ArticleLiterature Review

Exploring the links between posttraumatic stress disorder and social support: Processes and potential research avenues

June 2006
Journal of Traumatic Stress 19(3):327-38

June 2006
19(3):327-38

DOI:10.1002/jts.20124

Source
PubMed

Authors:

Stéphane Guay

Université de Montréal

André Marchand

Université du Québec à Montréal

Social support after a traumatic event is linked to posttraumatic stress disorder (PTSD). However, little is known about the ways in which social support influences the adaptation to trauma and development of PTSD. The aim of the present article is threefold: to outline the various processes by which social support is linked to PTSD, to review the most relevant research in the field, and to suggest potential future research.

Resilience factors among adults affected by mass conflict: Recommendations for researchers

Article

Full-text available

Aug 2022

Resilience refers to the process of adapting to a crisis and bouncing back to life. Studying resilience among war-affected adult refugees and general civilians in post-conflict settings is critical, as it is directly related to their health and social inclusion. Not only is resilience helpful in preventing war-affected individuals from developing dysfunctional coping strategies or mental disorders, but it also helps them in their adaptation and (re)integration in society. The purpose of this review is to examine factors influencing the resilience process among this group. Highlighting the main findings and gaps in the existing literature, this paper provides some researchable questions and methodological recommendations. The authors review the factors across ecological levels of individual, interpersonal, community, organizational, and macro levels. At the individual level, values, beliefs, and meanings given to adversity and resilience are discussed. These cultural meanings demonstrate the strong capability of war-affected individuals. However, application of these findings in practice and research is missing. Another individual level protective factor that is reviewed is coping strategies. These strategies might be affected by the cultural and political climate of the larger society. This needs more examination in future studies. At the interpersonal level, the importance of family and friends, especially for emotional support, is frequently highlighted; however, more studies are needed to investigate social support from communities and organizations. Factors at the macro level are understudied. In a few studies in this area, these factors mainly emerge as risk factors, especially for those conflict-affected populations living in developing countries. That is, the lack of legal recognition and employment opportunities are hindering the process of adaptation after experiencing trauma. The macro level factors influencing resilience need more attention from researchers.

Identification of Psycho-Socio-Judicial Trajectories and Factors Associated With Posttraumatic Stress Disorder in People Over 15 Years of Age Who Recently Reported Sexual Assault to a Forensic Medical Center: Protocol for a Multicentric Prospective Study Using Mixed Methods and Artificial Intelligence

Article

Full-text available

Oct 2023

Background Sexual assault (SA) can lead to a range of adverse effects on physical, sexual, and mental health, as well as on one’s social life, financial stability, and overall quality of life. However, not all people who experience SA will develop negative functional outcomes. Various risk and protective factors can influence psycho-socio-judicial trajectories. However, how these factors influence trauma adaptation and the onset of early posttraumatic stress disorder (PTSD) is not always clear. Objective Guided by an ecological framework, this project has 3 primary objectives: (1) to describe the 1-year psycho-socio-judicial trajectories of individuals recently exposed to SA who sought consultation with a forensic practitioner; (2) to identify predictive factors for the development of PTSD during the initial forensic examination using artificial intelligence; and (3) to explore the perceptions, needs, and experiences of individuals who have been sexually assaulted. Methods This longitudinal multicentric cohort study uses a mixed methods approach. Quantitative cohort data are collected through an initial questionnaire completed by the physician during the first forensic examination and through follow-up telephone questionnaires at 6 weeks, 3 months, 6 months, and 1 year after the SA. The questionnaires measure factors associated with PTSD, mental, physical, social, and overall functional outcomes, as well as psycho-socio-judicial trajectories. Cohort participants are recruited through their forensic examination at 1 of the 5 participating centers based in France. Eligible participants are aged 15 or older, have experienced SA in the last 30 days, are fluent in French, and can be reached by phone. Qualitative data are gathered through semistructured interviews with cohort participants, individuals who have experienced SA but are not part of the cohort, and professionals involved in their psycho-socio-judicial care. Results Bivariate and multivariate analyses will be conducted to examine the associations between each variable and mental, physical, social, and judicial outcomes. Predictive analyses will be performed using multiple prediction algorithms to forecast PTSD. Qualitative data will be integrated with quantitative data to identify psycho-socio-judicial trajectories and enhance the prediction of PTSD. Additionally, data on the perceptions and needs of individuals who have experienced SA will be analyzed independently to gain a deeper understanding of their experiences and requirements. Conclusions This project will collect extensive qualitative and quantitative data that have never been gathered over such an extended period, leading to unprecedented insights into the psycho-socio-judicial trajectories of individuals who have recently experienced SA. It represents the initial phase of developing a functional artificial intelligence tool that forensic practitioners can use to better guide individuals who have recently experienced SA, with the aim of preventing the onset of PTSD. Furthermore, it will contribute to addressing the existing gap in the literature regarding the accessibility and effectiveness of support services for individuals who have experienced SA in Europe. This comprehensive approach, encompassing the entire psycho-socio-judicial continuum and taking into account the viewpoints of SA survivors, will enable the generation of innovative recommendations for enhancing their care across all stages, starting from the initial forensic examination. International Registered Report Identifier (IRRID) DERR1-10.2196/46652

Post-traumatic stress disorder and associated factors among adults exposed to stress in Ethiopia: A meta-analysis and systematic review

Article

Full-text available

Mar 2023

Objective Post-traumatic stress disorder is a complex psychiatric disorder that develops after exposure to traumatic events, such as violent physical assaults, accidents, rape, natural disasters, and conflicts, stranger than usual human experiences. The typical presentation of intrusive thoughts, the persistence of the trauma, the avoidance of pertinent stimuli, emotional numbness, and physiological hyperarousal are the characteristics of this anxiety symptom. Despite the presence of a study conducted on this problem, the pooled effect, particularly in Ethiopia, is not known; therefore, this study assessed the allover burden of post-traumatic stress disorder. Method The available study was extracted and conducted on post-traumatic stress disorder and its associated factors in Ethiopia by three independent authors. The data were analyzed by using STATA version 11 after extraction was done on a Microsoft Excel spreadsheet. The random-effect model was used to estimate the pooled effect size of post-traumatic stress disorder and its effect in the previous studies with 95% confidence intervals. Funnel plots analysis and Egger regression tests were conducted to detect the presence of publication bias. A subgroup analysis and a sensitivity analysis were done. Result Thirteen (13) studies were included with a total of 5874 study participants in this meta-analysis and systematic reviews. The pooled prevalence of post-traumatic stress disorder in Ethiopia was 39.28% with a 95% confidence interval (26.54, 52.01). Poor social support (adjusted odds ratio = 2.86; 95% confidence interval (1.81, 4.53)), being female (adjusted odds ratio = 1.89; 95% confidence interval (1.53, 2.34)), presence of previous mental illness (adjusted odds ratio = 4.72; 95% confidence interval (2.62, 8.36)), and witness (adjusted odds ratio = 2.01; 95% confidence interval (1.30, 3.11)) were associated with post-traumatic stress disorder. Conclusion The burden of post-traumatic stress disorder in this meta-analysis and systematic review is high; therefore, immediate intervention is needed for those specific traumatized individuals.

Social network responses to victims of potentially traumatic events: A systematic review using qualitative evidence synthesis

Article

Full-text available

Nov 2022
PLOS ONE

Background A substantial number of qualitative studies examined how adult victims of potentially traumatic events (PTEs) experienced support provided by family members, friends, colleagues, and other significant others in the informal network. Importantly, the large majority of qualitative studies focused on the perceived support of victims of specific events such as sexual offences, partner violence, homicide, accidents and disasters. Although it is likely that across specific PTEs there are similarities as well as differences in experienced support from the informal network, to date no systematic review synthesized the results of qualitative studies on support from the informal network following various types of PTEs. The aim of the present systematic review is to fill this gap in the scientific knowledge, which is also highly relevant for victim services, policymakers, and the informal network. Methods A literature search of qualitative studies was conducted using the electronic databases of PubMed, Web of Science, CINAHL, Psych INFO, Scopus, Criminal Justice Abstracts and Picarta. The quality of the identified studies was assessed with the Consolidated Criteria for Reporting Qualitative research (COREQ) checklist, followed by analysis of the results of the identified studies using Qualitative Evidence Synthesis. Findings Seventy-five papers were included in the synthesis, involving 2799 victims of PTEs such as accidents, disasters, homicide, intimate partner violence (IPV), and sexual offences. Saturation was only achieved for IPV. Overall, four major categories of perceived social support were identified, namely, support perceived as supportive, supportive but insufficient, unsupportive, and absent from informal support providers, which included friends, family, neighbors, (if applicable) offender’s family, religious group members, work/school colleagues, fellow victims, the local community, and the social network in general. Across the PTE groups, there were similarities in experiencing positive forms of support (particularly empathy and sharing experiences ) as well as negative forms of support ( abandonment , avoidance , lack of empathy , and not experiencing support despite victim’s request for help). There were also differences across PTE groups, in particular, victims of sexual and intimate partner violence mentioned a number of other supportive ( mobilizing support , no unsupportive responses ) and non-supportive (e.g., justification or normalization of violence and minimizing responses) responses. Conclusions The review showed that different actors within the social informal network can play an important role in providing support after victims experience violence, homicide, accidents, and disasters. However, the review revealed that the large majority of qualitative studies were aimed at victims of IPV, and only for this type of PTE was saturation achieved. This indicates that, although this synthesis identified several similarities and differences, it is still too early to draw more definitive conclusions on similarities and differences in experienced social support after various PTEs and that future qualitative studies focusing on other PTEs are much needed.

Perceived Coworker Social Support: A Protective Factor against Workplace Violence and Psychopathologies in Paramedics and Firefighters

Article

Full-text available

May 2022

First responders are routinely exposed to potentially traumatic events, such as workplace violence (WPV), which has been associated with a higher risk of developing psychopathologies. Perceived social support is a protective factor that may enhance first-responders’ resilience in the face of violence. Specifically, the shared experiences of unique stressors among coworkers may lead to a sense of relatability that may help reduce WPV’s psychological impacts above support from loved ones. Accordingly, the current study created a measure of coworker social support. We assessed how perceived social support from coworkers and personal supports moderated the relationship of WPV to psychopathology in first responders. A sample of active-duty firefighters (n= 117) and paramedics (n= 129) from a large Canadian city completed online measures of emotional psychopathology. Overall, we found that WPV positively predicted emotional psychopathology, but only at low levels of coworker social support. Consistent with a buffering effect, WPV was not associated with emotional issues at high levels of work support. In contrast, the level of personal social support from loved ones did not moderate WPV’s negative impacts. We discuss the implications of our findings on the benefits of social support and support networks within the work environment.

Attachment, Emotion, and Change: Emotionally focused individual therapy (EFIT) within a process-based therapy (PBT) Framework

Article

Apr 2024

In this paper we present emotionally focused individual therapy (EFIT; Johnson & Campbell, 2022) within a process-based therapy (PBT) framework. A case presentation follows detailed descriptions of the theoretical underpinnings of EFIT, of the specific interventions involved in the approach, and of the evidence upon which the therapeutic processes in EFIT are based. We conclude that the Extended Evolutionary Meta-Model (EEMM) perspective, with its common language; nonpathologizing stance on psychological suffering; and attention to intrapsychic, interpersonal, and sociocultural aspects of change provides an excellent context for learning and practicing EFIT.

Prevalence of post-traumatic stress disorder among residents of Shanghai standardized training programs during the COVID-19 outbreak: a cross-sectional study

Article

Full-text available

Oct 2023

Background The COVID-19 pandemic may have increased the prevalence of psychiatric disorders, such as anxiety, depressive disorders, and post-traumatic stress disorder (PTSD), among healthcare workers. Purpose This study aims to investigate the prevalence of PTSD and its risk factors among residents in the standardized residency training programs (SRTPs) in Shanghai during the COVID-19 outbreak. Participants and methods An online cross-sectional survey was conducted between December 17, 2021, and January 7, 2022, among SRPT residents from 15 hospitals in Shanghai, China. Questionnaires comprising general information, medical-related traumatic event experiences, the PTSD Checklist (PCL-5), and the perceived social support scale (PSSS) were distributed to the participants using the online Questionnaire Star electronic system. Results We included 835 valid responses for the analysis. In total, 654 residents (78.3%) had experienced at least one traumatic event, and 278 residents (33.3%) were found to have PTSD symptoms. The age 26–30 years old, female sex, and increased resident working hours were identified as the risk factors for PTSD (p < 0.05), and perceived social support had a significant negative association with PTSD (p < 0.05). Conclusion During the COVID-19 pandemic, there was a high prevalence of PTSD among SRTPs residents in Shanghai. The age 26–30 years old, female sex, and increased resident working hours were identified as risk factors for PTSD, while perceived social support was identified as a protective factor against PTSD. The present findings can be applied in STRPs management and provide useful information for designing special interventions and protocols for SRTPs residents.

