Latent Classes of Childhood Poly-victimization and Associations with Suicidal Behavior among Adult Trauma Victims: Moderating Role of Anger

The aims of the present study were first to identify discrete patterns of childhood victimization experiences including crime, child maltreatment, peer/sibling victimization, sexual violence, and witnessing violence among adult trauma victims using latent class analysis; second, to examine the association between class-membership and suicidal behavior, and third to investigate the differential role of dispositional anger on the association between class-membership and suicidal behavior. We hypothesized that those classes with accumulating exposure to different types of childhood victimization (e.g., poly-victimization) would endorse higher suicidal behavior, than the other less severe classes, and those in the most severe class with higher anger trait would have stronger association with suicidal behavior. Respondents were 346 adults (N = 346; Mage = 35.0 years; 55.9% female) who had experienced a lifetime traumatic event. Sixty four percent had experienced poly-victimization (four or more victimization experiences) and 38.8% met the cut-off score for suicidal behavior. Three distinct classes emerged namely, the Least victimization (Class 1), the Predominantly crime and sibling/peer victimization (Class 2), and the Poly-victimization (Class 3) classes. Regression analysis controlling for age and gender indicated that only the main effect of anger was significantly associated with suicidal behavior. The interaction term suggested that those in the Poly-victimization class were higher on suicidal behavior as a result of a stronger association between anger and suicidal behavior in contrast to the association found in Class 2. Clinical implications of findings entail imparting anger management skills to facilitate wellbeing among adult with childhood poly-victimization experiences

Assessing relations between PTSD's dysphoria and reexperiencing factors and dimensions of rumination.

The purpose of the present study was to investigate the relations between posttraumatic stress disorder's (PTSD) dysphoria and reexperiencing factors and underlying dimensions of rumination. 304 trauma-exposed primary care patients were administered the Stressful Life Events Screening Questionnaire, PTSD Symptom Scale based on their worst traumatic event, and Ruminative Thought Style Questionnaire (RTSQ). Confirmatory factor analyses (CFAs) were conducted to determine the dysphoria and reexperiencing factors' relationships with the four factors of rumination. Results revealed that both the dysphoria and reexperiencing factors related more to problem-focused thinking and anticipatory thoughts than counterfactual thinking. Additionally, the reexperiencing factor related more to anticipatory thinking than repetitive thinking. Clinical and theoretical implications are discussed

The relationship between distress tolerance regulation, counterfactual rumination, and PTSD symptom clusters

Highlights We examined counterfactual (CFT) rumination, distress tolerance (DT) regulation, and PTSD. DT\u27s regulation was negatively associated with DSM-5 PTSD symptom clusters. CFT rumination mediated between DT\u27s regulation and PTSD\u27s intrusion symptoms. CFT rumination mediated between DT\u27s regulation and PTSD\u27s avoidance symptoms. Researching underlying mechanisms can lead to more precise clinical interventions. Abstract Background Distress tolerance (DT) and rumination both influence the development and maintenance of posttraumatic stress disorder (PTSD). However, few studies have investigated these constructs simultaneously. We investigated whether the regulation dimension of DT was associated with PTSD symptom clusters (intrusions, avoidance, negative alternations in cognitions and mood, alterations in arousal and reactivity), and whether counterfactual rumination (CFT) mediated these relationships. Methods This cross-sectional study sampled trauma-exposed adults (N = 119) seeking mental health services at a community mental health center. Participants completed self-report measures of DT, rumination, and PTSD. Mediation analyses were conducted using the SPSS PROCESS Macro. Results Lower scores on the DT regulation dimension were associated with higher PTSD symptom severity for all four symptom clusters, controlling for depression and number of traumas. CFT significantly mediated this relationship between DT\u27s regulation and PTSD\u27s intrusions and avoidance symptoms. Limitations Limitations included use of self-report data and the cross-sectional nature of this data. Conclusions Clinically, this study highlights that difficulties with regulating negative emotions can result in the use of maladaptive cognitive strategies, such as CFT. This, in turn, may exacerbate PTSD symptom severity, particularly intrusions and avoidance. This study highlights the importance of understanding specific dimensions of DT, rumination, and PTSD symptom clusters to develop precise and efficient psychological interventions

Persistent Complex Bereavement Disorder Symptom Domains Relate Differentially to PTSD and Depression: A Study of War-Exposed Bosnian Adolescents.

