Anger and posttraumatic stress disorder symptoms in crime victims: a longitudinal analysis

Among trauma-exposed individuals, severity of posttraumatic stress disorder (PTSD) symptoms is strongly correlated with anger. The authors used 2 longitudinal data sets with 282 and 218 crime victims, respectively, to investigate the temporal sequence of anger and PTSD symptoms following the assault. Cross-lagged regression analyses indicated that PTSD symptoms predicted subsequent level of anger, but that anger did not predict subsequent PTSD symptoms. Testing alternative models (common factor model, unmeasured 3rd variable model) that might account for spuriousness of the relation strengthened confidence in the results of the cross-lagged analyses. Further analyses suggested that rumination mediates the effect of PTSD symptoms on anger.     

Associations among socioeconomic status,perceived neighborhood control,perceived individual control,and self‐reported health

Recent research has suggested that perceived control and a person's perceptions of their neighborhood environment may mediate the association between socioeconomic status (SES) and health. This cross‐sectional study assessed whether perceptions of informal social control mediated the association between SES and self‐reported health, and if these two constructs represented distinct mechanisms linking SES with self‐reported health. The sample consisted of 869 adults residing in 300 census tracts in Montreal, Canada. Multilevel methods were used to assess the associations among self‐reported health, SES, perceived control, and perceived informal social control adjusting for sociodemographic variables. Perceived control (mediation estimate=?0.16, p<.001) and perceived informal social control (mediation estimate=?0.05, p<.05) partially mediated the association between SES and self‐reported health. Perceived control did not mediate the association of perceived informal social control with self‐reported health. Perceived informal social control may act alongside but distinct from perceived control as a mechanism linking SES to self‐reported health. © 2010 Wiley Periodicals, Inc.     

A randomized clinical trial to dismantle components of cognitive processing therapy for posttraumatic stress disorder in female victims of interpersonal violence

The purpose of this experiment was to conduct a dismantling study of cognitive processing therapy in which the full protocol was compared with its constituent components--cognitive therapy only (CPT-C) and written accounts (WA)--for the treatment of posttraumatic stress disorder (PTSD) and comorbid symptoms. The intent-to-treat (ITT) sample included 150 adult women with PTSD who were randomized into 1 of the 3 conditions. Each condition consisted of 2 hr of therapy per week for 6 weeks; blind assessments were conducted before treatment, 2 weeks following the last session, and 6 months following treatment. Measures of PTSD and depression were collected weekly to examine the course of recovery during treatment as well as before and after treatment. Secondary measures assessed anxiety, anger, shame, guilt, and dysfunctional cognitions. Independent ratings of adherence and competence were also conducted. Analyses with the ITT sample and with study completers indicate that patients in all 3 treatments improved substantially on PTSD and depression, the primary measures, and improved on other indices of adjustment. However, there were significant group differences in symptom reduction during the course of treatment whereby the CPT-C condition reported greater improvement in PTSD than the WA condition.     

A comparison of exposure therapy, stress inoculation training, and their combination for reducing posttraumatic stress disorder in female assault victims

Ninety-six female assault victims with chronic posttraumatic stress disorder (PTSD) were randomly assigned to 4 treatment conditions: prolonged exposure (PE), stress inoculation training (SIT), combined treatment (PE-SIT), or wait-list control (WL). Treatment consisted of 9 twice-weekly, individual sessions. Independent evaluations were conducted at pretreatment; posttreatment; and 3-, 6-, and 12-month follow-ups. All 3 active treatments reduced severity of PTSD and depression compared with WL but did not differ significantly from each other, and these gains were maintained throughout the follow-up period. However, in the intent-to-treat sample, PE was superior to SIT and PE-SIT on posttreatment anxiety and global social adjustment at follow-up and had larger effect sizes on PTSD severity, depression, and anxiety. SIT and PE-SIT did not differ significantly from each other on any outcome measure.     

Self‐compassion,trauma, and posttraumatic stress disorder: A systematic review

Self‐compassion has emerged as an important construct in the mental health literature. Although conceptual links between self‐compassion and trauma are apparent, a review has not been completed to examine whether this association is supported by empirical research findings. To systematically summarize knowledge on the association between trauma and/or posttraumatic stress disorder (PTSD) and self‐compassion. Searches were conducted in PsycINFO, PubMed, Ovid Medline, Web of Science, Embase, and PILOTS databases, and papers reporting a direct analysis on the relationship between these constructs were identified. The search yielded 35 studies meeting inclusion criteria. Despite considerable heterogeneity in study design, sample, measurement, and trauma type, there was consistent evidence to suggest that increased self‐compassion is associated with less PTSD symptomatology and some evidence to suggest that reduced fear of self‐compassion is associated with less PTSD symptomatology. There was tentative evidence to suggest that interventions based, in part or whole, on a self‐compassion model potentially reduce PTSD symptoms. Although findings are positive for the association between increased self‐compassion and reduced PTSD symptoms, the precise mechanism of these protective effects is unknown. Prospective and longitudinal studies would be beneficial in clarifying this. The review also highlighted the variability in what is and should be referred to as trauma exposure, indicating the need for further research to clarify the concept.     

Self‐compassion,self‐forgiveness,suicidal ideation,and self‐harm: A systematic review

Self‐compassion has been implicated in the aetiology and course of mental health with evidence suggesting an association between greater self‐compassion and lower emotional distress. However, our understanding of the nature and extent of the relationship between self‐compassion and self‐harm (self‐injury regardless of suicidal intent) or suicidal ideation remains unclear. This review, therefore, aimed to critically evaluate the extant literature investigating this relationship. To do so, a systematic search, including terms synonymous with self‐compassion, was conducted on three main psychological and medical databases (Web of Science, PsycINFO, and Medline). Only studies investigating self‐compassion or self‐forgiveness and self‐harm or suicidal ideation were found to be relevant to the review. Eighteen studies were included in the final narrative synthesis. Heterogeneity of studies was high, and the majority of studies were quantitative and cross‐sectional (n = 16) in design. All studies reported significant associations between higher levels of self‐forgiveness or self‐compassion and lower levels of self‐harm or suicidal ideation. Several studies suggested that self‐compassion or self‐forgiveness may weaken the relationship between negative life events and self‐harm. In conclusion, this review highlights the potential importance of self‐compassion in the aetiology of suicidal thoughts and self‐harm. We discuss the clinical and research implications.     

Type D personality and posttraumatic stress disorder in victims of violence: a cross-sectional exploration

The current study explored the relationship between type D personality and posttraumatic stress disorder (PTSD) among victims of violence (n = 189). The basic premise underlying the type D concept is that it is not the experience of negative emotions per se that renders individuals at risk of maladjustment in the face of adversity, but the way they are dealt with. Particularly the combination of high negative affectivity and social inhibition (i.e., the non-expression of emotions and inhibition of behaviours in social interactions) is assumed to be maladaptive. It was hypothesized that a high score on negative affectivity (i.e., above a pre-determined cut-off score) would only contribute to PTSD in the presence of a high score on social inhibition (also above a pre-determined cut-off score). Univariate results indicated that type D subjects (type Ds) reported higher PTSD symptom levels than those characterized by high negative affectivity/low social inhibition or low negative affectivity. Type Ds more often suffered from probable PTSD than non-type Ds. In multivariate analyses, type D personality was associated with an increased risk of probable PTSD above and beyond background variables, while high negative affectivity/low social inhibition was not. Results were discussed in light of victim support practices and study limitations.