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The current study aimed to identify profiles of youth presenting with a unique combination of environmental characteristics and understand the differential relationship between profile membership, anxiety, and depression symptoms. Data were drawn from 158 Latino youth between the ages of 11 and 13. Youth provided information on community violence exposure, acculturative stress, familial and peer support, and parental supervision. Main analyses included Latent Profile Analysis and Multivariate Analysis of Variance. Support for a four-profile model was found. Profiles are distinguished by mean levels of community violence exposure, acculturative stress, familial and peer support, and parental supervision. Profile membership was significantly associated with anxiety and depression, separately. Those belonging to the profile with the highest levels of environmental risk reported the highest levels of anxiety and depression. Findings contribute to a personalized understanding of risk and protective experiences in the environment for Latino youth.
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Ansiedade , Depressão , Exposição à Violência , Meio Social , Adolescente , Criança , Humanos , Hispânico ou LatinoRESUMO
Brief behavioral therapy (BBT) is an efficacious transdiagnostic intervention for pediatric anxiety and depression that targets behavioral avoidance as a key mechanism. It is unknown if change in avoidance mediates treatment effects, as theorized. Data on avoidance at baseline and Week 16 were available on 52 youth (ages 8-16 years) from a randomized controlled trial (Weersing, Jeffreys, et al., 2017) comparing BBT and assisted referral to community care (ARC). BBT had significant effects on youth-reported behavioral avoidance, and significant indirect effects on functioning and anxiety, statistically mediated through changes in youth-reported behavioral avoidance. Change in youth-reported avoidance was not a significant mediator of depression. Parent-report of avoidance was not impacted by treatment and was not a significant mediator. Overall, BBT appears to be an effective treatment for targeting behavioral avoidance, which in turn, may improve functioning and lessen anxiety. CLINICAL TRIAL REGISTRATION INFORMATION: https://clinicaltrials.gov; NCT01147614.
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Terapia Cognitivo-Comportamental , Depressão , Adolescente , Humanos , Criança , Depressão/terapia , Transtornos de Ansiedade/terapia , Transtornos de Ansiedade/diagnóstico , Terapia Comportamental , Ansiedade/terapiaRESUMO
OBJECTIVE: Research to date has not examined how childhood sexual trauma (CST) followed by sexual trauma during military service (MST) relates to posttraumatic stress disorder (PTSD), depression, and suicidality among women and men. Given the strong association between MST in particular, and these serious posttraumatic outcomes, the current study sought to address this gap. METHOD: The current study compared the mental health concerns of 268 treatment-seeking veterans who were survivors of CST, MST, or both (CST + MST). We hypothesized that MST would be associated with greater severity of symptoms compared with CST and that those who experienced sexual revictimization (CST + MST) would report more severe symptoms than veterans who experienced CST or MST alone. RESULTS: Veteran men presented with significantly higher suicidality but not higher PTSD or depression scores than women. Controlling for gender, MST survivors had significantly higher PTSD and depression symptom severity scores, but not suicidality, than CST survivors. PTSD, depression, and suicidality scores were significantly higher for the CST + MST group than for CST only survivors, but did not significantly differ from survivors of MST alone. CONCLUSION: Findings support the more severe clinical impact of CST + MST-specific sexual revictimization compared with CST-only among military men and women, but also suggest that MST alone can have negative consequences similar to revictimization. While results point to the need to consider context and trauma history in future trauma research and clinical applications, they should be interpreted in light of our sample demographics, which were representative of the southwest U.S. veteran population. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Studies informing ways to target aggression in youth, particularly through the identification of internal patterns predictive of concurrent and future levels of aggression, could be particularly beneficial. To this end, the current study surveyed 216 elementary-aged children on topics of perceived containment (i.e., perceived ability of authority figures to control, limit, and set consequences for one's behaviors), coping responses, and reactive (RA) and proactive aggression (PA). Using multilevel modeling, the individual and interactive effects of coping responses and perceived containment on aggression within time and across two school years were examined. Within time, lower levels of perceived containment were associated with greater RA and PA. Passive coping was also positively associated with RA. The relation between perceived containment and RA within time was dependent on humor, whereas the relation between perceived containment and PA depended on problem-solving. Across time, while T1 passive coping predicted the trajectory of both functions of aggression, a greater number of T1 coping responses predicted the slope of RA with problem-solving and friend support-seeking as well as T1 perceived containment also predicting the trajectory of RA. No coping responses moderated the relation between T1 perceived containment and the trajectory of RA. In contrast, humor moderated the influence of T1 perceived containment and the trajectory of PA. Findings give insight into the ways internal processes of perceived containment and coping are associated with patterns of aggression in elementary-aged youth. This work is valuable in identifying several potential areas for prevention and intervention research.
