Coping self-efficacy mediates effects of posttraumatic distress on communal coping in parent-adolescence dyads after floods.

Social cognitive theory provides a framework of human agency during environmental challenges, with coping self-efficacy (CSE) as an important construct underlying adaptation. We examined two alternative models involving CSE as a mediator of the association between posttraumatic stress symptoms (PTSS) and communal coping among parent-youth dyads after severe floods using Bayesian dyadic multilevel modeling. The first model included PTSS as the independent variable and communal coping as the dependent variable (disaster distress model). The independent and dependent variables were replaced for each other in the second model (communal coping model). We used data from 485 parent-youth dyads who experienced floods between 2015 and 2016 in Texas, USA. Parents of children (69% women) aged 10-19 years old, and their oldest child (53% male; Mean age = 13.75) in that age range were recruited. We assessed PTSS, CSE, and communal coping for parents and youths. Results favored the disaster distress model over the communal coping model. In the disaster distress model, results demonstrated that CSE declines as PTSS increases, predicting decreased communal coping. This mediation effect of CSE is stronger for youths compared to parents, indicating that children's CSE is affected more by PTSS.

Resilience enhancing programs in the U.S. military: An exploration of theory and applied practice.

U.S. service members are at an enhanced risk for developing mental disorders. To address these challenges, while promoting operational readiness and improving mental health outcomes, the Department of Defense directed each service component to develop and implement universal resilience enhancing programs. This paper provides a review of theoretical approaches conceptualizing resilience to trauma, including the theoretical foundations of programs currently in place. The resilience programs of U.S. Army, U.S. Air Force, U.S. Navy and U.S. Marine Corps are described, and available program effectiveness data are reviewed. Gaps between theory and practice are identified and an alternative method of assessing psychological readiness in Army units that is informed by resilience theory is offered as one way to address these gaps and scientific concerns. By comprehensively assessing the stressors affecting Soldiers at regular intervals, military leaders may be able to better identify and mitigate stressors in a systematic way that bolsters individual and unit psychological fitness. An enhanced psychological readiness metric stands to strengthen the validity of current resilience programs, bring clarity to the mechanisms of resilience, and provide a novel way for leaders to promote readiness in their units. Application of this metric within the infrastructure of existing reporting systems stands to improve mental health outcomes for Service Members, enhance the psychological readiness of the force, and reduce healthcare costs over time.

Nonlinear Changes in Facial Affect and Posttraumatic Growth: Assessment of Ecological Momentary Assessment Video Data.

Posttraumatic Growth (PTG), characterized by newfound meaning, perspective, and purpose for trauma survivors, remains enigmatic in its nature. This state is thought to arise from the dynamic interplay of biopsychosocial factors; however, the nature of this interplay is unclear. This study aimed to investigate the intricate relationship between PTG and facial affect dynamics, shedding light on the complex interplay of biopsychosocial factors that underpin this transformative process. We conducted a comprehensive investigation involving 19 wildfire survivors who provided daily self-reported PTG ratings alongside smartphone videos analyzed using Automated Facial Affect Recognition (AFAR) software. Our findings revealed compelling evidence of self-organization within facial affect, as indicated by notably high mean R2 and shape parameter values (i.e., nonlinear indices indicative of structural integrity and flexibility). Further regression analyses unveiled a significant interaction between the degree of facial affect 'burstiness' and coping self-efficacy (CSE) on PTG. This interaction suggested that PTG development was a nuanced process intricately linked to the coherence of emotion patterns exhibited by individuals. These insights illuminate the multifaceted dynamics at play in the emergence of PTG and contribute to a broader understanding of its biopsychosocial foundations.

Social cognitive mechanisms in healthcare worker resilience across time during the pandemic.

