Trauma and aggression: Evaluating the influence of primed hostility and survivor sex.

OBJECTIVES: The relation between posttrauma symptoms and aggression is an area of growing interest in the larger clinical literature. The current project looked to examine the impact of primed hostility on aggressive responding in men and women with and without a history of prior trauma. DESIGN: Experimental aggression paradigm assessed in a 2 (Group) × 2 (Sex) × 2 (Prime) mixed factorial ANOVA. METHODS: Trauma-naïve participants (N = 52) and survivors reporting active symptoms (N = 43) were exposed to hostile and neutral lexical primes in what was presented as a reaction time task played against an unseen 'opponent'. In actuality, 'wins' and 'losses' during the task were assigned by an automated system. The intensity of an aversive sound blast delivered by participants to the supposed opponent in trials the participant 'won' served as an index of behavioural aggression. RESULTS: Repeated-measures ANOVA identified a between-by-within interaction of exposure group and lexical prime (p = .010; η p 2  = .070), with trauma-exposed participants (p = .002, Δ = .30), but not controls (p = .159, Δ = .11), demonstrating elevations in aggression subsequent to hostile priming. A sex by prime interaction (p = .001; η p 2  = .117) similarly indicated elevated aggression following hostile priming in men (p = .007, Δ = .58) as compared to women (p = .062, Δ = .10). CONCLUSIONS: Results offer preliminary support for the association of situationally primed hostility and biological sex with aggressive responding in survivors reporting active symptoms.

Moderating effects of brooding on the link between functional impairment and interpersonal needs in survivors of serious trauma.

OBJECTIVES: Trauma and resulting functional limitations demonstrate associations with perceived burdensomeness and thwarted belongingness, factors contributing to elevated risk for suicidal ideation. However, survivors display differential risk in response to impairment, highlighting the need for research on exacerbating factors. The current study examined the impact of brooding on the association of functional impairment with burdensomeness and belongingness among trauma-exposed undergraduates (N = 262). METHOD: Trauma was assessed via clinical interview with questionnaires for study variables. Regression models examined the unique and interactive effects of physical impairment, emotional impairment, and brooding on burdensomeness and thwarted belongingness. RESULTS: An interaction of brooding and impairment due to emotional difficulties was observed for burdensomeness with impairment linked to elevated burdensomeness at high (ß = -0.46; p < 0.001), but not low (ß = -0.07; p = 0.476) brooding. Impairment due to emotional difficulties (ß = -0.38; p < 0.001) and brooding (ß = 0.25; p < 0.001) were associated with belongingness. CONCLUSIONS: Findings identify brooding as a potential target for assessment and intervention in trauma-exposed individuals.

Exploring the relation between posttraumatic stress disorder and interpersonal outcomes: The role of social acknowledgment and trauma type.

OBJECTIVES: Research demonstrates consistent relations between posttrauma symptoms and interpersonal dysfunction. The current study examined the extent to which perceptions of community rejection account for the relation between posttraumatic stress disorder (PTSD) and interpersonal outcomes in students exposed to assaultive and nonassaultive trauma. METHOD: Participants (N = 137; 66.4% female; M = 20 years) completed a trauma history interview, questionnaires assessing symptom severity, social disapproval, and interpersonal outcomes. RESULTS: Assault survivors (n = 83) reported greater symptoms (d = 0.57), disapproval (d = 0.80), and social impairment (d = 0.51) relative to the nonassault group (n = 54). However, regression analyses indicated stronger associations between PTSD and community disapproval in survivors of nonassaultive (ß = 0.69; p < 0.001) versus assaultive (ß = 0.34; p < 0.001) events. Indirect effects of PTSD on perceived support and interpersonal functioning through social disapproval were also larger for nonassaultive versus assaultive groups (p < 0.05). CONCLUSION: Despite greater dysfunction among assault survivors, perceptions of disapproval may be a more salient factor for interpersonal dynamics following nonassaultive trauma.

Behavioral inhibition and posttrauma symptomatology: Moderating effects of safety behaviors and biological sex.

OBJECTIVES: Behavioral inhibition is a trait-level factor associated with posttraumatic stress. Safety behaviors may impact this link by interfering with anxiety habituation. The current study examined the unique and interactive effects of behavioral inhibition, safety behaviors, and participant sex on posttrauma symptom clusters. METHOD: Participants (N = 131; 75.6% female; M = 19.9 years) completed a trauma history interview and questionnaires assessing behavioral inhibition, safety behavior, and posttrauma symptom severity. RESULTS: Safety behaviors were associated with intrusion (partial correlations [pr] = 0.319), avoidance (pr = 0.274), cognition-mood (pr = 0.274), and arousal-reactivity (pr = 0.538) symptoms (all p ≤ 0.001). An interaction of sex and safety behaviors was noted for avoidance (p = 0.047, pr = -0.159) with a significant relation observed only among women ( p < 0.001, pr = 0.442). Safety behaviors also moderated the link between behavioral inhibition and arousal-reactivity (p = 0.002, pr = 0.272) with inhibition predicting symptoms at high levels of safety behavior (p = 0.024, pr = 0.171). CONCLUSION: Trauma-related safety behaviors are associated with greater posttrauma symptoms and evidence differential effects across individual symptom domains.

Replication and longitudinal measurement invariance of the PTCI-9.

