Journal of traumatic stress最新文献_第10页

The effects of acute versus repeated cannabidiol administration on trauma-relevant emotional reactivity: A double-blind, randomized, placebo-controlled trial 急性与反复服用大麻二酚对创伤相关情绪反应的影响：双盲、随机、安慰剂对照试验。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-07-03 DOI: 10.1002/jts.23072

L. Riley Gournay, Morgan L. Ferretti, Anna-Marie Nguyen, Sarah Bilsky, Grant S. Shields, Eric Mann, Parker Williams, Sydney Woychesin, Marcel Bonn-Miller, Ellen W. Leen-Feldner

{"title":"The effects of acute versus repeated cannabidiol administration on trauma-relevant emotional reactivity: A double-blind, randomized, placebo-controlled trial","authors":"L. Riley Gournay, Morgan L. Ferretti, Anna-Marie Nguyen, Sarah Bilsky, Grant S. Shields, Eric Mann, Parker Williams, Sydney Woychesin, Marcel Bonn-Miller, Ellen W. Leen-Feldner","doi":"10.1002/jts.23072","DOIUrl":"10.1002/jts.23072","url":null,"abstract":"Despite the widespread use and perceived efficacy of cannabidiol (CBD) as an anxiolytic, few controlled studies have evaluated the effects of CBD on anxiety-relevant indications, and only one has done so in the context of trauma-related symptoms. The current study was designed to address this gap in the literature. Participants were 42 trauma-exposed individuals (Mage = 23.12 years, SDage = 6.61) who endorsed elevated stress. They were randomly assigned to take 300 mg of oral CBD or placebo daily for 1 week. Acute (i.e., following an initial 300 mg dose) and repeated (i.e., following 1 week of daily 300 mg dosing) effects of CBD were evaluated in relation to indicators of anxious arousal (i.e., anxiety, distress, heart rate) in response to idiographic trauma script presentation. The results of the current study suggest that relative to placebo, 300 mg CBD did not significantly reduce anxiety, B = 13.37, t(37) = 1.71, p = .096, d = 0.09, Bayes factor (BF10) = 0.54; distress, B = 15.20, t(37) = 1.31, p = .197, d = 0.07, BF10 = 0.51; or heart rate, B = -1.09, t(36) = -0.32, p = .755, d = 0.02, BF10 = 0.29, evoked by idiographic trauma script presentation in the context of acute or repeated administration. These data suggest that CBD may not effectively reduce trauma-relevant emotional arousal; however, more work is needed to confidently assert such claims due to the small sample size. The current study extends the groundwork for additional studies in this important area.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"946-958"},"PeriodicalIF":2.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Walking the line between fidelity and flexibility: A conceptual review of personalized approaches to manualized treatments for posttraumatic stress disorder 在忠实性和灵活性之间游刃有余：创伤后应激障碍手册化治疗个性化方法的概念回顾。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-07-02 DOI: 10.1002/jts.23073

Tara E. Galovski, Reginald D. V. Nixon, Shannon Kehle-Forbes

{"title":"Walking the line between fidelity and flexibility: A conceptual review of personalized approaches to manualized treatments for posttraumatic stress disorder","authors":"Tara E. Galovski, Reginald D. V. Nixon, Shannon Kehle-Forbes","doi":"10.1002/jts.23073","DOIUrl":"10.1002/jts.23073","url":null,"abstract":"The heterogeneity of the core symptoms of posttraumatic stress disorder (PTSD), high rates of comorbid mental and physical health conditions, and substantial impact of the disorder on functioning and well-being contribute to complex clinical presentations that can be challenging to treat. Despite these challenges, there are excellent manualized treatments for PTSD with significant empirical support. Although the success of frontline treatments for PTSD is evident, there remains room for improvement as indicated by suboptimal response and attrition rates. To address challenges to optimal therapy outcomes (COTOs), researchers have conducted numerous clinical trials designed to (a) enhance the core structure of treatment protocols to increase flexibility or (b) expand the protocols to address comorbid conditions that inhibit recovery. However, it is implausible to ever conduct the number of enhancement and expansion clinical trials necessary to test manual modifications for the universe of possible COTOs. This conceptual review describes the concept of a personalized model of therapy that leverages a case formulation approach to implementing an evidence-based treatment for PTSD. This personalized approach provides guidance for the clinician in assessing the patient's COTOs, monitoring them throughout treatment, and relying on the patient's idiosyncratic data to inform treatment decisions, including how and when to diverge from treatment when clinically indicated and ensuring a clear path to return to trauma-focused work when the COTO is stabilized. This personalized, case formulation approach to treating PTSD provides guidance for adopting a more flexible approach to treating clinically complex patients while ensuring fidelity to the protocol.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 5","pages":"768-774"},"PeriodicalIF":2.4,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141492460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

