Survivor-spouse dissociation and posttraumatic stress disorder: Personal and dyad relationships.

This study examined the relationships between dissociation and posttraumatic stress disorder (PTSD) symptoms among injured survivors of terror attacks and their spouses (N = 210), specifically exploring survivor-spouse dyadic associations. Structural equation modeling and the actor-partner interdependence model were used to test the bidirectional dyadic association of both the survivors' and the spouses' dissociation with PTSD symptoms. The results demonstrated a positive association both between the survivors' trait dissociation and PTSD symptoms and between the spouses' trait dissociation and their PTSD symptoms. However, no significant associations were found at the bidirectional level. Taken together, our findings shed new light on the role of trait dissociation in PTSD. Although trait dissociation is associated with higher PTSD symptoms for both survivors and their spouses, its role may be limited in the bidirectional partner context. Theoretical and clinical implications of the findings are discussed.

Acute symptoms of posttraumatic stress and dissociative experiences among female israeli civilians exposed to war: the roles of intrapersonal and interpersonal sources of resilience.

BACKGROUND: The positive personality characteristics of optimism, hope, self-esteem, and perceived availability of social support are believed to play an important role in psychological adjustment to stressful life events. For example, these characteristics have been shown to be associated with fewer mood disturbances in response to a variety of stressors. However, relatively little is known about the extent to which these characteristics serve as sources of resilience among civilians during real-time exposure to war. OBJECTIVE: This "natural laboratory" study examined the role that individual differences both in intrapersonal (i.e., positive personality features of hope, optimism, and self-esteem) and in interpersonal (i.e., perceived social support from family, friends, and significant others) sources of resilience may play in the development of acute anxiety symptoms of posttraumatic stress disorder (PTSD) and dissociative experiences during exposure to war. METHOD: A nonclinical community sample of 140 female adults was assessed during real-time exposure to missile and rocket fire during an eruption of violence in the Middle East in November 2012. RESULTS: The results demonstrate that both intrapersonal and interpersonal sources of resilience were negatively associated with acute PTSD and dissociative symptoms. CONCLUSION: The findings of this study provide evidence that both intrapersonal and interpersonal sources of resilience may significantly mitigate the risk for acute anxiety symptoms among civilian communities exposed to traumatic events.

Totally All Alone with My Thoughts: Development, Psychometric Properties and Correlates of the Loneliness Automatic Thoughts Questionnaire.

Introduction: The current article introduces the Loneliness Automatic Thoughts Questionnaire (LATQ) and describes research evaluating its psychometric properties and correlates. Methods: Two separate samples of university student participants (Study 1; N = 282, Study 2; N = 289) were administered the LATQ along with a battery of other measures. Whereas Study 1 involved a preliminary investigation of the psychometric properties of the LATQ, Study 2 provided an opportunity to further expand on this aim by assessing the concurrent validity of the measure across studies. Results: Overall, psychometric analyses confirmed that the LATQ items are measured with an adequate degree of internal consistency and confirmatory factor analyses established that the nine items loaded significantly on one replicable factor. Concurrent validity was established in terms of links with other loneliness measures and a measure of persistent and intrusive negative thoughts. Furthermore, LATQ scores were associated with anti-mattering, social hopelessness, anxiety, depression, and unbearable psychache. Moreover, regression analyses established that the LATQ predicted significant unique variance in depression and psychache beyond the variance attributable to measures of loneliness and adaptability to loneliness. Discussion: Collectively, results indicate that loneliness-related automatic thoughts represent a unique and important element of the loneliness construct. Future research applications and additional psychometric issues to address in future research are discussed and a need for a greater focus on the cognitive aspects of loneliness is explored.

The status-signaling property of self-esteem: the role of self-reported self-esteem and perceived self-esteem in personality judgments.

OBJECTIVE: The provision of information appears to be an important feature of self-esteem. The present studies examined whether self-esteem possesses a status-signaling property such that an individual's level of self-esteem is associated with how the individual is perceived by others. METHOD: In Study 1, trained judges watched brief videos of 157 participants and rated targets as having higher levels of self-esteem when the targets were believed to possess more positive personality characteristics. Study 2 found that participants (357 targets) were rated as having higher levels of self-esteem when they were given more positive personality evaluations by their friends and family members (1,615 perceivers). RESULTS: Consistent with the proposed status-signaling model, high levels of self-esteem were generally associated with the perception of positive personality characteristics. CONCLUSIONS: These findings are discussed in the context of an extended informational model of self-esteem consisting of both the status-tracking and status-signaling properties of self-esteem.

