Intrusion-based reasoning and depression: Cross-sectional and prospective relationships

Intrusion-based reasoning refers to the tendency to form interpretations about oneself or a situation based on the occurrence of a negative intrusive autobiographical memory. Intrusion-based reasoning characterises post-traumatic stress disorder, but has not yet been investigated in depression. We report two studies that aimed to investigate this. In Study 1 both high (n = 42) and low (n = 28) dysphoric participants demonstrated intrusion-based reasoning. High-dysphoric individuals engaged in self-referent intrusion-based reasoning to a greater extent than did low-dysphoric participants. In Study 2 there were no significant differences in intrusion-based reasoning between currently depressed (n = 27) and non-depressed (n = 51) participants, and intrusion-based reasoning did not predict depressive symptoms at 6-month follow-up. Interestingly, previously (n = 26) but not currently (n = 27) depressed participants engaged in intrusion-based reasoning to a greater extent than never-depressed participants (n = 25), indicating the possibility that intrusion-based reasoning may serve as a "scar" from previous episodes. The implications of these findings are discussed. © 2013 © 2013 Taylor & Francis

Parental Trajectories of PTSD and Child Adjustment: Findings From the Building a New Life in Australia Study

© 2019 Global Alliance for Behavioral Health and Social Justice. Evidence suggests that the psychosocial adjustment of children of refugees may be compromised when a parent has symptoms of posttraumatic stress disorder (PTSD). We sought to determine whether trajectories of parental PTSD symptoms might relate to child adjustment and whether there is an additive effect when both parents, as opposed to just one, has prominent PTSD symptoms. We report data from the first three years of a prospective study of recent Australian humanitarian migrants: the Building a New Life in Australia study. Parental PTSD symptoms were assessed on three occasions, and latent class growth analysis was used to identify homogenous groups of parents based on their PTSD symptoms. The Strength and Difficulties Questionnaire was administered to assess child psychosocial adjustment. Regression analyses were then conducted to determine whether trajectories of parental PTSD symptoms predicted child adjustment. After controlling for child age and gender, the presence of either one or both parents with persistently high PTSD symptoms was associated with children's having greater emotional difficulties and poorer overall psychosocial adjustment. Children with both parents with persistently high PTSD had higher levels of emotional difficulties than did children with a single parent with high PTSD symptoms. For emotional difficulties, though not other domains of child psychosocial adjustment, there indeed appears to be an additive impact of having two parents, rather than just one, with persistently high PTSD symptoms, although the magnitude of these effects was small. The clinical and service provision implications of these findings are discussed

Emotional Reasoning Processes and Dysphoric Mood: Cross-Sectional and Prospective Relationships

Emotional reasoning refers to the use of subjective emotions, rather than objective evidence, to form conclusions about oneself and the world [1]. Emotional reasoning appears to characterise anxiety disorders. We aimed to determine whether elevated levels of emotional reasoning also characterise dysphoria. In Study 1, low dysphoric (BDI-II≤4; n = 28) and high dysphoric (BDI-II ≥14; n = 42) university students were administered an emotional reasoning task relevant for dysphoria. In Study 2, a larger university sample were administered the same task, with additional self-referent ratings, and were followed up 8 weeks later. In Study 1, both the low and high dysphoric participants demonstrated emotional reasoning and there were no significant differences in scores on the emotional reasoning task between the low and high dysphoric groups. In Study 2, self-referent emotional reasoning interpretations showed small-sized positive correlations with depression symptoms. Emotional reasoning tendencies were stable across an 8-week interval although not predictive of subsequent depressive symptoms. Further, anxiety symptoms were independently associated with emotional reasoning and emotional reasoning was not associated with anxiety sensitivity, alexithymia, or deductive reasoning tendencies. The implications of these findings are discussed, including the possibility that while all individuals may engage in emotional reasoning, self-referent emotional reasoning may be associated with increased levels of depressive symptoms. © 2013 Berle, Moulds

The influence of ruminative processing mode on the trajectory of intrusive memories following a negative mood induction

© 2019 Elsevier Ltd Background and objectives: Rumination following an event, particularly in an abstract as opposed to concrete processing mode, is associated with increased intrusive memory frequency. However, the temporal trajectory of intrusive memories following abstract and concrete rumination remains unclear. We examined the association between processing mode and the frequency of intrusive memories over a 6-h time period following a negative mood induction. Methods: One hundred and sixteen community participants watched a video sequence designed to induce negative mood. Participants were then randomised into condition (abstract, concrete or distraction) and completed a verbally mediated task designed to induce the respective processing mode. Participants then completed hourly ratings of rumination and intrusive memories about the video after leaving the laboratory. Results: Negative mood and intrusive memories were reliably induced. There were no differences in the frequency of intrusive memories between the abstract and concrete conditions. In contrast, participants in the distraction condition reported significantly more sensory intrusive memories than either ruminative condition. Three classes were found among participants following the video (intrusion free, rapid remitters, slow remitters). Condition was not predictive of class membership. Limitations: It cannot be ruled out that the differences between rumination and distraction conditions were due to task differences. Conclusions: In contrast to previous findings, our results suggest that any form of rumination about an event (whether in an abstract or concrete mode) may temporarily result in fewer intrusive memories in comparison to distraction. Processing mode does not appear to predict particular trajectories of intrusions following a mood induction

Visuospatial Working Memory Tasks May Not Reduce the Intensity or Distress of Intrusive Memories.