State of the Science: Evidence-based treatments for posttraumatic stress disorder delivered via telehealth 科学现状：通过远程医疗提供创伤后应激障碍的循证治疗。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-30 DOI: 10.1002/jts.23074

Madeline J. Bruce, Antonio F. Pagán, Ron Acierno

{"title":"State of the Science: Evidence-based treatments for posttraumatic stress disorder delivered via telehealth","authors":"Madeline J. Bruce, Antonio F. Pagán, Ron Acierno","doi":"10.1002/jts.23074","DOIUrl":"10.1002/jts.23074","url":null,"abstract":"Psychotherapy delivered via telehealth technology is not an artifact of the COVID-19 pandemic. Indeed, widespread, telehealth-delivered, evidence-based psychotherapy preceded the pandemic, as did randomized controlled noninferiority trials supporting this modality. It is, thus, not difficult to predict that telehealth will be an integral part of daily clinical life moving forward. With respect to posttraumatic stress disorder (PTSD) specifically, there is a substantial number of studies on the feasibility, acceptability, and effectiveness of evidence-based treatments provided via videoconferencing. In this review, we delineate the literature establishing strong support for remote delivery of prolonged exposure (PE) and cognitive processing therapy (CPT); there is also promising support for written exposure therapy (WET) and trauma-focused cognitive behavioral therapy (TF-CBT). We also mention adjunctive and integrative modifications to better serve patients with PTSD. One such intervention, behavioral activation and therapeutic exposure (BATE), has several studies supporting telehealth delivery, whereas concurrent treatment of PTSD and substance use disorders using the PE protocol (COPE) and cognitive behavioral therapy for insomnia (CBT-I) would benefit from further research. Integrating instrumental peer support into telehealth-delivered PE shows promise in retaining patients in treatment. Finally, we provide ideas to maximize telehealth delivery effectiveness, explore future research directions, and discuss ways to advocate for the expansion of telehealth services from an equity perspective.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"38 1","pages":"5-15"},"PeriodicalIF":2.4,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Adverse childhood experiences, posttraumatic stress disorder symptoms, and compulsive behaviors among adults in substance use treatment: A latent class analysis 接受药物使用治疗的成年人的童年不良经历、创伤后应激障碍症状和强迫行为：潜类分析

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-30 DOI: 10.1002/jts.23079

Evan J. Basting, Alyssa M. Medenblik, Julie D. Eberwein, Alisa R. Garner, Ryan C. Shorey, Gregory L. Stuart

{"title":"Adverse childhood experiences, posttraumatic stress disorder symptoms, and compulsive behaviors among adults in substance use treatment: A latent class analysis","authors":"Evan J. Basting, Alyssa M. Medenblik, Julie D. Eberwein, Alisa R. Garner, Ryan C. Shorey, Gregory L. Stuart","doi":"10.1002/jts.23079","DOIUrl":"10.1002/jts.23079","url":null,"abstract":"Adverse childhood experiences (ACEs) are prevalent and associated with common problems among adults with substance use disorders (SUDs), including posttraumatic stress disorder (PTSD) symptoms and compulsive behaviors. Most studies consider cumulative ACEs when examining their associations with health and behavioral outcomes. We tested whether patterns of ACEs related to SUD symptoms, PTSD symptoms, and compulsive behaviors among adults receiving treatment for substance use. We identified latent classes of ACEs using medical record data from 721 patients in residential SUD treatment and conducted Wald chi-square tests to assess whether these latent classes differed in alcohol and drug use disorder symptoms, PTSD symptoms, compulsive sexual behavior, and compulsive gambling. We identified four latent classes: high ACEs (15.1%), maltreatment (12.4%), household problems (22.3%), and low ACEs (49.1%). There were significant differences across latent classes in drug use disorder symptoms, PTSD symptoms, and compulsive sexual behavior, χ2(1, N = 721) = 37.42–107.07, ps < .001. Participants in the high ACEs and household problems classes had more drug use disorder symptoms than those in the low ACEs class. Relative to all other classes, individuals in the low ACEs class had the lowest PTSD symptoms and those in the high ACEs class had the highest PTSD symptoms. Findings indicate that adults with SUDs who have more ACEs have the highest risk for PTSD symptoms and compulsive sexual behavior. Screening for ACEs while considering ACE patterns and frequency may benefit treatment planning for SUD patients with comorbid concerns such as PTSD symptoms and compulsive sexual behavior.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"971-983"},"PeriodicalIF":2.4,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141469087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Bidirectional associations between prolonged grief symptoms and depressive, anxiety, and posttraumatic stress symptoms: A systematic review 长期悲伤症状与抑郁、焦虑和创伤后应激症状之间的双向关联：系统综述。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-25 DOI: 10.1002/jts.23061

