Trauma and PTSD symptoms: Does spiritual struggle mediate the link?

Because exposure to potentially traumatic events is common (Kessler, Sonnega, Bromet, & Hughes, 1995), the mechanisms through which posttraumatic stress disorder (PTSD) symptoms develop is a critical area of investigation (Ozer, Best, Lipsey, & Weiss, 2003). Among the mechanisms that may predict PTSD symptoms is spiritual struggle, a set of negative religious cognitions related to understanding or responding to stressful events. Although prominent theories emphasize cognitive factors in the development and maintenance of PTSD symptoms, they have not explicitly addressed spiritual struggle. The present prospective study tested the role of spiritual struggle in the development and maintenance of PTSD symptoms following trauma. We assessed exposure to trauma and nontrauma events during the first year of college, spiritual struggle due to the most stressful event, and PTSD symptoms resulting from the index event. Spiritual struggle partially mediated the relationship between trauma and PTSD symptoms. We found interesting that some individual subscales of spiritual struggle (specifically, Punishing God Reappraisal, Reappraisal of God's Powers, and Spiritual Discontent) partially mediated the relationship between trauma and PTSD symptoms; however, reappraisal of the event to evil forces did not relate to PTSD symptoms. These results suggest that spiritual struggle is an important cognitive mechanism for many trauma victims and may have relevance for cognitive therapy for PTSD

Measuring Beliefs about Suffering: Development of the Views of Suffering Scale

Efforts to measure religion have intensified and many specific dimensions have been identified. However, although belief is a core dimension of all world religions, little attention has been given to assessment of religious beliefs. In particular, one essential set of religious beliefs, those concerning the reasons for human suffering, has remained virtually unexamined in spite of the potential clinical relevance of these beliefs. To fill the need for a measure of people’s beliefs about suffering, we developed the Views of Suffering Scale (VOSS). Analyses identified factors related to traditional Christian teachings, unorthodox theistic beliefs, karma, and randomness. Internal consistency and test-retest reliability for VOSS subscale scores were good (α’s and r’s ≥ .70). Comparisons to measures of related constructs suggest that the VOSS scores demonstrate good convergent validity. One subscale score was modestly correlated with social desirability related to image management, and seven were positively correlated to self-deceptive enhancement. These preliminary studies suggest that the VOSS differentiates religious perspectives on suffering among a sample of US university students, though more research is needed to confirm its utility in diverse populations. The VOSS provides a valid way to measure individuals’ beliefs about suffering, allowing for inquiry into the factors that lead to various beliefs about suffering and the roles of these beliefs in adjusting to stressful life events

PTSD as meaning violation: Testing a cognitive worldview perspective

The cognitive perspective on posttraumatic stress disorder (PTSD) has been successful in explaining many PTSD-related phenomena and in developing effective treatments, yet some of its basic assumptions remain surprisingly underexamined. The present study tested 2 of these assumptions: (1) situational appraisals of the event as violating global meaning (i.e., beliefs and goals) is related to PTSD symptomatology, and (2) the effect of situational appraisals of violation on PTSD symptomatology is mediated by global meaning (i.e., views of self and world). We tested these assumptions in a cross-sectional study of 130 college students who had experienced a Diagnostic and Statistical Manual of Mental Disorders (4th ed., American Psychiatric Association, 1994) level trauma. Structural equation modeling showed that appraisals of the extent to which the trauma violated one's beliefs and goals related fairly strongly to PTSD. In addition, the effects of appraisals of belief and goal violations on PTSD symptoms were fully mediated through negative global beliefs about both the self and the world. These findings support the cognitive worldview perspective, highlighting the importance of the meaning individuals assign to traumatic events, particularly the role of meaning violation

