Journal of traumatic stress
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The work group revising the criteria for trauma-related disorders in the International Classification of Diseases (ICD-11) made several changes. Specifically, they simplified the criteria for posttraumatic stress disorder (PTSD) and added a new trauma disorder called complex PTSD (CPTSD). These proposed changes to taxonomy require new instruments to assess these novel constructs. ⋯ Supplementary analyses supported the gender invariance of the CFA model, as well as convergent and discriminant validity of the CTI. The validity of the CTI supports the distinction between CPTSD and PTSD. Moreover, the CTI will assist clinicians with diagnosis, symptom tracking, treatment planning, and assessing outcomes.
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Although traditionally conceptualized as an anxiety disorder, variability in posttraumatic stress disorder (PTSD) may be explained by individual differences in peri- or posttraumatic disgust. We examined relationships between disgust reactions and other trauma-related symptoms in 100 veterans with a history of interpersonal trauma and gender differences in these variables. We also evaluated the mediating role of posttraumatic disgust and guilt in the relationship between peritraumatic disgust and PTSD symptoms. ⋯ Posttraumatic disgust and guilt mediated the relationship between peritraumatic disgust and PTSD symptoms, controlling for gender (a1 a2 b1 = 0.18, SE = 0.09, PM = .19). Our results converge with those found in other studies suggesting that disgust is a common trauma-related emotion and that men and women may experience differential relationships between peri- and posttraumatic emotional experiences. Further study of the role of trauma-related emotional responses in PTSD etiology and treatment is warranted.
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Social support and coping affect each other after stressful life events, including sexual assault (Taylor & Stanton, 2007). The present study examined the associations among assault-specific support, maladaptive coping, and posttraumatic stress symptoms (PTSS) over 3 years in a sample of female sexual assault survivors from a large metropolitan area (N = 1,863). A 3-wave cross-lagged panel model revealed significant weak-to-moderate reciprocal associations between maladaptive coping and PTSS (βs = .09 to .21), significant weak reciprocal associations between turning against social reactions and PTSS (βs = .07 to .10), and inconsistent weak reciprocal associations between maladaptive coping and unsupportive acknowledgment reactions (βs = .06 to .14). We conclude with implications regarding treatment and intervention for survivors and their support networks.
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Persons living in communities with limited resources are at heightened risk of posttraumatic stress (PTS) after disasters, especially if they were highly exposed. The support deterrence desistence model and the conservation of resources theory suggest that this risk might increase in the longer-term aftermath of disasters. In the present study, we aimed to test this hypothesis. ⋯ Multilevel models found that disaster-related stressors were more strongly associated with PTS for participants living in communities with high unemployment, but only at Time 2 (Est. = .58, SE = .21, p = .006). Mapping of community unemployment and disaster-related stressors suggested that communities in southern Brooklyn and Queens, and northeastern Staten Island were at particularly high risk for PTS at Time 2. The results suggest the need for ongoing support to economically disadvantaged communities in which residents have endured disaster-related stressors.
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Randomized Controlled Trial
Structured Approach Therapy for Combat-Related PTSD in Returning U.S. Veterans: Complementary Mediation by Changes in Emotion Functioning.
To address the impact of combat-related posttraumatic stress disorder (PTSD) on U. S. Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) veterans, the investigators developed a 12-session manualized PTSD treatment for couples called structured approach therapy (SAT). ⋯ Veterans assigned to the SAT condition showed significantly greater decreases than those assigned to PTSD family education in emotion regulation problems (p < .001, Cohen's f(2) = .18) and fear of intense emotions (p < .001, Cohen's f(2) = .152). Decreases in both emotion regulation problems (mediated effect:ab̂= .36), and fear of intense emotions (mediated effect:ab̂ = .24) were found to be complementary mediators of reductions in PTSD symptoms greater with SAT. These findings suggest that SAT may aid veterans in improving their ability to regulate trauma-related emotions.