Antje Janshen, Maarten C. Eisma

{"title":"Bidirectional associations between prolonged grief symptoms and depressive, anxiety, and posttraumatic stress symptoms: A systematic review","authors":"Antje Janshen, Maarten C. Eisma","doi":"10.1002/jts.23061","DOIUrl":"10.1002/jts.23061","url":null,"abstract":"Prolonged grief symptoms frequently co-occur with symptoms of depression, posttraumatic stress, and anxiety; however, little is known about how prolonged grief symptoms temporally relate to symptoms of neighboring stress-related and affective disorders. Clarifying such associations can help elucidate which symptoms to prioritize during treatment for distressed bereaved adults. We conducted a systematic review to provide a comprehensive overview of the empirical research on the bidirectional temporal associations between prolonged grief symptoms and symptoms of depression, posttraumatic stress, and anxiety. A search of the PsycInfo, Web of Science, and Scopus databases (final search: December 2023) identified eight relevant empirical longitudinal studies utilizing lower-level mediation (two studies), cross-lagged panel modeling (CLPM; four studies), or random-intercept CLPM (RI-CLPM; two studies). The studies included a total of 2,914 bereaved adult participants. Studies showed considerable methodological heterogeneity, including different sample characteristics, study designs (e.g., measurement moments, time frames), statistical analyses, and measures. Temporal associations between prolonged grief symptoms and different types of symptoms appeared intertwined. Prolonged grief symptoms more consistently predicted symptoms of depression and posttraumatic stress across measurement waves than vice versa, tentatively suggesting that prolonged grief may be a transdiagnostic risk factor for depressive and PTS symptoms. However, this pattern was not observed in the two studies utilizing RI-CLPM. Future research should aim to decrease methodological heterogeneity by using validated measures to capture prolonged grief symptoms, appropriate timeframes, and RI-CLPM to clarify associations between temporal within-person fluctuations of prolonged grief, depressive, posttraumatic stress, and anxiety symptoms.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"825-836"},"PeriodicalIF":2.4,"publicationDate":"2024-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11629839/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141457695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Experiences of intimate partner violence and valued living among women veterans: The role of self-efficacy 女性退伍军人的亲密伴侣暴力经历和有价值的生活：自我效能感的作用。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-11 DOI: 10.1002/jts.23059

Emily Taverna, Nora Kline, Shaina A. Kumar, Katherine M. Iverson

{"title":"Experiences of intimate partner violence and valued living among women veterans: The role of self-efficacy","authors":"Emily Taverna, Nora Kline, Shaina A. Kumar, Katherine M. Iverson","doi":"10.1002/jts.23059","DOIUrl":"10.1002/jts.23059","url":null,"abstract":"Predominantly cross-sectional research suggests that self-efficacy may play an important role in women's psychological health after experiencing intimate partner violence (IPV). However, few studies have examined these associations over time or with respect to broader aspects of psychological well-being. Valued living, which reflects behavioral engagement within personally important life domains, represents a key aspect of well-being that may be negatively impacted by experiences of IPV. Participants were 190 women veterans who completed three web-based surveys. We examined whether IPV experiences at Time 1 were associated with valued living at Time 3 (i.e., 4 years after Time 1) through self-efficacy at Time 2 (i.e., 3 years after Time 1). We separately examined overall, psychological, physical, and sexual IPV and investigated lifetime and recent (i.e., past 6 months) IPV experiences for each subtype. Separate path analysis models indicated that lifetime overall, β = -.10, 95% CI [-.19, -.02]; psychological, β = -.08, 95% CI [-.17, -.001]; physical, β = -.10, 95% CI [-.18, -.01]; and sexual, β = -.11, 95% CI [-.22, -.01], IPV experiences were indirectly associated with less valued living through less self-efficacy, whereas the indirect effect only emerged for recent physical IPV, β = -.26, 95% CI [-.50, -.02], but not for recent overall, psychological, or sexual IPV. These findings suggest that experiencing IPV is associated with less self-efficacy and valued living, which highlights the importance of providing early psychosocial interventions to enhance well-being among individuals managing the effects of experiencing IPV.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"913-923"},"PeriodicalIF":2.4,"publicationDate":"2024-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300937","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Conceptualizing impulsivity as a construct in relation to posttraumatic stress disorder symptom severity among women 将冲动性概念化为一种与女性创伤后应激障碍症状严重程度相关的结构。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-10 DOI: 10.1002/jts.23060