TRAVMA SONRASI BİLİŞLER İLE SOMATİZASYON ARASINDA DUYGULARIN ARACI ROLÜ

Thesis

Full-text available

May 2021

Alperen Şenol

Bu araştırmada en az bir ya da daha fazla travmatik deneyimi bulunan yetişkin bireylerde, travma sonrası bilişler ve somatizasyon düzeyleri arasındaki ilişkide duygu yönetme becerileri ile olumsuz duygulanımın sıralı aracı rolünün incelenmesi amaçlanmıştır. Buna yönelik olarak travma sonrası bilişler, duygu yönetme becerileri ve olumsuz duygulanımın somatizasyon düzeyi üzerindeki doğrudan, dolaylı ve toplam etkileri test edilmiştir. Bu araştırmanın çalışma grubu uygun örneklem yöntemi ile oluşturulmuş olup, en az bir ya da daha fazla travmatik yaşam deneyimine sahip olma ölçütünü karşılayan 397 kadın, 94 erkek ve 3 herhangi bir cinsiyet belirtmeyen toplamda 494 katılımcı çalışma grubunu oluşturmaktadır. Bu araştırmada veriler 2020 Ağustos ayı içerisinde çevrimiçi formlar kullanılarak, gönüllülük ve gizlilik esasına göre toplanmıştır. Katılımcıların kişisel ve demografik bilgilerini elde etmek için araştırmacı tarafından geliştirilen Kişisel Bilgi Formu; katılımcıların travma deneyimlerini taramak için Foa, Cashman, Jaycox, and Perry (1997) tarafından geliştirilen, Işıklı (2006) tarafından Türkçe’ye uyarlanan Travma Sonrası Stres Tanı Ölçeği’nin 1. Bölümü; katılımcıların travma sonrası bilişlerini incelemek için Foa ve diğ. (1999) tarafından geliştirilen, Yetkiner (2010) tarafından Türkçe’ye uyarlanan Travma Sonrası Bilişler Ölçeği; katılımcıların duygu yönetme becerilerini ölçmek için Çeçen (2002) tarafından geliştirilen Duyguları Yönetme Becerileri Ölçeği; katılımcıların olumsuz duygulanım düzeyini belirlemek için Watson, Clark ve Tellegen (1988) tarafından geliştirililen ve Gençöz (2000) tarafından dilimize uyarlanan Pozitif ve Negatif Duygusallık Ölçeği; son olarak katılımcıların somatizasyon düzeyini belirlemek için Minnesota Çok Yönlü Kişilik Envanteri’nin (MMPI) Somatizasyon Bozukluğu ile ilgili maddeleri esas alınarak Dülgerler (2010) tarafından uyarlanan Somatizasyon Ölçeği kullanılmıştır. Araştırmada veriler makro eklentili ve lisanslı SPSS 21 bilgisayar programı kullanılarak analiz edilmiştir. Veriler analiz öncesi normallik testlerinden geçirilerek, çalışmaya uygunluğu incelenmiş ve parametrik testler ile çalışmaya devam edilmesi uygun görülmüştür. Bu araştırmada yapılan fark testlerinden elde edilen bulgulara göre, travmatik bir deneyim sonrası erkekler kadınlara göre daha yüksek olumsuz biliş sergilemektedir. Gelir düzeyinin düşük olması ise travma sonrası olumsuz bilişler geliştirme ve somatizyon açısından risk faktörü olarak öne çıkmaktadır. Bu araştırmada yapılan yordayıcılık analizlerine göre travma sonrası bilişler, duygu yönetme becerilerini negatif yönde, iii olumsuz duygulanımı pozitif yönde ve somatizasyonu pozitif yönde ve anlamlı düzeyde; duygu yönetme becerileri, olumsuz duygulanım ve somatizasyonu negatif yönde ve anlamlı düzeyde; olumsuz duygulanım, somatizasyonu pozitif yönde ve anlamlı düzeyde yordamaktadır. Son olarak bu çalışmada yapılan aracılık analizlerine göre, travma sonrası bilişler ve somatizasyon arasında duygu yönetme becerileri ve olumsuz duygulanım değişkenlerinin tam aracı rolü olduğu bulgusu elde edilmiştir. Bu bulguya göre, travma sonrası olumsuz bilişler ve somatizasyon arasında duygu yönetme becerileri ve olumsuz duygulanım sıralı olarak modele girdiğinde, travma sonrası olumsuz bilişlerin somatizasyon üzerindeki istatistiksel yordayıcılığı anlamlılığını kaybetmekte, duygu yönetme becerileri ve olumsuz duygulanım, travma sonrası bilişler ve somatizasyon arasında tam aracı değişkenler olarak belirmektedir. Dolayısıyla bu çalışmada, travma sonrası olumsuz bilişlerin somatizasyon üzerinde duygu yönetme becerileri ve olumsuz duygulanımın sıralı aracılığı ile dolaylı bir etkisi var iken, doğrudan bir etkisinin ise olmadığı gözlenmektedir.

Creating Relational Density to Buffer the Effects of Childhood Maltreatment in Preadolescent Foster Youth

Article

Full-text available

Jun 2023
CLIN SOC WORK J

Katelyn I. King

Caring adult relationships play a vital role in buffering the consequences of childhood maltreatment. However, many young people living in foster care have few relationships with trusted adults. Children and youth in foster care experience higher rates of maltreatment and trauma-related sequelae, including PTSD and associated conditions, and the trauma of removal from caregivers can itself intensify these effects. These impacts can be especially pronounced for foster children in preadolescence, when support from adults is critical for various aspects of development, including social and emotional learning. In this article I synthesize foundational and more recent research on adult-child relationships using attachment and trauma theory perspectives, pointing in particular to evidence about relational density, relational permanence, and placement stability. I argue that a clinical social worker’s central intervention in working with preadolescent foster children must be to build, coordinate, and participate in a relationally dense network of adult support. This network should consist of a small group of adults who know and interact with the child at different points in a day and week. In addition to a foster parent, it may include family members, a school social worker or counselor, teachers, or other school staff such as an administrator or reading specialist. Members meet regularly to discuss and support each other’s interactions with the child, build communication skills, and prepare for continuity even across placement disruptions. I conclude by discussing local and state policy interventions necessary for supporting rather than undermining such an approach to active coordination of relational density.

Sensory modulation and trauma-related symptoms during rocket attacks

Article

Full-text available

May 2023

Background: War is a highly traumatogenic experience that may result in trauma-related symptoms during exposure. Although most individuals exhibit recovery after the trauma ends, symptomatology during exposure may serve as an initial indicator underlying symptomatology at the posttraumatic phase, hence the imperative to identify risk factors for trauma-related symptoms during the peritraumatic phase. While research has uncovered several factors associated with peritraumatic distress, such as age, gender, history of mental disorder, perceived threat, and perceived social support, the role of sensory modulation has not been explored. Method: To address this gap, 488 Israeli citizens were assessed using an online survey for sensory modulation and trauma-related symptoms during rocket attacks. Results: Analyses revealed that while the association between high sensory responsiveness and elevated levels of specific trauma-related symptoms is somewhat weak (0.19<r<.0.22), it serves as a major risk factor for developing trauma-related symptoms during the peritraumatic phase in general. Specifically, the risk for elevated symptoms was doubled (OR = 2.11) for each increase in the high sensory-responsiveness score, after controlling for age, gender, history of mental disorder, perceived threat, and perceived social support. Limitations: This study relied on convenience sampling and a cross-sectional design. Conclusions: The present findings suggest that sensory modulation evaluation may serve as an important screening tool for identifying individuals who are vulnerable to trauma-related symptoms during the peritraumatic phase, and that implementing sensory modulation strategies as part of preventative interventions for PTSD might be effective.

Posttraumatic Stress Symptom Profiles of Aid Workers: Identifying Risk and Protective Factors

Article

Full-text available

May 2023

Objective: Researchers have documented elevated rates of posttraumatic stress disorder (PTSD) in aid workers. Yet, few have investigated the heterogeneity of PTSD presentations in this population. This study examined clinically relevant patterns of PTSD symptomatology in aid workers and examined whether factors such as the degree of trauma exposure (e.g., morally injurious events), social support, and sociodemographic and work characteristics predict symptom profiles. Method: Participants were 243 aid workers who had completed 8.2 assignments on average. They completed measures of trauma exposure, PTSD symptoms, and various types of social support. Latent profile analysis was used to identify PTSD symptom profiles using PCL-5 subscale scores. Next, profiles were compared on 15 potential risk and protective factors. Results: Five profiles were identified: a no PTSD profile (49.4%), a low subclinical PTSD profile (21.8%), a dysphoric subclinical PTSD profile (5.8%), an intermediate clinical PTSD profile (14.8%), and a severe clinical PTSD profile (8.2%). Profiles differed in terms of witnessed traumatic events, morally injurious exposure, social support adequacy, age, number of assignments, types of assignments, and organizational support. Conclusions: This study is the first to identify distinct patterns of PTSD symptomatology in aid workers and to investigate novel psychological risk factors such as potentially morally injurious events. Overall, these findings provide further insight into the risk and protective factors for the psychological well-being of aid workers as well as avenues for improving the psychological assessment and support.

Examination of PTSD Symptom Networks Over the Course of Cognitive Processing Therapy

Article

Full-text available

Apr 2023

Objectives: Cognitive processing therapy (CPT) is an evidence-based psychotherapy for posttraumatic stress disorder (PTSD); however, little is known about how interrelationships between PTSD symptoms change over the course of treatment. The current study examined baseline, midtreatment, and posttreatment PTSD symptom networks during CPT for PTSD. Method: Adults with PTSD (n = 107) received 12 sessions of CPT as part of a randomized trial. Self-reported PTSD symptoms were assessed at pretreatment, midtreatment, and posttreatment, and network analysis was used to examine the interrelationships between symptoms at these three timepoints. Linear regression was conducted to examine whether any baseline symptoms or midpoint symptoms predicted overall treatment change. Results: In the baseline PTSD network, feelings of detachment and feeling upset at reminders of the trauma were central to the symptom network. These symptoms were no longer central at midtreatment, possibly suggesting that CPT quickly reduces the importance of these symptoms. These findings were consistent with regression results that, after accounting for multiple comparisons, high baseline scores of feeling upset at trauma reminders predicted later treatment change. At the conclusion of treatment, strong negative emotions were the most central symptom and may be most important in maintaining or lowering other PTSD symptoms at the conclusion of treatment. Conclusions: Though replication is necessary, these findings offer insights into identifying which symptoms may be most predictive of treatment outcomes and the course by which CPT reduces PTSD symptoms. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The impact of pre- and post-trauma financial problems on posttraumatic stress symptoms, anxiety and depression symptoms, and emotional support: A prospective population-based comparative study

Article

Full-text available

Apr 2023
J ANXIETY DISORD

Potentially traumatic events (PTEs) are associated with a higher risk of mental health problems and a lack of emotional support. The extent to which pre- and/or post-trauma financial problems further increase this risk, while controlling for pre-trauma mental health problems and lack of support and compared to nonvictims, is largely unknown. To better understand this risk, data was extracted from four surveys of VICTIMS study using the Dutch population-based longitudinal LISS-panel. Multivariate logistic regression analyses (MLRA) showed that nonvictims (nnonvictims total=5003) with persistent financial problems (present at T1 and present at T2 one year later) more often suffered from severe anxiety and depression symptoms (ADS; Adjusted OR (aOR)= 1.72) and lack of emotional support (aOR=1.96) than nonvictims without these problems, and that victims of PTEs (nvictims total=872) with persistent financial problems more often suffered moderate ADS (aOR=2.10) than nonvictims with persistent financial problems. MLRA showed that victims with pre- and/or post-trauma financial problems were more at risk of probable PTSD than victims without financial problems (aORs ≥ 2.02). Victim services and (mental) health care professionals should screen for pre- and post-trauma financial problems and, when found, refer the victims to relevant professionals since these problems can significantly hinder recovery.

Disrupting the cycle of youth violence: The role of social support for youth in a Northern Irish Youth Work Programme

Article

Full-text available

Mar 2023
J Child Adolesc Trauma

Colm Walsh

Youth violence is a significant concern and previous research has found that violence is both trauma inducing and violence inducing. Meta-analyses have demonstrated that peri-trauma contextual factors such as the presence or absence of social supports following the onset of trauma may be predictive of the onset and duration of psychological stress. The aim of this study is to build upon the existing research evidence to clarify the links between social support, psychological stress and physical violence among a cross-section of youth living in high-violence areas of Northern Ireland. Participants were a sample of 10–25-year-olds (N = 635) who participated in a targeted youth work programme in Northern Ireland. This study conducted a mediation analysis, entering social support as the independent variable, psychological distress as the mediator and self-reported violence as the outcome variable. Violent victimisation was entered as a covariate in the analysis. After controlling for violent victimisation, social support operates through psychological stress to influence the risk of physical violence. Social support may contribute to reductions in psychological stress and thus buffer against the risks of living in areas of elevated community violence. Specialist youth work approaches may provide an opportunity to reduce psychological stress and thus help to mitigate the risk of further violence. Combined, these insights provide opportunities for harm reduction and prevention. At the same time, these findings advance our understanding of the distinct mechanisms of change involved in youth work-led violence prevention efforts.

