A Complex Relationship: Intimate Partner Violence, Identification With the Aggressor, and Guilt.

This study explored the relation between guilt and identification with the aggressor (IWA) and the moderating role of IWA in the relation between intimate partner violence (IPV) and guilt. An online survey was conducted among a convenience sample of 700 women. IPV survivors demonstrated elevated guilt, and IWA was related to guilt. Furthermore, IWA moderated the relation between IPV and guilt: Among participants with low IWA levels, IPV was unrelated to guilt, but among participants with high IWA levels, IPV was related to guilt. These findings suggest that IWA may be a key element in explaining guilt among IPV survivors.

Frontline love: Romantic partners of frontline doctors and nurses during the New York City COVID-19 outbreak.

Objective: This qualitative study's aim was to learn how the spouses and romantic partners of frontline doctors and nurses dealt with the acute stress of the outbreak; the kinds of support they provided when the frontliners had to navigate COVID-19 at their hospitals; and, according to their perceptions, how this crisis impacted their relationship. Background: This study focused on the partners of frontliners working in hospitals during the crisis of the coronavirus outbreak in New York City (NYC)-one of the earliest epicenters of the COVID-19 pandemic in the United States. This study expanded upon the Family Stress Model-which examines how economic problems can affect marital quality and stability. Method: Interviews were conducted with 29 partners of frontliners who had been treating COVID-19 patients in NYC hospitals during the pandemic outbreak from February 29 to June 1, 2020. Partners were recruited via snowball sampling, interviewed via Zoom or telephone, and results were analyzed using thematic content analysis. Results: The following themes were found in the narratives: The burden of running the home independently; providing various kinds of support (concrete, emotional, and refraining from sexual and physical closeness); and the effects of the pandemic on the relationship via writing a will and discussing the possibility of death, the lack of relationship-ending threats, and emerging from the crisis with a strengthened relationship. Conclusion: The pandemic crisis unified the partners and frontliners, even in the face of multiple stressors.

Emotion Regulation and Distress During the COVID-19 Pandemic: The Role of Childhood Abuse.

The COVID-19 pandemic may be experienced as traumatogenic and may fuel or exacerbate psychological distress and trauma-related symptoms. Based on trauma research, one might expect that survivors of childhood abuse would be susceptible to these negative outcomes during the pandemic, and that among this population a stronger relation between emotion regulation difficulties and symptomatology would be found. Aiming to explore these suppositions, an online survey was conducted among 710 Israeli adults. Of them, 370 were childhood abuse survivors. A history of childhood abuse, COVID-19-related stressors, overall psychological distress, and peritraumatic stress symptoms during the pandemic were assessed via self-report measures. Participants with a history of childhood abuse had elevated overall psychological distress as well as peritraumatic stress symptoms during the pandemic, compared to nonabused participants, above and beyond demographic characteristics and COVID-19-related stressors. Emotion regulation difficulties were related to elevated psychological distress and peritraumatic stress symptoms among both childhood abuse survivors and nonabused participants. Nonetheless, a history of childhood abuse moderated the relations between the emotion regulation difficulty of being unable to engage in goal-directed behaviors when distressed (on one hand) and mental outcomes (on the other): Although the associations between inability to engage in goal-directed behaviors, overall psychological distress, and peritraumatic stress symptoms were nonsignificant among nonabused participants, they were significant among childhood abuse survivors. The current findings suggest that a history of childhood abuse might be a risk factor for distress in the face of COVID-19, and that childhood abuse survivors would benefit from clinical interventions that promote emotion regulation skills during this ongoing global health crisis.

Profiles in COVID-19: peritraumatic stress symptoms and their relation with death anxiety, anxiety sensitivity, and emotion dysregulation.