A glimpse behind the mask: facets of narcissism and feelings of self-worth.

This study examined the connections that the facets of narcissism captured by the Narcissistic Personality Inventory (NPI; Raskin & Hall, 1979) and the Pathological Narcissism Inventory (PNI; Pincus et al., 2009) have with self-esteem. This was accomplished by asking 372 participants to complete measures of narcissism and self-esteem level as well as daily diary measures concerning their state self-esteem and daily experiences. Our analyses found that the facets of narcissism differed in their associations with average level of self-esteem, fluctuations in state self-esteem over time, and self-esteem reactions following daily events. These results suggest that it is important to consider specific facets of narcissism when examining feelings of self-worth rather than relying on broader composite measures of narcissistic personality features. Implications of these results for our understanding of the dynamics of the narcissistic personality are discussed.

Who Wants to (Digitally) Live Forever? The Connections That Narcissism Has with Motives for Digital Immortality and the Desire for Digital Avatars.

We examined the role that death anxiety (for self and others) and motivation for digital immortality played in the associations that narcissistic personality traits had with the desire for digital avatars (of self and others) in a sample of Israeli community members (N = 1041). We distinguished between four forms of narcissism: extraverted narcissism (characterized by assertive self-enhancement), antagonistic narcissism (characterized by defensiveness and hostility), neurotic narcissism (characterized by emotional distress), and communal narcissism (characterized by attempts to emphasize superiority over others by exaggerating communal characteristics such as being extraordinarily helpful). Our sequential parallel mediation analyses showed that narcissistic personality traits were associated with fear of death and the desire for symbolic immortality (having a digital avatar for self and others), with mainly indirect associations via fear of death and the motivation for eternal life and to be there for others. Discussion is focused on the role that fear of death and specific "defensive control" motives for having digital avatars (e.g., motivation for eternal life and to be there for others) may play in the desire for digital immortality reported by individuals with narcissistic personality traits.

Psychological consequences of indirect exposure to disaster due to the Haiti earthquake.

INTRODUCTION: Few studies have focused on the mental health consequences of indirect exposure to disasters caused by naturally occurring hazards. The present study assessed indirect exposure to the 2010 earthquake in Haiti among Haitian-Americans now living in Miami; these subjects had no direct exposure to the earthquake, but retained their cultural identity, language, and connection to family and friends in Haiti. METHODS: Two months following the earthquake a sample of Haitian-Americans was surveyed inquiring about: (1) their psychological reactions to the quake; (2) types of exposures experienced by their family members and friends in Haiti; and (3) symptom levels of (a) major depression, (b) generalized anxiety disorder, (c) complicated grief, (d) mental health status, and (e) physical health status. RESULTS: Haitian-Americans living in Miami experienced a broad spectrum of indirect exposures to the 2010 earthquake in Haiti. These exposures were strongly associated with psychological distress, trauma-related mental health consequences, and diminished health status. Most notable was the multiplicity of indirect exposures to the on-scene experiences of multiple family members and friends in Haiti. CONCLUSIONS: Consideration should be given to the psychological impact and needs for support among indirectly-exposed populations with strong affiliation to directly-impacted victims.

The effect of attorneys' work with trauma-exposed clients on PTSD symptoms, depression, and functional impairment: a cross-lagged longitudinal study.

To date, few studies have examined mental health consequences among attorneys exposed to clients' traumatic experiences. A longitudinal, 2-wave, cross-lagged study was used in a cohort of attorneys (N = 107) from the Wisconsin State Public Defender's Office. We assessed changes in posttraumatic stress disorder (PTSD), depression, and functional impairment over a 10-month period and tested the effects of intensity of contact with trauma-exposed clients on symptom levels over time. Attorneys demonstrated strong and significant symptom stability over time in PTSD, depression, functional impairment, and levels of exposure. Analyses involving cross-lagged panel correlation structural equation modeling path models revealed that attorneys' levels of exposure to trauma-exposed clients had significant positive effects, over time, on PTSD, depression, and functional impairment. Gender, age, years on the job, and office size did not predict any of the outcomes. Level of exposure to trauma-exposed clients predicted reduction of weekly working hours over time, but there was no reciprocal relationship between PTSD, depression, and functional impairment and level of exposure over time. These findings underscore the central role of exposure to trauma-exposed clients in predicting mental health outcomes and emphasize the need to support attorneys by managing the intensity of exposure as well as addressing emerging symptoms.