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Adaptação Psicológica , Agressão , Adolescente , Criança , Humanos , Idoso , Agressão/fisiologia , Instituições Acadêmicas , Inquéritos e QuestionáriosRESUMO
INTRODUCTION: The perinatal period constitutes an important window of opportunity for optimizing healthy development of offspring but is heavily influenced by maternal mental health. Maternal pregnancy-related anxiety (PrA), depression, and post-traumatic stress disorder (PTSD) have been implicated in adverse outcomes for both mother and child. The current study examined whether psychopathology during pregnancy and postpartum was associated with greater experienced parenting stress and bonding difficulties in women veterans, who may be predisposed to develop psychopathology due to heightened risk of exposure to traumatic events. METHODS: Pregnant veterans (N = 28) completed self-report questionnaires regarding their PrA, depression and PTSD symptoms during pregnancy and postpartum, as well as on their experience of parenting stress and bonding with their infant. RESULTS: PrA was a more robust predictor of postpartum depression (PPD) than depression during pregnancy. PPD, in turn, was significantly associated with bonding and parenting stress, such that more depressed mothers were more likely to experience greater general bonding difficulties, increased rejections and pathological anger towards their infants, greater anxiety towards their infants, and more parenting stress. CONCLUSIONS: PrA might be a high-yield modifiable risk factor in the prevention of PPD for women veterans and their subsequent experiences with high parenting stress and bonding difficulties.
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Depressão Pós-Parto , Transtornos de Estresse Pós-Traumáticos , Veteranos , Depressão Pós-Parto/diagnóstico , Depressão Pós-Parto/epidemiologia , Feminino , Humanos , Lactente , Relações Mãe-Filho , Mães , Apego ao Objeto , Período Pós-Parto , Gravidez , Transtornos de Estresse Pós-Traumáticos/epidemiologiaRESUMO
BACKGROUND: Pregnant veterans are a subpopulation known to be at elevated risk of developing mental health symptoms, such as depression and suicidal ideation. Inflammation has been associated with depression, specifically during the perinatal period. Critical changes in estradiol, cortisol, and inflammatory cytokines are necessary for the progression of a healthy pregnancy, which are then rapidly altered in the postpartum period. We explored changes in estradiol, cortisol, and pro-inflammatory cytokines relative to depressive symptoms and suicidal thoughts across pregnancy and postpartum in this pilot and feasibility study. METHODS: We measured estradiol, cortisol, and the inflammatory cytokines IL-1ß, IL-6, IL-8, IFN-γ, and TNF-α in 18 pregnant veterans and analyzed the data using descriptive statistics, dependent t-tests, and correlation analyses. We assessed depression severity with the Edinburgh Postnatal Depression Scale and suicidality with the Columbia-Suicide Severity Rating Scale. Thirteen of the women repeated assessments in the early postpartum period at an average of 6.7 weeks after birth. RESULTS: As anticipated, estradiol (t(12) â= â12.47, p â< â.001) and cortisol (t(12) â= â9.43, p â< â.001) significantly decreased from pregnancy to postpartum. There were no differences in the means of gestational and postpartum IL-1ß, IL-6, TNF-α, or IFN-γ, but IL-8 was significantly increased from pregnancy to postpartum (t(12) â= â-4.60, p â= â.001). Estradiol during pregnancy was positively correlated with IL-6 levels both during pregnancy (r p â= â.656, p â= â.008) and postpartum (r â= â0.648, p â= â.023). Elevated IL-1ß was associated with suicidal thoughts during pregnancy (r â= â0.529, p â= â.029). Although not statistically significant, depressive symptom severity trended towards a positive association with larger increases in IL-1ß (r â= â0.535, p â= â.09) and TNF-α (r â= â0.501, p â= â.08) from pregnancy to postpartum. CONCLUSION: This preliminary study suggests the feasibility of our approach for exploring a complex interplay between hormonal and pro-inflammatory changes from pregnancy to postpartum, and their relationship with depressive symptoms. Given our small sample and the relatively exploratory nature of our analyses, additional investigation focusing on hormonal and inflammatory changes and their potential associations with perinatal mental health is necessary to confirm and extend our preliminary findings and examine additional potential covariates.
