Assessing relations between PTSD's dysphoria and reexperiencing factors and dimensions of rumination.

The purpose of the present study was to investigate the relations between posttraumatic stress disorder's (PTSD) dysphoria and reexperiencing factors and underlying dimensions of rumination. 304 trauma-exposed primary care patients were administered the Stressful Life Events Screening Questionnaire, PTSD Symptom Scale based on their worst traumatic event, and Ruminative Thought Style Questionnaire (RTSQ). Confirmatory factor analyses (CFAs) were conducted to determine the dysphoria and reexperiencing factors' relationships with the four factors of rumination. Results revealed that both the dysphoria and reexperiencing factors related more to problem-focused thinking and anticipatory thoughts than counterfactual thinking. Additionally, the reexperiencing factor related more to anticipatory thinking than repetitive thinking. Clinical and theoretical implications are discussed.

Predictors of mental healthcare use among domestic violence survivors in shelters.

We examined sociodemographic and illness/need associations with mental health care use and service use intensity (i.e., number of visits) among domestic violence survivors. Data from 252 women recruited from 5 Midwestern domestic violence shelters were analyzed. Univariate analyses indicated a more positive treatment attitude was related to increased mental health service use and service use intensity. Second, being Caucasian and greater PTSD severity were associated with increased service use intensity. A sociodemographic and attitudinal multivariate predictor model explained 14% of variance in treatment use intensity, and a need/illness model significantly contributed an additional 10% variance. In contrast, the interaction of PTSD Symptom Severity × Perceived Need was significant. Results demonstrate illness has a significant effect above and beyond sociodemographic variables in accounting for mental health care use, and that PTSD severity moderated the relationship between perceived need and service use.

PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation.

Reinforcement sensitivity theory (RST) stipulates that individuals have a behavioral activation system (BAS) guiding approach (rewarding) behaviors (Gray, 1971, 1981), and behavioral inhibition system (BIS) guiding conflict resolution between approach and avoidance (punishment) behaviors (Gray & McNaughton, 2000). Posttraumatic stress disorder (PTSD) severity overall relates to both BIS (e.g., Myers, VanMeenen, & Servatius, 2012; Pickett, Bardeen, & Orcutt, 2011) and BAS (Pickett et al., 2011). Using a more refined approach, we assessed specific relations between PTSD's latent factors (Simms, Watson, & Doebbeling, 2002) and observed variables measuring BIS and BAS using 308 adult, trauma-exposed primary care patients. Confirmatory factor analysis and Wald chi-square tests demonstrated a significantly greater association with BIS severity compared to BAS severity for PTSD's dysphoria, avoidance, and re-experiencing factors. Further, PTSD's avoidance factor significantly mediated relations between BIS/BAS severity and PTSD's dysphoria factor.

Heterogeneity in clinical presentations of posttraumatic stress disorder among medical patients: testing factor structure variation using factor mixture modeling.

The present study used factor mixture modeling to explore empirically defined subgroups of psychological trauma victims based on confirmatory factor analysis (CFA) and latent class analysis of posttraumatic stress disorder (PTSD) symptoms. We sampled 310 medical patients with a history of trauma exposure. Confirmatory factor analysis revealed that the 4-factor emotional numbing PTSD model yielded the best model fit. Using latent factor means derived from this model and the 4-factor dysphoria PTSD model (indexing severity on PTSD factors), 3 latent classes of participants were identified using factor mixture modeling. The 3-class model fit the data very well and was validated against external measures of anxiety and rumination.