Self-blame, posttraumatic stress, and cardiovascular reactivity among sexual trauma survivors.

Although trauma is closely linked with hyperarousal and cardiovascular health, little research has examined the effects of posttraumatic stress symptoms (PTSS) on cardiovascular reactivity to trauma reminders among sexual trauma survivors. One type of negative appraisal after trauma, self-blame, is common after sexual trauma, but its relation to cardiovascular reactivity is unknown. The present study aimed to examine the influence of both PTSS and self-blame on blood pressure and heart rate (HR) reactivity to a trauma reminder. Cardiovascular reactivity was measured before, during, and after a laboratory-based sexual trauma reminder among 72 young adult women who have experienced sexual trauma. Higher PTSS predicted lower diastolic blood pressure (DBP) reactivity during the trauma reminder. Higher levels of self-blame predicted higher HR and systolic blood pressure (SBP) reactivity during and after the trauma reminder. Overall, these findings suggest that survivors of sexual trauma with higher levels of PTSS experience a blunting reaction of DBP when exposed to trauma reminders, as opposed to a more typical cardiovascular stress reaction that may elevate and then extinguish to baseline levels. Meanwhile, individuals with higher levels of self-blame have heightened cardiovascular SBP and HR responses during trauma reminders that do not return to baseline levels, perhaps due to self-blame leading individuals to be more 'on guard' to prevent future threats. Longitudinal studies are needed to explore the potential long-term cardiovascular impacts of heightened self-blame and PTSS and their associated cardiovascular reactivity patterns.

Impact of cognitive behavioural therapy on neural, inflammatory, & autonomic markers in a sample with PTSD and cardiovascular risk: protocol for a pilot randomised controlled trial.

Background: Individuals with posttraumatic stress disorder (PTSD) are at heightened risk for cardiovascular disease (CVD) compared to the general population. Inflammation and autonomic dysfunction are candidate mechanisms of CVD risk in PTSD; however, these mechanisms have not been well-characterised in the PTSD-CVD link. Further, these mechanisms may operate through altered stress-related neural activity (SNA). Yet, it remains unknown if changes in PTSD are associated with changes in CVD risk mechanisms.Objective: This manuscript describes the design and procedures of a pilot randomised controlled trial to assess the impact of a first-line treatment for PTSD (Cognitive Processing Therapy; CPT) versus waitlist control on mechanisms of CVD risk. Further, this study will test the hypothesis that CPT reduces CVD risk through its effects on inflammation and autonomic function and that these changes are driven by changes in SNA.Methods: Adults with PTSD and CVD risk (N = 30) will be randomised to CPT or waitlist control. Participants complete two laboratory visits (baseline and post-treatment) that include surveys, brain and peripheral imaging via 18F-fluorodeoxyglucose positron emission tomography (FDG-PET), and resting measures of autonomic function. Primary outcomes include arterial inflammation and heart rate variability. Secondary outcomes include leukopoiesis (bone marrow uptake), heart rate, and blood pressure. The indirect effects of PTSD treatment on changes in inflammation and autonomic function through SNA will also be examined.Conclusions: This study seeks to characterise candidate neuroimmune mechanisms of the PTSD-CVD link to identify treatment targets and develop personalised interventions to reduce CVD events in PTSD populations.Trial registration: ClinicalTrials.gov identifier: NCT06429293..

Individuals with posttraumatic stress disorder (PTSD) have greater risk for cardiovascular disease (CVD) than the general population.Autonomic dysfunction and inflammation are candidate mechanisms of the PTSD-CVD link, which may be driven by changes in neural activity.This pilot randomised controlled trial will test the impact of a first-line PTSD treatment on autonomic dysfunction and inflammation, and whether neural alterations are associated with changes in these mechanisms.

Physical activity, posttraumatic stress, and gender: A longitudinal study of post-9/11 veterans.

Given the importance of physical activity (PA) for both physical and mental health, the present study characterizes post-9/11 veterans' leisure-time PA engagement over time. Further, this study examines the relationship between PA and posttraumatic stress symptoms (PTSS), as well as whether this relation differs by gender and time since military discharge. This study was a secondary analysis of a 12-month longitudinal observational investigation of 410 (39.5% female) post-9/11 veterans. Participants completed self-report questionnaires at baseline and 12 months. Over a third of post-9/11 veterans were not engaging in any weekly leisure-time PA at study baseline and PA engagement significantly decreased in the subsequent year. The longitudinal relationship between PA and PTSS depended on both gender and time since military discharge. These results underscore the importance of considering both gender and time since discharge when tailoring interventions to support leisure-time PA as a key health habit in post-9/11 veterans.