Identification of psycho-socio-judicial trajectories and factors associated with PTSD after recent sexual assault: the IADViSe study protocol for a multi-centric prospective study using mixed methods and artificial intelligence

Preprint

Full-text available

Jan 2023

Background Sexual assault (SA) has numerous negative outcomes on physical, sexual and mental health, social life, financial stability and overall quality of life. It is known as one of the most traumatogenic event. However, not all people who experienced SA will develop negative functional outcomes. Multiple risk and protection factors can influence their psycho-socio-judicial trajectories. The way by which these factors impact trauma adaptation are not always clear. Guided by an ecological framework, this project aims to (1) describe psycho-socio-judicial one-year trajectories of people recently exposed to SA, to (2) identify predictive factors for the development of posttraumatic stress disorder (PTSD) at first forensic examination using artificial intelligence and to (3) explore the notions of “victim” and “trauma” and the needs and experiences of people who have been sexually assaulted. Methods and design This longitudinal multi-centric cohort study will use a mixed-method approach. Quantitative cohort data will be collected based on questionnaires repeated in time, starting from first forensic examination and covering up to a year after the SA, measuring factors associated with PTSD, mental, physical, social and overall functional outcomes, and psycho-socio-judicial trajectories. Qualitative data will be based on semi-structured interviews with members of the cohort, people who experienced SA but not included in the cohort, and actors professionally involved in their psycho-socio-judicial care. Bivariate and multivariate analyses will be performed to study the associations between each variable and mental, physical, social and judicial outcomes. Predictive analyses will be conducted on multiple prediction algorithms to predict PTSD. Qualitative data will be integrated to the quantitative data to identify psycho-socio-judicial trajectories of participants and data on the representations of the place and usefulness of the notions of “trauma” and “victims” will be used independently. Discussion This project will collect numerous data never before collected over such long periods, which will lead to unprecedented results on psycho-socio-judicial trajectories of people who experienced SA. By being based on the entire psycho-socio-judicial chain and on the perspective of people who experienced SA, this work will allow to make innovative recommendations to improve their care at all levels, from the initial forensic examination.

Sexual Victimization and Mental Health Among LGBQ + College Students: Examining Social Support and Trauma-Related Drinking as Mediators

Article

Full-text available

Jan 2023
Int J Ment Health Addiction

Sexual victimization is associated with worse mental health outcomes among LGBQ + adolescents and adults; however, limited work has focused on these relations among emerging adults in college and has not tested mechanisms that might explain these associations. Thus, the current study tested the associations between sexual victimization and mental health outcomes (i.e., anxiety symptoms, depressive symptoms, and posttraumatic stress disorder symptoms) and examined social support and trauma-related drinking as mediators of these associations among diverse LGBQ + college student emerging adults. Additionally, we tested whether findings varied among Students of Color and White Students. Participants included 179 LGBQ + college students (M = 19.48, SD = 0.74) who completed measures of sexual victimization, social support, trauma-related drinking, and mental health. Trauma-related drinking was a significant mediator, such that sexual victimization was associated with greater trauma-related drinking and, in turn, greater anxiety symptoms, depressive symptoms, and posttraumatic stress disorder symptoms. Although social support was not a significant mediator, social support was associated with less anxiety symptoms and less depressive symptoms. Findings did not vary by ethnicity/race. Findings have research and intervention implications by highlighting the ways in which sexual victimization, social support, and trauma-related drinking affect LGBQ + college students’ mental health.

THE PAINS OF PARAMILITARISM: The Latent Criminogenic Effects of Exposure to Paramilitary Violence Among Young Men in a Post-Conflict Society

Article

Full-text available

Jan 2023
J Child Adolesc Trauma

Purpose: Whilst most people who experience adversity recover, there is a cumulative body of evidence that illustrates that the effects can be long lasting, and can even become debilitating over time. Links have been made between traumatic distress, mental health disorders and disturbances in behavioural and emotional regulatory systems that may in context elevate the risk of offending. Despite the burgeoning evidence around the criminogenic effects of adversity, few studies have examined the traumatic effects of paramilitary related adversity in the context of post-conflict Northern Ireland. Methods: With reference to DSM-V PTSD diagnostic clusters, the aim of this study was to explore the latent impact of adversity and latent trauma among justice involved young men and identify potential criminogenic effects of exposure to paramilitary related adversity. Results and conclusions: This study found that across the sample, young men had self-reported to have experienced significant adversity, including violent victimisation. Exposure to paramilitary adversity often began during early adolescence. The participants described symptoms that were consistent with clinically diagnosable disorders such as Post-Traumatic Stress Disorder. Despite this, there appears to be a paucity of trauma screening and assessment, and few supports that victim could benefit from. In the absence of appropriate and evidence-based supports, many young men appear to find other (and more maladaptive) ways to cope. This exacerbates the risk of interfacing with the justice system and may even contribute towards a deterioration in wider psycho-social outcomes. Implications for practice are discussed.

Were there losses in social support during the pandemic? Testing the impact of COVID-19 on psychological adjustment to trauma in United States adults

Article

Full-text available

Dec 2022

Introduction Social support is a key protective factor in the psychological adjustment of individuals to traumatic events. However, since March 2020, extant research has revealed evidence of increased loneliness, social isolation, and disconnection, likely due to COVID-19 pandemic-related recommendations that restricted day-to-day contact with others. Methods In this investigation, we applied a case-control design to test the direct impacts of the pandemic on social support in United States adults recovering from a significant injury caused by PTSD-qualifying, traumatic events (e.g., motor vehicle crashes, violence, etc.). We compared individuals who experienced trauma during the pandemic, the “cases” recruited and evaluated between December 2020 to April 2022, to trauma-exposed “controls,” recruited and evaluated pre-pandemic, from August 2018 through March 9, 2020 (prior to changes in public health recommendations in the region). Cohorts were matched on key demographics (age, sex, education, race/ethnicity, income) and injury severity variables. We tested to see if there were differences in reported social support over the first 5 months of adjustment, considering variable operationalizations of social support from social network size to social constraints in disclosure. Next, we tested to see if the protective role of social support in psychological adjustment to trauma was moderated by cohort status to determine if the impacts of the pandemic extended to changes in the process of adjustment. Results The results of our analyses suggested that there were no significant cohort differences, meaning that whether prior to or during the pandemic, individuals reported similar levels of social support that were generally protective, and similar levels of psychological symptoms. However, there was some evidence of moderation by cohort status when examining the process of adjustment. Specifically, when examining symptoms of post-traumatic stress over time, individuals adjusting to traumatic events during COVID-19 received less benefit from social support. Discussion Although negative mental health implications of the pandemic are increasingly evident, it has not been clear how the pandemic impacted normative psychological adjustment processes. These results are one of the first direct tests of the impact of COVID-19 on longitudinal adjustment to trauma and suggest some minimal impacts.

Stuck in a Moment: Tonic Immobility Predicts Poor Quality of Life in Treated PTSD Patients

Article

Oct 2022
PSYCHIAT DANUB

Background: Posttraumatic stress disorder (PTSD) is a prevalent and disabling multisystem disorder, with significant physical and psychiatric morbidity and poor quality of life (QOL). Although peritraumatic reactions - tonic immobility and dissociation - are established predictors of PTSD severity and development, there is a dearth of investigation assessing the impact of peritraumatic reactions on QOL of PTSD patients. Quality of life has become increasingly important in health care and research as a reliable outcome measure. It comprises psychological, physical, social and environmental domains, providing important information about the impact of diseases on patient's life. This study aims to investigate the impact of peritraumatic tonic immobility and peritraumatic dissociation on QOL of PTSD civilian outpatients. Subjects and methods: It is a cross-sectional study of 50 victims of urban violence with current PTSD, recruited in a specialized outpatient clinic. Instruments used were: Structured Clinical Interview IV, Peritraumatic Dissociative Experiences Questionnaire, Tonic Immobility Scale and WHOQOL-BREF (psychological, physical, social and environmental domains). Linear regression models were fitted to evaluate the impact of peritraumatic reactions - tonic immobility and dissociation - on WHOQOL-BREF scores. We controlled for sex as potential confounding. Results: The severity of peritraumatic tonic immobility negatively impacted on psychological and environment domains of quality of life. For each additional point on the Tonic Immobility Scale, there was a decreased of 0.8 points on the scores of these domains of WHOQOL-BREF. Neither the peritraumatic reactions showed effects on physical nor social domains. Possible limitations of this study include cross-sectional design, relatively small sample size of tertiary center outpatients and recall bias. Conclusions: Peritraumatic tonic immobility is related to poor quality of life, adding new insights about the relationship between this immobility reaction and PTSD.

Disaster Resilience Reduces Radiation-Related Anxiety Among Affected People 10 Years After the Fukushima Daiichi Nuclear Power Plant Accident

Article

Full-text available

Jul 2022

This study examined whether disaster resilience affects the recovery of mental health states and mitigates psychosocial anxiety 10 years later the Fukushima Daiichi nuclear power plant accident. The survey was conducted in Fukushima's evacuation-directed and non-evacuation-directed areas in January 2020. The 695 participants responded to a questionnaire including items on radiation-related anxiety regarding the Fukushima Daiichi accident, an action-oriented approach as a resilience factor, psychological distress, and demographic information. The structural equation modeling showed that the action-oriented approach also eased radiation-related anxiety by mediating with improving mental health states. Moreover, a multi-group model analysis was conducted for evacuation-directed and non-directed areas. In the evacuation-directed area, we found stronger associations among resilience, mental health states, and radiation-related anxiety, and a direct effect of resilience factors on radiation risk anxiety. These findings emphasize the importance of resilience in post-disaster contexts, at least for a decade, where mental health deteriorates and various psychosocial issues become more complex.

The brain at rest: Exploratory Neurophysiological Findings Among Men With Histories of Childhood Sexual Abuse

Article

Full-text available

Jul 2022
J Child Adolesc Trauma

Purpose: There is a lack of research on childhood sexual abuse (CSA) experienced by men, with even less research examin- ing long term neurophysiological repercussions. This study explored the neurophysiology of the brain at rest to examine the influence of CSA on resting state functional connectivity (RSFC) into adulthood. Methods: RSFC was examined with functional magnetic resonance imaging (fMRI) within the default mode, salience and limbic networks in men with CSA histories, with and without post-traumatic stress disorder (PTSD; CSA + PTSD n = 7, CSA-PTSD n = 9), and men without a CSA history nor PTSD (n = 13). Results: CSA + PTSD participants had increased functional connectivity (FC) in the medial prefrontal cortex (mPFC) from the default mode network seed compared to participants with CSA-PTSD. Both CSA groups showed significantly less FC in the striatal-thalamic circuits of the salience network than the control group. Similarly, the robust FC between the bilateral amygdalae and the mPFC that was notable in control participants, was not exhibited in participants who experienced CSA with or without PTSD histories. Conclusions: These findings demonstrate that intrinsic neurophysiological differences in limbic, salience and default mode network connectivity are apparent even during a resting state between the groups of participants. This is preliminary evidence of long-term neurophysiological effects of CSA in men with PTSD, and even in those without. Importantly, these findings can validate the lived experiences of males with CSA histories and guide researchers and clinicians to potential avenues to support their well-being.

MOSAIC (MOthers’ AdvocateS In the Community) for pregnant women and mothers of children under 5 with experience of intimate partner violence: A pilot randomized trial study protocol

Article

Full-text available

May 2022
PLOS ONE

Background Pregnancy and motherhood increase the risk for long-term exposure to physical, psychological and sexual intimate partner violence (IPV; sexual or physical violence by current or former partners). Pregnant women and mothers with children under 5 who have experienced IPV exhibit poor physical and mental health and obstetric outcomes. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. There is good evidence that women with good social support have better mental health and IPV outcomes. Methods This study will develop MOthers’ AdvocateS In the Community (MOSAIC) Plus intervention for pregnant women and mothers with children under the age of 5. MOSAIC uses trained mentor mothers and has been found to reduce subsequent IPV. This study will blend the original MOSAIC intervention with principles of interpersonal psychotherapy (IPT) to address symptoms of depression, PTSD, and prevent subsequent risk of IPV. We will conduct a pilot randomized trial of the MOSAIC Plus intervention compared to the traditional MOSAIC intervention to determine its feasibility and acceptability. Study samples include focus groups (n = 36), open trial (n = 15), and a randomized pilot trial including 40 pregnant women and mothers with children under 5 who report current/recent of IPV and elevated symptoms of maternal depression and/or PTSD. The study’s primary outcome will be changes in maternal depressive and PTSD symptoms. Secondary outcomes will include reduction in subsequent IPV, improvement in functioning, changes in social support and effectiveness in obtaining resources. Discussion This is a formative study evaluating the feasibility and acceptability of a mentor mother intervention for pregnant women and mothers with children under 5. Promising results of this study will be used for a larger, fully-powered randomized trial evaluating the effectiveness of a mentor mother intervention in preventing subsequent IPV and reducing depressive and PTSD symptoms in this population.

Effects of posttraumatic stress and combat losses on the combatants’ resilience

Article

Full-text available

Apr 2022
CESK PSYCHOL

Objectives. At the beginning of the War in Eastern Ukraine, military personnel of the Armed Forces, National Guard of Ukraine (NGU), and soldiers of volunteer battalions, who had no combat experience for the first time faced the death of their comrades. This study aims to determine the effects of posttraumatic stress and combat losses on the mental health of combatants and to develop the typology of their resilience to extreme events. Sample and settings. N = 117 NGU male officers (76% of contract military members and 24% of officers) participated in the study. These combatants were withdrawn from the combat zone in June 2014 due to combat losses and the death of the unit commander. Hypothesis. After participating in hostilities, military personnel developed different types of personality resilience to the effects of traumatic stress. Statistical analyses. The participants’ typification of resilience and adaptation to extreme events was determined by hierarchical cluster analysis. The differences between groups in mean values were determined using Student’s t-test. Results. Four types of personality resilience to combat stressors were identified: “Those who predicted danger” (68.38%), “Those who were open to danger” (21.37%), “Those who identified themself with the role of the victim” (6.83%), and “Those who hid their fear” (3.42%). The results showed that self-identification of a personality with symptoms of acute stress disorder affects the features of the implementation of the anxiety buffer role. Limitations. The conclusions on the anxiety buffer role for the formation of PTSD require clarification and further studies.

