Long-Term Reactions to the Loss of a Close Friend in an Extreme Terror Incident.

This article presents results from one of the first longitudinal studies exploring the effects of losing a close friend to traumatic death, focusing on complicated grief over time and how this is affected by avoidant behavior and rumination about the loss. The sample consists of 88 persons (76% women and 24% men, mean age = 21) who lost a close friend in the Utøya killings in Norway on July 22, 2011.Quantitative data were collected at three time-points; 18, 28, and 40 months postloss. Main findings are that bereaved friends are heavily impacted by the loss and their grief reactions are affected negatively by avoidant behavior and rumination. This indicates that close bereaved friends are a group to be aware of and that there is a need for better strategies for identifying individuals in need for follow-up.

Facing spousal cancer during child-rearing years: The short-term effects of the Cancer-PEPSONE programme-a single-center randomized controlled trial.

OBJECTIVE: To measure the short-term effects of the Cancer-PEPSONE programme (CPP) on the partners' received and perceived social support, psychological distress, and quality of life (QOL), as well as explore the role of received social support as a mediator of the intervention effects. METHODS: Open single-center randomized controlled trial, trial number 15982171(ISRCTN). Eligible participants were the partners of cancer patients who were concomitantly caring for minors (the well parents). The sample consisted of 35 participants randomly allocated to receive either intervention (n = 17) or support as usual (n = 18). At the 3-month follow-up (approximately 1 month after intervention), 24 continued to participate (intervention n = 13, control n = 11). The intervention group selected supporters to participate in CPP (N = 130). Data were obtained using validated questionnaire. RESULTS: The multivariate analysis of covariance revealed significant intervention effects (P = .03, η2p  = 0.42), with main effects on received and perceived social support. A mediational analysis suggested that CPP may have indirect effects on QOL through received social support. CONCLUSIONS: Even though the long-term effects are yet to be studied, CPP seems to increase social support for the well parents' short term, which in turn may improve their QOL. Given the study's low sample size, further replications in larger samples are required.

The combined influence of hardiness and cohesion on mental health in a military peacekeeping mission: A prospective study.

A large number of studies have shown that hardiness and cohesion are associated with mental health in a military context. However, most of them are presented without controlling for baseline mental health symptoms, which is their most significant source of error. The present study investigates the combined effect of hardiness and cohesion in a prospective design, controlling for baseline levels of symptoms among Norwegian personnel serving in a peacekeeping operation in Kosovo. Multivariate regression analyses were performed in which self-reported mental health complaints were regressed on our explanatory variables. Our findings suggest that both cohesion and hardiness contributed to increased stress resiliency, as measured by a lower level of reported mental health complaints. Our baseline measure of mental health accounted for a larger proportion of the variance than our other predictors. A significant interaction between cohesion and hardiness suggested a combined effect, over and above the individual contributions of the predictors. For individuals who scored high on hardiness, cohesion levels did not influence levels of mental health complaints. Individuals who scored low on hardiness, on the other hand, reported lower levels of mental health complaints when cohesion levels were high.

Psychopathy and the ability to read the "language of the eyes": divergence in the psychopathy construct.

The capacity to interpret others people's behavior and mental states is a vital part of human social communication. This ability, also called mentalizing or Theory of Mind (ToM), may also serve as a protective factor against aggression and antisocial behavior. This study investigates the relationship between two measures of psychopathy (clinical assessment and self-report) and the ability to identify mental states from photographs of the eye region. The participants in the study were 92 male inmates at Bergen prison, Norway. The results showed some discrepancy in connection to assessment methodology. For the self-report (SRP-III), we found an overall negative association between mental state discrimination and psychopathy, while for the clinical instrument (PCL-R) the results were more mixed. For Factor 1 psychopathic traits (interpersonal and affective), we found positive associations with discrimination of neutral mental states, but not with the positive or negative mental states. Factor 2 traits (antisocial lifestyle) were found to be negatively associated with discrimination of mental states. The results from this study demonstrate a heterogeneity in the psychopathic construct where psychopathic traits related to an antisocial and impulsive lifestyle are associated with lower ability to recognize others' mental states, while interpersonal and affective psychopathic traits are associated with a somewhat enhanced ability to recognize others' emotional states.