Stressful and positive experiences of women who served in Vietnam

Experiences of women who served during the Vietnam War have been described in interviews/anecdotal reports but rarely in empirical literature. Potential positive (versus negative) aspects of service or its impact on well-being are seldom considered. We describe stressful and positive experiences reported by approximately 1,300 female military personnel, Red Cross workers, and others deployed to Vietnam. Prominent stressful (e.g., negative living/working conditions) and positive (e.g., interpersonal relationships) themes and differences based on trauma history, Vietnam experiences, and group membership are explored. We evaluate associations between themes and psychological well-being. Findings provide insight into experiences of this understudied group of women

Facets of spirituality as predictors of adjustment to cancer: Relative contributions of having faith and finding meaning

Spirituality is a multidimensional construct, and little is known about how its distinct dimensions jointly affect well-being. In longitudinal studies (Study 1, n = 418 breast cancer patients; Study 2, n = 165 cancer survivors), the authors examined 2 components of spiritual well-being (i.e., meaning/peace and faith) and their interaction, as well as change scores on those variables, as predictors of psychological adjustment. In Study 1, higher baseline meaning/peace, as well as an increase in meaning/peace over 6 months, predicted a decline in depressive symptoms and an increase in vitality across 12 months in breast cancer patients. Baseline faith predicted an increase in perceived cancer-related growth. Study 2 revealed that an increase in meaning/peace was related to improved mental health and lower cancer-related distress. An increase in faith was related to increased cancer-related growth. Both studies revealed significant interactions between meaning/peace and faith in predicting adjustment. Findings suggest that the ability to find meaning and peace in life is the more influential contributor to favorable adjustment during cancer survivorship, although faith appears to be uniquely related to perceived cancer-related growth

Factor structure of the acute stress disorder scale in a sample of Hurricane Katrina evacuees

Acute stress disorder (ASD) is a poorly understood and controversial diagnosis (A. G. Harvey & R. A. Bryant, 2002). The present study used confirmatory factor analysis (CFA) to test the factor structure of the most widely used self-report measure of ASD, the Acute Stress Disorder Scale (R. A. Bryant, M. L. Moulds, & R. M. Guthrie, 2000), in a sample of Hurricane Katrina evacuees relocated to a Red Cross emergency shelter in Austin, Texas. Results indicated that the proposed 4-factor structure did not fit the data well. However, an alternate 2-factor model did fit the data well. This model included a second-order Distress factor (onto which the Reexperiencing, Arousal, and Avoidance factors loaded strongly) that was positively correlated with the Dissociation factor. Implications for the ASD construct and its measurement are discussed

Investigating Veterans’ Pre-, Peri-, and Post-Deployment Experiences as Potential Risk Factors for Problem Gambling

Background and aims Gambling disorder and its comorbid diagnoses are observed at higher rates in military veterans than in the general population. A significant research gap exists regarding the relationships of veterans’ life and service experiences to problematic gambling. The present study explored pre-, peri-, and post-deployment factors associated with problem gambling in veterans. Methods Veterans of Operation Iraqi Freedom, Operation Enduring Freedom, and Operation New Dawn (n = 738; 463 males, and 275 females) completed questionnaires via structured telephone interview. We conducted bivariate and multinomial logistic regression analyses exploring associations among problem-gambling severity and socio-demographic variables, psychiatric comorbidities, and 10 scales of the Deployment Risk and Resilience Inventory measuring experiences pre-, peri-, and post-deployment. Results Approximately 4.2% of veterans indicated at-risk or probable pathological gambling (ARPG) post-deployment (two or more DSM-IV criteria for pathological gambling). Bivariate analyses found more severe gambling in males, higher frequencies of post-traumatic stress disorder, substance dependence, traumatic brain injury, panic disorder, and depression in veterans with ARPG, and higher general harassment during deployment, and lower social support and more stressful life events post-deployment in those with ARPG. In multivariable models, both post-deployment factors remained significantly associated with ARPG. Discussion The study suggests that problem gambling among veterans is related to service experiences, and particularly to life experiences post-deployment. Conclusions Adverse service and life experiences and lack of social support may contribute to the risk of problem gambling in military veterans. Investigation of how Veterans Affairs clinical settings may serve veterans following deployment to prevent behavioral addictions is warranted