Social Network Changes and Disclosure Responses After Sexual Assault

Article

Apr 2022

Social support after sexual assault is important for recovery, but violence and recovery may also challenge relationships. We examined functional and structural social support changes following sexual assault and their association with mental health. College women ( N = 544) with and without a sexual assault history completed a cross-sectional survey assessing current and past egocentric social networks. Functional support (perceived global support, assault disclosure, and perceived helpfulness of responses) and structural support (network density, size, and retention) were examined. Multilevel models revealed that, relative to non-survivors, survivors reported smaller, less dense past networks, but similarly sized current networks. Survivors retained less of their networks than non-survivors, and network members who provided unhelpful responses to disclosure were less likely to be retained. Structural equation modeling revealed that, among survivors, perceived unhelpful responses to disclosure and a greater loss of network members were associated with worse mental health. Findings suggest that survivors may experience a restructuring of social networks following sexual assault, especially when network members respond in unhelpful ways to disclosure. Although survivors appeared to build new relationships, this restructuring was associated with more mental health problems. It is possible that interventions to improve post-assault social network retention may facilitate recovery.

Sensory Modulation and Peritraumatic Stress Symptoms During Operation Guardian of the Walls

Article

Jan 2022

Isolation, Economic Precarity, and Previous Mental Health Issues as Predictors of PTSD Status in Females Living in Fort McMurray During COVID-19

Article

Full-text available

Mar 2022

Objectives The COVID-19 pandemic represents an instance of collective trauma across the globe; as such, it is unique to our lifetimes. COVID-19 has made clear systemic disparities in terms of access to healthcare and economic precarity. Our objective was to examine the mental health repercussions of COVID-19 on adult females living in Fort McMurray, Canada in light of their unique circumstances and challenges. Method To investigate this issue, we analyzed responses gathered from an anonymous cross-section of online survey questionnaire responses gathered from females living in the Fort McMurray area (n = 159) during the COVID-19 pandemic (April 24–June 2, 2021). This included relevant demographic, mental health history, and post-traumatic stress disorder (PTSD), as well as COVID-19 data. Chi-squared analysis was used to determine outcome relevance, and binary logistic regression was employed to generate a model of susceptibility to PTSD. Results 159 females completed the survey. The prevalence of putative PTSD in our sample was 40.8%. A regression analysis revealed 4 variables with significant, unique contributions to PTSD. These were: a diagnosis of depression; a diagnosis of anxiety; job loss due to COVID-19; and lack of support from family and friends. Specifically, women with a previous diagnosis of either depression or anxiety were ~4–5 times more likely to present with PTSD symptomatology in the wake of COVID-19 (OR = 3.846; 95% CI: 1.13–13.13 for depression; OR = 5.190; 95% CI: 1.42–19.00 for anxiety). Women who reported having lost their jobs as a result of the pandemic were ~5 times more likely to show evidence of probable PTSD (OR = 5.182; 95% CI: 1.08–24.85). Receiving inadequate support from family and friends made the individual approximately four times as likely to develop probable PTSD (OR = 4.258; 95% CI: 1.24–14.65), while controlling for the other variables in the regression model. Conclusions Overall, these results support our hypothesis that volatility in factors such as social support, economic stability, and mental health work together to increase the probability of women developing PTSD in response to a collective trauma such as COVID-19.

Social Support Over Time for Men and Women Veterans With and Without Complex Trauma Histories

Article

Full-text available

Feb 2022

Social support is closely linked to health, but little is known about United States (U.S.) veterans' social support over time and factors that may influence their support trajectories. This study investigates social support over time for U.S. men and women Post-9/11 veterans in relation to trauma history and gender. A secondary analysis of longitudinal cohort data from the Survey of Experiences of Returning Veterans (SERV), which employed a repeated-measures longitudinal design using five waves of data (baseline, 3, 6, 9, 12 months) with 672 combat veterans. Results from random intercept multilevel models found no significant gender differences in social support over time. Veterans with complex trauma histories were at risk for lower social support across waves. A stability trend was also observed; specifically, at baseline, veterans who started with high support maintained their level over time whereas veterans who started with deficits in social support remained low over time. Veterans identifying as African American or Latinx, and those with lower annual incomes, reported lower support compared to White and higher-income veterans. Furthermore, low social support was significantly associated with severe posttraumatic stress symptoms and active suicidal ideation across 12 months. SERV utilized a nonrandom sampling method that may reduce generalizability of findings. There is also potential for residual confounding by factors related to both social support levels and time since discharge that were not available in this data set. Findings have implications for developing clinical and community interventions intended to support veterans as they transition back to the community. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Social Determinants of the Mental Health of Young Migrants

Article

Full-text available

Jan 2022

Background: Young migrants face particular risks to develop mental health problems. Discrimination and social support impact mental health, yet little is known about the differential impact thereof on mental health in newcomers, non-newcomer migrants, and non-migrants. Aim: This study sheds light on mental health (posttraumatic stress, behavioral problems, hyperactivity, emotional distress, peer relationship problems, prosocial behavior) and the overall well-being of newcomers, non-newcomer migrants, and non-migrants. Furthermore, the impact of social support and discrimination on mental health is investigated. Method: Descriptive analysis and Structural Equation Modelling (SEM) were applied to analyze responses of 2,320 adolescents through self-report questionnaires in Finland, Sweden, and the UK. Results: Newcomers, non-newcomer migrants, and non-migrants have different psychological profiles. While newcomers suffer more from posttraumatic stress disorder (PTSD) and peer problems, non-newcomers and non-migrants report more hyperactivity. Discrimination strongly threatens all mental health dimensions, while support from family serves as a protective factor. Support from friends has a positive impact on PTSD among newcomers. Limitations: As this study has a cross-sectional design, conclusions about causality cannot be drawn. In addition, history of traumatic life events or migration trajectory was lacking, while it may impact mental health. Conclusion: Different mental health profiles of newcomers, non-newcomer migrants, and non-migrants point to the need for a tailored and diversified approach. Discrimination remains a risk factor for mental health, while family support is a protective factor for adolescents. Interventions that foster social support from friends would be especially beneficial for newcomers.

Emotionally Focused Couple Therapy Within VA Healthcare: Reductions in Relationship Distress, PTSD, and Depressive Symptoms as a Function of Attachment-Based Couple Treatment

Article

Full-text available

Dec 2021

Emotionally Focused Couple Therapy (EFT) is a well-established, attachment-based treatment for relationship distress. This study seeks to further previous research by examining the impact of EFT on veterans’ and their partners’ symptoms of posttraumatic stress disorder (PTSD), depression, and relationship distress, in a real-life clinical setting. The present study uses dyadic data analyses to test three hypotheses: from pre to posttherapy veterans and their partners would report (a) increases in relationship satisfaction and decreases in (b) PTSD and (c) depression symptoms. In addition, we tested whether diagnostic status at the start of therapy, that is, meeting clinical criteria for that outcome, moderated the changes. Data were collected as part of routine care at an outpatient clinic at a Veterans Affairs (VA) Hospital. The sample consisted of 29 couples. Pre and postmeasures were obtained at the first and final sessions (Msessions = 15.52 SD = 7.19). Multilevel models examining changes across time for all partners found that the difference between pre and posttherapy scores for relationship satisfaction (b = 10.85, p < .01) and depression symptoms (b = −1.61, p < .05) was significant. Moreover, diagnostic status moderated treatment effects for all outcomes: the difference between pre and posttherapy scores was significant for partners who met clinical criteria for relationship distress (b = 13.93, p < .001), PTSD (b = −12.39, p < .01), and depression (b = −7.64, p < .001). Although PTSD and depression are not the focus of treatment, results indicate EFT is effective at reducing relationship distress and individual symptomatology in veterans and their partners.

DETERMINING THE CONTRIBUTION OF SEPARATE MOTIVES TO THE EFFICIENCY OF MILITARY SERVICES OF THE NATIONAL GUARD OF UKRAINE

Article

Full-text available

Nov 2021

Визначено, що на ефективність службово-бойової діяльності військовослужбовців Національної гвардії України впливають професійна амбітність, професійна гідність, професійна самореалізація та адекватність професійного самооцінювання. Стримує професійний розвиток самооцінка як неадекватно завищена, так і неадекватно занижена, побудована на уявленні про брак власних ресурсів. Реалізація мотивації залежить від локусу контролю, який визначає зв’язок мотивації з «Я», показує, чи керує людина своїм життям, чи є керованою іншими людьми, від незадоволених власних потреб, від емоцій тощо.

Traffic Accidents in Contemporary Turkish Films: A Qualitative Study - Modern Dönem Türk Filmlerinde Trafik Kazaları: Nitel Bir Çalışma

Article

Full-text available

Oct 2021

Traffic accidents can be traumatic events. These traumatic events end up with different psychological reactions such as post-traumatic stress and post-traumatic growth. Media channels' framing can create social reality about trauma. Thus, examining media channels' framing of traumatic events gains importance. In the current study, examining the framing and content of contemporary Turkish movies, which includes traffic accidents, was aimed. Primary materials of this study were three Turkish movies, namely "Yol Ayrımı", "Müslüm", and "Bi Küçük Eylül Meselesi". Thematic Analysis (TA) revealed three themes: namely, "Physical changes", "Psychological changes", and "Interaction with the environment". These three themes had two, five, and three subthemes, respectively. "Physical changes" theme included physiological impacts of the accidents on the characters. "Psychological changes" theme reflected the psychological differences in the characters during pre and post-accident. Finally, the "Interaction with the environment" theme revealed how the characters' relations with the environment changed after having a traffic accident. When the interaction of subthemes was examined, it was found that the subthemes of Psychological changes occur together frequently. This can be interpreted as psychological processes being closely connected with each other. When the three movies were compared, it can be said that Müslüm and Bi Küçük Eylül Meselesi generally reflect negative or post-traumatic stress effects of the accident; and Yol Ayrımı generally reflects positive or post-traumatic growth sides of the accident. As a result, while movies reflect reality in some aspects, they cannot cover the parts of the reality in some aspects. The findings were evaluated in the light of the literature. --- Trafik kazaları, travmatik sonuçları olabilecek olaylardandır. Sonuç üzerinde etki edebilecek etmenlerin sayısı fazla olsa da bu olay, travma-sonrası stres ve travma-sonrası büyüme şeklinde iki farklı psikolojik tepki ile sonuçlanmaktadır. Medya kanallarının olayları çerçeveleyişi, travmaya ilişkin bir sosyal gerçeklik oluşturabilmektedir. Bu nedenle, medya kanallarının travmatik olayları çerçeveleyişini incelemek önem kazanmaktadır. Mevcut çalışmada, trafik kazası içeren modern dönem Türk filmlerinin çerçeveleniş ve içeriğini incelemek amaçlanmaktadır. Bu çalışmanın temel materyallerini, “Yol Ayrımı”, “Bi Küçük Eylül Meselesi” ve “Müslüm” isimli üç Türk filmi oluşturmaktadır. Tematik Analiz süreci sonucunda üç temaya ulaşılmıştır: “Fiziksel değişimler”, “Psikolojik değişimler” ve “Çevreyle etkileşim”. Bu temaların sırasıyla iki, beş ve üç alt teması bulunmaktadır. “Fiziksel değişimler” teması kazaların karakterler üzerindeki fizyolojik etkilerini içermektedir. “Psikolojik değişimler” teması karakterlerin kaza öncesi ve sonrasındaki psikolojik değişimlerini yansıtmaktadır. Son olarak, “Çevreyle etkileşim” teması trafik kazası geçirdikten sonra karakterlerin çevreleriyle ilişkilerinin nasıl farklılaştığını ortaya koymaktadır. Temaların birbiriyle ilişkisi incelendiğinde, “Psikolojik değişimler” temasının alt temalarının sıklıkla birlikte görüldüğü bulunmuştur. Bu bulgu, psikolojik süreçlerin birbiriyle sıkı bir ilişki içerisinde olduğu şeklinde yorumlanabilir. Üç film karşılaştırıldığında, Müslüm ve Bi Küçük Eylül Meselesi’nin çoğunlukla trafik kazalarının olumsuz ya da travma-sonrası stres ögelerini, Yol Ayrımı’nın ise çoğunlukla kazaların olumlu ya da travma-sonrası büyüme ögelerini barındırdığı söylenebilir. Sonuç olarak incelenen filmlerin bazı yönleriyle gerçekliği yansıttığı bazı yönleriyle ise yansıtamadığı gözlemlenmiştir. Bulgular literatür ışığında değerlendirilmiştir.