Background: The COVID-19 pandemic might be experienced as an ongoing traumatic event and could result in peritraumatic stress symptoms. Evidence implies that individuals' levels of death anxiety, anxiety sensitivity, and difficulties in emotion regulation may contribute to their peritraumatic stress symptomatology in the aftermath of trauma exposure. Objective: The current study aimed to explore these hypotheses in the context of the COVID-19 pandemic. Method: An online survey was conducted among a convenience sample of 846 Israeli adults from April 2 to 19 April 2020. COVID-19-related stressors, death anxiety, anxiety sensitivity, difficulties in emotion regulation, and peritraumatic stress symptoms were assessed via self-report questionnaires. Results: Analyses indicated significant relations between death anxiety, anxiety sensitivity, and emotion regulation difficulties, on the one hand, and peritraumatic stress symptoms, on the other. Three distinct profiles were identified. Furthermore, profile type - namely having low, medium, and high levels of death anxiety, anxiety sensitivity, and emotion dysregulation - had a significant effect in explaining peritraumatic stress symptoms. Conclusions: Results suggest that during the pandemic, levels of death anxiety, anxiety sensitivity, and emotion dysregulation may explain heterogeneity in individuals' trauma-related symptomatology.

Antecedentes: La pandemia del COVID-19 podría ser experimentada como un evento traumático en curso y podría resultar en síntomas de estrés peritraumático. La evidencia implica que los niveles individuales de la ansiedad por la muerte, la sensibilidad de la ansiedad, y las dificultades en la regulación emocional podrían contribuir a su sintomatología del estrés peritraumático en las secuelas de la exposición al trauma.Objetivo: El presente estudio buscó explorar estas hipótesis en el contexto de la pandemia del COVID-19.Método: Se realizó una encuesta en línea en una muestra por conveniencia de 846 adultos israelíes desde el 2 al 19 de abril de 2020. Los estresores relacionados al COVID-19, la ansiedad por la muerte, la sensibilidad de ansiedad, las dificultades en la regulación emocional, y los síntomas de estrés peritraumático fueron evaluados por medio de cuestionarios de auto-reporte.Resultados: Los análisis indicaron relaciones significativas entre la ansiedad por la muerte, la sensibilidad de la ansiedad, y las dificultades de regulación emocional, por un lado, y los síntomas de estrés peritraumático, por el otro lado. Tres perfiles distintivos fueron identificados. Además, el tipo de perfil ­ específicamente tener niveles bajos, medios, y altos de ansiedad por la muerte, sensibilidad de la ansiedad, y desregulación emocional ­ tuvieron un efecto significativo en explicar los síntomas de estrés peritraumático.Conclusión: Los resultados sugieren que, durante la pandemia, los niveles de ansiedad por la muerte, sensibilidad de la ansiedad, y desregulación emocional podrían explicar la heterogeneidad en la sintomatología relacionada al trauma de los individuos.

Punishing the Self: Post-Traumatic Guilt Mediates the Link Between Trauma and Deficient Pain Modulation.

Trauma survivors may suffer from post-traumatic stress disorder (PTSD), elevated post-traumatic guilt (PG), and alterations in the pain system. However, the association between PG and alterations in pain perception and modulation among trauma survivors has not been established, nor has the possible underlying role of PG. This longitudinal study investigated: 1) the unique contribution of PG in predicting pain perception and modulation, while controlling for PTSD symptoms; and 2) the mediating role of PG in explaining pain perception and modulation among torture survivors, above and beyond PTSD symptoms. Participants were 59 torture survivors and 44 age-matched controls. PG and PTSD symptoms were assessed in 2003 (T1). Heat-pain threshold, heat-pain tolerance, temporal summation of pain (TSP), and conditioned pain modulation (CPM) were measured 5 years later (T2). Torture survivors had elevated PG and PTSD symptoms, enhanced TSP, and reduced CPM, compared to controls. While PTSD predicted reduced pain tolerance and CPM, PG predicted increased pain tolerance. Moreover, PG mediated the associations between torture and (increased) pain threshold, pain tolerance, and TSP. It appears that PTSD and PG induce opposite effects on the pain modulation capacity of torture survivors, a dichotomy that may explain paradoxical pain responses among trauma survivors, as discussed. PERSPECTIVE: This longitudinal study sheds light on the possible mechanisms underlying variations in pain perception and modulation among trauma survivors. PTSD and PG each mediated opposing pain modulation profiles, suggesting that individual responses to trauma, rather than the trauma itself, influence pain responses.

