Failure to confirm the factor structure of the CEBRACS: An assessment of food and alcohol disturbance.

Objectives: Food and Alcohol Disturbance (FAD) is the phenomenon in which individuals exhibit co-occurring hazardous alcohol and eating behaviors to either negate caloric intake associated with alcohol and/or maximize intoxication. While the Compensatory Eating and Behaviors in Response to Alcohol Scale (CEBRACS) is the most widely used measure to assess FAD to date, its factor-structure has yet to be confirmed. Methods: The current study utilized confirmatory factor analysis (CFA) to examine the CEBRACS' four factor subscales as well as recently proposed alternative scoring structures. Participants: Participants (N = 582) were American college students from seven universities (18-24 years; 67% cisgender women; 70% non-Hispanic White). Results: The CFA failed to provide optimal fit for all models tested. Results of invariance testing found no measurement variance by sex, suggesting the failure of the four-factor solution was not due to noninvariance. Conclusions: Overall, findings do not support continued use of the original 21-item CEBRACS.

Crisis Work Embedded in a Global Crisis: The Early Phase Impact of COVID-19 on Survivors of Intimate Partner Violence and Service Provisions.

COVID-19, as a global pandemic, was a public health inflection point for individuals affected by intimate partner violence (IPV) and those who provide IPV services. Public health guidelines that were intended to reduce risk of exposure to the virus impacted vulnerability factors for IPV survivors and associated systems of services. We aimed to (1) explore the effect of COVID-19 on survivors of IPV; (2) assess the effect of COVID-19 on IPV-related service provisions and service providers; and (3) explore challenges and opportunities in the wake of COVID-19 on broader IPV services and advocacy. METHOD: Twelve directors of IPV shelter, criminal justice, and other advocacy services within a diverse, Midwestern metropolitan area were recruited to participate in in-depth, semi-structured interviews in June-August 2020. Interviews were transcribed verbatim and analyzed using Dedoose. Data were coded and analyzed through thematic analysis. RESULTS: Four major themes, contextualized by COVID-19 and racial injustice, emerged from the data analysis: (1) IPV-related trends; (2) impact on IPV survivors, services, and agency morale; (3) inter-agency collaborations; and (4) future opportunities for innovative service delivery. Gaps and opportunities for developing culturally congruent, trauma-informed services were identified. CONCLUSION: Findings suggest that responsive and accessible IPV resources and associated advocacy services can make the difference between life and death for survivors.

Massed cognitive processing therapy for posttraumatic stress disorder in women survivors of intimate partner violence.

OBJECTIVE: Survivors of intimate partner violence (IPV) report significant trauma histories, high rates of posttraumatic stress disorder (PTSD), head injuries and comorbid disorders, and multiple barriers to treatment that often preclude the regular attendance and engagement required in typical therapy protocols. The significant challenges faced by IPV survivors needing treatment may be ameliorated by condensing effective treatments for PTSD, such as cognitive processing therapy (CPT), in an accelerated delivery timeline. METHOD: Using a multiple subject, single case design of six matched pairs of 12 female IPV survivors, we preliminarily tested the relative effectiveness of individual massed CPT delivered over 5 days (mCPT) as compared with standard CPT (sCPT) delivery in women IPV survivors. Assessments included full psychiatric diagnostic interviews, clinical interviews assessing trauma history and head injury prior to treatment, symptom monitoring during treatment, and full repeat assessments at 1 month and 3 months following treatment. RESULTS: No treatment group effect was found for PTSD severity between mCPT and sCPT among intention-to-treat, F(1, 10) = .01, p = .93. Both mCPT and sCPT were associated with significant improvement in PTSD, F(2, 20) = 45.05, p < .001, ds = 1.32-2.38). CONCLUSION: Overall, findings indicate mCPT appears effective in reducing psychological symptoms for women IPV survivors and suggest that condensed treatment is both palatable and feasible. Accelerated treatment delivery in this population may provide a necessary lifeline for women with IPV-related PTSD. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Testing Cognitive Models to Characterize Trauma Anniversary Reactions Marked by Stress and Growth.

OBJECTIVE: Contemporary theories conceptualize the anniversary of a traumatic event as a trauma reminder capable of activating posttraumatic stress disorder (PTSD) symptoms. The current study uses the cognitive stress and growth model to examine this model's usefulness in characterizing anniversary reactions. METHOD: Participants (N = 197) were MTurk workers who endorsed an "emotionally charged reaction on or near the anniversary of a tragic event." They completed assessments of PTSD, posttraumatic growth (PTG), sense of control, rumination, and trauma centrality. RESULTS: Multiple regression analyses found both anniversary-related stress and PTSD symptoms were associated with similar factors with similar magnitude across both outcomes. Trauma centrality was uniquely associated with anniversary-related PTG. CONCLUSIONS: Anniversaries marked by stress are characterized by factors similar to PTSD generally, but growth-related reactions have different correlates compared to PTG outside the reaction. These findings suggest the anniversary period may be a time of self-reflection about the event and its impact.