Inflexible negative trauma-related cognitions are a common consequence of trauma exposure and an important indicator of posttraumatic stress disorder. One common measure of trauma-related cognitions is the 36-item Posttraumatic Cognitions Inventory (PTCI; Foa et al., 1999). Recently, a nine-item abbreviated version was developed (PTCI-9; Wells et al., 2019), which may be a reliable alternative with improved model fit. The present study examined the latent factor structure of the PTCI and PTCI-9 in a sample of 185 treatment-seeking outpatients with traumatic stress symptoms to replicate and extend initial findings on the psychometric properties of the PTCI-9. Using confirmatory factor analysis, the correlated three-factor model of the PTCI-9 demonstrated excellent model fit at Time 1 and Time 2 (6 weeks later), as well as strong internal and test-retest reliability. It also exhibited configural, metric, and scalar invariance across time. The present study replicated previous findings that the PTCI-9 may be a psychometrically sound alternative for measuring trauma-related cognitions. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

PTSD and anger: Evaluation of an indirect effect model in a civilian trauma sample.

BACKGROUND AND OBJECTIVES: Theoretical models propose that PTSD symptoms and subjective anger are indirectly associated through hostile attribution bias, physiological reactivity, and aggressive psycho-motor scripts (Chemtob, Novaco, Hamada, Gross, & Smith, 1997). Originally developed to account for symptoms observed in military personnel, proposed anger mechanisms have received limited attention in civilian populations. The current study looked to evaluate the generalizability of Chemtob et al.'s model in trauma-exposed university students (N = 152). METHODS: Trauma exposure and corresponding symptoms were assessed during an initial screening procedure. Hostile attributions and aggressive scripts were examined prior to a laboratory-based anger induction procedure. Physiological reactivity was monitored throughout the provocation task. Ratings of subjective anger and anger recovery were completed following the induction period. Relations of post-trauma symptoms with subjective anger through hypothesized anger processes were examined using bootstrapped estimates of indirect effects. RESULTS: A significant indirect effect of PTSD severity on state-level anger was noted for hostile attribution bias (ab = 0.020, 95% CI [0.002, 0.041]) and a marginal effect through aggressive inclinations (ab = 0.015, 95% CI [-0.001, 0.039]). Data failed to provide evidence for physiological reactivity as an intervening variable. Trauma symptoms did not moderate anger recovery following the provocation task. LIMITATIONS: Induction of anger in a sub-clinical sample may limit tests of hypothesized effects and the generalizability of the present findings. CONCLUSIONS: Results indicate the proposed model may be applicable beyond combat trauma samples and suggest potential anger-related targets for PTSD treatment.

Stability of reported trauma over extended intervals: Initial evaluation of an exposure screening protocol.

The reliability and validity of reported exposure to significant trauma is critical to research evaluating outcomes following serious and distressing life events. The current study examined the reliability of reported exposure to disaster, fire, transportation accidents, physical assault, and sexual assault across 5- (N = 251), 12- (N = 223), and 24-month (N = 109) intervals in undergraduates completing a screening measure of probable trauma (N = 3,045). Concordance with later responses to an alternate checklist and events assessed via clinical interview was examined in a subset of participants (N = 274). Five-month reliabilities ranged from good to fair (κ = .40-.71) and were similar to 1-2 week retest estimates in the extant literature. Reliabilities for fire, accidents, and sexual assault remained stable over 12- and 24-month intervals. Coefficients for disaster and physical assault decreased over time. Agreement with the alternate checklist was fair to excellent in those completing the follow-up assessment (κ = .51-.87). Concordance with interview-based trauma was acceptable for accidents (κ = .52) and sexual violence (κ = .82) but poor for disaster, fire, and physical assault (κ = .34-.38). Specificity, negative predictive power, and negative likelihood ratios suggest checklists may hold utility in ruling out previous trauma. Sensitivities indicate that screening instruments may broadly capture individuals experiencing traumatic life events although positive predictive power was limited except in the prediction of traffic accidents and sexual assault. Variability across domains suggests that the properties of checklist measures could be better conceptualized at the level of individual exposure events. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A prospective examination of risk factors in the development of intrusions following a trauma analog.

Several factors have been linked to the severity of posttraumatic distress, although retrospective designs in much of the literature limit conclusions regarding the temporal relation between risk factors and corresponding symptoms. To address these concerns, the current project employed an analog trauma paradigm to assess the impact of background characteristics, stress response, and post-stressor affect regulation on subjective distress and intrusive memories experienced during the subsequent processing of emotional stimuli. University students (N = 184; 56% female, 42% White/Non-Hispanic) were shown graphic scenes of a televised suicide. Physiological activation was recorded during exposure with emotion ratings collected following the film. Participants then viewed a sadness- or humor-eliciting prime under instructions to inhibit or naturally express emotion. Intrusions experienced during the priming film and residual distress at study's conclusion were rated prior to debriefing. Hierarchical regression identified reductions in emotional valence as a robust predictor of intrusions and distress. Sympathetic activation and exposure to the sadness prime were associated with intrusion frequency, whereas attenuated parasympathetic response predicted intrusion intensity. Expressive inhibition demonstrated a unique association with residual distress. Results suggest peritraumatic processes and post-exposure factors may hold more prominent relations with immediate trauma-related distress as compared to pre-existing survivor characteristics.