Cognitive interventions involving visuospatial tasks, such as the game "Tetris" have demonstrated efficacy in reducing the frequency of intrusive memories. However, it remains unclear whether these tasks also reduce the perceived intensity and distress of these memories. We investigated whether either of two visuospatial tasks: a Tetris intervention or Digital Corsi task, following the viewing of an analog trauma (film) resulted in decreased intensity and distress for intrusive memories over the following week, when compared to a control condition. Participants (n = 110) were randomly assigned to task conditions after viewing the film. Linear mixed models indicated no between-group differences for reductions in intensity or distress over the course of the week. These findings highlight an important boundary to the benefits of such visuospatial tasks, in that while they may be associated with reductions in intrusion memory frequency, individuals may nonetheless continue to experience distress when intrusions do occur

Trauma-focused psychotherapies for post-traumatic stress disorder: A systematic review and network meta-analysis.

IntroductionMeta-analytic reviews suggest similar outcomes across trauma-focused psychotherapies for adults with post-traumatic stress disorder (PTSD). However, this conclusion may be premature due to suboptimal statistical-review methodologies. Network meta-analysis (NMA) allows a detailed rank-ordering of the efficacy of established psychotherapy interventions derived from indirect evidence as well as results from direct head-to-head comparisons.ObjectiveWe sought to determine the efficacy and attrition rates of psychotherapy interventions for PTSD by applying NMA.MethodsWe searched EMBASE, PsychINFO, PTSDPubs and PubMed for randomised controlled trials that compared psychotherapies either head-to-head or against controls for adults with PTSD. A frequentist NMA was used to compare direct and indirect effects to determine the efficacy and attrition rates of psychotherapy interventions.ResultsOf the 5649 papers identified, 82 trials comprising of 5838 patients were included. The network comprised 17 psychotherapies and four control conditions. Network estimates indicated superior efficacy of meta-cognitive therapy and cognitive processing therapy over other psychotherapies (ESs between = 0.26 and 2.32). Written exposure therapy and narrative exposure therapy were associated with lower risk of drop out when considered alongside other psychotherapies. Confidence in the network meta-analytic estimates was considered moderate for both outcomes.ConclusionsIn broad terms, therapeutic commensurability was evident. Nevertheless, with additional studies and larger sample sizes, meta-cognitive and written exposure therapies could indeed differentiate themselves from other approaches as having favourable efficacy and acceptability respectively. These findings may inform clinical decision-making, as well as guide future research for PTSD

Posttraumatic stress disorder (PTSD) symptom profiles among people who have experienced abuse: Findings from the NESARC-III study.

Greater recognition of diversity in psychological responses to traumatic events has led to increased exploration of posttrauma symptom typologies and risk factors for more "complex" presentations. OBJECTIVES: We sought to identify unique PTSD symptom profiles associated with the experience of physical and sexual abuse and to determine whether exposure in childhood, type of abuse, frequency of abuse and familial support were associated with profiles indicating increased symptom complexity. METHOD: We analyzed data from 6,769 American adults (M = 43.93 years, SD = 15.35, 70.9% female) from the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported histories of physical or sexual abuse. Latent Class Analysis was used to identify distinct profiles of the twenty PTSD symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). Abuse in childhood, type of abuse, frequency of childhood abuse, emotional support in childhood and a range of demographic variables were compared across classes. RESULTS: Five classes were educed: High All (19.6%), Threat (14.4%), Dysphoric (13.7%), Moderate Threat (29.4%) and Low Symptom (22.9%). Contrary to our hypotheses, trauma exposure in childhood did not predict class membership while type of abuse did. The High All and Dysphoric classes had greater frequency of childhood abuse, lower support in childhood, and a history of sexual abuse when compared to their less complex, predominantly fear-based counterparts (Threat and Moderate Threat classes, respectively). CONCLUSIONS: These constellations of DSM-5 PTSD symptoms may be a proxy for increased "complexity" and may indicate a need for alternative or additional therapeutic interventions. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Anger and predictors of drop-out from PTSD treatment of veterans and first responders.

Background: Drop-out is an important barrier in treating post-traumatic stress disorder (PTSD) with consequences that negatively impact clients, clinicians and mental health services as a whole. Anger is a common experience in people with PTSD and is more prevalent in military veterans. To date, no research has examined if anger may predict drop-out in military veterans or first responders. Aims: The present study aimed to determine the variables that predict drop-out among individuals receiving residential treatment for PTSD. Method: Ninety-five military veterans and first responders completed pre-treatment measures of PTSD symptom severity, depression, anxiety, anger, and demographic variables. Logistic regression analyses were used to determine if these variables predicted drop-out from treatment or patterns of attendance. Results: Female gender was predictive of drop-out. However, when analysed by occupation female gender was predictive of drop-out among first responders and younger age was predictive of drop-out in military participants. Anger, depression, anxiety and PTSD symptom severity were not predictive of drop-out in any of the analyses. No variables were found to predict attendance patterns (consistent or inconsistent) or early versus late drop-out from the programme. Conclusion: These results suggest that although anger is a relevant issue for treating PTSD, other factors may be more pertinent to drop-out, particularly in this sample. In contrast with other findings, female gender was predictive of drop-out in this study. This may indicate that in this sample, there are unique characteristics and possible interacting variables that warrant exploration in future research