Assessment of Comorbid Obsessive-Compulsive Disorder and Posttraumatic Stress Disorder.

Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are commonly comorbid and share prominent features (e.g., intrusions, safety behaviors, and avoidance). Excellent self-report and clinician-administered assessments exist for OCD and PTSD individually, but few assess both disorders, and even fewer provide instruction on differential diagnosis or detection of comorbid OCD and PTSD. To address this gap in the literature, the current paper aims to (1) highlight diagnostic and functional similarities and differences between OCD and PTSD to inform differential diagnosis, (2) outline assessment recommendations for individuals with suspected comorbid OCD and PTSD, OCD with a significant trauma history or posttraumatic symptoms, or PTSD with significant obsessive-compulsive symptoms, and (3) explore future directions to evaluate and improve methods for assessing co-occurring OCD and PTSD.

Obsessive-Compulsive Symptoms and Daily Experiences of Posttraumatic Stress and Mental Contamination Following Sexual Trauma.

Although cross-sectional research highlights similarities between symptoms of obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) among individuals exposed to sexual trauma, little is known about how these disorders relate over time. The goal of the present study was to examine whether 1) OCD symptoms prospectively predicted daily symptoms of PTSD, and 2) OCD and PTSD symptoms prospectively predicted daily experiences of sexual trauma-related mental contamination (i.e., dirtiness in the absence of a physical pollutant). Forty-one women with a sexual trauma history completed baseline measures of OCD and PTSD, as well as twice-daily assessments of PTSD symptoms and mental contamination over a two-week period. Total OCD symptoms and the unacceptable thoughts dimension significantly predicted daily PTSD symptoms after accounting for other OCD dimensions. Only total OCD symptoms significantly predicted daily mental contamination when examined together with total PTSD symptoms. No individual PTSD or OCD clusters/dimensions significantly predicted daily mental contamination when examined simultaneously. Findings from this study highlight the nuanced associations among OCD symptoms, PTSD symptoms, and experiences of mental contamination. Future research is needed to further understand the development of PTSD, OCD, and mental contamination over time to inform targets for intervention.

Fear of sin and fear of God: Scrupulosity predicts women's daily experiences of mental contamination following sexual trauma.

Mental contamination refers to feelings of dirtiness in response to thoughts, images, or memories. Mental contamination is frequently reported after sexual trauma and is associated with symptoms of posttraumatic stress disorder (PTSD). Differences in individuals' views about morality and purity may influence the severity of mental contamination, though this has been studied primarily outside of samples assessed for trauma and/or PTSD. The present study addressed this gap by investigating scrupulosity as a prospective predictor of daily sexual trauma-related mental contamination and PTSD symptoms. Participants included 40 adult women with a history of sexual trauma and current sexual trauma-related mental contamination who completed baseline diagnostic interviews and questionnaires followed by two assessments every day for 2 weeks. The results indicate that scrupulosity was positively correlated with PTSD symptom severity and sexual trauma-related mental contamination at baseline. Scrupulosity was also a prospective predictor of increased daily sexual trauma-related mental contamination, B = 0.19, SE = 0.07, p = .010, but not daily PTSD symptoms, B = -0.10, SE = .08, p = .198. The findings indicate that scrupulosity may be an important factor in understanding recovery from sexual assault.

Consultation competencies in prolonged exposure therapy for posttraumatic stress disorder.

INTRODUCTION: The Emory University Prolonged Exposure (PE) Consultant Training Program seeks to develop a national network of competent PE consultants. Comprehensive training in empirically supported treatment (EST), such as PE, includes a didactic training followed by a period of experiential learning through consultation during real-world clinical practice (Karlin & Cross, 2014). Expert consultants are needed to meet demand as ESTs are disseminated. METHOD: The Emory program has developed a training model to develop 18 consultation skills within five competency domains: the consultation relationship, general psychotherapy skills, PE-specific skills, trainee barriers to delivery, and implementation. RESULTS: The current article outlines these domains and discusses their theoretical background and applied value for PE consultant training, drawing on examples from the Emory program. DISCUSSION: Just as manualizing therapy has allowed for EST dissemination, the operationalizing of consultation competencies can provide a first step in disseminating evidence-based consultation practice. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Creating a national network of community-based consultants in prolonged exposure for PTSD: Outcomes and lessons learned from a consultant training program.

OBJECTIVE: Dissemination of prolonged exposure (PE) for the treatment of posttraumatic stress disorder (PTSD) requires the availability of consultants who can help mental health clinicians learn to deliver the protocol faithfully and effectively. However, there is a dearth of PE consultants. We created a training program that aims to develop a national network of community-based PE consultants. The purpose of the study is to evaluate program effectiveness. METHOD: Our training program requires each consultant to provide consultation to two trainees, each of whom must treat two patients. Our team observes consultants engage with their trainees during virtual meetings and then provides feedback on each consultant's performance. Throughout the training, we collect outcome data on consultants, their trainees, and the patients of their trainees. RESULTS: We have graduated 36 consultants, representing 14 American states. The vast majority of consultants (90%) were able to meet training requirements and expectations. Additionally, the majority of the consultants' trainees (60%) demonstrated competence for independent practice as evidenced primarily by high treatment fidelity ratings across two patients. Among consultants' trainees who reached competency benchmarks, their patients had a robust decrease in PTSD symptom severity from pretreatment to posttreatment (Cohen's d = 1.69). Lastly, follow-up survey data indicated that consultants and their trainees spent more time providing PE consultation and delivering PE, respectively, after completing their training. CONCLUSIONS: Outcome data from the first six cohorts indicate feasibility and effectiveness in PE consultant training. We share lessons learned in the development, maintenance, and improvement of our consultant training program. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

DSM-5 alternative model for personality disorders trait domains and PTSD symptoms in a sample of highly traumatized African American women and a prospective sample of trauma center patients.

Posttraumatic stress disorder (PTSD) has a specified precipitant (i.e., trauma), and thus, is particularly well-suited to examine risk and maintenance factors for the development of the disorder. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) alternative model of personality disorder (AMPD) is based, in part, on a dimensional trait model; previous research suggests that personality traits are related to PTSD symptoms. To date, there is little research examining this model with regard to PTSD symptoms, and such research could elucidate new strategies for identification and prevention. The present study investigates associations between AMPD traits and PTSD symptoms in a cross-sectional high-risk sample (N = 490; 100% female; 97.8% African American) and in a prospective, longitudinal sample of Level 1 trauma center patients (N = 185; 46.8% female; 72.5% African American). The Personality Inventory for DSM-5 Brief Form domains were significantly associated with PTSD total symptom severity and symptom clusters across both self-report and clinical interview measures. Personality Inventory for DSM-5 Negative Affectivity and Psychoticism emerged as significant predictors of concurrent PTSD. When prospectively predicting PTSD symptoms in the longitudinal cohort, Negative Affectivity and Psychoticism were significant predictors of PTSD symptom severity. These findings indicate how the DSM-5 AMPD pathological traits are associated with risk for stress-related disorders cross-sectionally and prospectively. (PsycInfo Database Record (c) 2021 APA, all rights reserved).