Disorders Specifically Associated with Stress: PTSD, Complex PTSD, Acute Stress Reaction, Adjustment Disorder

Chapter

Feb 2024

Emotional coping by chance: Experiences of emotional coping strategies among on-scene commanders in the Norwegian police services

Article

Jan 2024

The purpose of our research is to identify the emotional coping strategies used by on-scene commanders, both to safeguard their own well-being and that of their policing colleagues. However, understanding the conditions and application of sustainable coping strategies has proven to be more complex than the literature considers. Using explorative qualitative methods, the data collection includes two studies with on-scene commanders across Norway covering minor and major incidents. We found that when on-scene commanders are left to develop their own coping strategies, they rely on random practices that can have negative long-term consequences on officers’ emotional well-being. We identified four conditions as crucial for the development of healthy emotional coping strategies: mandatory defuse and debrief practices, level of experience, social support, and leadership. The main conclusion emerging from our research is the necessary institutionalization of formal and appropriate defuse and debrief practices, including the use of colleague support and psychologists.

The Role of Race, Social Support, Empowerment, and Posttraumatic Cognitions in Survivors of Intimate Partner Violence Symptoms of Posttraumatic Stress Disorder

Article

Dec 2023

Black women experience more frequent and severe intimate partner violence (IPV), but there are mixed findings on their posttraumatic stress disorder (PTSD) symptom severity. This may be explained by cultural-salient factors which are associated with fewer posttraumatic cognitions. We hypothesized an indirect effect of race on PTSD symptoms via social support, empowerment, and posttraumatic cognitions, serially. Path analysis revealed Black women reported increased social support, which was associated with higher levels of empowerment, which was associated with lower levels of posttraumatic cognitions. Decreased posttraumatic cognitions were associated with less severe PTSD symptoms. Results increase understanding of culturally-salient factors that may impact PTSD symptoms in Black women.

Posttraumatic Stress Symptoms in Middle School Students at-Risk for Aggressive Behavior: Examining the Role of Pandemic Exposure and Perceived Discrimination

Article

Dec 2023

Disclosing Sexual Victimization Online and In Person: An Examination of Bisexual+ and Heterosexual Survivors

Article

Dec 2023
J INTERPERS VIOLENCE

Bisexual+ (bisexual, pansexual, queer, attraction to more than one gender) people are at elevated risk for sexual victimization relative to their heterosexual counterparts. Disclosure of sexual victimization and social reactions received upon disclosure can play a major role in recovery following an assault. Using an online survey, the current study examined whether bisexual+ and heterosexual survivors of sexual victimization ( N = 657) varied in disclosure of victimization, the type of disclosure (in-person vs. online via #MeToo), and receipt of various social reactions to disclosure in person and online. A chi-square test examined differences in disclosure and differences in types of disclosure (in-person only vs. MeToo across sexual identity). MANOVAS were used to examine whether in-person and online reactions varied across sexual identity. Bisexual+ survivors were more likely to disclose sexual victimization relative to heterosexual survivors. Among those who disclosed, bisexual+ survivors were more likely to disclose in person only whereas heterosexual survivors were more likely to disclose online via #MeToo. Whereas we did not find any significant differences for in-person reactions, we did find significant differences for online social reactions using #MeToo. Heterosexual survivors received higher turning against reactions (e.g., avoided talking to you or spending time with you) and more unsupportive acknowledgment relative to bisexual+ participants. Whereas bisexual+ participants received less turning against reactions and unsupportive acknowledgment during #MeToo/online disclosure, they were also less likely to disclose using #MeToo. Findings suggest that bisexual+ and heterosexual people vary in the way they disclose sexual victimization, and in how they are responded to when disclosing in person and online.

Separation Anxiety and Posttraumatic Stress Disorder

Chapter

Nov 2023

Separation anxiety disorder and posttraumatic stress disorder overlap in important characteristics and as clinical comorbidity. This chapter explores similarities and differences between the two disorders and presents preliminary research on their comorbidity and treatment.

Prospective associations between social support and posttraumatic stress disorder may be spurious: A re-meta-analysis of longitudinal studies and a simulation

Article

Aug 2023
J AFFECT DISORDERS

A recent meta-analysis concluded to have found proof for both a social causation model, according to which social support protects against posttraumatic stress disorder (PTSD), and a social selection model, which claims that PTSD erodes social support. However, the prospective cross-lagged effects were estimated while adjusting for a prior measurement of the outcome and this method is vulnerable for spurious findings due to correlations with residuals and regression toward the mean. The present re-analyses of the meta-analytic effects indicated that depending on used model one can choose to claim that social support has either a decreasing, an increasing, or no prospective effect on subsequent change in PTSD symptom severity, and vice versa. Therefore, claims over and above a negative cross-sectional correlation between social support and PTSD, including the social causation and social selection models, can be questioned. The findings were validated by analyses of simulated data, which indicated that prospective effects were not necessary for the observed meta-analytic associations.

ISAF15: Mental health of a cohort of Danish soldiers 6.5 years after homecoming from deployment

Book

Full-text available

Jun 2023

This report presents the findings of a study on Danish military personnel deployed to Afghanistan with the International Security Assistance Force (ISAF) team 15 from February to August 2013. The aim is to assess rates of moderate and severe symptoms of post-traumatic stress disorder (PTSD) and depression 6.5 years after home coming. Further, we wish to examine the prevalence of possible bodily distress syndrome, and to compare those with moderate or severe PTSD-symptoms 6.5 years after deployment to those with low level of PTSD symptoms with regards to deployments after ISAF15, traumas experienced after home coming, social support, and suicidal thoughts within the last year, and other possible risk factors measured before deployment. In brief, we find that 13.0 % and 4.7 % respectively reported moderate and severe levels of PTSD symptoms, measured by the PTSD-Checklist civilian DSM-version IV (PCL-C) where we calculated a total symptom severity score (and not specific symptom). The proportion who met the criteria for a possible PTSD or complex PTSD diagnosis, based on the disease classification system ICD-11, where the presence of specific symptoms is required as well as they cause functional impairment in everyday life, were respectively 1.1 % and 1.1 %. The proportion with moderate, severe or very severe depressive symptoms was respectively 5.7 % and 3.3 %. A total of 11.4 % had either severe PTSD symptoms, moderate or severe depressive symptoms, or both. Those with moderate or severe PTSD symptoms 6.5 years after home coming had not been re-deployed to a greater extent after ISAF15 deployment compared to those with low PTSD symptom levels. In contrast, those with severe PTSD symptom 6.5 years after home coming had experienced more potentially traumatic events after home coming than those with low PTSD symptoms; no difference was found between those with moderate and low PTSD-symptoms. Those with moderate or severe PTSD-symptoms experienced less social support (from friends, family and partner or other close persons) than those with a low PTSD symptom level. Within the last year, 37 people (10.0 %) have had suicidal thoughts, while 15 (4.0 %) have had suicide plans, but none (0 %) had attempted suicide. The rate of suicidal ideation within the last year was higher among those with moderate or severe PTSD symptoms than those with low PTSD symptom level. For ISAF15, we also examined the rate of possible bodily distress syndrome (BDS), i.e. living with severe bodily symptoms. We found that 17.9 % had possible BDS 6.5 years after home coming caused by symptoms from four different symptom groups (heart and lung, gastrointestinal, muscles and joints, or general symptoms) or caused by four or more symptoms of muscle and joint genes. The rate of possible BDS increased with the severity of PTSD symptoms. We compared the results for ISAF15 with results from two other teams, ISAF7 and ISAF10, deployed to Afghanistan in respectively 2009 and 2010. We found a lower overall PTSD symptom level on ISAF15 6.5 years after home coming. The difference was statistically significant even when the rate of severe PTSD symptoms was compared between ISAF15 and ISAF7 (4.7 % vs. 13.7 %) and ISAF15 and ISAF10 (4.7 % vs. 9.8 %). For depression symptoms we found no statistically significant differences for the rate of severe / very severe depressive symptoms between ISAF15 and ISAF10 (3.3 % vs. 4.2 %), whereas the rate for ISAF15 was slightly lower than for ISAF7 (3.3 % vs. 6.5 %), but the difference was not significant when the analysis accounted for age and gender differences between the two teams. Finally, we examined whether vulnerability factors measured before deployment and risk factors related to traumatic events experienced during deployment and after home coming increased the risk of having moderate or severe PTSD symptoms 6.5 years after home coming. We found that decrease in perceived social support increased the risk of being in the moderate or severe PTSD group 6.5 years after home coming. Furthermore, lower levels of social support before deployment increased the risk for having severe PTSD symptoms 6.5 years after home coming. Neither age, previous trauma exposure, trauma exposure after home coming, number of previous deployments before ISAF15 nor the PTSD symptom level before deployment had an impact on whether a person belonged to the moderate or severe PTSD group 6.5 years after home coming.

Medical and Psychological Management of Victimization

Chapter

Oct 2022

This chapter briefly discusses the mental health consequences of criminal victimization. General guidelines for working with victims of violent crime are discussed in the context of the ‘Declaration of Basic Principles of Justice For Victims of Crime and Abuse of Power’ adopted by the General Assembly of the United Nations in 1985. Mental Health interventions for victims of violent crime in the immediate aftermath of victimization, including debriefing and psychological first aid, are evaluated with research evidence. Debriefing is NOT recommended in the immediate aftermath of victimization. There is a dearth of literature specifically evaluating the psychological treatment of victimization. However, participants in many trauma treatment research trials are survivors of violent crime. Trauma-focused approaches, including prolonged exposure therapy, cognitive processing therapy, trauma-focused CBT, and eye movement desensitization and reprocessing therapy, are briefly discussed. Non-trauma-focused approaches include person-centred therapy and brief eclectic therapy. Pharmacological interventions are also briefly mentioned. The evidence base for these treatments is discussed per Cochrane reviews, NICE guidelines, and American Psychological Association guidelines.KeywordsImpact of victimizationManagement of victimizationTrauma-focused therapyNon-trauma-focused therapyPharmacological interventions

The Effects of Social Support on Disaster Resilience: Focusing on Disaster Victims

Article

Jun 2022

Dae Woong Lee

The purpose of this study is to reveal the impacts of the relationship between the social support given to disaster victims and their resilience to the disaster. Social support was subdivided into emotional, appraisal, information, and instrumental support. The effects of each support on the resilience of the victims who experienced the disaster were analyzed using Hierarchical regression. The analysis results of this study are as follows: First, analysis of all of the disaster victims showed that emotional support, appraisal support, and instrumental support had a positive impact on their resilience to disaster. Second, analysis of the victims who experienced large-scale damage caused by the disaster revealed that emotional support was the only type that influenced their disaster resilience. Third, analysis of victims who experienced minor damage from disasters revealed that social support did not have a significant impact on their resilience.

Couple Treatment for Posttraumatic Stress Disorder

Chapter

Jun 2022

Posttraumatic stress disorder (PTSD) is bidirectionally associated with couple distress and dysfunction, as well as mental health difficulties in partners and children. PTSD can elicit responses from friends and family that are well-meaning but may maintain the symptoms of PTSD. Negative family interactions have been linked to poorer individual therapy outcomes, and individual evidence-based treatments for PTSD do not consistently improve relational functioning. Consequently, there have been efforts to develop and test dyadic treatments that improve relational functioning and PTSD and, in some cases, also improve the health and well-being of partners. The current chapter describes different ways to conceptualize couple treatment of PTSD and reviews the efficacy of these interventions.

Traumatic Autobiographical Memories: Preliminary fMRI Findings Among Men With Histories of Childhood Sexual Abuse

Article

Full-text available

May 2022
AM J MENS HEALTH

Childhood sexual abuse (CSA) is associated with autobiographical memory (AM) disturbances. AM is important for future thinking, sense of self, and coping with negative emotions. CSA is under-researched among men, with research examining long-term neural correlates limited even further. This study explored the neural correlates of re-experiencing traumatic/negative memories to examine the influence of CSA on AM into adulthood. Fifteen males who experienced CSA, with and without posttraumatic stress disorder (PTSD; CSA+PTSD, n = 6; CSA–PTSD, n = 9) and control males without CSA histories nor PTSD (n = 11) completed a script-driven imagery paradigm during functional magnetic resonance imaging (fMRI). Males with CSA histories, with and without PTSD, processed their negative autobiographical memories with less activation compared to control males. The CSA+PTSD group of males had less activation in the left superior occipital, left superior parietal and left parahippocampal gyri compared to control participants. The CSA–PTSD group had reduced activation in the same regions to a lesser extent. This study provides preliminary empirical evidence to suggest CSA impacts AM for traumatic experiences, and the impact is notable even for men who experienced CSA but do not have PTSD. This study highlights the need for more research with men who have experienced CSA, so that, we can fully understand the neural correlates of emotional memories, and better support the mental health and continued wellness of men who experienced CSA.