Psychological Stress and Vocal Symptoms Among University Professors in Israel: Implications of the Shift to Online Synchronous Teaching During the COVID-19 Pandemic.

OBJECTIVES: Psychological stress may have an adverse impact on the voice. The purpose of the present cross-sectional study was to investigate the relationship between the change in levels of perceived psychological stress and vocal symptoms among Israeli academic college professors required to shift to synchronous online teaching during the global COVID-19 pandemic. METHODS: An online questionnaire was completed by 313 professors (156 men and 157 women) from 14 academic colleges in Israel at the end of the first week of online synchronous teaching during the COVID-19 pandemic, which was assumed to be the most burdened and stressful week of the transition. Participants provided self-reports for the current levels of psychological stress and vocal symptoms during the transition to online synchronous teaching, as well as general psychological stress and general vocal symptoms during previous periods of teaching. RESULTS: The results revealed higher levels of psychological stress but not vocal symptoms during the transition to online synchronous teaching compared with previous periods of teaching. Psychological stress during the transition to online synchronous teaching was positively associated with vocal symptoms during this period but this association was moderated by general stress. Although there was a positive association between psychological stress and vocal symptoms for individuals who reported low levels of psychological stress during previous periods of teaching, this association was especially strong for individuals who reported high levels of psychological stress during previous periods of teaching. CONCLUSIONS: It is important to examine vocal symptoms of professors in specific contexts that are potentially stressful. The psychological stress surrounding the transition to online synchronous teaching was associated with elevated levels of vocal symptoms especially for those who reported high levels of psychological stress during previous periods of teaching. These results with professors accord with the notion that psychological stress may have a negative impact on the voice.

Personality, Cognition, and Adaptability to the COVID-19 Pandemic: Associations with Loneliness, Distress, and Positive and Negative Mood States.

The current research examined personality and individual difference factors associated with the perceived ability to adapt to the significant challenges accompanying the ongoing public health crisis concerning the COVID-19 pandemic. This cross-sectional study investigated the associations among self-reported adaptability to the pandemic and personality predispositions (dependency, self-criticism, mattering, and self-esteem), cognitive factors (positive, negative, and loneliness automatic thoughts), loneliness, distress, and mood states. A sample of 462 college students from Israel completed an online questionnaire after 10 weeks of social distancing during the COVID-19 pandemic. The results confirmed that personality vulnerability factors underscored by a negative sense of self (i.e., self-criticism and dependency) and individual difference factors reflecting self-esteem, feelings of mattering, and fear of not mattering are associated in meaningful ways with adaptability to the pandemic, loneliness, distress, negative mood states, and positive mood states. Most notably, higher self-reported adaptability to the pandemic is associated with lower dependency, self-criticism, and fear of not mattering, and higher levels of self-esteem and mattering. The findings attest to the central role of adaptability and related individual difference factors in acclimatizing to the numerous changes and challenges associated with the COVID-19 crisis. The theoretical and practical implications of our findings are discussed.

Do humor styles mediate or moderate the relationship between self-criticism and neediness and depressive symptoms?

This study examined whether, in a community sample of Israeli adults (N = 335), benign (i.e., affiliative and self-enhancing) and injurious (i.e., aggressive and self-defeating) humor styles mediated or moderated the relationship between self-criticism and neediness, two traits that confer vulnerability to depression, on the one hand, and levels of depressive symptoms, on the other. There was no evidence of any moderating effect of humor styles on the relationship between self-criticism and neediness and depressive symptoms. However, results indicated that the use of injurious styles of humor mediated the relationship between self-criticism and depressive symptoms as well as the relationship between neediness and depressive symptoms. Moreover, the relationship between neediness and depressive symptoms was also mediated by low levels of benign humor. These findings may have important implications for theories concerning vulnerability to depressive symptoms and intervention strategies.

Secondary traumatic stress in attorneys and their administrative support staff working with trauma-exposed clients.

Although secondary trauma has been assessed in various groups of mental health professionals, few studies, to date, have examined secondary trauma among attorneys exposed to clients' traumatic experiences. This study examined indicators of secondary trauma among attorneys (N = 238) and their administrative support staff (N = 109) in the Wisconsin State Public Defender Office. Attorney participants demonstrated significantly higher levels of posttraumatic stress disorder symptoms, depression, secondary traumatic stress, burnout, and functional impairment compared with the administrative support staff. This difference was mediated by attorneys' longer work hours and greater contact with clients who had experienced or had been directly involved with trauma. Sex, age, years on the job, office size, and personal history of trauma did not predict symptoms. These findings suggest a need to support attorneys experiencing these symptoms and to address high workloads as well as the intensity of contact with trauma-exposed clients.