Changes in Interoception in Mind-body Therapies for Chronic Pain: A Systematic Review and Meta-Analysis.

BACKGROUND: Emerging literature has demonstrated deficits in interoception (i.e., the perception of physical sensations from inside the body) in individuals with chronic pain conditions. Mind-body therapies (MBTs) are purported to improve chronic pain in part through improving or restoring interoceptive abilities. The present systematic review and meta-analysis aimed to examine changes in interoception in MBTs for chronic pain conditions. METHODS: A systematic search of PubMed, PsycINFO, Scopus, CINAHL, and ProQuest Dissertation and Theses was conducted from database inception to February 2023. English language intervention studies evaluating the effect of MBTs on interoception in adults with chronic pain conditions were examined. Changes in pain (severity and interference) following treatment were examined as secondary outcomes. RESULTS: A total of 11 studies (10 unique samples) were identified. Meta-analytic results reveal significant improvements in total interoceptive awareness (Becker's d = 1.168, p < .01) as well as improvements in seven of eight subdomains of interoceptive awareness (ds = 0.28 to 0.81). MBTs were also associated with reductions in both pain intensity (d = -1.46, p = .01) and pain interference (d = -1.07, p < .001). CONCLUSIONS: Preliminary research suggests that MBTs demonstrate improvements in interoceptive awareness and reduce pain in adults with chronic pain. Literature on changes in other domains of interoception, such as interoceptive accuracy, following MBTs is severely lacking. Although more rigorous studies are needed to corroborate results, the present findings lay an important foundation for future research to examine interoception as a possible underlying mechanism of MBTs to improve pain outcomes.

Use of religious and spiritual responses after trauma to prevent posttraumatic stress symptoms and suicidality: The role of meaning in life.

BACKGROUND: The present study examined the relationship between religious/spiritual (R/S) responses to trauma, meaning in life, and psychopathology among US veterans (n = 729). METHODS: Participants (66.7% male and 83.2% White) completed study questionnaires assessing positive religious coping, divine spiritual struggle, meaning in life, posttraumatic stress symptoms (PTSS), and suicidality severity. Assessments were conducted via telephone interviews at baseline (T1), 3 months (T2) and 6 months (T3). RESULTS: Divine spiritual struggle was associated with lower meaning in life, higher suicidality and higher PTSS at all time points. Positive religious coping was associated with higher meaning in life at all time points and lower suicidality at T2. Meaning in life fully mediated relationships between divine spiritual struggle and both PTSS and suicidality. While higher levels of T1 positive religious coping predicted increased T3 PTSS when controlling for T1 PTSS, meaning in life partially mediated this relationship, with a negative indirect effect. Meaning in life also fully mediated the relationship between positive religious coping and later suicidality, with a negative indirect effect. DISCUSSION: These findings suggest that divine spiritual struggle consistently predicts both higher PTSS and suicidality. Further, a sense of meaning plays a large role in linking R/S responses to trauma and psychological outcomes. It holds promise as a means through which positive religious coping may exert beneficial effects. Clinicians should be particularly mindful of negative R/S responses after trauma as a risk factor for adverse psychological outcomes. Future research should examine whether meaning-based interventions are beneficial after trauma.

Cognitive Coping Reduces Posttraumatic Stress Symptoms, Especially in the Context of Self-Blame.