Persistent Complex Bereavement Disorder (PCBD) is a newly proposed diagnosis placed in the Appendix of the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an invitation for further research. To date, no studies have examined the dimensionality of PCBD or explored whether different PCBD criteria domains relate in similar, versus differential, ways to other psychological conditions common to war-exposed bereaved youth, including symptoms of Posttraumatic Stress Disorder (PTSD) and depression. We evaluated the dimensionality of proposed PCBD B and C symptom domains, and their respective relations with measures of PTSD and depression, in 1142 bereaved Bosnian adolescents exposed to the 1992-1995 Bosnian civil war. Instruments included the UCLA PTSD Reaction Index, the Depression Self-Rating Scale, and the UCLA Grief Screening Scale (a prototype measure of PCBD symptoms). We investigated potential differences in grief, PTSD, and depression scores as a function of cause of death. We then examined hypothesized differential relations between PCBD B and C symptom domain subscales and selected external correlates, specifically measures of depression and the four-factor emotional numbing model of PTSD. Results of both analyses provide preliminary evidence of a multidimensional structure for PCBD in this population, in that the PCBD Criterion C subscale score covaried more strongly with each of the four PTSD factors and with depression than did PCBD Criterion B. We conclude by discussing theoretical, methodological, clinical, and policy-related implications linked to the ongoing study of essential features of PCBD

Hispanic ethnicity and Caucasian race: Relations with posttraumatic stress disorder\u27s factor structure in clinic-referred youth.

The severity of posttraumatic stress disorder (PTSD) symptoms is linked to race and ethnicity, albeit with contradictory findings (reviewed in Alcántara, Casement, & Lewis-Fernández, 2013; Pole, Gone, & Kulkarni, 2008). We systematically examined Caucasian (n = 3,767) versus non-Caucasian race (n = 2,824) and Hispanic (n = 2,395) versus non-Hispanic ethnicity (n = 3,853) as candidate moderators of PTSD\u27s 5-factor model structural parameters (Elhai et al., 2013). The sample was drawn from the National Child Traumatic Stress Network\u27s Core Data Set, currently the largest national data set of clinic-referred children and adolescents exposed to potentially traumatic events. Using confirmatory factor analysis, we tested the invariance of PTSD symptom structural parameters by race and ethnicity. Chi-square difference tests and goodness-of-fit values showed statistical equivalence across racial and ethnic groups in the factor structure of PTSD and in mean item-level indicators of PTSD symptom severity. Results support the structural invariance of PTSD\u27s 5-factor model across the compared racial and ethnic groups. Furthermore, results indicated equivalent item-level severity across racial and ethnic groups; this supports the use of item-level comparisons across these groups

Factor Correlations for the Four-Factor Rumination Model.

<p><i>Note</i>. All factor correlations are significant at <i>p</i> < 0.001 level.</p><p>Factor Correlations for the Four-Factor Rumination Model.</p

Standardized Factor Loadings for the PTSD Dysphoria Model.

<p><i>Note</i>. All factor loadings are significant at <i>p</i> < 0.001 level.</p><p>Standardized Factor Loadings for the PTSD Dysphoria Model.</p

Factor Correlations for the Combined Dysphoria Model of PTSD and Four-Factor Rumination Model.

<p><i>Note</i>. All factor correlations are significant at <i>p</i> < 0.001 level.</p><p>Factor Correlations for the Combined Dysphoria Model of PTSD and Four-Factor Rumination Model.</p

Correlations between the Four-Factor Rumination Model and PTSD’s Dysphoria Factor, and the Corresponding Wald Test Values.

<p><i>Note</i>. PFT = Problem-Focused Thinking from RTSQ. CT = Counterfactual Thinking from RTSQ. RT = Repetitive Thinking from RTSQ. AT = Anticipatory Thinking from RTSQ.</p><p>RE = PTSD’s Reexperiencing DYS = PTSD’s Dysphoria.</p><p>*<i>p</i> < 0.05.</p><p>**<i>p</i> < 0.01.</p><p>Correlations between the Four-Factor Rumination Model and PTSD’s Dysphoria Factor, and the Corresponding Wald Test Values.</p

Factor Correlations for the PTSD Dysphoria Model.

<p><i>Note</i>. All factor correlations are significant at <i>p</i> < 0.001 level.</p><p>Factor Correlations for the PTSD Dysphoria Model.</p