PURPOSE: Healthcare workers are at increased risk for mental health problems during disasters such as the COVID-19 pandemic. Identifying resilience mechanisms can inform development of interventions for this population. The current study examined pathways that may support healthcare worker resilience, specifically testing enabling (social support enabled self-efficacy) and cultivation (self-efficacy cultivating support) models. METHODS: Healthcare workers (N = 828) in the Rocky Mountain West completed self-report measures at four time points (once per month from April to July of 2020). We estimated structural equation models to explore the potential mediating effects that received social support and coping self-efficacy had (at time 2 and time 3) between traumatic stress symptom severity (at time 1 and time 4). Models included covariates gender, age, minority status, and time lagged co-variations between the proposed mediators (social support and coping self-efficacy). RESULTS: The full model fit the data well, CFI = .993, SRMR = .027, RMSEA = .036 [90% CIs (0.013, 0.057)]. Tests of sequential mediation supported enabling model dynamics. Specifically, the effects of time 1 traumatic stress severity were mediated through received social support at time 2 and time 3 coping self-efficacy, in sequential order to reduce time 4 traumatic stress severity. CONCLUSIONS: Findings show the importance of received social support and coping self-efficacy in mitigating psychopathology risk. Interventions can support mental health by focusing on social resource engagement that facilitates coping empowerment, which may decrease risk for mental health job-related problems among frontline healthcare workers exposed to highly stressful events.

Social engagement, self-efficacy, and posttraumatic stress symptoms across 6 months of psychotherapy.

OBJECTIVE: The current study was conducted in a naturalistic treatment setting to examine whether and how perceptions about social engagement, trauma coping self-efficacy, and posttraumatic stress symptoms (PTS) influence one another across 6 months of psychotherapy for trauma survivors. METHOD: The sample included 183 clients who reported exposure to traumatic events and significant PTS (PCL-5 ≥ 33). Participants (Mage = 37.8, 53.6% female) completed surveys at intake, 3 months, and 6 months into treatment. A cross-lagged panel analysis was used to test the relationships among perceived social engagement, coping self-efficacy, and PTS across three assessment points. RESULTS: PTS at 3-months was a mediator in the relationship between intake perceived social engagement and 6-month coping self-efficacy and between intake perceived social engagement and 6-month perceived social engagement. CONCLUSIONS: PTS several months into treatment may serve as a mechanism between intake perceived social engagement and functional outcomes such as coping self-efficacy.

Addressing Disaster Exposure Measurement Issues With Latent Class Analysis.

Disaster exposure can put survivors at greater risk for subsequent mental health (MH) problems. Within the field of disaster MH research, it is important to understand how the choice of analytic approaches and their implicit assumptions may affect results when using a disaster exposure measure. We compared different analytic strategies for quantifying disaster exposure and included a new analytic approach, latent class analysis (LCA), in a sample of parents and youth. Following exposure to multiple floods in Texas, a sample of 555 parents and 486 youth were recruited. Parents were predominantly female (70.9%) and White (60.8%). Parents were asked to have their oldest child between the ages of 10 and 19 years old participate (M = 13.74 years, SD = 2.57; 52.9% male). Participants completed measures on disaster exposure, posttraumatic stress, depression, and anxiety. The LCA revealed four patterns of exposure in both parents and youth: high exposure (15.5% parent, 9.5% child), moderate exposure (19.8% parent, 28.2% child), community exposure (45.9% parent, 34.4% child), and low exposure (18.8% parent, 27.8% child). In terms of MH, there were similarities across analytic approaches, but the LCA highlighted a threshold effect, with the high exposure class doing worse than all others, d = 1.12. These results have important implications in understanding the different exposure experiences of survivors and the linkage to MH outcomes. The findings are also informative in the development and use of screening tools used in postdisaster contexts in determining who may or may not need MH services.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Abordando los Problemas de Medición de la Exposición a los Desastres con un Análisis de Clases Latentes ABORDANDO LA MEDICION DE LA EXPOSICION A DESASTRES La exposición a los desastres puede poner a los sobrevivientes en un riesgo más alto de posteriores problemas de salud mental (SM). En el campo de investigación de la SM sobre desastres, es importante entender como la elección de perspectivas analíticas y sus supuestos implícitos podrían afectar los resultados cuando se usa una medida de exposición al desastre. Comparamos estrategias analíticas diferentes para cuantificar la exposición al desastre e incluimos una perspectiva analítica nueva, análisis de clase latente (LCA en sus siglas en inglés), en una muestra de padres y jóvenes. Luego de la exposición a numerosas inundaciones en Texas, se reclutó una muestra de 555 padres y 486 jóvenes. Los padres fueron principalmente mujeres (70.9%) y de raza blanca (60.8%). Se les pidió a los padres la participación de su hijo mayor entre las edades de 10 y 19 años (M = 13.74 años, DE = 2.57; 52.9% varones). Los participantes completaron las medidas sobre exposición a desastres, estrés postraumático, depresión, y ansiedad. El LCA reveló cuatro patrones de exposición en ambos padres y jóvenes: alta exposición (15.5% padres, 9.5% niños), exposición moderada (19.8% padres, 28.2% niños), exposición comunitaria (45.9% padres, 34.4% niños), y baja exposición (18.8% padres, 27.8% niños). En términos de la SM, hubo similitudes a lo largo de los enfoques analíticos, pero el LCA destacó un efecto umbral, con la clase de alta exposición presentando características peores que todas las otras, d = 1.12. Estos resultados tienen implicaciones importantes para entender las diferentes experiencias de exposición de los sobrevivientes y su vínculo con resultados de la SM. Los hallazgos son también informativos en el desarrollo y el uso de herramientas de tamizaje usadas en los contextos post-desastres en determinar quién podría o no necesitar servicios de SM.

