Beyond the mean: examining associations between intraindividual variability in posttraumatic stress disorder symptoms and posttrauma reckless behaviors.

BACKGROUND/OBJECTIVES: Posttrauma reckless behaviors have been linked to the onset and exacerbation of posttraumatic stress disorder (PTSD) symptoms. However, PTSD symptoms fluctuate across time, triggered by environmental stimuli in daily life, referred to as (intraindividual) variability in PTSD symptoms. DESIGN: We utilized experience sampling methods to investigate associations between engagement in posttrauma reckless behaviors and variability in PTSD symptoms and the moderating role of emotion dysregulation in this association. METHODS: Data from 166 trauma-exposed university students (Mage = 21.43 ± 5.07, 85.4% women) were collected between January 2019 to August 2020. Participants completed baseline and follow-up surveys to assess engagement in posttrauma reckless behaviors and daily surveys (10-days) to assess variability in PTSD symptoms. Results. Analyzes indicated greater baseline engagement in posttrauma reckless behaviors was associated with greater 10-day variability in PTSD symptoms (ß = 0.23, p = .031), and baseline emotion dysregulation moderated this association (ß = -0.33, p = .003). Additionally, greater 10-day variability in PTSD symptoms was associated with greater follow-up engagement in posttrauma reckless behaviors (ß = 0.14, p = .045). CONCLUSIONS: Findings substantiate the interplay between engagement in posttrauma reckless behaviors and daily fluctuations in PTSD symptoms and support therapeutically targeting both engagement in posttrauma reckless behaviors and emotion dysregulation to impact PTSD symptoms.

Posttraumatic stress disorder symptoms and mental health treatment parameters among Asian Indians residing in the United States.

OBJECTIVE: Asian Indians in the United States experience psychological impacts from traumatic experiences, such as posttraumatic stress disorder (PTSD) symptoms. However, Asian Indians underutilize mental health services that are attributed to culturally contextualized barriers and preferences for seeking mental health services. To advance this literature, we uniquely examined associations of PTSD symptom severity with institutional and internal help-seeking barriers for mental health services and with psychotherapy preferences. METHOD: Participants were a community sample of 77 trauma-exposed Asian Indians residing in the southwest area of the United States (Mage = 31.61, 71.4% women). RESULTS: Multiple regression analyses indicated that institutional barriers marginally associated with greater PTSD symptom severity. Supplemental analyses on the institutional barrier domain scores indicated that more ageist attitudes associated with lower PTSD symptom severity (ß = -.52, p = .020), and more transportation difficulties associated with higher PTSD symptom severity (ß = .36, p = .039). Lastly, results indicated that greater preference for psychotherapist directiveness associated with lower PTSD symptom severity (ß = -.45, p = .016). CONCLUSIONS: Clinical implications can be viewed from a socioecological framework recognizing the interplay of societal, familial, and individual-level factors that influence PTSD symptom severity among Asian Indians. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The role of affect in associations between sleep disturbances and posttraumatic stress disorder symptoms: A systematic review.

Strong evidence supports a bidirectional association between sleep disturbances and posttraumatic stress disorder (PTSD). Affect - temporary internal states experienced as feeling good or bad, energized or enervated - may play a central role in explaining this link. The current systematic review summarizes the literature on associations between sleep, PTSD, and affect among trauma-exposed adults. We systematically searched five electronic databases (PubMed, PsycInfo, PTSDpubs, Web of Science, CINAHL) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Of 2656 screened articles, 6 studies met inclusion criteria. Four findings emerged: (1) greater insomnia symptom severity predicted greater PTSD symptom severity above the influence of negative affect, (2) negative affect mediated the effect of sleep quality on next-day PTSD symptom severity, (3) positive affect mediated the effect of PTSD symptom severity on insomnia symptom severity and sleep disturbances, and (4) greater negative affect (specifically, greater anger) was associated with greater severity of PTSD and sleep disturbances. Findings highlight areas for future research, such as the need to investigate more dimensions, timescales, and methods of studies simultaneously assessing affect, sleep, and PTSD, as well as the need for more longitudinal and experimental work to determine causality across these constructs.

Associations between positive memory count and hazardous substance use in a trauma-exposed sample: Examining the moderating role of emotion dysregulation.