MOSAIC (MOthers' AdvocateS In the Community) for Pregnant Women and Mothers of Children Under 5 with Experience of Intimate Partner Violence: A pilot randomized trial study protocol

Preprint

Full-text available

Apr 2022

Background Pregnancy and motherhood increase the risk for long-term exposure to physical, psychological and sexual intimate partner violence (IPV; sexual or physical violence by current or former partners). Pregnant women and mothers with children under 5 who have experienced IPV exhibit poor physical and mental health and obstetric outcomes. Depression and posttraumatic stress disorder (PTSD) are the two most common mental health consequences of IPV. There is good evidence that women with good social support have better mental health and IPV outcomes. Methods This study will develop MOthers’ AdvocateS In the Community (MOSAIC) Plus intervention for pregnant women and mothers with children under the age of 5. MOSAIC uses trained mentor mothers and has been found to reduce subsequent IPV. This study will blend the original MOSAIC intervention with principles of interpersonal psychotherapy (IPT) to address symptoms of depression, PTSD, and prevent subsequent risk of IPV. We will conduct a pilot randomized trial of the MOSAIC Plus intervention compared to the traditional MOSAIC intervention to determine its feasibility and acceptability. Study samples include focus groups (n=36), open trial (n=15), and a randomized pilot trial including 40 pregnant women and mothers with children under 5 who report current/recent of IPV and elevated symptoms of maternal depression and/or PTSD. The study’s primary outcome will be changes in maternal depressive and PTSD symptoms. Secondary outcomes will include reduction in subsequent IPV, improvement in functioning, changes in social support and effectiveness in obtaining resources. Discussion This is a formative study evaluating the feasibility and acceptability of a mentor mother intervention for pregnant women and mothers with children under 5. Promising results of this study will be used for a larger, fully-powered randomized trial evaluating the effectiveness of a mentor mother intervention in preventing subsequent IPV and reducing depressive and PTSD symptoms in this population. Strengths and limitations of this study The study is informed by a robust qualitative approach to intervention development that involves a series of focus group discussions. This study aims to develop an intervention that reduces future intimate partner violence, while also addressing related maternal mental health outcomes. A rigorous and reproducible design includes randomization, clear inclusion criteria, manualized treatment protocols and fidelity assessments. The study will use reliable and validated measures. Given the small sample size, results from the pilot randomized trial are underpowered to draw firm conclusions about effectiveness.

Involving a Significant Other in Treatment of Patients With PTSD Symptoms: A Systematic Review of Treatment Interventions

Article

Apr 2022

Previous studies have called for the inclusion of social support in the treatment of PTSD. The current review identifies interventions for adults with PTSD symptoms, which include a significant other as a source of social support. 11 articles focusing on eight interventions were found, including a total of 495 participants who had experienced trauma. These interventions were divided according to level of involvement of the significant other in treatment. Significant others were either passively or actively involved in the treatment. Preliminary results show that interventions actively involving a significant other in the treatment of the patient with posttraumatic stress symptoms were most effective in reducing PTSD symptoms. The current review provides recommendations for future research and suggests that significant others should be actively involved in the treatment of PTSD symptoms.

“Post‐election stress disorder?” Examining the increased stress of sexual harassment survivors after the 2016 election

Article

Mar 2022

In this paper, we explore if Donald Trump's electoral success in 2016 led to heightened levels of stress for sexual harassment survivors. Logistic regression models predicting voter stress using original survey data collected in the weeks following the 2016 election were utilized. We find that women survivors of sexual harassment experienced elevated stres when compared to women who were never harassed. Female survivors of sexual harassment may be concerned that their well‐being was under attack due to the triumph of hostile sexism.

Sexual and physical revictimization in U.S. military veterans

Article

Mar 2022

The present study examined revictimization, defined as sexual or physical assault in adulthood that followed a history of childhood maltreatment. We aimed to identify factors associated with revictimization over time in a group of U.S. military veterans deployed following the September 11, 2001, terrorist attacks (9/11). As revictimization is associated with multiple negative mental health outcomes in the literature, identifying risk and protective factors can aid in the prevention of revictimization and associated poor health outcomes among veterans. In this sample, the proportion of adult revictimization was 2.7% for men, 95% CI [2.0, 3.6] and 22.9% for women, 95% CI [20.5, 25.8]. Using multilevel logistic models, we found that women, β = 2.2, p < .001; Navy veterans, β = 1.5, p < .001; and participants who reported posttraumatic stress symptoms, β = 0.2, p = .028, were at significantly higher risk of revictimization across time compared to nonrevictimized counterparts. Social support while in the military was protective, β = −0.1, p < .001, against revictimization. In addition, childhood abuse experiences combined with characteristics such as female gender were related to an increased risk of revictimization during and following military service. The findings highlight opportunities for intervention and areas of strength within this population; social connection garnered during military service may serve as a protective factor against revictimization. Future research is needed to examine the role of social support in possibly lowering veterans’ risk of revictimization over time, particularly for post‐9/11 veterans struggling with transitioning from military to civilian life.

Social cognitive mechanisms in healthcare worker resilience across time during the pandemic

Article

Full-text available

Jul 2022
SOC PSYCH PSYCH EPID

Purpose Healthcare workers are at increased risk for mental health problems during disasters such as the COVID-19 pandemic. Identifying resilience mechanisms can inform development of interventions for this population. The current study examined pathways that may support healthcare worker resilience, specifically testing enabling (social support enabled self-efficacy) and cultivation (self-efficacy cultivating support) models. Methods Healthcare workers (N = 828) in the Rocky Mountain West completed self-report measures at four time points (once per month from April to July of 2020). We estimated structural equation models to explore the potential mediating effects that received social support and coping self-efficacy had (at time 2 and time 3) between traumatic stress symptom severity (at time 1 and time 4). Models included covariates gender, age, minority status, and time lagged co-variations between the proposed mediators (social support and coping self-efficacy). Results The full model fit the data well, CFI = .993, SRMR = .027, RMSEA = .036 [90% CIs (0.013, 0.057)]. Tests of sequential mediation supported enabling model dynamics. Specifically, the effects of time 1 traumatic stress severity were mediated through received social support at time 2 and time 3 coping self-efficacy, in sequential order to reduce time 4 traumatic stress severity. Conclusions Findings show the importance of received social support and coping self-efficacy in mitigating psychopathology risk. Interventions can support mental health by focusing on social resource engagement that facilitates coping empowerment, which may decrease risk for mental health job-related problems among frontline healthcare workers exposed to highly stressful events.

Posttraumatische Belastungsstörung und komplexe PTBS

Chapter

Jan 2021

Dieses Kapitel erläutert das schematherapeutisch erweiterte Vorgehen in der Verhaltenstherapie der (komplexen) PTBS. Nach einer Unterscheidung in einfache und komplexe PTBS, werden ausgesuchte traumafokussierte VT-Modelle und die ST-Modelle überblicksartig dargestellt. Die Wirkfaktoren der VT- und ST-Modelle werden im schematherapeutisch erweiterten verhaltenstherapeutischen Störungsmodell der PTBS kombiniert. Spezifische Hinweise zum schematherapeutisch erweiterten Vorgehen umfassen eine ausführliche Darstellung des Imagery Rescriptings bei komplexer PTBS nach (sexueller) Gewalterfahrung in der Kindheit inklusive der Diskussion um die Länge von Expositionszeiten und der Darstellung der in aktuellen RCT Studien gewonnenen Erkenntnisse über sehr hohe Effektstärken und geringere Abbruchquoten im Vergleich zur traumafokussierten VT.

Mediating role of avoidance of trauma disclosure and social disapproval in ICD-11 post-traumatic stress disorder and complex post-traumatic stress disorder: cross-sectional study in a Lithuanian clinical sample

Article

Full-text available

Nov 2021

Background ICD-11 includes a new diagnosis of complex post-traumatic stress disorder (CPTSD), resulting predominantly from reoccurring or prolonged trauma. Previous studies showed that lack of social support is among the strongest predictors of PTSD, but social factors have been sparsely studied in the context of the ICD-11 definition of PTSD and CPTSD. Aims To analyse the factor structure of the International Trauma Questionnaire (ITQ) in a Lithuanian clinical sample and to evaluate the mediating role of social and interpersonal factors in the relationship between trauma exposure and ICD-11 PTSD and CPTSD. Method The sample comprised 280 adults from out-patient mental health centres (age, years: mean 39.48 (s.d. = 13.35); 77.5% female). Trauma-related stress symptoms were measured with the ITQ. Social disapproval was measured with the Social Acknowledgment Questionnaire (SAQ) and trauma disclosure using the Disclosure of Trauma Questionnaire (DTQ). Results ICD-11 PTSD and CPTSD prevalence among the participants in this study was 13.9% and 10.0% respectively. Results indicated that avoidance of trauma disclosure mediated the relationship between trauma exposure and PTSD as well as CPTSD, whereas social disapproval mediated only the relationship between trauma exposure and CPTSD. Conclusions The findings suggest that disclosure of traumatic experiences and support from closest friends and family members might mitigate the effects of traumatic experiences, potentially reducing the risk of developing CPTSD.

Coping Strategies and Posttraumatic Stress Disorder in Female Victims of Sexual and Nonsexual Assault

Article

Full-text available

Aug 1996

The coping behaviors and posttraumatic stress disorder (PTSD) symptoms of 215 female assault victims (103 rape victims and 112 nonsexual assault victims) were assessed within 2 weeks following the assault (Time 1), and 133 of them (62%) were followed up 3 months later (Time 2). Posttrauma symptom severity significantly decreased during the 3-month study period, but PTSD severity levels at Times 1 and 2 were highly correlated. Three coping scales were constructed on the basis of exploratory factor analyses: Mobilizing Support, Positive Distancing, and Wishful Thinking. Three months postassault, rape victims showed higher levels of wishful thinking and PTSD than nonsexual assault victims. Wishful thinking showed a positive association and positive distancing a negative association with PTSD severity, controlling for assault type, initial levels of PTSD severity, and other coping strategies. The clinical relevance of these findings is discussed.

Assessing social support: The Social Support Questionnaire

Article

Full-text available

Jan 1983

Describes the Social Support Questionnaire (SSQ) and 4 empirical studies employing it. The SSQ yields scores for (a) perceived number of social supports and (b) satisfaction with social support that is available. Three studies (N = 1,224 college students) dealt with the SSQ's psychometric properties, its correlations with measures of personality and adjustment, and the relation of the SSQ to positive and negative life changes. The 4th study (40 Ss) was an investigation of the relation between social support and persistence in working on a complex, frustrating task. The research reported suggests that the SSQ is a reliable instrument and that social support is (a) more strongly related to positive than negative life changes, (b) more related in a negative direction to psychological discomfort among women than men, and (c) an asset in enabling a person to persist at a task under frustrating conditions. Clinical implications are discussed. (47 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).

A Test of the Social Support Deterioration Model in the Context of Natural Disaster

Article

Full-text available

Mar 1993

This prospective longitudinal study examined stress-mediating potentials of 3 types of social support: social embeddedness, perceived support from nonkin, and perceived support from kin. As participants in a statewide panel study, 222 older adults were interviewed once before and twice after a severe flood. It was hypothesized that disaster exposure (stress) would influence depression directly and indirectly, through deterioration of social support. LISREL analyses indicated that postdisaster declines in social embeddedness and nonkin support mediated the immediate and delayed impact of disaster stress. No evidence was found for the mediational role of kin support. Findings are in accord with conceptualizations of social support as an entity reflecting dynamic transactions among individuals, their social networks, and environmental pressures.

Social constraints, intrusive thoughts, and depressive symptoms among bereaved mothers

Article

Full-text available

Feb 1996

The study examined how social constraints on discussion of a traumatic experience can interfere with cognitive processing of and recovery from loss. Bereaved mothers were interviewed at 3 weeks (T1), 3 months (T2), and 18 months (T3) after their infants' death. Intrusive thoughts at T1, conceptualized as a marker of cognitive processing, were negatively associated with talking about infant's death at T2 and T3 among socially constrained mothers. The reverse associations were found among unconstrained mothers. Controlling for initial level of distress, there was a positive relation between T1 intrusive thoughts and depressive symptoms over time among socially constrained mothers. However, higher levels of T1 intrusive thoughts were associated with a decrease in T3 depressive symptoms among mothers with unconstrained social relationships.

A cognitive model of posttraumatic stress disorder

Article

Full-text available

Apr 2000
BEHAV RES THER

Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or ist sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualisation, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies provided preliminary support for several aspects of the model.

Predictors of Posttraumatic Stress Disorder and Symptoms in Adults: A Meta-Analysis

Article

Full-text available

Aug 2008

A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.

Interpersonal problems of Vietnam combat veterans with symptoms of posttraumatic stress disorder

Article

Full-text available

Dec 1982

274 male veterans seeking treatment for substance abuse were divided on the basis of combat experience and DSM-III criteria of posttraumatic stress disorder (PTSD). Ss with evidence of PTSD were compared with a non-PTSD group of Vietnam combat veterans and a noncombat group of Vietnam-era veterans on measures of specific interpersonal problems using the Horowitz Interpersonal Problem Inventory, traditional measures of family and social adjustment, and the MMPI. The PTSD group scored significantly higher on clusters of problems dealing with intimacy and sociability than did either of the comparison groups. PTSD Ss also scored higher on the MMPI scales of Paranoia, Psychopathic Deviate, Social Introversion, Social Maladjustment, Family Problems, and Manifest Hostility, but did not differ from other groups on Family Environment Scale variables. Results, which were not attributable to premilitary adjustment differences or to confounding demographic variables, are compared to previous studies, and research questions that remain outstanding are discussed. (11 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).

The dynamic role of social support in the link between chronic stress and psychological distress

Article

Full-text available

Dec 1991

How a chronic environmental stressor can interfere with the buffering effects of social support by eroding social support was analyzed in this prospective, longitudinal study. A classic buffering effect of support was found after 2 months of exposure to the stressor, household crowding. Crowded residents with low perceived support had greater increases in psychological distress than did crowded residents with high perceived support. However, after 8 months exposure the buffering effect disappeared. Moreover, greater crowding had become directly associated with lower support, which in turn was associated with greater increases in psychological distress. All analyses controlled for prior distress. Under some types of chronic stress, the buffering effects of social support may be short-lived because the stressor eventually erodes social support.