Loneliness and subjective physical health among war veterans: Long term reciprocal effects.

RATIONALE: Poor subjective physical health and loneliness are among the most detrimental ramifications of trauma. Indeed, substantial research has examined the link between subjective physical health and loneliness, mainly focusing on how loneliness leads to poorer physical health. However, the effects of poor subjective physical health on loneliness, as well as the reciprocal effects of these two factors, have scarcely been examined. Even less is known regarding the course of these mutual effects among individuals who have been exposed to trauma. OBJECTIVE: The current investigation examines the reciprocal effects of subjective physical health and loneliness among a group of war veterans over four decades. METHODS: Two-hundred and seventy-four Israeli veterans from the 1973 Yom- Kippur War reported self-rated health (SRH), somatization and loneliness at 1991 (T1), 2003 (T2), 2008 (T3) and 2015 (T4). An autoregressive cross-lagged (ARCL) modeling strategy was employed to test the bidirectional relationship between subjective health and loneliness. RESULTS: The results showed that from T1 to T2, loneliness predicted subjective physical health. However, from T2 to T3, and from T3 to T4, subjective physical health predicted loneliness. PTSD moderated the association between loneliness and subjective physical health. CONCLUSION: The findings show a novel pattern of influences, demonstrating that the reciprocal effects of subjective physical health and loneliness change over time. The findings imply that subjective health and interpersonal experiences are inherently connected.

Does It Help? The Contribution of Wives' Ways of Giving Support to Their Veteran Husbands' Posttraumatic Stress Symptoms and Functional Impairment.

In this study, we aimed to understand female partners' ways of giving support to their male military veteran partners' adjustment. Specifically, we examined the direct and moderating contributions female partners' ways of giving support-active engagement, protective buffering, or overprotection-make on their male partners' posttraumatic stress symptoms (PTSS) and functional impairment. Our hypotheses were that (a) female partners' active engagement would be negatively correlated with male veterans' PTSS and positively associated with veterans' functioning, (b) female partners' protective buffering and overprotection would be positively correlated with veterans' PTSS and negatively associated with veterans' functioning, and (c) female partners' ways of giving support would moderate the association between their secondary PTSS and male partners' adjustment. Participants were 300 male Israeli veterans of the 2006 Israel-Lebanon War and their female partners, all of whom completed self-report questionnaires. Active engagement did not contribute to female partners' or veterans' adjustment. In addition, whereas the correlations showed both female partners' protective buffering and overprotection were associated with male veterans' adjustment, the regression analysis showed only protective buffering made a direct, η2 = .040 and .053, and moderating contribution to veterans' adjustment, η2 = .019 and .016. Results revealed that when the level of protective buffering was high, female partners' secondary PTSS was associated more positively and strongly with veterans' PTSS than when protective buffering was low. The discussion reviews the complexity of giving support in couples when the veteran has PTSS.

Twofold trauma exposure - the dual function of attachment avoidance.

Spouses of traumatized war veterans might suffer from distress following indirect exposure to combat and direct exposure to domestic abuse. Yet the effect of this twofold trauma exposure is far from being fully understood. Theory views attachment security as a personal resource mitigating adversity, whereas attachment insecurities intensify distress. Nevertheless, there are mixed results concerning the effects of attachment in the aftermath of trauma. Furthermore, the role of trauma exposure levels regarding the effects of attachment remains largely uninvestigated. Filling these gaps, this study assessed female military spouses 30 (T1) and 38 (T2) years after the 1973 Yom Kippur War. Direct (domestic abuse) and indirect (veteran partners' posttraumatic stress symptoms) trauma exposure, attachment, depression, and anxiety were assessed. Findings indicated an interaction between the trauma types in predicting spouses' anxiety. Domestic abuse moderated the relations between attachment and distress. Although attachment anxiety had nonsignificant effects on anxiety among low-level domestic abuse sufferers, it predicted elevated anxiety among high-level domestic abuse sufferers. Furthermore, while attachment avoidance predicted elevated distress among low-level domestic abuse sufferers, its effects dissolved or became positive in nature among high-level domestic abuse sufferers. Discussion focuses on evolutionary explanations of the functions of attachment under different conditions of threat.