The Temporal Relationship Between Coping Self-Efficacy and Dissociation in Undergraduate Students.

Dissociation is a lack of information integration resulting from a process that ranges on a continuum from normative experiences (e.g., daydreaming) to a pervasive traumatic response involving alterations and/or fragmentation in mental processes such as memory, emotion, and perception. Perceived coping self-efficacy (CSE) is a cognitive appraisal ability utilized to regulate internal and external stressors that arise from traumatic events, and is crucial for effective adaptation after extreme stress or trauma. Thus, CSE may be a critical component in decreasing dissociative experiences following a traumatic event. In the present study, 136 undergraduate students (M age = 22.36 years, SD = 6.27; 81% female, 69.1% Caucasian, 77.2% attended some college) completed self-report measures of trauma, dissociation, and coping self-efficacy. All measures were completed by the same participants at two different time points (Time 1 and Time 2) two months apart; all participants reported a history of exposure to at least one Criterion A traumatic event (according to the DSM-5) at Time 1. We hypothesized that CSE for posttraumatic coping demands at Time 2 would mediate the relationship between dissociation at Time 1 and dissociation at Time 2, and subsequently found evidence of significant mediation, 95% CI [.02, .18]. These findings suggest that initial levels of persistent dissociation negatively predict CSE, which in turn directly and negatively influence persistent dissociation at a later time point. This highlights how CSE may serve as a protective factor against persistent dissociation.

Burnout Among US Military Behavioral Health Providers.

The present study investigated the prevalence of burnout among US military behavioral health providers (BHPs) and tested a mechanism of developing burnout in a job demands-resources model. Surveys were sent to BHPs working with US military populations globally (T1). Six months after, surveys were collected again at T2. In total, 271 providers completed T1, and 116 completed T2. The job demands-resources model showed that T1 burnout self-efficacy and support predicted T2 burnout and work engagement. T1 job demands predicted T2 burnout. To provide a deeper comparison of our findings, we included a meta-analysis, which indicated burnout among BHPs working on a military installation was equivalent with other professions. Providers working with military clients within the community reported lower burnout than other professionals. Findings suggest BHPs working on a military installation might be at greater risk of developing burnout. Burnout might be preventable by increasing job resources and decreasing job demands.

Self-Regulation Shift Theory: A Dynamic Systems Approach to Traumatic Stress.

Self-regulation shift theory (SRST) is a threshold theory explaining self-regulation following trauma that utilizes nonlinear dynamics to capture systemic shifts in trauma adaptation. Cusp catastrophe modeling tests nonlinear changes in an outcome (e.g., posttraumatic distress) based on an identified bifurcation factor under specific conditions (i.e., asymmetry variables). We evaluated two cusp models in a motor vehicle accident (MVA) database and then confirmed findings within a similar dataset. Based on SRST, we tested coping self-efficacy (CSE) as the bifurcation factor and a set of asymmetry controlling variables. Results demonstrated significant cusp models with CSE as a consistent bifurcation factor in all models. When participants reported lower peritraumatic dissociation, early lower CSE was a significant bifurcation factor for 3-month trauma symptoms in Sample 1, R2 = .18. The cusp model for changes in symptoms from 30 days to 3 months showed CSE as a significant bifurcation variable with higher levels of avoidant coping (R2 = .27). In a separate sample, early lower CSE was again a significant bifurcation variable with lower injury severity (R2 = .52). Results support the importance of self-regulatory appraisals in nonlinear shifts in posttraumatic stress symptoms 3 months post-MVA. Theoretical and practical implications are discussed.