Ironic Processes of Mental Control

Article

Full-text available

Jan 1994

Daniel M. Wegner

A theory of ironic processes of mental control is proposed to account for the intentional and counterintentional effects that result from efforts at self-control of mental states. The theory holds that an attempt to control the mind introduces 2 processes: (a) an operating process that promotes the intended change by searching for mental contents consistent with the intended state and (b) a monitoring process that tests whether the operating process is needed by searching for mental contents inconsistent with the intended state. The operating process requires greater cognitive capacity and normally has more pronounced cognitive effects than the monitoring process, and the 2 working together thus promote whatever degree of mental control is enjoyed. Under conditions that reduce capacity, however, the monitoring process may supersede the operating process and thus enhance the person's sensitivity to mental contents that are the ironic opposite of those that are intended.

Social Constraints, Intrusive Thoughts, and Mental Health after Prostate Cancer

Article

Full-text available

Mar 1998
J SOC CLIN PSYCHOL

We examined how the social environment influences men's ability to cognitively process and recover psychologically from the trauma associated with prostate cancer. We hypothesized that men who judge others to be unreceptive to their attempts to talk about their cancer-related concerns would have poorer mental health than men with more receptive social networks. In a survey with 178 prostate cancer survivors, we measured intrusive thoughts about cancer, social constraints in talking about cancer, avoidance in thinking and talking about cancer, and mental health. There were significant interactive effects of Family/Friend Social Constraints × Intrusive Thoughts and Wife Social Constraints × Intrusive Thoughts on mental health. Plots of the interactions showed a stronger negative relation between intrusive thoughts and mental health among men who felt socially constrained in talking about their cancer than among men who felt unconstrained. In addition, level of constraints from family and friends was positively associated with level of avoidance in thinking and talking about cancer which, in turn, was associated with poorer mental health. These results suggest that supportive social networks may promote psychological adjustment by facilitating cognitive processing of the cancer experience.

Family Functioning, Perceived Societal Support, and Combat-Related Psychopathology: The Moderating Role of Loneliness

Article

Full-text available

Dec 1990
J SOC CLIN PSYCHOL

The main aim of the current study was to investigate the effects of external sources of perceived social support (family, society) and feelings of loneliness on combat-related psychopathology following a breakdown in war. A sample of Israeli soldiers who fought in the 1982 Lebanon war and suffered from combat stress reaction were given a battery of questionnaires assessing social support, loneliness, and psychopathology 2 years after the war. Results indicate that external sources of perceived social support and loneliness were significantly associated with various dimensions of psychopathology. It was also found that the external sources of perceived social support influenced psychopathology indirectly via their impact on feelings of loneliness. In addition, loneliness was found to be the only direct antecedent of combat-related psychopathology. The multifaceted nature of social support and the differential contributions of its components to mental health are discussed.

Mending Broken Hearts: Effects of Expressive Writing on Mood, Cognitive Processing, Social Adjustment and Health Following a Relationship Breakup

Article

Full-text available

Oct 2002

Seventy-two male and 73 female undergraduates were randomly assigned to an experimental group, in which they wrote expressively about a relationship breakup, or to a control group, in which they wrote in a non-emotional manner about impersonal relationship topics. Control participants reported short-term increases in upper respiratory illness (URI) symptoms, tension and fatigue, whereas experimental participants did not. Further, higher levels of intrusive thoughts and avoidance were associated with short-term increases in URI symptoms in the control group, but were unrelated to URI symptoms in the experimental group. Finally, there was a trend (p Keywords: Avoidance; Emotional expression; Expressive writing; Intrusive thoughts; Social adjustment; Upper respiratory illness Document Type: Research Article DOI: http://dx.doi.org/10.1080/08870440290025768 Affiliations: 1: Department of Health and Behavior Studies, Teachers College, Columbia University, Thorndike Hall, Box 114, 525 West 120th Street, New York, NY 10027, USA 2: Clinical Psychology, Alliant International University, 10455 Pomerado Rd., San Diego, CA 92131, USA Publication date: January 1, 2002 $(document).ready(function() { var shortdescription = $(".originaldescription").text().replace(/\\&/g, '&').replace(/\\, '<').replace(/\\>/g, '>').replace(/\\t/g, ' ').replace(/\\n/g, ''); if (shortdescription.length > 350){ shortdescription = "" + shortdescription.substring(0,250) + "... more"; } $(".descriptionitem").prepend(shortdescription); $(".shortdescription a").click(function() { $(".shortdescription").hide(); $(".originaldescription").slideDown(); return false; }); }); Related content In this: publication By this: publisher In this Subject: Psychology By this author: Lepore, Stephen J. ; Greenberg, Melanie A. GA_googleFillSlot("Horizontal_banner_bottom");

Sexual Harassment and Assault as Predictors of PTSD Symptomatology Among U.S. Female Persian Gulf War Military Personnel

Article

Full-text available

Feb 1998

Rates and sequelae of sexual harassment and assault among women in a wartime military sample were examined. A second goal was to explore the comparative impacts of these stressors and combat exposure on posttraumatic stress disorder (PTSD) symptomatology. Army women (n=160) were interviewed on return from the Persian Gulf War and again 18 to 24 months later. Rates of sexual assault (7.3%), physical sexual harassment (33.1%), and verbal sexual harassment (66.2%) were higher than those typically found in civilian and peacetime military samples. Sexual assault had a larger impact on PTSD symptomatology than combat exposure. Frequency of physical sexual harassment was significantly predictive of PTSD symptomatology. Furthermore, the number of postwar stressful life events mediated the relationship between physical sexual harassment and symptomatology but was not related to combat exposure. Sexual assault, sexual harassment, and combat exposure appear to be qualitatively different stressors for women, with different correlates and mechanisms of action.

Gender differences in the social moderators of stress

Article

Full-text available

Jan 1988

Deborah Belle

A social–cognitive processing model of emotional adjustment to cancer.

Article

Full-text available

Jan 2001

Stephen J. Lepore

Cancer diagnosis and treatments can profoundly and, sometimes, irrevocably alter people's lives. Cancer treatments are invasive, painful, and often create long-term negative side effects. Yet despite the dread, discomfort and dysfunction associated with this disease, some individuals are able to maintain or quickly reestablish their precancer emotional equilibrium. Understanding this adjustment process is a primary goal of psychologists and health care providers who conduct psychosocial interventions with cancer patients. By examining natural processes and predictors of adjustment in cancer patients, we can find clues to designing effective interventions. This chapter applies a social-cognitive processing theory of adjustment to stressors to explain how the social context of recovery influences emotional adjustment to cancer. The theory also is applied to understanding who benefits from psychosocial interventions for cancer and why. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Secondary Traumatization Among Wives of Posttraumatic Combat Veterans: A Family Typology

Article

Full-text available

Jun 1993

Examined the relationship between family environment and the psychosocial adjustment of 127 wives of Israeli combat stress reaction (CSR) and 85 non-CSR veterans of the 1982 Lebanon War. Wives from conflict-oriented families were found to display the highest levels of psychological and behavioral problems, followed by wives from rigid-moral and midrange families. The healthiest wives in this sample came from expressive families. Results indicate that family environment has a similar effect on all wives, irrespective of whether or not the husband had suffered a wartime stress reaction. Findings show, however, that wives of traumatized veterans have to contend far more often than other wives with conflict and rigidity in family functioning, whereas wives of nontraumatized veterans tend to benefit from an expressive family environment. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Construct of Attributional Style in Depression and Marital Distress

Article

Full-text available

Jun 1995

Although important theoretically, consistency in attribution responses or attributional style has rarely been investigated empirically. The responses of 150 couples were used to examine whether consistency of attribution responses within attribution dimensions and consistency in the pattern of responses across attribution dimensions were associated with adaptational outcomes. Replicating previous findings, mean attribution scores correlated with depression and with marital distress. Consistency of attribution responses was unrelated to either adaptational outcome, whereas (1) theoretically derived pessimistic and optimistic attribution patterns were related to depression scores and (2) benign and nonbenign marital attribution patterns were related to marital satisfaction scores. The implications of these findings for the level at which attributional style is best conceptualized are discussed. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Interpersonal friction and PTSD in female victims of sexual and nonsexual assault

Article

Oct 1999
J TRAUMA STRESS

This study examines the relationship among features of social relationships, both negative and positive, and later posttrauma pathology. Using a prospective design, 142 female victims of sexual or nonsexual assault were assessed at both 2 weeks and 3 months following the assault. We examined self‐reported perceptions of how often the participant has been the recipient of socially supportive actions by others and how often the participant has been engaged in interpersonal friction with others. Degree of interpersonal friction shortly after the assault predicted PTSD severity 3 months later. On the contrary, positive social support did not predict later PTSD severity. These results are consistent with previous studies that underscore the association between negative features of social relationships and PTSD.

Predictors of PTSD symptom severity and social reactions in sexual assault victims

Article

Apr 2001
J TRAUMA STRESS

Demographics, assault variables, and postassault responses were analyzed as correlates of PTSD symptom severity in a sample of 323 sexual assault victims. Regression analyses indicated that less education, greater perceived life threat, and receipt of more negative social reactions upon disclosing assault were each related to greater PTSD symptom severity. Ethnic minority victims reported more negative social reactions from others. Victims of more severe sexual victimization reported fewer positive, but more negative reactions from others. Greater extent of disclosure of the assault was related to more positive and fewer negative social reactions. Telling more persons about the assault was related to more negative and positive reactions. Implications of these results for developing contextual theoretical models of rape‐related PTSD are discussed.

Gender, social support, and PTSD in victims of violent crime

Article

Aug 2003
J TRAUMA STRESS

Gender differences in social support levels and benefits were investigated in 118 male and 39 female victims of violent crime assessed for PTSD symptomatology 1 and 6 months postcrime. Within 1 month postcrime both genders reported similar levels of positive support and support satisfaction, but women reported significantly more negative responses from family and friends. Women also reported an excess of PTSD symptoms that was similar at 1 and 6 months postcrime, and negative responses mediated the relationship between gender and later symptoms. Overall negative response and support satisfaction, but not positive support, were significantly associated with PTSD symptoms. However, the effects of support satisfaction and negative response on 6‐month symptoms were significantly greater for women than men. The findings are consistent with previous studies of predominantly female assault victims concerning the stronger impact of negative over positive support, and might help explain women's higher PTSD risk in civilian samples.

Factors associated with PTSD symptoms following treatment for breast cancer: Test of the Andersen model

Article

Apr 1998
J TRAUMA STRESS

The utility of Andersen's (1993, 1994) model of psychologic morbidity following cancer treatment for predicting PTSD symptoms in breast cancer survivors (N = 82) was examined. PTSD symptoms, physical comorbidity, social support, depression history, and pre‐cancer traumatic stressors were assessed in a structured telephone interview. Multiple regression analysis indicated that Andersen model variables (physical comorbidity, education, disease stage, cancer treatment, depression history, social support) accounted for 39% of variance in PTSD symptom reports (p < .001). Addition to the model of time since treatment completion, pre‐cancer traumatic stressors, age at diagnosis, and tamoxifen usage accounted for an additional 16% of variance (p < .001). Higher levels of PTSD symptoms were associated with less social support, greater pre‐cancer trauma history, less time since treatment completion, and more advanced disease.

Treating the Trauma of Rape: Cognitive Behavioral Therapy for PTSD

Article

Jan 1999

Elizabeth M. Ellis

Construct of attributional style in depression and marital distress.

Article

Jun 1995

Although important theoretically, consistency in attribution responses or attributional style has rarely been investigated empirically. The responses of 150 couples were used to examine whether consistency of attribution responses within attribution dimensions and consistency in the pattern of responses across attribution dimensions were associated with adaptational outcomes. Replicating previous findings, mean attribution scores correlated with depression and with marital distress. Consistency of attribution responses was unrelated to either adaptational outcome, whereas (a) theoretically derived pessimistic and optimistic attribution patterns were related to depression scores and (b) benign and nonbenign marital attribution patterns were related to marital satisfaction scores. The implications of these findings for the level at which attributional stvle is best conceptualized are discussed.

The epidemiology of sex differences in PTSD across developmental, societal, and research contexts

Article

Jan 2002

Toward an Interactional Description of Depression

Article

Feb 1976

James C. Coyne

Measuring Perceived and Received Social Support

Chapter

Oct 2000

This chapter considers the measurement of supportive functions that are perceivedto be available if needed (perceived support) or functions that are reportedto be recently provided (received support). The basic assumption for the choiceof such measures is that they tap the availability of resources provided throughsocial relationships that should help persons to cope with acute or chronic stressors.

The social Readjustment Rating scale

Article

Jan 1976
J PSYCHOSOM RES

The Costs of Caring: A Perspective on the Relationship Between Sex and Psychological Distress

Chapter

Jan 1985

This paper is different from the others in this volume in that we discuss the health-damaging effects of providing social support rather than the health-promoting effects of receiving it. Our topic has heretofore been neglected. Yet, as we show below, there is good reason to think that there are serious personal costs associated with being a supporter; costs that should be taken into account by those who advocate community interventions to increase access to support.