Narcissism and Exercise Addiction: The Mediating Roles of Exercise-Related Motives.

The present research examined whether the associations that narcissistic personality features had with exercise addiction were mediated by particular motives for engaging in exercise in a large Israeli community sample (N = 2629). The results revealed that each aspect of narcissism was positively associated with exercise addiction. Narcissistic admiration and narcissistic rivalry had similar positive indirect associations with exercise addiction through the interpersonal motive for exercise. However, these aspects of narcissism diverged in their indirect associations with exercise addiction through psychological motives, body-related motives, and fitness motives for exercise such that these indirect associations were positive for narcissistic admiration but negative for narcissistic rivalry. Narcissistic vulnerability had positive indirect associations with exercise addiction through body-related motives and fitness motives that were similar to those observed for narcissistic admiration. These results suggest that exercise-related motives may play important roles in the associations that narcissistic personality features have with exercise addiction. The discussion will focus on the implications of these results for understanding the complex connections between narcissism and exercise addiction.

The mediating role of self-criticism and dependency in the association between perceptions of maternal caring and depressive symptoms.

BACKGROUND: This study examined a theoretically based mediation model including participants' perceptions of early relationships with their mother, self-criticism, dependency, and current depressive symptoms. We expect that (a) early relationships characterized by low levels of care and high levels of overprotection will be positively associated with both current depressive state and self-criticism and dependency; (b) high levels of self-criticism and dependency will be positively associated with depressive symptoms; and (c) self-criticism and dependency will play a mediating role in the association between participants' perceptions of early relationships characterized by low levels of care and high levels of overprotection and their current depressive symptoms. METHODS: A nonclinical community sample of 200 Portuguese adults participated in the study. Perceptions of early relationships were measured using the mother scales of the Parental Bonding Instrument (Parker et al. [1979: Br J Med Psychol 52:1-10]), levels of self-criticism and dependency were measured using the Depressive Experiences Questionnaire (Blatt et al. [1976: J Abn Psy 6:383-389]), and depressive symptoms were measured using the Center for the Epidemiological Studies of Depression Scale (Radloff [1977: Appl Psychol Meas 1:385-401]. RESULTS: Structural equation modeling showed that the link between participants' perceptions of early caretaking relationships with their mothers and their current depressive symptoms is mediated by high levels of self-criticism--a personality trait associated with vulnerability to depression--but not Dependency. However, an ancillary analysis indicated that the link between participants' perceptions of early maternal overprotective relationships and their current depressive symptoms is mediated by high levels of Neediness. CONCLUSIONS: Findings underscore the role of perceived early relationships in psychological vulnerability to depression among highly self-critical and among highly needy individuals and highlight the negative role played by perceived mothers' early dysfunctional practices, characterized by low levels of caring and high levels of overprotection, for the self-critical vulnerability to depression and by perceived mothers' high levels of overprotection, for the neediness vulnerability to depression. These potential causal mechanisms warrant longitudinal evaluation. Theoretical and clinical implications of the findings are discussed.

Stability and change in levels of depression and personality: a follow-up study of postpartum depressed mothers that were hospitalized in a mother-infant unit.

This prospective longitudinal study investigated the role of the personality dimensions of dependency and self-criticism in the course of depressive symptoms in a sample of inpatient severely postpartum depressed mothers (n = 55). Depressive symptoms and personality were measured during hospitalization and on average 3 1/2 years later. In line with previous research, a considerable subgroup of mothers (39%) reported moderate to severe symptoms of depression at time 2. In addition, although these mothers did not exhibit more depressive episodes during follow-up period compared with mothers with a less chronic course of depression, their depressive episodes were considerably longer, and they had higher levels of severity of depression as well as of dependency and self-criticism at Time 1. Finally, self-criticism, but not dependency, assessed at Time 1, predicted both depression diagnosis and levels of depression at follow-up, supporting a vulnerability model positing that self-criticism confers vulnerability for depression over time.

A longitudinal study of posttraumatic stress disorder, depression, and generalized anxiety disorder in Israeli civilians exposed to war trauma.

