Introduction to the Special Section on Complex Posttraumatic Stress Disorder (CPTSD): The Evolution of a Disorder

The inclusion of complex posttraumatic stress disorder (CPTSD) in the 11th revision of the International Classification of Diseases is an important development in the field of psychotraumatology. Complex PTSD was developed as a response to a clinical need to describe difficulties commonly associated with exposure to traumatic stressors that are predominantly of an interpersonal nature. With this special section, we bring attention to this common condition following exposure to traumatic stressors that only recently has been designated an official diagnosis. In this introduction, we review the history of CPTSD as a new condition and we briefly introduce the papers for the special section in the present issue of the Journal of Traumatic Stress. It is our hope that the work presented in the special section will add to an ever?expanding evidence base. We also hope that this work inspires further research on the cultural validity of CPTSD, its assessment, and treatment

The child as held in the mind of the mother: The influence of prenatal maternal representations on parenting behaviors

Using a longitudinal design, this study examined the relationship of a mother’s prenatal representation of her child and her parenting behavior with that child at one-year-of-age in a sample of women who were either exposed or not exposed to intimate partner violence (IPV) (n = 164; mean child age = 1.1 years, sd = .11 years; 52% male). Controlling for prenatal IPV, a MANCOVA analysis revealed that prenatal representational typology was significantly related to parenting behavior one year post-partum. Mothers whose representations were affectively deactivated (disengaged) were more behaviorally controlling with their children. Mothers whose representations were affectively overactivated (distorted) were more hostile with their children. Mothers with balanced representations demonstrated more positive parenting. Exposure to IPV did not moderate this relationship. There was no direct association between pre-natal or post-natal IPV and parenting behavior. These findings suggest that prenatal representations influence postnatal parenting behavior in significant and theoretically consistent ways and that this relationship functions similarly for both abused and non-abused women. Results add to the growing literature that internal representations serve to guide behavior throughout development and suggest that maternal working models may be one important link in the intergenerational transmission of attachment relationships

The impact of psychopathology associated with childhood trauma on quality of life in Portuguese adolescents: a two-wave longitudinal study

Introduction: The aim of this study was to explore the mediating effect of psychopathology between childhood adversity and trauma and quality of life (QOL) in adolescents. The second aim of the study was testing the moderation by social support of this mediation effect.Methods: Self-reports of childhood adversity and trauma, QOL, social support, and psychopathology were collected from 150 Portuguese adolescents' who had been exposed to at least one traumatic event or one childhood adversity (M-age = 16.89, SD = 1.32). The surveys were administered at two time points with an approximate time interval of 1 year.Results: Indirect effects were observed for depression (B = -0.33, CI [-0.62, -0.11]), somatization (B = -0.52, CI [-0.82, -0.23]), and post-traumatic stress symptoms (PTSS) (B = -0.23, CI [-0.45, -0.01]), but not for anxiety (B = 0.20, CI [-0.08, 0.50]). A moderated mediation was found between social support and depression (B = -0.10, CI [-16, -0.04]), and PTSS (B = 0.03, CI [-0.1, -0.05]), but not for somatization (B = -0.02, CI [-0.8, 0.05]).Conclusions: We found that depression and somatization were strong mediators of the relationship between adversity/trauma and QOL, whereas PTSS was moderately mediated this relationship. Anxiety did not mediate this relationship. The moderated-mediation effect of social support was only found for depression and PTSS. The improvement of QOL in adolescents exposed to childhood adversity and trauma should include the assessment of psychopathology symptoms and social support, with the aim of identifying risk and protective factors.- (undefined