Social networks and support

Article

Apr 1990

Traolach Brugha

Social Support: Theory, Research and Application

Chapter

Jan 1985

Peggy A. Thoits

Considerable controversy has centered on the role of social support in the stress process. Some theorists (Cassel, 1976; Cobb, 1976; Kaplan, Cassel, & Gore, 1977) have argued that support acts only as a resistance factor; that is, support reduces, or buffers, the adverse psychological impacts of exposure to negative life events and/or chronic difficulties, but support has no direct effects upon psychological symptoms when stressful circumstances are absent. Several studies confirm this buffering-only view of social support influences (sec Turner, 1983, for a review). Others (Thoits, 1982a, 1983c) have argued that lack of social support and changes in support over time are stressors in themselves, and as such ought to have direct influences upon psychological symptomatology, whether or not other stressful circumstances occur. A number of studies now confirm this main-effect view of social support influences (e.g., Andrews, Tennant, Hewson, & Vaillant, 1978; Aneshensel & Frerichs, 1982; Lin, Ensel, Simeone, & Kuo, 1979; Thoits, 1983b; Turner, 1981; Williams, Ware, & Donald, 1981). These studies report an inverse association between measures of support and indicators of psychological disturbance, and no stress-buffering effects at all.

The impact of sexual and non-sexual assault on secondary victims

Article

Feb 1995
Violence Vict

Much information has been collected on the effects of crime upon victims. Experts have spoken as well about the ripple effects of crime on those close to victims. To date, however, little empirical data are available to assess the impact of crime upon “secondary victims.” Our research looks at the effects of crime on a sample of persons named by victims of sexual and nonsexual assault as their primary significant others (SOs). We found that distress experienced by SOs did not vary according to victim distress or according to whether the crime was a sexual or nonsexual assault. Female SOs, however, experienced greater fear of crime than male SOs. High levels of SO distress did not interfere with the ability of SOs to lend supportive actions, but were associated with higher levels of SO unsupportive behavior. Higher levels of unsupportive behavior were also more likely among SOs of sexual assault victims than among SOs of nonsexual assault victims. Clinical implications of the findings are discussed.

Posttraumatic Stress Disorder in the National Comorbidity Survey

Article

Dec 1995
ARCH GEN PSYCHIAT

Ronald C. Kessler

Background: Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated lifetime prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode.Methods: Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey.Results: The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years.Conclusions: Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas.

The Inner American: A Self-Portrait from 1957 to 1976

Article

Jan 1981
Socio Anal

Conclusions: An integrative psychosocial model of PTSD

Chapter

Jan 1999

Psychometric Characteristics of the Social Reactions Questionnaire: A Measure of Reactions to Sexual Assault Victims

Article

Sep 2000

Sarah E. Ullman

Negative social reactions are common responses to disclosures of sexual assault. A study was undertaken to evaluate the psychometric characteristics of a new measure of social reactions to sexual assault victims, the Social Reactions Questionnaire (SRQ). Good reliability and validity were demonstrated for the measure in three samples of sexual assault victims: community volunteers, college students, and victims contacting mental health agencies. The SRQ provides a much needed measure of both the positive forms of social support and several negative social reactions received by sexual assault victims disclosing their assaults to a range of informal social network members and formal support providers.

Post-traumatic stress: Psychosocial perspectives on PTSD and treatment

Book

Jan 1997

The European Challenge to Foreign Policy Analysis

Article

Mar 1999
EUR J INT RELAT

BRIAN WHITE

This article explores `European foreign policy' as an important new empirical domain of foreign policy and also as a challenging vehicle for evaluating the current status of Foreign Policy Analysis (FPA). It begins by identifying the weaknesses of the dominant institutionalist mode of analysis of foreign policy activity in Europe which include a restrictive definition of `foreign policy' in this context. A case is then made for arguing that critics of FPA have underestimated the significance of developments in this sub-field of International Relations over the last 30 years and that `traditional' FPA can be adapted to aid the task of understanding the complex arena of European foreign policy defined here as constituted by three interrelated types of activity; Community, Union and National (member states') foreign policy. Having sketched out an analytical framework which demonstrates the continuing strengths of FPA, the article reflects upon what we might learn from this application about the weaknesses of this mode of analysis. Continuing problems notwithstanding, a revitalized FPA is revealed here which has the potential to incorporate both positivist and `post-positivist' approaches.

Perceived Control and Adjustment to Trauma: A Comparison Across Events

Article

Jun 2004
J SOC CLIN PSYCHOL

The relations among measures of perceived control and adjustment were assessed among women who had experienced a sexual assault (n = 135) or sudden bereavement (n = 159) several years previously on average. Perceived control was assessed in terms of past, present, and future control over the trauma, and adjustment was assessed in terms of current symptoms of distress (i.e., depression and anxiety) and posttraumatic stress disorder, and life satisfaction. Levels of distress in both groups were higher than norm group means. The relations between control and adjustment differed across types of control and across events. Present control (i.e., control over the recovery process) was associated with better adjustment in both samples, across all adjustment measures, and after accounting for the effects of other variables (e.g., neuroticism). Past control over the trauma itself generally was unrelated to adjustment. Future control was associated with better adjustment only following sexual assault. Limitations and directions for future research are discussed.

Examining the Theory and Clinical Utility of Writing About Emotional Experiences

Article

May 1997

Richard R. Bootzin

Pennebaker's (this issue) intervention for writing about emotional experiences shows promise as a module for inclusion in therapeutic packages. There are conceptual, methodological, and practical issues to be considered, however. These issues are discussed, and parallels are drawn from the literatures on the mood-regulatory function of dreams and on the effects of social support on health. Although there is evidence that writing about emotional experiences has beneficial effects on health, it is premature to recommend writing intervention as a treatment component for specific problems. What is needed at this point is systematic research to evaluate its clinical utility.

Social support in the face of adversity: The role of cognitive appraisal

Article

Sep 1989

In this paper we examine the hypothesis that individuals' perceptions and use of the social support available to them when negative outcomes occur are influenced by their cognitive appraisal of those outcomes. We report two investigations of the relation between social support and cognitive appraisal, one involving hypothetical events and one involving actual life events. In the first study perceptions of the number of potential providers of support were related to appraisals that negative outcomes were not consensual and were caused by stable and global factors. In the second study social withdrawal following a stressful experience was also related to appraisals involving low consensus, global attributions, and blame directed at personal inadequacy. These relations were independent of the level of self-rated depression and self-esteem at the time of the interview. It is argued that studies of social support processes need to take into account cognitive appraisals and powerful emotions such as shame and guilt.

Coping strategies used by staff following assault by a patient: An exploratory study

Article

Jan 1991

This study investigates how people deal with the stress of being the victim of a violent assault at work. A consecutive sample of 24 employees of a psychiatric hospital were questioned over a three-week period following an assault by a patient. The ways in which these staff spontaneously attempted to cope with these assaults was used as a basis for a classification scheme. In addition their psychological difficulties were measured. Despite the restricted sample some interesting associations were found. Ignoring the incident by avoiding thinking about it and taking time away from work or work colleagues was associated with decreases in psychological difficulties over time. Although the causal link is still unclear, further studies using similar analyses may be able to tease this out.

Reactions to Victims of Life Crises: Support Attempts That Fail

Article

Jan 1985

We became interested in the topic of social support while studying how people cope with a variety of life crises such as loss of a loved one, life-threatening illness, and physical disability. In most discussions of social support, it is generally assumed that support attempts made by the provider will be valued and appreciated by the receiver. There is growing awareness that in many cases, however, others’ well-intentioned efforts to provide support may be regarded as unhelpful by the recipient, may result in negative consequences, or both (Dunkel-Schetter & Wortman, 1982a; 1982b; House, 1981; Thoits, 1982). In a study we recently completed on coping with the loss of a spouse or child (Lehman, Wortman & Williams, in press), respondents reported that others frequently tried to support them by making statements like, “I know exactly how you feel,” “It was God’s will,” or “It’s a good thing you have other children.” Such statements were commonly judged by respondents to be unhelpful (see also Glick, Weiss & Parkes, 1974; Maddison & Walker, 1967).

Controllability of Stressful Events and Satisfaction With Spouse Support Behaviors

Article

Apr 1992
COMMUN RES

Among married couples, the effect of the controllability of stressful events was tested as a predictor of the type of social support communications provided and preferred. Sixty married individuals disclosed stressful events to their spouse. Controllability of the stress was rated by observers. The Social Support Behavior Code was used to assess the frequency with which each of five types of social support was provided by the spouse. Action-promoting support (information) was provided most frequently when the stressed person had high control over the event. Of the five types of support communications assessed, only information was evaluated differently in high- and low-controllable situations. Both controllability by the support recipient and controllability by his or her spouse were relevant to support evaluations. Results provide limited support for the optimal matching model proposed by Cutrona and Russell (Cutrona, 1990; Cutrona & Russell, 1990).

PTSD and the Social Support of the Interpersonal Environment: The Development of Social Cognitive Behavior Therapy

Article

Apr 2003
J Cognit Psychother

We will argue that, although the evidence for the effectiveness of cognitive-behavioral treatment, of PTSD is compelling, not all patients engage or respond to treatment and in those who do, residual symptomatology is not uncommon. We then briefly examine the literature on the influence of the interpersonal and emotional aspects of social support on the development, maintenance, and treatment of post-traumatic stress disorder (PTSD). Two areas of social support are suggested as potentially important to the study of PTSD: (1) the literature on expressed emotion (EE) and the underlying beliefs held by significant others which influence their negative coping behaviors and interactions with the patient, and (2) examination of the concept of reciprocity, the ability to receive and provide social support. Finally, we suggest a range of possible treatment options suggested by this review as possible adjuncts to conventional CBT. These include formal family interventions, re-engagement with social networks, and modification of perceptions of social interactions.

Premilitary, military, and postmilitary factors in the development of combat-related posttraumatic stress disorder

Article

Jan 1987

Based on an examination of trauma studies, etiological factors of potential posttraumatic stress disorder (PTSD) are proposed. From a premilitary time frame, a positive family history of psychiatric disorder, particularly alcoholism, appears to play a role under low combat-exposure conditions. Under high-combat conditions, a positive family history of mental illness seems less of a risk factor. From the military time frame, combat trauma exposure emerges as the single most influential factor. Postmilitary factors of note include the nature of the homecoming environment and available social support during the first 6 mo after military discharge. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Relatives' expressed emotion (EE) and PTSD treatment outcome

Article

Jul 1999
PSYCHOL MED

Background. Expressed emotion (EE) is a measure that has been used to assess the quality of the relationship between patient and their key relative. It has been shown to be strongly predictive of clinical outcome in a range of psychiatric and medical disorders. This study investigated the effect of EE on treatment outcome in chronic post-traumatic stress disorder (PTSD).

Stress, Appraisal and Coping

Chapter

Jan 1984

Social Support and Psychological Symptomatology Following a Natural Disaster

Article

Jan 1990

The effects of perceived availability of social support on psychological symptomatology following a natural disaster were studied in a sample of victims of a major flood in Roanoke, Virginia. Ninety-six subjects were administered questionnaires that measured self-reported levels of depression, anxiety, and somatization 1 week after the disaster and four additional times within 6 months after the disaster. A questionnaire mailed 3 months after the disaster assessed perceived availability of social support. Results indicated that subjects experienced severe distress immediately following the disaster, that this distress decreased sharply 6 weeks after the flood, and decreased more gradually in the following months. Perceived availability of social support was not related to distress immediately following the disaster nor 5 months afterwards. Social support and symptomatology were significantly correlated during the intermediate period.

Mental health consequences of the San Ysidro McDonald's Massacre: A community study

Article

Jan 1990

This paper reports on the reactions of a portion of the population of San Ysidro, California, to the McDonald''s massacre in 1984. Recently immigrant, poor, Mexican American women, 35–50 years of age, who were not directly involved in the accident were surveyed to determine their emotional reactions approximately 6 months following the massacre. Approximately one third of the women indicated they were seriously affected by the event. Some 12% reported had mild or severe levels of Post-Traumatic Stress Disorder (PTSD) symptomatology at some point in time since the massacre and some 6% still felt symptoms 6 to 9 months after the event. The women most affected were those having relatives or friends involved in the massacre and those with general social vulnerability (e.g., the widowed, separated, or divorced, unemployed and those with less income and fair to poor health). These women reported relatively little impact on their children. Onset and chronicity of PTSD and health care utilization patterns were also explored. Results of more intensive, open ended interviews with the women most affected by the event are summarized.

Interpersonal mood induction: Situational and individual determinants

Article

Dec 1982

Several situational and individual aspects of interpersonal mood induction were investigated in an attempt to elucidate the mechanisms by which depressed mood is transmitted from one individual to another. Eighty-four psychology students interacted with confederates previously trained to enact one of three mood states — depressed, neutral, or elated. Participants were randomly assigned to same-sex confederates in one of two roles — helper or stranger, resulting in a 322 design. Mood and self-esteem were independent variables assessed prior to the interaction. Mood, perceptions, and reactions to the confederate were dependent variables assessed following the interaction. Results indicated induction of depression and anxiety in participants exposed to depressed confederates, and induction of hostility following interaction with elated confederates. Induction of depression and hostility were significantly attenuated in participants in the helper role as opposed to person perception role, while the concept of individual vulnerability to mood induction was not supported in this study. Rejection of depressed persons was only modestly associated with negative mood induction. Thus, role components of the situation affected mood induction more than did individual participant differences. The results and their implications for therapists and family members of depressed individuals are discussed within the framework of Lazarus's cognitive model of emotional arousal.

Exploring the links between posttraumatic stress disorder and social support: Processes and potential research avenues

Abstract

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