The day-to-day relationship between posttraumatic stress symptoms and social support after sexual assault.

Background: Experiencing sexual assault is associated with a significant increase in risk for developing posttraumatic stress disorder and related concerns (e.g. alcohol misuse). Cross-sectional and longitudinal evidence suggests that social support may be both broadly protective against and eroded by posttraumatic stress symptoms. However, little is known about how different aspects of social support and posttraumatic stress symptoms influence each other in the weeks and months immediately following sexual assault, when posttraumatic stress (PTS) symptoms first emerge.Objective: The present study assessed the day-to-day relationship between social support and PTS in a sample of distressed, alcohol-using, recently-assaulted female survivors participating in a clinical trial of an app-based intervention (N = 41).Method: Participants completed 3 weeks of daily diaries starting within 10 weeks of sexual assault. Mixed-effects models were used to examine prior-day and same-day relationships between PTS and four social support constructs (social contact, emotional support, pleasantness of social interactions, and talking about sexual assault).Results: Results indicate that higher quantity and pleasantness of social interactions over the full sampling period was associated with lower PTS symptoms on any given day. Experiencing better-than-typical social interactions on one day was associated with lower than typical PTS symptoms on that day and the next day. On days when participants discussed their sexual assault with others, they tended to be having higher than usual PTS symptoms.Conclusions: Findings suggest that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.Trial registration: ClinicalTrials.gov identifier: NCT03703258.

In N = 41 distressed and alcohol-using female survivors of recent sexual assault, having a higher quantity of social interactions and more pleasant social interactions within 10 weeks of assault was associated with lower posttraumatic stress symptoms.When survivors' social interactions were more pleasant than average on one day, their posttraumatic stress symptoms tended to be lower than average the next day, and recent survivors were more likely to talk about sexual assault on days when their posttraumatic stress symptoms were higher than usual.Interventionists should take note that increasing the quantity and pleasantness of social interactions soon after sexual assault might protect against worsening posttraumatic stress symptoms.

Design and Implementation of a Clinical Science Specialty Clinic for Adults with Neurological Disorders and Their Caregivers.

Mental health problems are common for persons with neurological disorders (PWNDs) and their caregivers (CGs) but often are not adequately treated. Despite this growing need, the training of clinical psychologists typically does not include coursework or practicum experience working with these populations. To address this, a team of faculty, supervisors, and doctoral students in UC Berkeley's Clinical Science program undertook a year-long process that consisted of building a training curriculum that integrated coursework and consultation with visiting experts; providing supervised practicum training with PWNDs and CGs and evaluating training and clinical outcomes. We hoped to prepare students to train other mental health professionals to work with these populations in the future. In this article, we describe the Specialty Clinic with special attention given to the training provided, challenges faced and solutions found, clinic operations and logistics, and lessons learned. We also review key clinical issues and report key indicators of client outcomes. Finally, we evaluate the success of the Specialty Clinic and offer recommendations for others interested in providing these kinds of much needed training and clinical services in this important area.

Identifying and predicting posttraumatic stress symptom states in adults with posttraumatic stress disorder.

Between-person heterogeneity of posttraumatic stress disorder (PTSD) is well established. Within-person analyses and the DSM-5 suggest that heterogeneity may also be evident within individuals across time as they move through social contexts and biological cycles. Modeling within-person symptom-level fluctuations may confirm such heterogeneity, elucidate mechanisms of disorder maintenance, and inform time- and person-specific interventions. The present study aimed to identify and predict discrete within-person disorder presentations, or symptom states, and explore group-level patterns of these states. Adults (N = 20, 60.0% male, M age = 38.25 years) with PTSD responded to symptom surveys four times per day for 30 days. We subjected each individual's dataset to Gaussian finite mixture modeling (GFMM) to uncover latent, within-person classes of symptom levels (i.e., states) and predicted those states with idiographic elastic net regularized regression using a set of time-based and behavioral predictors. Next, we conducted a GFMM of the within-person GFMM outputs and tested idiographic prediction models of these states. Multiple within-person states were revealed for 19 of 20 participants (Mdn = 4; 66 for the full sample). Prediction models were moderately successful, M AUC = .66 (d = 0.58), range: .50-1.00. The GFMM of the within-person model outputs revealed two states: one with above-average and one with below-average symptom levels. Prediction models were, again, moderately successful, M AUC = .66; range: .50-.89. The findings provide evidence for within-person heterogeneity of PTSD as well as between-person similarities and suggest that future work should incorporate additional contextual variables as symptom state predictors.