The double-edged sword: The role of empathy in military veterans' partners distress.

OBJECTIVE: The existing literature has shown that war veterans' posttraumatic stress symptoms (PTSS) are associated with high levels of distress in their female partners. According to the literature, spouses' empathy for their spouses can be a risk factor for their own mental health. However, this subject has not been examined among veteran couples. The current study therefore investigated both the direct and moderating contribution of females' cognitive and affective empathy to their own PTSS and depression symptoms, above and beyond the preexisting traumatic events of the women's own lives and the veterans' PTSS. METHOD: Participants were 300 Israeli men who had served in the 2006 Israel-Lebanon War and their female partners, all of whom completed survey questionnaires. RESULTS: Results revealed that although cognitive empathy can play a positive role for the female in the aftermath of a traumatic event, affective empathy can potentially make a negative contribution to her distress. Women's education, in number of years, and their own previous traumatic life events, as well as veterans' levels of PTSS, were all found to make a direct contribution to females' PTSS and depression symptoms. CONCLUSION: Findings support the theory that although higher empathy can play a positive role in military couples in which the male partner displays symptoms of PTSS symptoms, it can also contribute negatively to her distress. (PsycINFO Database Record

The contribution of mastery to mental health and purpose in life among female veterans with disabilities in Israel.

Self-report questionnaires assessing mental health, purpose in life (PIL) and mastery were administered to 61 female veterans with disabilities (FVWD) and compared 72 demographically matched women in control group without disabilities to learn about use of personal resources in promoting well-being and resilience. Age range was 20-82, average age was 48.87. Data were collected in Israel. FVWD reported significantly lower levels of mental health, PIL, and mastery than the comparison group. Group affiliation moderated association between mastery and mental health, and between mastery and PIL. For FVWD, higher mastery was associated with lower mental health and PIL.

School-related experiences of adolescents in foster care: A comparison with their high-school peers.

Although adolescents in foster care are known to be more at risk for school-related academic challenges, there is a paucity of research on their school-related experiences, such as victimization and relationships with teachers, compared with their same-age peers not in care. The aim of this article is to compare foster-care adolescents and their schoolmates on data that was drawn from the statewide representative California Healthy Kids survey and includes 165,815 nonfoster youth and 706 foster youth in 9th and 11th grades. Findings indicate a consistent pattern: After controlling for age, gender and race, adolescents in foster care have lower (self-reported) academic achievements and experiences that are more negative in school compared with their peers. However, hierarchical regression equations indicate that after controlling for background and school experiences, there were no significant differences in academic achievements between foster care youth and their high school peers. This finding may reflect that in-school experiences are responsible for many of the more negative academic outcomes experienced by foster youth. (PsycINFO Database Record

Secondary traumatization of partners of war veterans: The role of boundary ambiguity.

The existing literature has shown that war veterans' posttraumatic stress disorder (PTSD) symptoms are associated with a higher level of distress in their female partners. However, less agreement exists regarding the sources of this distress and the mechanism by which this process occurs. The current study examined the consequences of Israeli war veterans' PTSD on their female partners, as manifested by the females' PTSD symptoms, mental health status, and functioning, while taking into account females' earlier traumatic events. Using the theory of ambiguous loss, it also suggested boundary ambiguity as a mediating variable by which the PTSD of the male veteran is transmitted to his female partner. Participants were 300 men who had served in the 2006 Israel-Lebanon War and their female partners. Results revealed direct associations between males' PTSD and their female partners' PTSD, functioning, and mental health. In addition, boundary ambiguity mediated the association between males' PTSD and females' adjustment. Finally, females' own earlier traumatic events were directly associated with their own PTSD symptoms. Implications of this model for intervention and research are further discussed.