Following a traumatic event, coping strategies may affect the natural course of posttraumatic stress symptoms (PTSS). In particular, cognitive coping strategies (how one thinks about stressors) may reduce PTSS by increasing individuals' perceived control over events, appraising them as less threatening, particularly for individuals who experience self-blame after trauma. Individuals who experience a traumatic event (n =344) completed assessments at baseline (T1), one month (T2), and two months (T3). We tested whether T1 cognitive coping strategies (positive reinterpretation, acceptance, religious coping) predicted reduced T3 PTSS and whether this reduction was mediated by increased perceived control at T2. We tested whether this effect was particularly strong for individuals experiencing self-blame. Positive reinterpretation predicted decreases in, religious coping predicted increases in, and acceptance had no direct effect on PTSS. Overall, acceptance showed the greatest potential for reducing PTSS through increased perceived control over one's life. In a fully moderated mediation model, positive reinterpretation significantly interacted and acceptance marginally interacted with self-blame to predict increased perceived control and, subsequently, decreased T3 PTSS. Specifically, acceptance and positive reinterpretation were most helpful for those with higher levels of self-blame. Religious coping interacted with self-blame to predict decreased perceived control and subsequent increased PTSS. For trauma survivors experiencing self-blame, cognitive coping strategies that utilize compassionate self-talk, such as positive reinterpretation and acceptance, may be particularly helpful at increasing perceived control after trauma, while religious coping may have deleterious effects.

Resilience across the Transition to Cancer Survivorship.

Resilience is highly relevant in the context of cancer, and understanding how survivors adapt and potentially thrive following their diagnosis and treatment may provide insights into better supports and interventions to promote healthier survivorship. In this paper, we characterize two different ways to conceptualize and study resilience in cancer survivorship, as a trait and as a process. We focus specifically on the transition from active treatment to post-treatment survivorship. We present data from 225 cancer patients transitioning from active treatment (baseline assessment) to early survivorship (6-month follow-up). Results demonstrate that resilience assessed as a trait at baseline was unrelated to changes in survivors' mental or physical wellbeing at follow-up, but did predict a decline in social satisfaction and spiritual wellbeing over time. However, when resilience is conceptualized as a dynamic process, the sample showed substantial resilience on multiple aspects of wellbeing. We suggest that different ways of conceptualizing resilience--as a trait versus as a dynamic process--may lead to very different conclusions and discuss future research directions for cancer survivors and for science of resilience.

People of color in North America report improvements in racial trauma and mental health symptoms following psychedelic experiences.

This study examined how psychedelics reduced symptoms of racial trauma among black, indigenous, and people of color (BIPOC) subsequent to an experience of racism. A cross-sectional internet-based survey included questions about experiences with racism, mental health symptoms, and acute and enduring psychedelic effects. Changes in mental health were assessed by retrospective report of symptoms in the 30 days before and 30 days after an experience with psilocybin, Lysergic acid diethylamide (LSD), or 3,4-Methylenedioxymethamphetamine (MDMA). We recruited 313 diverse BIPOC in the US and Canada. Results revealed a significant (p < .001) and moderate (d = -.45) reduction in traumatic stress symptoms from before-to-after the psychedelic experience. Similarly, participants reported decreases in depression (p < .001; d = -.52), anxiety (p < .001; d = -.53), and stress (p < .001; d = -.32). There was also a significant relationship (Rc = 0.52, p < .001) between the dimension of acute psychedelic effects (mystical-type, insight, and challenging experiences) and decreases in a cluster of subsequent psychopathology (traumatic stress, depression, anxiety, and stress), while controlling for the frequency of prior discrimination and the time since the psychedelic experience. BIPOC have been underrepresented in psychedelic studies. Psychedelics may decrease the negative impact of racial trauma. Future studies should examine the efficacy of psychedelic-assisted therapy for individuals with a history of race-based trauma.

Meaningful military engagement among male and female post-9/11 veterans: An examination of correlates and implications for resilience.

OBJECTIVE: Post-9/11 military deployment is commonly reported as stressful and is often followed by psychological distress after returning home. Yet veterans also frequently report experiencing meaningful military engagement (MME) that may buffer detrimental effects of military stressors. Focusing on the under-investigated topic of association of MME with post-deployment psychological adjustment, this study tests gender differences in MME and post-deployment outcomes. METHOD: This cross-sectional study examined the relationship of MME with deployment stressors, subsequent psychological distress (posttraumatic stress symptoms (PTSS) and depression), and gender among 850 recent-era U.S. veterans (41.4% female). RESULTS: On average, both male and female veterans reported high MME. Greater MME was associated with less PTSS and depression following combat and general harassment, and more depression after sexual harassment. For men only, MME associated with less PTSS after sexual harassment. CONCLUSIONS: MME is high among post-9/11 veterans, but its stress-buffering effects depend on gender and specific stressor exposure.

Post-9/11 military veterans' adjustment to civilian life over time following separation from service.