Colin T. Mahoney, Brigitta M. Beck, Kelly E. Dixon, Shantel D. Horne, Steven R. Lawyer

{"title":"Conceptualizing impulsivity as a construct in relation to posttraumatic stress disorder symptom severity among women","authors":"Colin T. Mahoney, Brigitta M. Beck, Kelly E. Dixon, Shantel D. Horne, Steven R. Lawyer","doi":"10.1002/jts.23060","DOIUrl":"10.1002/jts.23060","url":null,"abstract":"Despite the established association between posttraumatic stress disorder (PTSD) and impulsivity, the literature is limited regarding impulsivity as a multifaceted construct. That is, the field's understanding of how PTSD symptoms may increase particular impulsive tendencies and behaviors is constrained by examining impulsivity solely as an umbrella term. The aim of the present study was to determine if there are differential associations between PTSD symptom severity and various components of impulsivity across multiple self-report measures. A sample of 215 undergraduate women (M age = 19.77 years, SD = 1.91, Range: 18–39 years) completed the PTSD Checklist for DSM-5 (PCL-5), Barratt Impulsiveness Scale (BIS-11), short version of the UPPS-P Impulsive Behavior Scale (SUPPS-P), and Delaying Gratification Inventory (DGI). Structural equation modeling was used to examine associations between PTSD symptoms and each measure's subscales. The findings included significant predictions from PTSD symptoms to the BIS-11 Attentional Impulsiveness subscale, β = .23, SE = .07, 95% CI [.09, .37]; DGI Physical Pleasures, β = -.24, SE = .07, 95% CI [-.38, -.11], and Achievement subscales, β = -.19, SE = .08, 95% CI [-.34, -.04]; and the SUPPS-P Positive Urgency, β = .22, SE = .08, 95% CI [.07, .37], and Negative Urgency subscales, β = .32, SE = .07, 95% CI [.19, .46]. These results have implications for precision medicine approaches that emphasize targeting these specific facets of impulsivity, with likely downstream effects on health risk behaviors for emerging adult women.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"924-935"},"PeriodicalIF":2.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141296341","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

State of the Science: Treatment of comorbid posttraumatic stress disorder and substance use disorders 科学现状：治疗创伤后应激障碍和药物使用障碍。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-10 DOI: 10.1002/jts.23049

Sudie E. Back, Amber M. Jarnecke, Sonya B. Norman, Angela J. Zaur, Denise A. Hien

{"title":"State of the Science: Treatment of comorbid posttraumatic stress disorder and substance use disorders","authors":"Sudie E. Back, Amber M. Jarnecke, Sonya B. Norman, Angela J. Zaur, Denise A. Hien","doi":"10.1002/jts.23049","DOIUrl":"10.1002/jts.23049","url":null,"abstract":"Posttraumatic stress disorder (PTSD) and substance use disorders (SUDs) co-occur at high rates, with research showing that up to nearly 60% of individuals with PTSD also suffer from an alcohol and/or drug use disorder. PTSD/SUD is complex; associated with adverse health, social, and economic outcomes; and can be challenging to treat. Over the past decade, the landscape of treatment research addressing PTSD/SUD has significantly expanded. Ongoing efforts aimed at developing and evaluating novel treatments for PTSD/SUD, encompassing both psychotherapy and pharmacotherapy approaches, are steadily advancing. As such, this State of the Science paper reviews the literature on the latest scientific advances in treating PTSD/SUD. Clinical practice guidelines for the treatment of PTSD/SUD are discussed, along with evidence-based psychotherapies and emerging interventions. Rigorously conducted clinical trials demonstrate that individual, manualized, trauma-focused treatments are the most efficacious psychotherapies to use among individuals with PTSD/SUD. Moreover, patients do not need to be abstinent to initiate or benefit from evidence-based PTSD treatment. To date, no medications have been established for this comorbidity. We highlight ongoing research on novel treatments for PTSD/SUD, such as new forms of integrated trauma-focused psychotherapies, pharmacological augmentation strategies, and technology-based enhancements. Finally, promising future directions for the field are discussed.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"803-813"},"PeriodicalIF":2.4,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141300938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of neighborhood disadvantage on posttrauma outcomes after sexual assault 邻里劣势对性侵犯后创伤后结果的影响。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-05 DOI: 10.1002/jts.23056

