Biopsychosocial Correlates and Individual Differences for Eliciting Moral Elevation in Veterans With PTSD: An Experimental Case Series.

ABSTRACT: A promising approach to enhancing trauma-focused treatment is moral elevation-feeling inspired by witnessing a virtuous act. This study explored potential links between eliciting elevation and relevant outcomes in a series of case examples. Veterans with probable posttraumatic stress disorder completed experimental tasks including a written trauma narrative exercise and watching elevation-eliciting videos. Participants also completed baseline assessments, repeated measures of trauma-related cognitions, emotions, elevation, and saliva sample collection. Four cases were identified and reviewed: two positive responders (high elevation after videos) and two nonresponders (restricted elevation response). Positive responder cases reported decreased cognitions, emotions, and moral injury distress from after the trauma narrative to after elevation exercises, whereas nonresponders reported minimal to no changes. Positive responders also demonstrated decreases in cortisol, whereas nonresponders demonstrated increases in cortisol. Future work should examine whether elevation contributes to changes in biopsychosocial outcomes and identify individual factors that indicate who might benefit from elevation-based interventions.

Childhood Adversity and Adult Inflammation: Exploring the Mediating Role of Emotion Regulation in the MIDUS II Study.

The present study furthers understanding of how childhood adversity connects to inflammation and, in turn, poor health. Using the publicly available Midlife in the United States II (MIDUS II) dataset, we test a recent theoretical model that suggests emotion regulation is a potential mechanism of associations between adversity and inflammation. We examined the indirect effects of various types of adversity (e.g., stressful events, maltreatment, threat, and deprivation) on inflammation via two emotion regulation strategies (i.e., expressive suppression and reappraisal). Participants included 1096 adults without a history of cancer or HIV/AIDS who had completed the initial MIDUS II follow up and a sub-study examining biomarkers. Participants completed self-report measures inquiring about psychosocial factors including stressful life events, childhood trauma, and emotion regulation as well as provided blood samples. Bivariate correlation indicated that multiple forms of childhood adversity were associated with both C-reactive protein and fibrinogen. Deprivation, as measured by a stressful life events scale, was positively associated with both reappraisal and suppression. Tests of indirect effects indicated that deprivation was positively associated with fibrinogen through both emotion regulation strategies, particularly for female participants. Our findings partially support recent theory positing emotion regulation as a pathway through which childhood adversity may impact inflammation in adulthood. Further, deprivation may be particularly critical in understanding how adversity is connected to maladaptive emotion regulation and inflammation. Emotion regulation may be an important treatment target to mitigate the negative impact of childhood adversity on health and well-being. Supplementary Information: The online version contains supplementary material available at 10.1007/s40653-023-00594-2.

Understanding associations between rumination and inflammation: A scoping review.

A growing body of evidence suggests that rumination, or focused attention on mental representations of negative events, may have physiological consequences that adversely affect long term health. We conducted a scoping review on quantitative studies of humans examining associations between rumination and inflammation, which included 13 studies representing 14 samples and 1,102 unique participants. The review included 8 biomarkers measured in plasma, serum and saliva (C reactive protein, and C-C motif chemokine 11, interleukin (IL)- 1ß, IL-4, IL-6, IL-8, IL-10 and tumor necrosis factor alpha). More consistent findings of an association between greater rumination and increased inflammation were found in studies that used experimental designs and manipulated rumination. Emerging research suggests rumination may interact with other factors (e.g., socioeconomic status, anxiety) to predict inflammation. This review offers an up to date synthesis of the emerging research focused on rumination and inflammation. The relationship between inflammation and rumination may be contingent on how rumination is conceptualized and measured, as well as the measure of inflammation (i.e., at rest/ in response to stress).

Collage-based graphic elicitation method for capturing the lived experiences of veterans with Gulf War illness.

AIMS: Graphic elicitation is an emergent data gathering approach in qualitative research. An overview of the development and application of a collage based graphic elicitation method in gaining greater understanding about the experience of Gulf War Illness (GWI) is presented in this paper. The unique contributions of this method are also discussed. MAIN METHODS: Fourteen veterans with GWI were interviewed and then invited to represent their experiences in a visual format through a collage graphic elicitation task. Interviews and collage artworks were coded and compared to both verbal and art responses during the graphic elicitation process. KEY FINDINGS: Comparison of the content in the interview responses and collage artwork indicates that the graphic elicitation process resulted in three distinct responses: (1) Synthesis and confirmation of content articulated in the interviews, (2) focus on salient aspects of living with GWI, and (3) revealing previously unarticulated experiences. SIGNIFICANCE: This work demonstrates the unique contributions of collage graphic elicitation, including allowing for spontaneity, metaphorical thinking, enriching verbal explication, and uncovering lived experiences and new affective responses. The sample size was too small to make any generalizations, and more research is needed to further validate these initial findings.