Pretrauma Power and Control Beliefs and Posttraumatic Stress: A Longitudinal Study of Combat Soldiers.

Belief in one's ability to exert power and control over outcomes following trauma has long been understood as protective against the development of posttraumatic stress disorder (PTSD). The role of pretrauma beliefs about power and control, however, remains unclear. Though a strong pretrauma belief in power and control may similarly be protective, we predicted such a belief may actually be a diathesis for PTSD. When exposed to trauma, individuals with a strong pretrauma belief in power and control may believe they should have prevented the trauma and/or their acute reactions. Such expectations may lead to negative self-beliefs and a higher level of PTSD symptoms. Longitudinal structural equation modeling in a sample of combat soldiers (N = 305) supported our hypothesized model. Stronger predeployment power and control beliefs predicted more negative postdeployment self-beliefs, ß = .15, p = .035, 95% CI [.11, .18], and in turn, a higher level of PTSD symptoms, ß = .08, 95% CI [.01, .15]. Prior combat exposure moderated these effects in that soldiers with no prior combat experience evidenced the hypothesized associations, whereas those with moderate or high prior combat exposure did not. Resilience interventions for soldiers who are first entering combat may thus benefit from promoting acceptance of uncontrollable events in addition to agentic change skills.

Commentary: Understanding adolescent health-risk behaviors from a prevention science perspective.

Prevention science offers a unique perspective on adolescent health-risk behavior and provides a framework for developing interventions that promote adaptive functioning and resilience among youths. Research in the area of social and emotional learning (SEL) has provided empirical evidence that SEL programs are effective in informing constructive decision-making and reducing problem behaviors among youths. Consultation with school and community service providers offers psychiatrists a more contextualized picture of adolescents' needs and assets. The invaluable role that forensic psychiatry plays in understanding the clinical and legal implications of adolescent engagement in various health-risk behaviors is discussed.