Protective Factors, Coping Appraisals, and Social Barriers Predict Mental Health Following Community Violence: A Prospective Test of Social Cognitive Theory.

This study tested social cognitive theory of posttraumatic adaptation in the context of mass violence, hypothesizing that pre-event protective factors (general self-efficacy and perceived social support) would reduce posttraumatic stress symptoms (PTSS) and depression severity through boosting post-event coping self-efficacy appraisals (mediator). We qualified hypotheses by predicting that post-event social support barriers would disrupt (moderate) the health-promoting indirect effects of pre-event protective factors. With a prospective longitudinal sample, we employed path models with bootstrapping resampling to test hypotheses. Participants included 70 university students (71.4% female; 40.0% White; 34.3% Asian; 14.3% Hispanic) enrolled during a mass violence event who completed surveys one year pre-event and 5-6 months post-event. Results revealed significant large effects in predicting coping self-efficacy (mastery model, R2 = .34; enabling model, R2 = .36), PTSS (mastery model, R2 = .35; enabling model, R2 = .41), and depression severity (mastery model, R2 = .43; enabling model, R2 = .46). Overall findings supported study hypotheses, showing that at low levels of post-event social support barriers, pre-event protective factors reduced distress severity through boosting coping self-efficacy. However, as post-event social support barriers increased, the indirect, distress-reducing effects of pre-event protective factors were reduced to nonsignificance. Study implications focus on preventative and responsive intervention.

Cultivating secondary traumatic growth among healthcare workers: the role of social support and self-efficacy.

OBJECTIVE: This 2-study longitudinal investigation examined the indirect effects of secondary traumatic stress (STS) on secondary traumatic growth via two mediators: perceived social support and secondary trauma self-efficacy. In particular, we tested if the 2 hypothetical mediators operate sequentially, that is, with secondary trauma self-efficacy facilitating social support (i.e., cultivation hypothesis) and/or social support enhancing self-efficacy (i.e., enabling hypothesis). METHOD: Participants in Study 1 (N = 293 at Time 1, N = 115 at Time 2) were behavioral healthcare providers working with U.S. military personnel suffering from trauma. Study 2 was conducted among Polish healthcare workers (N = 298 at Time 1, N = 189 at Time 2) providing services for civilian survivors of traumatic events. RESULTS: In both studies, multiple mediational analyses showed evidence for the cultivation hypothesis. The relationship between STS at Time 1 and secondary traumatic growth at Time 2 was mediated sequentially by secondary trauma self-efficacy at Time 1 and social support at Time 2. The enabling hypothesis was not supported. CONCLUSION: Education and development programs for healthcare workers may benefit from boosting self-efficacy with the intent to facilitate perceived social support.

Random intercept cross-lagged relations among trauma coping self-Efficacy, trauma coping, and PTSD symptoms among rural hurricane survivors.

BACKGROUND AND OBJECTIVES: The trajectories of recovery and non-recovery following a disaster are well-documented, but the mechanisms of post-disaster adaptation remain poorly understood. Rooted in social cognitive theory and the transactional model of stress and coping, this study longitudinally investigated the reciprocal relations among coping self-efficacy (CSE), coping behaviors (approach and avoidant), and posttraumatic stress symptoms (PTSS) among highly exposed hurricane survivors. DESIGN: 261 Hurricane Florence survivors completed measures of hurricane-related CSE, coping behaviors, and hurricane-related PTSS across three timepoints, beginning 5-8.5 months after Hurricane Florence. METHOD: Random-intercept cross-lagged panel models investigated the relations among study variables. RESULTS: Reciprocal, cross-lagged relations were identified between higher CSE and approach coping from T2 to T3. The lagged relations between approach coping at T1 and T2 were significant, as well as between avoidant coping at T2 and T3. Significant cross-sectional relations were also present for CSE, coping behaviors, and PTSS at T3. CONCLUSIONS: Results provide partial support for the positive feedback loop involving CSE and approach coping, but not for the negative feedback loop involving avoidant coping. CSE may be an important mechanism in longer-term disaster recovery, in part by increasing use of approach coping.