Risk factors for PTSD, anxiety, and depression among adolescents in Gaza.

The present study examined among adolescents in Gaza the relationship between exposure to war stressors and psychological distress as well as the effects of age, gender, and socioeconomic status. Data were collected from a sample of 139 adolescents 12 to 17 years old. Results showed that adolescents reported elevated levels of intrusion, avoidance, and depression compared to levels in communities not affected by war in the recent past. The proportion scoring within the clinical range of posttraumatic stress disorder (PTSD) was 56.8% compared to 6.3% in peacetime populations, reflecting a Hedges's g of 1.29 (p < .001). Significant risk factors for PTSD were exposure (ß = .377, p < .001), female gender (ß = -.257, p < .001), older age (ß = .280, p < .01), and an unemployed father (ß = -.280, p < .01). Risk factors for anxiety were exposure (ß = .304, p < .001), female gender (ß = -.125, p < .01), and older age (ß = 272, p < .01), whereas female gender (ß = <.238, p < .001) was the only significant risk factor for depression. The present study suggests large individual differences in how adolescents are affected by war stressors.

Psychometric properties of the revised Norwegian dispositional resilience (hardiness) scale.

In the 30 years that have elapsed since it was first introduced, the concept of hardiness has continued to attract the attention and interest of researchers from all over the world. The purpose of this study was to examine the reliability and factor structure of a revised Norwegian hardiness scale (Dispositional Resilience Scale 15; DRS-15). Using exploratory and confirmatory factor analytic strategies with a large sample of working adults (N = 7,280), support was found for a hierarchical structure comprising a general hardiness dimension and three sub-dimensions (commitment, control, and challenge). Overall, the results support the reliability and validity of the revised DRS-15 and underscore the importance of examining the psychometric properties and cultural appropriateness of translated scales.

Psychometric properties of the Norwegian Impact of Event Scale-revised in a non-clinical sample.

BACKGROUND: Despite the widespread use of the Impact of Event Scale to measure post-traumatic stress symptoms, psychometric evaluations of the scale have revealed mixed findings. AIM: The aim of the present study is to provide new empirical evidence and examine the factor structure, reliability, and predictive validity of the Norwegian version of the IES-R. METHODS: Posttraumatic stress symptoms were recorded in a student sample (n=312) 3 weeks after the Southeast Asian tsunami disaster in December 2004. Confirmatory factor analyses of the IES-R behavior items using structural equation modeling (SEM) were performed on four models from existing research. RESULTS: The original three-factor model of intrusion, avoidance and hyperarousal symptoms exhibited the best goodness-of-fit indices when defined as oblique. The IES-R also revealed satisfactory reliability. Symptom levels of intrusion and avoidance were moderate, while hyperarousal scores were low, with a significant gender difference. CONCLUSION: Taken together, the IES-R revealed good psychometric properties in this nonclinical student sample and could be a useful instrument to assess and follow-up on PTSD symptoms after a certain identified trauma.

Hardiness, avoidance coping, and alcohol consumption in war veterans: A moderated-mediation study.

Military personnel often engage in excessive alcohol use after returning from deployments. Thus far, research has paid scant attention to personality factors that may increase or diminish the risk for increased alcohol consumption in this population. The present study explores how psychological hardiness, avoidance coping, and stress exposure may interact to influence alcohol consumption patterns in soldiers following deployment. U.S. Army National Guard soldiers (N = 357) were surveyed shortly after returning from combat operations in Afghanistan. Conditional process analysis was used to test for mediation and moderation effects. Mediation effects were further tested in a replication sample of Norwegian Army soldiers (N = 230) deployed to Kosovo. Findings show that hardiness is a significant (negative) predictor of increased alcohol use and that this relation is mediated by avoidance coping. Further, this effect was moderated by combat stress exposure in the U.S. sample, such that the mediation is stronger for those with greater exposure (moderated-mediation). Avoidance coping also mediated the effects of hardiness on alcohol consumption in the Norwegian sample. These findings suggest that avoidance coping and hardiness may be fruitful areas for interventions aimed at reducing risky drinking in high-stress groups like the military.