OBJECTIVES: US military veterans face many challenges in transitioning to civilian life; little information is available regarding veterans' reintegration experiences over time. The current study characterized veterans' postdeployment stressful life events and concurrent psychosocial wellbeing over one year and determined how stressors and wellbeing differ by demographic factors. METHODS: Recent Post-911 veterans (n = 402) were assessed approximately every three months for 1 year. Participants were 60% men, primarily White (78%), and 12% Latinx; the average age was 36 years. RESULTS: The frequency of stressful events decreased over time but was higher for men and minority-race veterans (independent of time since separation). Veterans reported high mean levels of posttraumatic stress disorder, anxiety, and insomnia symptoms, which improved slightly over time. Minority-race and Latinx veterans had higher symptom levels and slower rates of symptom reduction. CONCLUSION: Veterans remain distressed in their overall transition to civilian life. Interventions to promote resilience and help veterans manage readjustment to civilian life appear urgently needed.

Social Well-Being in Adolescent and Young Adult Cancer Survivors.

PURPOSE: Adolescents and young adults (AYAs) diagnosed with cancer between ages 15-39 years are a unique and vulnerable population, encountering many typical developmental challenges while also dealing with the demands of illness and its aftermath. Overwhelming evidence demonstrates the importance of social well-being in survivorship quality of life. For AYAs, social connections may be of heightened importance as they assert independence from their parents and create their own personal lives. Few studies have characterized AYA survivors' social well-being and its determinants over time, particularly how psychological adjustment might promote improved social well-being. METHODS: We assessed 83 AYA survivors at two time points across 1 year to characterize their social well-being, identify common social connection concerns, describe how social well-being changes over time, examine how psychological adjustment relates to social well-being at a given time point, and determine whether psychological adjustment predicts changes in social well-being over time. RESULTS: Our sample rated their quality of life as lower than population mean scores, and despite relatively high levels of social support and satisfaction, more than half of participants also reported concerns in specific social well-being domains. On average, social well-being increased across the year. Psychological adjustment was strongly positively related to various aspects of social well-being, and it predicted improved social well-being over time. CONCLUSION: These results suggest that improving psychological adjustment may be important for strengthening social support networks and improving AYAs' lives in survivorship.

Testing the Validity of Self-Reported Posttraumatic Growth in Young Adult Cancer Survivors.

Posttraumatic growth has garnered increasing interest as a potential positive consequence of traumatic events and illnesses. However, scientific investigations have yet to demonstrate the validity of self-reports of posttraumatic growth. The most common measure used to assess this construct is the Post Traumatic Growth Inventory (PTGI); however, the extent to which the PTGI (as well as other self-report measures of perceived posttraumatic growth; PPTG) assess actual positive change remains unknown. The present study aimed to examine the validity of PPTG measures. We assessed 83 adolescent and young adult (AYA) cancer survivors at two time points, one year apart. We measured the stability of PTGI from T1 to T2, correlated three measures of PPTG that used different methods (only positive, positive or negative, positive and negative change) with wellbeing measures, and compared PTGI scores with changes in psychosocial resources. PTGI scores were stable over time. More nuanced measures of PPTG appeared to capture more perceived change, although no measure of PPTG was favorably related to wellbeing. Finally, PTGI did not correlate with change in psychosocial resources, with the exception of spirituality. Overall, our results suggest that measures of PPTG do not capture actual positive changes experienced by AYA cancer survivors.

Mindfulness-Based Interventions for Weight Loss and CVD Risk Management.

Obesity affects more than one-third of U.S. adults and is a major cause of preventable morbidity and mortality, primarily from cardiovascular disease. Traditional behavioral interventions for weight loss typically focus on diet and exercise habits and often give little attention to the role of stress and emotions in the initiation and maintenance of unhealthy behaviors, which may account for their modest results and considerable variability in outcomes. Stress eating and emotional eating are increasingly recognized as important targets of weight loss interventions. Mindfulness-based interventions were specifically developed to promote greater self-efficacy in coping with stress and negative emotions, and appear to be effective for a variety of conditions. In recent years researchers have begun to study mindfulness interventions for weight loss and CVD risk management. This review describes the rationale for the use of mindfulness in interventions for weight loss and CVD risk management, summarizes the research to date, and suggests priorities for future research.