Big ideas series: self-regulation shift theory: trauma, suicide, and violence.

BACKGROUND: Traumatic stress, suicide, and impulsive violence arguably are three of the most consequential problems facing societies today. Self-regulation shift theory is introduced to capture the underlying coping dynamics involved in these three grave challenges. OBJECTIVES: Self-regulation shift theory, based in a nonlinear dynamical systems framework, focuses on critical psychological self-regulation thresholds and the role of cognitive self-appraisals in human adaptation to help understand these three significant societal challenges. METHODS: This essay reviews existing evidence within the posttraumatic adaptation process utilizing SRST for understanding dynamic self-regulation. This is followed by integrating SRST within existing current theoretical models for suicidal behaviors and violent outbursts. CONCLUSIONS: The essay concludes with methodological suggestions for future research applying SRST and how this research offers important opportunities to develop early warning systems that promote hope when hope seems impossible.

Self-compassion reduces posttraumatic stress symptom severity in hurricane survivors via perceived social support.

OBJECTIVE: Following disasters such as hurricanes, self-compassion (e.g., being understanding and showing care toward oneself) can be a valuable personal resource that facilitates social support and reduces posttraumatic symptoms. As a result of their increased connection to other people and interpersonal competence, self-compassionate people may perceive more social support following a traumatic event, which in turn reduces posttraumatic stress symptoms (PTSS). The present study is the first to utilize a longitudinal design and latent variable modeling to test this mediation hypothesis. METHOD: A three-wave longitudinal design was utilized to assess hurricane exposure, self-compassion, perceived social support, and PTSS in hurricane survivors at baseline (T1), 3-month (T2), and 6-month (T3) follow-up. Participants at T1 included 261 hurricane survivors (88.5% women) who were racially diverse and particularly vulnerable to loss of resources (53.2% with an income of less than $30,000). Participants were recruited using online, print, and face-to-face methods, and all survey responses were completed online. RESULTS: Participants reported high hurricane stressor exposure (M = 9.14 serious stressors out of a possible 24). Controlling for hurricane exposure, self-compassion at T1 predicted PTSS at T3, and this was mediated by perceived social support at T2. CONCLUSIONS: Following hurricane exposure, self-compassionate people experience less PTSS over time because they perceive their social support resources to be more robust. Implementation of self-compassion education and training following a disaster could improve perceived social support networks that provide an additional protective factor against PTSS. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Impact of Adjustment on Workplace Attitudes and Behaviors Among Health Care Workers During the COVID-19 Pandemic.

OBJECTIVE: We examined the impact of health care workers' (HCWs) adjustment to the COVID-19 pandemic on their work-related attitudes and behaviors. METHODS: HCWs ( n = 1468) participated in an observational longitudinal study in which they completed surveys of anxiety and occupational health between 2020 and 2021. RESULTS: Most HCWs reported anxiety that was consistently below the diagnostic threshold (68%) or fell below the threshold within a year (16%). Others reported consistently high (14%) or increasing (2%) anxiety, especially women, younger HCWs, those with a weakened immune system, and allied health professionals. Consistently high or increasing anxiety was associated with poorer job satisfaction, work engagement, perceived supervisor support, burnout, and turnover intentions. CONCLUSIONS: Resources to support HCWs may be focused on those who report consistently high or increasing anxiety to minimize the effects of crises and disasters on the workforce.

Secondary traumatic stress among mental health providers working with the military: prevalence and its work- and exposure-related correlates.

Our research assessed the prevalence of secondary traumatic stress (STS) among mental health providers working with military patients. We also investigated personal, work-related, and exposure-related correlates of STS. Finally, using meta-analysis, the mean level of STS symptoms in this population was compared with the mean level of these symptoms in other groups. Participants (N = 224) completed measures of indirect exposure to trauma (i.e., diversity, volume, frequency, ratio), appraisal of secondary exposure impact, direct exposure to trauma, STS, and work characteristics. The prevalence of STS was 19.2%. Personal history of trauma, complaints about having too many patients, and more negative appraisals of the impact caused by an indirect exposure to trauma were associated with higher frequency of STS symptoms. A meta-analysis showed that the severity of intrusion, avoidance, and arousal symptoms of STS was similar across various groups of professionals indirectly exposed to trauma (e.g., mental health providers, rescue workers, social workers).