This 3-wave longitudinal study examined the mental health consequences of the Israel-Gaza 2008-2009 war among young Israeli civilians. Data on posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD), and their predictors were collected during the war, and 2 and 4 months after cease fire. Results showed a sharp decline in symptom levels of PTSD, MDD, and GAD over time. Perceived social support during the war moderated the effects of immediate emotional response on subsequent levels of PTSD, MDD, and GAD. These findings underscore the importance of social support and immediate emotional response to trauma in predicting trauma-related psychopathology, and highlight the potential need for providing early care to exposed individuals exhibiting immediate and severe emotional responses.

PTSD symptoms, satisfaction with life, and prejudicial attitudes toward the adversary among Israeli civilians exposed to ongoing missile attacks.

Few studies have examined the consequences of exposure to ongoing missile attacks in civilian populations. The authors examine the relationships between such exposure, and posttraumatic stress disorder (PTSD), satisfaction with life, and prejudicial attitudes toward the adversary. By using a stratified probability sampling, 160 adults, exposed to repeated missile attacks in southern Israel, were compared to 181 adults from areas outside the range of these attacks. Exposed participants reported more PTSD symptoms and less satisfaction with life, as compared to unexposed participants. The associations between PTSD and satisfaction with life and between PTSD and prejudicial attitudes were significantly stronger among the exposed participants, as compared to those who were not exposed to the attacks. Theoretical and clinical implications of the findings are discussed.

Emotional responses to a romantic partner's imaginary rejection: the roles of attachment anxiety, covert narcissism, and self-evaluation.

These studies tested the associations between responses to an induced imaginary romantic rejection and individual differences on dimensions of attachment and covert narcissism. In Study 1 (N=125), we examined the associations between attachment dimensions and emotional responses to a vignette depicting a scenario of romantic rejection, as measured by self-reported negative mood states, expressions of anger, somatic symptoms, and self-evaluation. Higher scores on attachment anxiety, but not on attachment avoidance, were associated with stronger reactions to the induced rejection. Moreover, decreased self-evaluation scores (self-esteem and pride) were found to mediate these associations. In Study 2 (N=88), the relative contributions of covert narcissism and attachment anxiety to the emotional responses to romantic rejection were explored. Higher scores on covert narcissism were associated with stronger reactions to the induced rejection. Moreover, covert narcissism seemed to constitute a specific aspect of attachment anxiety.

Maltreated children's representations of mother and an additional caregiver: a longitudinal study.

In the current longitudinal investigation, we explored the continuity of and changes in the mental representations of the mother and an additional caregiver among forty-five 9- to 11-year-old children who had been severely maltreated and subsequently placed in long-term residential care as well as the relationships between the content and structure of these representations and teacher's assessments of the child's externalizing and internalizing symptoms. At Time 1, a nonmaltreated comparison group was assessed concomitantly. Compared to nonmaltreated children, maltreated children scored higher for externalizing and internalizing symptoms, and their maternal representations were found to be significantly less benevolent and integrated and more punitive. In addition, among the maltreated children, the additional caregiver representations were found to be more benevolent and integrated, and less punitive, than the maternal representations. After 30 months, the maltreated children's levels of externalizing and internalizing symptoms diminished, their maternal representations become more benevolent and less punitive, and the additional caregiver representations became less benevolent. Moreover, the Benevolence of the additional caregiver representation was found to predict these children's changes in externalizing symptoms beyond the effects of their symptomatology and its associations with the Benevolence of these representations at Time 1.

Two primary configurations of psychopathology and change in thought disorder in long-term intensive inpatient treatment of seriously disturbed young adults.

OBJECTIVE: Change in three types of thought disorder as measured by Rorschach responses (contaminations, confabulations, and fabulized combinations) were assessed during intensive, long-term, psychodynamically oriented inpatient treatment. METHOD: Rorschach protocols for 90 seriously disturbed, treatment-resistant patients, 42 of whom were primarily preoccupied with primitive issues of interpersonal relatedness and used avoidant defenses (anaclitic patients) and 48 primarily preoccupied with primitive issues of self-definition and self-worth and used counteractive defenses (introjective patients), were evaluated at the beginning of treatment and, on average, 15 months into treatment. RESULTS: Change in anaclitic patients occurred primarily in more pathological forms of thought disorder (contaminations and confabulations) that express boundary disturbances; change in introjective patients occurred primarily in the less disturbed thought disorder (fabulized combinations) that expresses tendencies toward referential thinking. CONCLUSIONS: Seriously disturbed anaclitic and introjective patients expressed therapeutic progress in different but theoretically consistent ways.