The impact of sociocultural contexts on mental health following sexual violence: A conceptual model.

OBJECTIVE: Sexual violence has substantial mental health effects on survivors around the globe. Although there has been increasing attention to the ways that sociocultural environments can affect survivors' recovery, there has been no review to our knowledge of the specific factors within sociocultural environments that offer risk or protection, or the mechanisms by which these factors affect recovery. METHOD: To address this gap, we present a conceptual model supported by a theoretical and empirical review that prioritizes research conducted with ethnic minority and global samples. RESULTS: We identify three components of global sociocultural settings-norms, structures, and environmental stressors-that may affect mental health following sexual violence. We propose that these components may affect survivors' mental health by (1) influencing how survivors themselves, survivors' social contexts, and the systems with which survivors come into contact think about and respond to sexual violence, and (2) creating additional sources of stress, burden, or protection for survivors. CONCLUSIONS: We argue that future research, practice, and policy could have a greater effect on survivors by attending to sociocultural factors in recovery.

The Relationship between Women's Resources and Health-Related Quality of Life in a Sample of Female Victims of Intimate Partner Violence.

While it is known that resource inadequacy increases the risk of exposure to intimate partner violence (IPV) and that women's health is significantly impacted by IPV, scant research has documented diminished resources as a primary determinant of women's health. Fifty female victims of moderate to severe IPV completed assessments of their physical, sexual and psychological experiences of IPV, resource profile, symptoms of posttraumatic stress disorder (PTSD) and depression and mental and physical health-related quality of life (HRQoL). Women's resources, controlling for age, income, psychological abuse and sexual coercion, were unique predictors of symptoms of PTSD, symptoms of depression; and mental HRQoL. The public health implications of the adequacy of women's resources are discussed in the context of IPV prevention and intervention. Future studies should evaluate the efficacy of economic empowerment programs regarding the impact on IPV survivors' mental and physical health and safety.

The Efficacy of Binaural Beats as a Stress-buffering Technique.

CONTEXT: Distress has deleterious effects on health. While complementary and alternative medicine (CAM) is a growing system of practices in the treatment of health and mental-health conditions, many individuals have limited access to mind-body interventions. Creating accessible stress-inoculation strategies may augment traditional mental-health interventions and services. OBJECTIVE: This pilot study intended to assess the effectiveness of a theta binaural beat (TBB) auditory stimulus on heart rate and self-reported stress, which was experimentally induced by the Trier Social Stress Test (TSST). DESIGN: The repeated measures study compared the stress levels after a stimulus and stressor for two groups, within an experimentally induced psychological stress paradigm, the Trier Social Stress Test (TSST). SETTING: The study occurred at a private Midwestern university. PARTICIPANTS: Participants were 64 US adults recruited from undergraduate classes at the university, with a mean age of 19 years and a range from 18 to 30. INTERVENTION: Participants were randomly assigned to the intervention or the control group. The intervention group listened to pink sound, carrier tones, and embedded TBB, while the control group listened to pink sound and carrier tones without embedded TBB. OUTCOME MEASURES: Participants completed self-report assessments about the auditory stimulus, perceived stress, and mindfulness and then engaged in the Trier Social Stress Test (TSST). Subsequently, they completed measures on perceived stress using a visual analogue scale (VAS), and heart rate variability (HRV) was recorded throughout the study. RESULTS: With respect to the evaluation of subjective stress using the VAS, psychological stress increased significantly between the exposure to the stimuli and the TSST-F(1.28, 53) = 42.76, P = .01, partial η2 = 0.44. The change in stress levels for the intervention group, however, was not significantly different from that of the control group at any time point F(1.28, 53) = 1.03, P = .33, partial η2 = 0.02. With respect to the evaluation of physiological response to stress using the HRV, the changes in HF HRV between the 4, five-minute segments during stimulus exposure were not significantly different between the groups F(3, 55) = 0.90, P = .44, partial η2 = 0.02. A significantly greater change-F(1, 55) = 4.84, P = .03 partial η2 = 0.08-in the HF HRV occurred over the TSST period for the intervention group compared to the control group suggesting that on average across the TSST stress tasks, those in the intervention group demonstrated higher HF signals. CONCLUSIONS: The current study found that the intervention group, who listened to TBBs, had greater parasympathetic dominance during TSST than the control group. This suggests that TBB exposure may dampen subsequent stress responses to an acute, psychological stressor. This finding, however, should be interpreted with caution, because further research and independent replication are warranted.