Facing Spousal Cancer During Child-Rearing Years: Do Social Support and Hardiness Moderate the Impact of Psychological Distress on Quality of Life?

BACKGROUND: Partners of cancer patients report psychological distress and reduced quality of life. However, partners' mental health status and quality of life during child-rearing years and the influence of social support and hardiness on their well-being have not yet been studied. OBJECTIVE: The aim of this study was to describe psychological distress, quality of life, social support, and hardiness of the partners facing spousal cancer during child-rearing years and investigate whether social support or hardiness moderated the relationship between psychological distress and quality of life. METHODS: Cross-sectional data were collected in Norway from December 2013 to July 2015 as part of the Cancer-PEPSONE study. RESULTS: Five questionnaires were administered to 14 females and 21 males (n = 35). Participants reported more psychological distress and lower quality-of-life scores than other healthy Norwegian populations. Psychological distress seemed to be associated with their not being in control of their futures. Received social support moderated the effect of psychological distress on quality of life. CONCLUSIONS: Facing spousal cancer during child-rearing years seemed to have a substantial impact on partners' mental health and an adverse impact on their quality of life. Accordingly, these partners' self-care abilities may be reduced. Received social support may reduce the multiple burdens and consequently allow for enhancement of self-care. IMPLICATIONS FOR PRACTICE: Interventions should aim to improve the social support provided to child-rearing partners, which may improve their quality of life. Providing adequate information about their partner's cancer illness and treatment may enhance their feelings of control, which may be beneficial for their mental health status.

Reduced heart rate variability in chronic alcohol abuse: relationship with negative mood, chronic thought suppression, and compulsive drinking.

BACKGROUND: Previous research suggests that heart rate variability (HRV) may be an important factor in various maladaptive psychological conditions. METHODS: This study was conducted to investigate vagal tone assessed as tonic vagally mediated heart rate variability in alcoholic (n = 49) and control subjects (n = 45). RESULTS: Alcoholic subjects had faster heart rate and lower preimaginary exposure levels of HRV compared with the control group. An increase in HRV was observed in the alcoholic group when subjects were exposed to an imaginary alcohol script. Tonic HRV was found to be related inversely to negative mood and chronic thought suppression and positively to positive mood. Furthermore, the compulsive subscale of the Obsessive Compulsive Drinking Scale (OCDS) was inversely related to HRV during the imaginary alcohol exposure. CONCLUSIONS: It is concluded that the findings are in agreement with the neurovisceral integration model of affective regulation, which claims that dysfunctional psychologic states are rooted in an impaired inhibitory mechanism that is associated with low HRV.

Craving for alcohol and pre-attentive processing of alcohol stimuli.

The present study was designed to test the hypothesis of unconscious attending to alcohol-related information in alcoholics experiencing a high level of craving for alcohol. Subjects included a group of alcoholics (n=34) divided by a median split on a craving measure into two groups labeled as 'high craving' (n=18) and 'low craving' (n=16) alcoholics, and a non-alcoholic control group (n=39). The cardiovascular reactions of these groups were compared after their exposure to masked and unmasked alcohol and control stimuli. As expected the 'high craving' alcoholics showed an immediate heart rate deceleration after exposure to masked and non-consciously accessible alcohol pictures. The 'high craving' alcoholics reported a small but significant increase in difficulty resisting a drink after exposure to masked alcohol pictures. When the alcohol pictures were presented unmasked a significant increase was found in both high and low craving alcoholics on consciously expressed urges, fidgeting and reduced coping with temptation to drink. The 'high craving' alcoholics had lower tonic heart rate variability compared to the control group and the level of craving was positively associated with salivation during the exposure to all picture types. The findings generally support the psychobiological theory of craving, which suggests that the uncontrollability of the craving experience is rooted in unconscious processing of drug-related information.