The associations between coping self-efficacy and posttraumatic stress symptoms 10 years postdisaster: differences between men and women.

The mediating role of coping self-efficacy (CSE) perceptions between disaster-related posttraumatic stress symptoms (PSS) in the intermediate term (4 years postevent) and PSS in the long term (10 years postevent) were examined. Participants were 514 adult Dutch native residents affected by the Enschede fireworks disaster. The disaster (May, 2000) was caused by a massive explosion in a fireworks storage facility that destroyed a residential area. Multiple regression analysis and path analysis were used to examine the mediating role of CSE and whether the mediating role was the same for men and women. Age, education, disaster exposure, home destruction, optimism, and stressful life events were also taken into account. Regression analysis showed that the former variables were not associated with PSS at 10 years postevent, in contrast to PSS at 4 years, and were therefore omitted from the path analyses. CSE assessed at 10 years postdisaster partially mediated the relationship between PSS at 4 and PSS at 10 years postdisaster. Post hoc multigroup analysis showed that this effect was significantly stronger for men, whereas the association between PSS at 4 and 10 years postevent was stronger for women. PSS at 10 years postevent were better predicted among men (explained variance 59.5% vs 50.8%).

Not how often but when: Self-efficacy to control cannabis use and PTSS.

OBJECTIVE: Cannabis use is prevalent with trauma survivors. Yet, the effects of cannabis use on posttraumatic stress symptoms (PTSS) have been equivocal with some studies showing a positive association and some showing a negative association. Integrating the self-medication hypothesis and social cognitive theory (SCT), the present study aimed to elucidate differential outcomes by considering frequency of cannabis use and self-efficacy to control cannabis use in different contexts (i.e., social facilitation, opportunistic, and emotional relief) in relation to PTSS. METHOD: Undergraduate students (N = 314) who endorsed lifetime trauma exposure and past-month cannabis use completed self-report measures assessing cannabis use behaviors, self-efficacy to control use, and PTSS. RESULTS: Parallel mediation revealed that initially, greater frequency of cannabis use was associated with PTSS severity (ß = .16, SE = .09, p = .004). With the inclusion of emotional relief self-efficacy, opportunistic self-efficacy, and social facilitation self-efficacy to control cannabis use as parallel mediators, frequency of cannabis use no longer predicted PTSS severity. There was also a significant indirect effect of emotional relief self-efficacy to control cannabis use on frequency of use and PTSS (95% CI [.14, .31]). CONCLUSIONS: Self-efficacy to control cannabis use during moments of emotional distress could serve a critical role in the relationship between cannabis use and PTSS. These results may inform clinical intervention and provide survivors with a better understanding of how use impacts recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The mediating role of coping self-efficacy on social support and PTSD symptom severity among injury survivors.

BACKGROUND: Social support confers a protective effect against elevated PTSD symptomatology following injury. However, little is known about the mechanisms through which social support conveys this protective mental health effect in injury survivors. Coping self-efficacy is linked to both social support and PTSD symptomatology but has not been examined. OBJECTIVE: To test coping self-efficacy as a mechanism for the relationship between social support and PTSD symptom severity among injury survivors. METHOD AND DESIGN: Participants consisted of 61 injury survivors (62.3% male, 72.1% White) admitted to a Level-1 Trauma Center. Social support was assessed at 2-weeks post-injury; coping self-efficacy at 6-weeks post-injury; and PTSD symptom severity at 3-months post-injury. RESULTS: A statistically significant indirect effect was found for the social support - coping self-efficacy - PTSD symptomatology pathway, providing evidence of mediation even after controlling for age, sex, race, and education (B = -0.51, SE = 0.18, CI = -0.92, -0.20). CONCLUSIONS: Social support may exert an effect on PTSD symptom severity post-injury through its connection with coping self-efficacy. Coping self-efficacy represents an important intervention target following injury for those survivors with lower social support who are at risk for elevated PTSD symptom severity levels.