Impact of Adverse Childhood Experiences on Oral Health Among Women in the United States: Findings From the Behavioral Risk Factor Surveillance System.

It is well established that adverse childhood experiences (ACEs) negatively impact physical and mental health. There is a paucity of research examining the impact of ACEs on oral health. Therefore, the aim of this study was to better understand how ACEs may impact oral health utilizing a nationally representative sample of females. Data from the 2010 Behavioral Risk Factor Surveillance System (BRFSS) were utilized. The sample comprised 36,249 females. Chi-square tests were used to examine associations between multiple forms of ACEs and oral health, mental health, smoking, and health-related quality of life. Logistic regression models were generated for the outcomes of interest: last dental cleaning, significant tooth loss, smoking, and health-related quality of life. Post-hoc analyses were conducted to examine whether smoking and dental cleaning moderated the relationship between ACEs and significant tooth loss. All ACE categories were significantly associated with poor health-related quality of life, being a current or former smoker, last dental cleaning >1 year, and significant tooth loss even after adjusting for demographic variables. Last dental cleaning and being a current or former smoker moderated the relationship between ACEs and significant tooth loss. This study affirms other findings that women with a history of ACEs were more likely to engage in health-risk behaviors, specifically cigarette smoking, which has been strongly associated with ACEs. These findings underscore the importance of including oral health in future studies given it has implications for disease development. Furthermore, dental visits may provide a window of opportunity for trauma-informed care.

Intimate Partner Violence and Body Shame: An Examination of the Associations Between Abuse Components and Body-Focused Processes.

Intimate partner violence (IPV) is a stigmatizing, interpersonal violation with elements that confer risk for body shame. This study examined the role of body-focused processes (i.e., self-objectification and body surveillance) in the development of body shame within a sample of 61 primarily African American women, exposed to moderate to severe IPV. Severity of sexual coercion, physical assault, and psychological abuse were significantly associated with increased body shame and self-objectification. Mediation analyses revealed that self-objectification was a unique mediator of the relationship between psychological abuse, physical assault, sexual coercion, and body shame. Implications for women's health care experiences are discussed.

Three Types of Intimate Relationships among Individuals with Chronic Pain and a History of Trauma Exposure.

Individuals with chronic pain often have psychiatric disorders, such as depression and posttraumatic stress disorder (PTSD), which can affect their intimate relationship satisfaction and stability. Little is known about the nature of support stemming from chronic pain patients' intimate relationships, and therefore, this study sought to: (1) use cluster modeling to construct specific intimate relationship groups based on types of support patients receive, and (2) determine if there is a relationship between support type and PTSD, chronic pain, anxiety, and depression. Ward's method of cluster analysis in Stata was used to create groups based on the level of informational, affirmation, confident, emotional, and fun support received from chronic pain patients' most intimate relationship. Three types of support were identified: high (type 1, n = 17), high emotional/low instrumental (type 2, n = 9), and unstable (type 3, n = 15). Types 1 and 3 included more family members (Type 1: 100%, Type 2: 93%), than type 2 (77%). Type 2 patients experienced more trauma (Mean = 9.4 ± 1.7 vs. 7.5 ± 0.88 for types 1 and 3) and were significantly more likely to have PTSD (X² = 7.91, p < 0.05. Patients with low familial support may also benefit from PTSD screening and referral but further study is needed.

Impact of Engagement in Exercise on Sleep Quality Among Veterans With Posttraumatic Stress Disorder Symptoms.