OBJECTIVES: Research has demonstrated links between autobiographical memory retrieval and hazardous substance use. However, limited work has examined relations between positive autobiographical memories and hazardous substance use, as well as moderating factors influencing these relations. Thus, we examined the potential moderating roles of negative and positive emotion dysregulation in the relations between count of retrieved positive memories and hazardous substance use (alcohol and drug use separately). METHODS: Participants were 333 trauma-exposed students (Mage = 21.05; 85.9% women) who completed self-report measures assessing positive memory count, hazardous alcohol and drug use, negative emotion dysregulation, and positive emotion dysregulation. RESULTS: Positive emotion dysregulation significantly moderated the association between positive memory count and hazardous alcohol use (b = 0.04, 95% confidence interval [CI] [0.01, 0.06], p = 0.019), as well as the association between positive memory count and hazardous drug use (b = 0.02, 95% CI [0.01, 0.03], p = 0.002). Individuals with more positive emotion dysregulation had stronger associations between increases in positive memory count and increased hazardous substance use. CONCLUSION: Findings indicate that trauma-exposed individuals who retrieve more positive memories and experience difficulties regulating positive emotions report greater hazardous substance use. Positive emotion dysregulation may be an important target for memory-based interventions among trauma-exposed individuals who report hazardous substance use.

Relations Between Posttraumatic Stress Disorder Symptoms and Positive Memory Characteristics Among Women Reporting Intimate Partner Violence: A Micro-Longitudinal Study.

Evidence links posttraumatic stress disorder (PTSD) symptoms to positive autobiographical memory characteristics. To extend this research, we uniquely utilized micro-longitudinal data to examine (1) the trajectory of PTSD symptom count across 30 days; and (2) if more vividness and accessibility of retrieved positive memories at the daily level predicted decreases in the trajectory of PTSD symptom count across 30 days. The current study was a secondary data analysis of a larger study. The sample included 74 women who reported physical or sexual victimization in the past 30 days by their current male partner and reported the use of alcohol and/or drugs during that time (Mage = 39.68 years; 37.80% with diagnostic PTSD; 43.2% White; 37.8% Black or African American). They completed thrice daily measures of PTSD symptoms and positive memory characteristics (vividness and accessibility) across 30 days. Results of the random effects longitudinal multilevel model indicated that, on average, the relation between PTSD symptom count and positive memory vividness was positive and statistically significant (0.19, 95% Confidence Interval [CI] [0.2, 0.35]); and the relation between PTSD symptom count and positive memory accessibility was positive and statistically significant (0.31, 95% CI [0.15, 0.47]). The relationship between PTSD symptom count and positive memory vividness/accessibility (i.e., slopes) varied significantly across participants, with a wide range of positive and negative regression coefficients. Future research needs to investigate why and how positive memory vividness and accessibility may relate to trajectories of PTSD symptoms over time, with potential clinical implications for positive memory interventions addressing PTSD.

Evaluation of the Posttraumatic Stress Disorder Checklist for DSM-5 across United States and India samples: An item response theory analysis using the graded response model.

OBJECTIVES: The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is frequently used to assess PTSD symptoms. Extending its psychometric investigations across distinct samples (United States and India), the aims of the present study included investigating the item characteristics, person fit, and differential item functioning (DIF) across the two samples. METHOD: We (a) conducted item analysis using the graded response model to examine item characteristics (thresholds and discrimination parameters) and (b) examined person fit to determine participants' response patterns. The U.S. sample included 176 trauma-exposed individuals seeking mental health treatment, and the Indian sample included 148 trauma-exposed ex-military personnel. RESULTS: Results indicated low discrimination for Item 8 and low but acceptable discrimination for Item 17 for the U.S. and Indian samples, respectively. Across both samples, the most unused response categories were the middle-point or extreme (higher severity) categories (all response categories were better utilized in the Indian sample), and half the participants exhibited person misfit. Supplemental DIF analysis indicated that five items exhibited DIF indicating potential item bias; however, effect sizes for DIF were negligible. CONCLUSIONS: Although the PCL-5 demonstrated strong psychometric properties and showed promise for use across the samples differing on cultural and demographic characteristics, some of the items and the number of categories used to measure them could be revisited to create a more efficient instrument. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Psychometric Evaluation of the Posttrauma Risky Behaviors Questionnaire: Item Response Theory Analyses.

The Posttrauma Risky Behaviors Questionnaire (PRBQ) assesses extent of engagement in posttrauma reckless and self-destructive behaviors (RSDBs). Given PRBQ's recent development with limited psychometric investigations, we used item response theory to examine (a) item analysis, (b) person fit, and (c) differential item functioning (DIF) across gender-based groups and two different samples. One sample included 464 participants reporting potentially traumatic experiences (Mechanical Turk [MTurk], recruited online), and the other sample included 171 trauma-exposed women reporting current intimate partner violence and substance use (recruited in-person). All PRBQ items contributed to the RSDB scale, and all PRBQ items and the PRBQ scale provided maximum information for high levels of the RSDB latent trait. Seven and 11 items were conceptualized as low information items in the MTurk and intimate partner violence samples, respectively. Eight MTurk participants' responses did not fit the overall pattern of responses as expected. Seven items were flagged for DIF between the two samples, and eight items were flagged for DIF between men and women in the MTurk sample. However, all effect sizes were <8%. Conclusively, results suggest good psychometric properties for the PRBQ and support its use to compare RSDBs across different samples and gender-based groups.