Intimate Partner Violence, Mental Health, and HPA Axis Functioning

Research results are mixed as to whether stress exerts its damaging effects via under- or over-production of diurnal cortisol. Facets of the stressor itself as well as the mental health sequelae that follow have been put forward as important considerations in determining levels of cortisol secretion. We hypothesized that the contradictory findings in the literature were the result of variable-oriented methods masking the presence of distinctive subgroups of individuals. Using person-oriented methods, we explored whether there were classes of women who exhibited unique profiles of cortisol secretion, stress, and mental health by assessing 182 community women, many of whom had experienced intimate partner violence. The best fitting model in a latent profile analysis had 5 groups, each with distinct profiles of intimate partner violence stress (pregnancy and postpartum), cortisol secretion [cortisol awakening response (CAR) and diurnal slope], and mental health (posttraumatic stress, depressive, and anxiety symptoms). These were a Physiologically Under-Responsive group, a Healthy group, a Problematic CAR group, a Highest Stress/Normal Diurnal Slope group, and a Moderate Psychopathology/Normal Diurnal Slope group. Except for the Healthy group, the specific patterns of stress, mental health symptoms, and cortisol secretion identified in the literature were not found. The profiles were validated using variables that, in prior research, had shown relationships with the variables used to constitute the profiles—three types of parenting (neglectful, sensitive, and harsh), antisocial behavior, and physical health. We concluded that there is heterogeneity in women’s responses to stress. Current theories focused on the under- or over-production of diurnal cortisol in relation to stress and mental health symptoms are simplistic and fail to account for the significant subgroups of women who show unique biological and psychological responses. best free football betting tips uk oddslot latest football accumulator predictions u

Behavioral Coping Phenotypes and Associated Psychosocial Outcomes of Pregnant and Postpartum Women During the COVID-19 Pandemic

The impact of COVID-19-related stress on perinatal women is of heightened public health concern given the established intergenerational impact of maternal stress-exposure on infants and fetuses. There is urgent need to characterize the coping styles associated with adverse psychosocial outcomes in perinatal women during the COVID-19 pandemic to help mitigate the potential for lasting sequelae on both mothers and infants. This study uses a data-driven approach to identify the patterns of behavioral coping strategies that associate with maternal psychosocial distress during the COVID-19 pandemic in a large multicenter sample of pregnant women (N = 2876) and postpartum women (N = 1536). Data was collected from 9 states across the United States from March to October 2020. Women reported behaviors they were engaging in to manage pandemic-related stress, symptoms of depression, anxiety and global psychological distress, as well as changes in energy levels, sleep quality and stress levels. Using latent profile analysis, we identified four behavioral phenotypes of coping strategies. Critically, phenotypes with high levels of passive coping strategies (increased screen time, social media, and intake of comfort foods) were associated with elevated symptoms of depression, anxiety, and global psychological distress, as well as worsening stress and energy levels, relative to other coping phenotypes. In contrast, phenotypes with high levels of active coping strategies (social support, and self-care) were associated with greater resiliency relative to other phenotypes. The identification of these widespread coping phenotypes reveals novel behavioral patterns associated with risk and resiliency to pandemic-related stress in perinatal women. These findings may contribute to early identification of women at risk for poor long-term outcomes and indicate malleable targets for interventions aimed at mitigating lasting sequelae on women and children during the COVID-19 pandemic

Terminating supervision

The focus of this paper is on the termination of clinical supervision. Although clinical supervision is considered the backbone of most mental health training programs, it gets relatively little theoretical or empirical attention. The termination of supervision has received even less attention. In this paper, we describe an approach to terminating supervision in our treatment team, which integrates intensive assessment with a relational perspective in a clinical science training program (Levendosky & Hopwood, 2016). We describe our established conceptual framework, review empirical evidence, and provide verbatim examples from final supervision meetings on our team to elaborate the importance of conceptualizing individual differences across trainees and parallels between supervision and psychotherapy dynamics. We conclude by emphasizing the need for research on supervision in general and supervision termination in particular

A clinical science approach to training first year clinicians to navigate therapeutic relationships

In the rise of the clinical science movement within clinical psychology, the importance of the therapeutic relationship in training graduate students to do psychotherapy has been neglected compared with the emphasis on therapeutic techniques that target specific client symptoms. We argue that the reliable evidence for the importance of the therapeutic relationship for maintaining a therapeutic alliance and as a mechanism of change earns it a central place in training and supervision. We describe how we have used the principles of the clinical science perspective to develop a training model for graduate students emphasizing therapeutic relationships within the context of collaborative assessment and relational/interpersonal psychodynamic therapy. We use a case example to illustrate how our training model engages students in understanding and using the therapeutic relationship as a mechanism for change within treatments. We demonstrate how we have implemented this training model within the context of a clinical science program