Attentional and physiological characteristics of patients with dental anxiety.

Twenty patients with dental anxiety were investigated while seated in a dental chair in a dental clinic. Heart rate (HR), heart rate variability (HRV), and skin conductance level (SCL) were recorded while the patients were exposed to scenes of dental treatment as well as a Stroop attentional task. Results showed an attentional bias with longer manual reaction times (RT's) to the incongruent compared to the congruent color words as well as the threat compared to the neutral words. Longer RT's to the incongruent and the threat words were found in the low HRV patients compared to the high HRV patients. Furthermore, all patients showed an increase in HR during exposure and the Stroop task compared to baseline. The HRV showed a decrease during the exposure and the Stroop task compared to baseline. HR and HRV did not differ between exposure and the Stroop task. Moreover, HR and HRV did not return to baseline levels during the recovery period. The SCL showed an increase from baseline to exposure, from exposure to the Stroop task and a decrease in the recovery phase. Results showed the importance of vagal cardiac control in attentional, emotional, and physiological processes in patients suffering from dental fear.

Type of musical soundtrack affects behavior in gambling.

BACKGROUND AND AIMS: A long existing notion is that the presence of music might affect gambling behavior. In spite of this, little empirical research on the subject exists. The main aim of the present study was to corroborate and elaborate on the existing findings concerning gambling and music through a laboratory based experiment. METHODS: A nonclinical sample of 101 undergraduate students (72 females, 29 males) played a computerized gambling task in which either a high-tempo or a low-tempo musical soundtrack was present. Persistence in gambling, reaction time and evaluation of the game comprised the outcome variables. RESULTS: Low-tempo music was associated with increased gambling persistence in terms of overall number of bets placed, whereas high-tempo music was associated with intensified gambling in terms of faster reaction time per placed bet. Type of soundtrack was not associated with game evaluation. DISCUSSION: Our findings add to the existing knowledge by showing that both low-tempo and high-tempo music can be associated with more risky gambling behavior, the former by increasing gambling persistence and the latter by reducing reaction time for bets placed. CONCLUSIONS: In sum, the existing studies provide compelling evidence that music can affect various aspects of gambling behavior. These findings may have clinical implications by educating gamblers on the effects of structural mechanisms in gambling on behavior.

Tempo in electronic gaming machines affects behavior among at-risk gamblers.

Background and aims Electronic gaming machines (EGM) may be a particularly addictive form of gambling, and gambling speed is believed to contribute to the addictive potential of such machines. The aim of the current study was to generate more knowledge concerning speed as a structural characteristic in gambling, by comparing the effects of three different bet-to-outcome intervals (BOI) on gamblers bet-sizes, game evaluations and illusion of control during gambling on a computer simulated slot machine. Furthermore, we investigated whether problem gambling moderates effects of BOI on gambling behavior and cognitions. Methods 62 participants played a computerized slot machine with either fast (400 ms), medium (1700 ms) or slow (3000 ms) BOI. SOGS-R was used to measure pre-existing gambling problems. Mean bet size, game evaluations and illusion of control comprised the dependent variables. Results Gambling speed had no overall effect on either mean bet size, game evaluations or illusion of control, but in the 400 ms condition, at-risk gamblers (SOGS-R score > 0) employed higher bet sizes compared to no-risk (SOGS-R score = 0) gamblers. Conclusions The findings corroborate and elaborate on previous studies and indicate that restrictions on gambling speed may serve as a harm reducing effort for at-risk gamblers.

Outcome of pharmacological treatments of pathological gambling: a review and meta-analysis.