BACKGROUND: Exercise has beneficial effects for physical health outcomes and has also been shown to reduce the severity of psychological health symptoms. Recent studies have shown a potentially positive impact of exercise on posttraumatic stress disorder (PTSD). Prominent among those with PTSD, sleep disturbance and nightmares are among the top three PTSD symptoms commonly reported by treatment-seeking Veterans. Regular physical exercise has been consistently associated with better sleep. This study utilized a longitudinal design to explore the relationship between exercise and sleep among Veterans with PTSD symptoms at baseline and one-year follow-up. MATERIALS AND METHODS: Veterans (n = 76) who served in support of Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn were recruited for this study. Correlations were assessed between PTSD symptoms, sleep, and engagement in exercise at each time point (baseline, one-year follow-up). Regression analyses were conducted to examine the relationship between engagement in exercise at baseline and PTSD symptoms at one-year follow-up, as well as sleep quality at one-year follow-up. Regression models controlled for demographic variables (age and gender), alcohol use, baseline PTSD symptoms, and baseline sleep quality. RESULTS: Multiple regression analyses demonstrated that engagement in exercise at baseline was significantly associated with better sleep quality at one-year follow-up while controlling for age, gender, alcohol use, baseline PTSD symptoms, and baseline sleep quality (ß = -0.128, p < 0.05). Multiple regression analyses examining the relationship between engagement in exercise at baseline and PTSD symptoms at one-year follow-up (controlling for age, gender, alcohol use, baseline PTSD symptoms, and baseline sleep quality) did not yield statistically significant results (ß = 0.053, p = 0.57). CONCLUSION: Results from the present study found that engagement in exercise at baseline was associated with better sleep quality at one-year follow-up. These findings were consistent with the current literature suggesting exercise can have a positive impact on sleep quality. Furthermore, our findings suggest that exercise could be considered as an adjunctive intervention for individuals with PTSD-particularly for those patients whose difficulties with sleep are predominant. Given that exercise is highly accessible and is embedded in the military culture, future research should examine the way in which exercise can be leveraged in PTSD treatment, specifically in ameliorating sleep difficulties. Exercise may also reap demonstrable public health benefits in multiple psychological and physical domains and reduce the psychiatric and medical morbidity and mortality associated with PTSD.

The Impact of Intimate Partner Violence on Women's Physical Health: Findings From the Missouri Behavioral Risk Factor Surveillance System.

Intimate partner violence (IPV) is a significant public health problem. It has far reaching consequences such as social and economic costs, as well as a negative impact on women's health outcomes. This study assessed the relationship between IPV and health risk factors, health behaviors, and poor mental health in Missouri women utilizing 2005 Missouri Behavioral Risk Factor Surveillance System (BRFSS) data ( n = 3,110). Moderators (demographic indicators) of the relationship between IPV and health risk factors (high blood pressure, high cholesterol, and obesity) and health behaviors (physical inactivity, smoking, and binge drinking) were also examined. Women with a history of IPV were more likely to engage in health-compromising behaviors such as smoking and binge drinking, be obese, and report more poor mental health days compared with women without a history of IPV. Demographic variables moderated the relationship between IPV, obesity, smoking, high blood pressure, and high cholesterol. These findings underscore the importance that clinics, community, or other health care settings can play in identifying women who are victims of or have a history of IPV and provide them with appropriate resources as well as targeted interventions to reduce morbidity in this population.

Identifying and intervening with substance-using women exposed to intimate partner violence: phenomenology, comorbidities, and integrated approaches within primary care and other agency settings.

Substance use and/or disorders (SUDs) have been identified as a significant correlate of intimate partner violence (IPV) exposure and present complex issues that intersect with the topography of IPV, attendant mental health, and physical co-morbidities and may pose barriers to primary care- and other agency-based screening and intervention efforts. Despite substantial research indicating significantly higher rates of all types and severity of IPV victimization among women with SUDs and bidirectional associations between partner or self-use of drugs or alcohol and IPV victimization, effective screening, brief interventions, coordinated systems of care, and treatment approaches to address these co-occurring problems remain very limited. We integrated select research examining the intersection of IPV victimization and SUDs and several comorbidities that have significant public health impact and provided recommendations for scaling up targeted interventions to redress these co-occurring problems among women in primary, emergency, and other care settings.

Residual injury, appearance-related concerns, symptoms of post-traumatic stress disorder, and depression within a treatment-seeking veteran sample.

This study explored the associations among injury-related appearance changes experienced during deployment/combat, symptom severity of post-traumatic stress disorder and depression, and body image distress within a treatment-seeking veteran population (n = 91). Thirty-three percent of the sample reported having an appearance-related residual injury experienced during combat or deployment (n = 30). A subsample, who completed the body image distress measure (n = 69), was divided into two groups: those with an appearance-related residual injury (n = 22) and those without an appearance-related residual injury (n = 47). Correlational analyses revealed significant, positive correlations between body image distress and depression symptom severity. Results also showed a trend relationship between body image distress and post-traumatic stress disorder symptom severity for those with an appearance-related residual injury although correlations were nonsignificant among these constructs for those without an appearance-related residual injury. Multiple regression analyses revealed that body image distress was a unique predictor of depression symptom severity, controlling for residual injury status. Implications of these findings for exploring the psychological impact of residual injury were discussed.

Examining the role of negative urgency in a predictive model of bulimic symptoms.