Disability and Health in African Americans: Population Research and Implications for Occupational Therapy Community-Based Practice

Background: Population-based research and community-based interventions are integral to occupational therapy’s scope of practice, yet they are underdeveloped in actual implementation. Therefore, this paper focuses on some health challenges facing the African American population, guided by the Person-Environment-Occupation-Performance Model. Method: Using data from an observational cross-sectional nationwide telephone survey of African American adults, we examined differences between African Americans who are receiving disability payments (RDP) and those who are employed full time (FTE) on several physical health behaviors and psychosocial health indicators. We further compared the differences between African Americans RDP versus those FTE on those physical health behaviors and psychosocial health indicators across five US regions. Results: Findings suggest that African Americans RDP are engaging in fewer positive physical health behaviors and experiencing worse psychosocial health compared to their counterparts FTE. There are also nuanced regional variations in the differences between African Americans RDP and FTE in physical health behaviors and psychosocial health indicators. Conclusion: This research highlighted some health challenges of African Americans RDP and FTE using a regional lens, demonstrating the value of OT population-based research. There is a need for OT population-specific community-based practice to address the health disparities of underserved and minority populations, such as African Americans

Human interaction with the divine, the sacred, and the deceased: topics that warrant increased attention by psychologists

Humans have likely been attempting to communicate with entities believed to exist, such as the divine, sacred beings, and deceased people, since the dawn of time. Across cultures and countries, many believe that interaction with the immaterial world is not only possible but a frequent experience. Most religious traditions across the globe focus many rituals and activities around prayer to an entity deemed divine or sacred. Additionally, many people–religious, agnostic, and atheists alike–report communication with their departed loved ones. During highly stressful times associated with natural disasters, war, pandemics, and other threats to human life, the frequency and intensity of these activities and associated experiences substantially increase. Although this very human phenomenon seems to be universal, the empirical literature on the topic within psychology is thin. This paper discussed the topic and reviews what we know from the professional literature about how people perceive communication with these unseen entities. It highlights the perceptual and social cognition evidence and discussed the role of attribution theory, which might help us understand the beliefs, motivations, and practices of those engaged with communication with the unseen. Empirical laboratory research with mediums is discussed as well, examining the evidence for communication with the deceased. Final reflections and suggestions for future research are also offered

Psychopathology and Hypersexuality among Veterans with and without Histories of Alcohol‐use Disorders

Background and Objectives: Little research has examined the clinical characteristics of U.S. post‐9/11 military veterans coping with alcohol problems. Specifically, we examined psychopathology and hypersexuality among male and female post‐9/11 veterans with and without a lifetime history of alcohol‐use disorders (AUDs). Methods: Using data from a baseline telephone interview and follow‐up web‐based survey, we examined frequencies of AUDs, mental health and addictive disorders, sexual behaviors, hypersexuality, and problematic use of pornography in a national convenience sample of 283 U.S. veterans. Results: Many (39.1%) veterans met lifetime criteria for AUDs. Bivariate associations revealed that veterans with lifetime AUDs met clinically significant levels of posttraumatic stress disorder and criteria for drug‐use disorders (lifetime). Veterans with lifetime AUDs also attended religious services less often, engaged in more solitary masturbation in the past month, and reported more issues with problematic use of pornography and hypersexuality compared with veterans without AUDs. Results from a logistic regression found that lifetime drug‐use disorders (odds ratio [OR] = 4.22) and posttraumatic stress disorder symptoms (OR = 1.98) were significant predictors of veterans with lifetime AUD status. Discussion and Conclusions: We found differences among veterans with lifetime AUDs compared with those without on select measures of psychopathology, sexual behavior, and hypersexuality. Scientific Significance: Further screening for substance‐use disorders and hypersexuality in Veterans Affairs is strongly encouraged while veterans are transitioning back into civilian life