fewer negative appraisals about cognitive functioning following training. Change in appraisals of cognitive functioning was associated with change in PTSD as well as change in quality of life, with no differential associations based on group status. In contrast, neurocognitive test score changes were not associated with change in symptoms or functional outcomes.
We did not collect data on other appraisals (e.g., self-efficacy), which could have further elucidated pathways of change.
Our findings suggest that interventions that do not directly target PTSD symptoms can lead to PTSD symptom change via change in appraisals of functioning.
Objective: Posttraumatic stress disorder (PTSD) is associated with mild neurocognitive deficits, yet clients often complain of cognitive problems that exceed what their objective performance ...demonstrates. In addition, PTSD is associated with negative appraisals about the self, traumatic event, and one's ability to cope. This study examined posttraumatic cognitions as a moderator, and trauma coping self-efficacy as a mediator, of the relationship between PTSD symptoms and self-report of cognitive problems. Method: A sample of 268 trauma-exposed adults completed the PTSD Checklist for DSM-5, the Posttraumatic Cognitions Inventory, the Trauma Coping Self-Efficacy Scale, the Cognitive Self-Report Questionnaire, and the Quality of Life Scale. Results: Negative self-appraisals was a significant moderator in the relationship between PTSD symptoms and perception of cognitive problems (β = −.252, p = .001). In participants with high levels of negative posttraumatic cognitions, perception of cognitive problems was high regardless of PTSD symptom level. In a mediator analysis, there was a significant indirect effect of trauma coping self-efficacy (b = .125, 95% CI .088, .172). Finally, there was evidence of moderated mediation, such that trauma coping self-efficacy was a mediator only when posttraumatic cognitions were low or average. Conclusions: Results indicate that posttraumatic appraisals and coping self-efficacy play significant roles in perception of cognitive problems following trauma. Clinically, in patients for which there is a perception of cognitive impairment that is not borne out in neuropsychological testing, cognitive-behavioral therapy focused on altering negative self-perceptions and appraisals may be beneficial.
Objective
The Interpersonal Theory of Suicide (IPTS; Joiner, 2005. Why People Die by Suicide. Cambridge, MA: Harvard University Press) hypothesizes that repeated exposure to painful and provocative ...events (PPE) increases capability for suicide (CS), therefore facilitating the development of suicidal intent, and that impulsive individuals are more likely to experience these painful and provocative events, creating an indirect relationship between impulsivity and CS. Research to date largely supports this hypothesis but has not translated this theory to actual suicidal intent.
Method
The present study used data from the MacArthur Violence Risk Assessment Study to examine the relationship between PPE and intent, and the indirect relationship between impulsivity and intent among a sample of 245 recent suicide attempters, using the clinician‐rated Suicide Intent Scale as an objective measure of intent.
Results
Results supported the hypothesized direct relationship between PPE and intent, and the indirect relationship between impulsivity and intent through PPE. There was no direct relationship between impulsivity and intent, suggesting that the relationship between impulsivity and intent occurs entirely through exposure to PPE.
Conclusions
These findings suggest that assessing exposure to painful and provocative events is critical in evaluating risk of suicide, and that impulsivity itself does not confer an increased risk of lethal or nearly lethal attempts.
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