UNLABELLED: Although several qualitative reviews on pharmacological interventions for pathological gambling have been published, no quantitative review of this field has been conducted. METHODS: Studies of pharmacological interventions of pathological gambling were identified by computer searches in the PsychINFO and MEDLINE databases covering the period from 1966 to July 2006, as well as from relevant reference lists. The inclusion criteria were as follows: the target problem had to be pathological gambling, the interventions were pharmacological, the study was written in English, and the study reported outcomes particularly pertaining to gambling. A total of 130 potential studies were identified of which 16 met the inclusion criteria. A total of 597 subjects were included in the outcome analyses of these studies. The grand mean age was 43.3 years. The overall proportion of men was 62.8%. The included studies were coded for outcome measures of pathological gambling. For each condition, means and SDs for gambling-related outcome measures were compiled at 2 points in time: baseline and posttreatment. RESULTS: At posttreatment, the analysis showed that the pharmacological interventions were more effective than no treatment/placebo, yielding an overall effect size of 0.78 (95% confidence interval, 0.64-0.92). A multiple regression analysis showed that the magnitude of effect sizes at posttreatment was lower in studies using a placebo-control condition compared with studies using a predesign/postdesign without any control condition. Effect sizes were also negatively related to the proportion of male participants in the included studies. No differences in outcome between the 3 main classes of pharmacological interventions (antidepressants, opiate antagonists, mood stabilizers) were detected. CONCLUSION: Pharmacological interventions for pathological gambling may be an adequate treatment alternative in pathological gambling.

Preattentive processing of alcohol stimuli.

An experiment was conducted to test the automatic analysis of briefly presented alcohol stimuli in alcohol-dependent individuals. Alcoholics and controls were exposed to four different conditions: two brief (30 ms) and two long (130 ms) exposure conditions, each containing alcoholic and non-alcoholic pictures. Heart rate (HR) interbeat intervals were recorded and phasic cardiac responses assessed. Alcoholics had a stronger initial HR deceleration after exposure to masked alcohol slides compared with masked control slides, indicating a preattentive analysis of alcohol stimuli. This initial HR deceleration in the masked condition suggests an automatic attentional focusing to degraded alcohol cues. No such attentional effect was found when the pictures were presented unmasked and were clearly perceived. The implication of these results for the understanding of relapse in addictive behavior is discussed.

The effect of sensitization and coping style on post-traumatic stress symptoms and quality of life: two longitudinal studies.

The present study investigated the effects of multiple trauma exposure and coping style on post-traumatic stress symptoms and quality of life. It was hypothesized that sensitization would occur in subjects repeatedly exposed to life-threatening situations (study 1), and different coping styles would act as a resilience or facilitating factor in symptom development (study 2). The results showed that the single-exposure group revealed a decrease in trauma specific stress reactions from three weeks to four months, with a persistent reduction at 12-month follow-up, while the repeated-exposure group showed an increase in symptom reporting over the 12-month period. The same pattern emerged for perceived quality of life-measured by the General Health Questionnaire (GHQ-30). The second study revealed a correlation between scores on avoidant-focused coping style and the Impact of Event Scale-avoidance dimension, Post-traumatic Symptom Scale and GHQ-30. Furthermore, only subjects with a dominant coping style of emotion-focused or task-focused coping showed a reduction in trauma-specific symptom scores over time.

Dichotic listening and sleep deprivation: vigilance effects.

Twelve sleep-deprived and 13 non-deprived Navy cadets were tested with the dichotic listening procedure for effects of sleep deprivation on hemispheric asymmetry and sustained attention. Consonant-vowel syllables were presented to the subjects in three different conditions, a divided (non-forced) attention condition, a forced right ear and a forced left ear attention condition. In the two forced attention conditions the subjects were instructed to focus attention only on the right or left ear stimulus. The results showed an expected right ear advantage for both groups during the non-forced and forced right attention conditions, indicating superior left hemisphere processing. During the forced left attention condition, the sleep-deprived subjects showed no ear advantage at all, while the non-deprived subjects showed an expected left ear advantage. The results are discussed within a theoretical framework of a dual process model, where sleep deprivation disrupts the ability to sustain attention, caused by a temporary failure of the right hemisphere's top-down (instruction-driven) processing to override the left hemisphere's bottom-up (stimulus-driven) processing.