The impact of emotion regulation and dyadic coping within posttraumatic stress symptoms and risky drinking patterns on relationship distress among trauma-exposed individuals.

Individuals with posttraumatic stress symptoms (PTSS) often consume alcohol to manage PTSS-related discomfort, which can negatively impact individual and interpersonal functioning. Processes including emotion regulation and dyadic coping may influence the effects of PTSS and drinking patterns on relationship functioning. The present study examined how PTSS and risky drinking may function through the associations between maladaptive individual and interpersonal coping strategies and relationship distress among trauma-exposed individuals. Participants were 237 adults in a romantic relationship who endorsed lifetime trauma exposure and alcohol consumption within the past year and completed an online battery of self-report measures. Path analyses showed mixed support for the hypothesized theoretical causal model. PTSS was associated with maladaptive emotion regulation, ß = .537, p = .010, and negative dyadic coping, ß = .264, p = .009, whereas risky drinking was only related to negative dyadic coping, ß = .193, p = .024. Negative dyadic coping was significant in the pathways between PTSS and relationship distress, ß = .021, p = .009, and risky drinking and relationship distress, ß = .030, p = .014. Exploratory analyses based on trauma type did not significantly change the overall model; however, a direct path suggested PTSS may have a stronger negative impact on relationship distress among individuals who experienced assault trauma (e.g., physical or sexual assault), ß = .340, p = .012. Findings highlight the interrelations among intra- and interpersonal regulation and provide clinical targets of maladaptive emotion regulation and dyadic coping strategies for individuals with PTSS and harmful drinking.

Examining the Temporal Relation between Posttraumatic Stress Symptoms and Heavy Drinking among Veterans Receiving Mental Health Treatment in Primary Care.

OBJECTIVE: Evidence for the use of integrated treatments targeting co-occurring posttraumatic stress disorder (PTSD) and alcohol use disorders is steadily growing. However, limited work has evaluated the temporal association between posttraumatic stress symptoms (PTSS) and alcohol misuse over the course of integrated treatment, with no studies examining such interventions in primary care (PC). The current study examined temporal changes in PTSS and heavy drinking among individuals who received a brief treatment for co-occurring PTSD and alcohol misuse in PC (Primary Care Treatment Integrating Motivation and Exposure; PC-TIME) compared with those who received PC treatment as usual (PC-TAU). METHOD: A total of 63 veterans (33 randomized to PC-TIME and 30 randomized to PC-TAU) presenting to PC with co-occurring PTSD and alcohol misuse were included in this study. PTSS and heavy drinking were examined at each treatment session for those in PC-TIME. Veterans in both conditions provided reports of PTSS and heavy drinking at baseline, 8-weeks (post-treatment), 14-weeks, and 20-week follow-ups. RESULTS: Session-by-session findings for PC-TIME demonstrated that PTSS at Session 1 predicted a greater decrease in heavy drinking from Session 1 to Session 2. Moreover, heavy drinking at baseline predicted greater decreases in PTSS at 8-weeks for those in PC-TIME, whereas the reverse association was found for those randomized to PC-TAU. Additionally, heavy drinking at 8-weeks predicted decreased PTSS at 14-weeks for those randomized to PC-TAU. CONCLUSIONS: The current study evidenced mixed support for the temporal precedence of PTSS and alcohol misuse. Relations between PTSS and heavy drinking appeared to be linked to treatment targets within PC-TIME and varied between treatment condition (PC-TIME versus PC-TAU). Notably, those with greater than average heavy drinking at the initiation of integrated treatment appeared to have greater reductions in PTSS at post-treatment. Results suggest a mutual maintenance model may best characterize the association between co-occurring PTSS and heavy drinking among treatment-seeking individuals.

What can directed forgetting tell us about clinical populations?

This paper reviews and critically assesses the implications of directed forgetting (DF) research on clinical populations. We begin by reviewing the typical methods and results of the item method and list method directed forgetting procedures and provide best practice recommendations for future studies using clinical populations. Next, we note that DF was often interpreted as being due to inhibition, and when clinical populations showed impaired directed forgetting, it was treated as evidence in inhibitory control difficulties. However, inhibition may not be the cause of DF effects, based on current understanding of these cognitive tasks. We instead suggest that item method DF is tied to attentional control, which might include inhibitory mechanisms (or might not). In contrast, list method DF is tied to two forms of memory control: control of mental context (indicated by effective forgetting of List 1), and changes in the strategies used to remember (indicated by better learning of List 2). We review the current state of the clinical DF literature, assess its strength based on our best practice recommendations, and call for more research when warranted.

Pulling away: Links among disengaged couple communication, relationship distress, and depressive symptoms.

Interpersonal theories of depression suggest that how couples communicate helps to explain bidirectional links between depressive symptoms and relationship distress. Disengaged and aversive couple communication should help explain these links. However, most research examining associations among couple communication, depressive symptoms and relationship distress have focused on aversive communication behaviors. Thus, this research examined associations among depressive symptoms, disengaged couple communication, and relationship distress in 2 studies. Study 1 examined cross-sectional associations using 2 heterogeneous samples of individuals in romantic relationships assessed via online survey. Study 2 examined the associations over 2 time points using Actor-Partner Interdependence Modeling with data provided by newlywed couples. The first aim was to examine whether depressive symptoms were uniquely associated with disengaged couple communication after controlling for relationship distress and aversive couple communication. The second aim was to test whether disengaged couple communication explained the bidirectional associations between depressive symptoms and relationship distress controlling for aversive communication. Results for Aim 1 were consistent across studies. Depressive symptoms were uniquely associated with disengaged couple communication. Results for Aim 2 indicate that disengaged couple communication uniquely explains bidirectional associations between co-occurring relationship distress and depressive symptoms; and husbands' disengaged communication explains the association between husbands' depressive symptoms and husbands decline in relationship satisfaction. Results indicate there are unique contributions of disengaged couple communication for interpersonal theories of depression and suggest the importance of helping couple-members to effectively and meaningfully engage with one another. (PsycINFO Database Record (c) 2019 APA, all rights reserved).