Rachel Gaither, Tamsin Zandstra, Sarah D. Linnstaedt, Samuel A. McLean, Megan Lechner, Kathy Bell, Jenny Black, Jennie A. Buchanan, Jeffrey D. Ho, Melissa A. Platt, Ralph J. Riviello, Francesca L. Beaudoin

{"title":"Impact of neighborhood disadvantage on posttrauma outcomes after sexual assault","authors":"Rachel Gaither, Tamsin Zandstra, Sarah D. Linnstaedt, Samuel A. McLean, Megan Lechner, Kathy Bell, Jenny Black, Jennie A. Buchanan, Jeffrey D. Ho, Melissa A. Platt, Ralph J. Riviello, Francesca L. Beaudoin","doi":"10.1002/jts.23056","DOIUrl":"10.1002/jts.23056","url":null,"abstract":"In the United States, 8,000,000 people seek emergency care for traumatic injury annually. Motor vehicle collisions (MVCs) and sexual assault are two common sources of trauma, with evidence that reduced neighborhood-level socioeconomic characteristics increase posttraumatic pain and stress after an MVC. We evaluated whether neighborhood disadvantage was also associated with physical and mental posttrauma outcomes after sexual assault in a sample of adult women (N = 656) who presented for emergency care at facilities in the United States following sexual assault and were followed for 1 year. Neighborhood characteristics were assessed via the Area Deprivation Index, and self-reported pain, anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms were collected at 6 weeks posttrauma. Adjusted log-binomial regression models examined the association between each clinical outcome and neighborhood disadvantage. Women in more disadvantaged neighborhoods were more likely to be non-White and have lower annual incomes. At 6 weeks posttrauma, the prevalence of clinically significant pain, anxiety, and depressive symptoms more than doubled from baseline (41.7% vs. 18.8%, 62.4% vs. 23.9%, and 55.2% vs. 22.7%, respectively); 40.7% of women also reported PTSD symptoms. Black, Hispanic, and lower-income participants were more likely to report pre- and postassault pain, anxiety, and depression. After adjusting for race, ethnicity, and income, no significant association existed between neighborhood disadvantage and any outcome, ps = .197 - .859. Although neighborhood disadvantage was not associated with posttrauma outcomes, these findings highlight the need for continued research in diverse populations at high risk of adverse physical and mental health symptoms following sexual assault.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 6","pages":"877-889"},"PeriodicalIF":2.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The three axioms of resilience 复原力的三个公理。

IF 2.4 3区医学

Journal of traumatic stress Pub Date : 2024-06-05 DOI: 10.1002/jts.23071

George A. Bonanno, Maren Westphal

{"title":"The three axioms of resilience","authors":"George A. Bonanno, Maren Westphal","doi":"10.1002/jts.23071","DOIUrl":"10.1002/jts.23071","url":null,"abstract":"This article summarizes the growing literature on resilience in the face of aversive and potentially traumatic events (PTEs) in three basic axioms: (a) resilience is a common outcome, 2) there are no “key” traits to resilience (resilience is not a type), and (c) resilient outcomes occur through flexible self-regulation. The first axiom highlights the limitation of a traditional, binary view of trauma in terms of the presence–absence of posttraumatic stress disorder, emphasizing instead the heterogeneity of trauma outcomes. Four prototypical trajectories are reviewed: chronic symptoms; delayed symptoms; recovery; and the most common trajectory, resilience. The second axiom reviews the paradoxical inability of known correlates of resilience to adequately predict resilient outcomes. Resilience is instead described as a multifaceted phenomenon with no singular set of key traits, as various factors contribute to resilient outcomes in complex ways. The third axiom provides an explanation of how resilience can emerge from this complex array by introducing the concept of flexible self-regulation. The flexibility mindset is described as providing the motivation for flexible responding. The flexibility sequence is described as explaining the mechanisms underlying flexibility in terms of three serial stages: context sensitivity, strategy repertoire, and feedback adjustment. The final section briefly considers clinical implications.","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"37 5","pages":"717-723"},"PeriodicalIF":2.4,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141262176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0