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INTRODUCTION: Pregnancy and postpartum, or the perinatal period, are times when women are particularly vulnerable to mental health concerns, including suicidal ideation. Risk factors for suicidal ideation during this period of a woman's life are depression and exposure to trauma, the latter of which may occur during military operations. The number of women veterans in the United States continues to rise, as does their use of maternity benefits. In this pilot study, we examined the feasibility of recruiting pregnant veterans for longitudinal research. We hypothesized that hopelessness and depressive symptoms would be related to suicidal ideation during the perinatal period, and we investigated a possible relationship between post-traumatic stress symptoms (PTSS) and suicidal ideation. MATERIALS AND METHODS: Using the designated Veterans Affairs (VA) maternity care coordinator's census, we contacted pregnant women veterans for assessment during the 3rd trimester of pregnancy and 6 weeks postpartum at the San Diego VA. Between September 2017 and October 2018, 28 women volunteers completed the following measures: the Columbia-Suicide Severity Rating Scale (C-SSRS); the Beck Hopelessness Scale (BHS); the Edinburgh Postnatal Depression Scale (EPDS); and the PTSD Checklist for DSM-5 (PCL-5). We used correlational analyses and descriptive statistics to determine associations among the measures. RESULTS: As gathered from the C-SSRS, over 30% of the veteran women had past lifetime suicide attempts, and over 10% of the veterans had suicidal ideation in the perinatal period. Both depression and PTSS rates neared 30% during pregnancy and postpartum. Hopelessness and depressive symptoms were positively correlated at both time points. While the intensity of lifetime suicidal ideation was correlated with postpartum depressive symptoms, there was no correlation with current suicidal ideation and depressive symptoms. PTSS correlated with both depressive symptoms and hopelessness, but not suicidal ideation, at both time points. There was no correlation between hopelessness and suicidal ideation during the perinatal period in this cohort. CONCLUSIONS: It is important to understand the mental health needs of perinatal veterans given their vulnerability to develop mental health concerns, including suicidal ideation. The unpredicted pattern of correlations determined in this study implies the need for multifaceted measures for safety-related mental health assessment of perinatal veterans, including assessment for PTSS. Strengths of this study include its longitudinal assessment and a sampling from a general population of veterans. Limitations include small sample size, a single gestational time point, and loss of participants who did not return for their postpartum assessment. We demonstrated the feasibility of longitudinal research with pregnant and postpartum veterans, but additional assessment points during the perinatal period could help identify critical times for mental health intervention in this population.
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Veteranos , Depressão/epidemiologia , Feminino , Humanos , Serviços de Saúde Materna , Avaliação das Necessidades , Projetos Piloto , Período Pós-Parto , Gravidez , Fatores de Risco , Ideação Suicida , Estados Unidos/epidemiologiaRESUMO
There is considerable interest in developing complementary and integrative approaches for ameliorating posttraumatic stress disorder (PTSD). Compassion meditation (CM) and loving-kindness meditation appear to offer benefits to individuals with PTSD, including symptom reduction. The present study was a pilot randomized controlled trial of CM for PTSD in veterans. The CM condition, an adaptation of Cognitively-Based Compassion Training (CBCT®), consists of exercises to stabilize attention, develop present-moment awareness, and foster compassion. We compared CM to Veteran.calm (VC), which consists of psychoeducation about PTSD, rationale for relaxation, relaxation training, and sleep hygiene. Both conditions consist of 10 weekly 90-min group sessions with between-session practice assignments. A total of 28 veterans attended at least one session of the group intervention and completed pre- and posttreatment measures of PTSD severity and secondary outcomes as well as weekly measures of PTSD, depressive symptoms, and positive and negative emotions. Measures of treatment credibility, attendance, practice compliance, and satisfaction were administered to assess feasibility. A repeated measures analysis of variance revealed a more substantive reduction in PTSD symptoms in the CM condition than in the VC condition, between-group d = -0.85. Credibility, attendance, and satisfaction were similar across CM and VC conditions thus demonstrating the feasibility of CM and the appropriateness of VC as a comparison condition. The findings of this initial randomized pilot study provide rationale for future studies examining the efficacy and effectiveness of CM for veterans with PTSD.
Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Meditación de compasión para el trastorno de estrés postraumático en veteranos: un estudio aleatorio de prueba de concepto MEDITACIÓN DE COMPASIÓN PARA EL TEPT Existe un interés considerable en desarrollar enfoques complementarios e integrativos para mejorar el trastorno de estrés postraumático (TEPT). La meditación de compasión (CM en su sigla en inglés) y la meditación de bondad amorosa (LKM, en su sigla en inglés) parecen ofrecer beneficios a las personas con trastorno de estrés postraumático, incluida la reducción de síntomas. El presente estudio fue un ensayo piloto controlado aleatorizado de CM para el TEPT en veteranos. La condición de CM, una adaptación del entrenamiento de compasión de base cognitiva (CBCT® en sus siglas en inglés), consiste en ejercicios para estabilizar la atención, desarrollar la conciencia del momento presente y fomentar la compasión. Comparamos CM con Veteran.calm (VC en sus siglas en inglés), que consiste en psicoeducación sobre el TEPT y las razones para la relajación, entrenamiento de relajación e higiene del sueño. Ambas condiciones consisten en 10 sesiones de grupo semanales de 90 minutos con tareas de práctica entre sesiones. Un total de 28 veteranos asistieron al menos a una sesión de la intervención grupal y completaron las medidas previas y posteriores al tratamiento de la gravedad del TEPT y resultados secundarios, así como las medidas semanales de TEPT, síntomas depresivos y emociones positivas y negativas. Las medidas de credibilidad del tratamiento, asistencia, cumplimiento de la práctica y satisfacción se administraron para evaluar la viabilidad. Un análisis de la varianza de medidas repetidas reveló una reducción más sustancial en síntomas de TEPT en la condición de CM que en la condición de VC, d de Cohen = -0.85 entre grupos. La credibilidad, la asistencia y la satisfacción fueron similares en todas las condiciones de CM y VC y demostraron la viabilidad de CM y la idoneidad de VC como condición de comparación. Los hallazgos de este estudio piloto aleatorizado inicial proporcionan una base para futuros estudios que examinan la eficacia y la efectividad de CM para los veteranos con TEPT.