The etiological dual pathway model of bulimia nervosa suggests that dietary restraint and negative affect are significant predictors of this disorder. Negative urgency, or the tendency to act rashly in response to negative emotionality, is also associated with bulimia nervosa; however, no study has examined the role of negative urgency within the context of the dual pathway model. The purpose of this study was to investigate the relationship between bulimic symptomatology and negative urgency in the context of dietary restraint and depressive affect. Participants (N=166) were college women recruited from a private mid-western university through an online participant registry. A self-report battery assessed depressive affect, dietary restraint, negative urgency, and bulimic symptoms. Participants' height and weight were measured in-person to determine body mass index. A significant main effect of negative urgency was found after controlling for depressive affect and dietary restraint. The interaction between depressive affect and negative urgency to predict bulimic symptoms approached significance; however, no statistically significant interaction between dietary restraint and negative urgency was observed. These results provide support for the inclusion of negative urgency as a significant factor in etiological frameworks of bulimia nervosa.

Symptoms of posttraumatic stress, depression, and body image distress in female victims of physical and sexual assault: exploring integrated responses.

While body image concerns and interpersonal violence exposure are significant issues for women, their interrelationship has rarely been explored. We examined the associations between severity of acute injuries, symptoms of posttraumatic stress disorder (PTSD), depression, and body image distress within a sample of predominantly African American victims of interpersonal violence (N = 73). Severity of body image distress was significantly associated with each outcome. Moreover, body image distress was a significant, unique predictor of depression but not PTSD severity. We recommend continued exploration of body image concerns to further integrated research on violence against women.

Posttraumatic Growth Inventory: Factor Structure in the Context of DSM-IV Traumatic Events.

Studies examining the dimensionality of the Posttraumatic Growth Inventory (PTGI) have yielded varying results. To date, no study has investigated the measure's factor structure in the context of DSM-defined traumatic events. The present study examined the structure in an undergraduate student sample (N = 379) reporting DSM-IV Criterion-A potentially traumatic events. Confirmatory factor analysis (CFA) did not support the original five-factor structure. Follow-up exploratory factor analysis and CFA on random halves of the sample showed poor model fit for 1-, 3-, and 7-factor models. Results suggest that the PTGI factor structure is unclear amongst individuals with DSM-IV traumatic events, and continued use of the total score is most appropriate. Future directions including the utility of the PTGI factors are discussed.

Posttraumatic stress disorder, poor physical health and substance use behaviors in a national trauma-exposed sample.

Both experiencing a traumatic event and PTSD are related to physical health problems (e.g., Schnurr and Jankowski, 1999) and health-risk behavior (e.g., Stewart, 1996). Using structural equation modeling analyses, we examined the interrelationships among number of distinct traumatic event exposures, PTSD diagnosis, physical health, and substance use behavior using epidemiological data from the National Comorbidity Survey Replication (NCS-R; Kessler et al., 2004). Results provide some evidence that PTSD mediates the relationship between: (a) number of distinct traumatic event exposures and poor physical health defined by clusters of difficulties with gastrointestinal, musculoskeletal, and/or cardiovascular health, and (b) number of distinct traumatic event exposures and substance use behaviors. However, substance use behaviors did not significantly mediate the relationship between PTSD and poor physical health.

Sex differences in physiological and affective responses to stress in remitted depression.

Major depressive disorder (MDD) is associated with alterations in stress physiology. Severe melancholic depression is characterized by hypercortisolism, but community dwelling mildly depressed individuals and those with remitted MDD have shown reduced or normal reactivity to stress. There are also pronounced sex differences both in the incidence of MDD and in stress reactivity. To explore the relationships among depression history, sex differences, and stress, we examined stress reactivity in people with and without a history of MDD. Twenty-two participants with remitted MDD (12 men and 10 women) and 36 never depressed comparison participants (22 men and 14 women) participated in the study. Cortisol and alpha-amylase (sAA) were sampled from saliva before, 10 min after, and 30 min after the Trier Social Stress Test (TSST). Participants filled out the Positive Affect Negative Affect Schedule (PANAS) before and after they underwent the TSST. Women with remitted MDD showed reduced cortisol response to the TSST compared with the never MDD women, while men with remitted MDD showed comparable cortisol reactivity to the never depressed men. The groups did not differ on sAA reactivity to stress. The remitted MDD group (overall and men and women separately) reported greater negative affect both before and after stress compared to the never depressed group. Women from both groups reported greater post-stress negative affect than men. In contrast, men from both groups reported higher positive affect before and after stress than women. Given that the sex difference findings were not dependent on depression history, self-reported affective differences in response to stress may predate depressive symptoms and contribute to sex differences in depression incidence.