Flexible emotional regulation typology: associations with PTSD symptomology and trait resilience.

BACKGROUND: Multiple factors influence posttraumatic stress disorder (PTSD) risk in trauma exposed individuals. An established association exists between trait resilience and decreased PTSD distress and between emotion regulation (ER) ability/flexibility and trait resilience. Typologies in ER ability/flexibility, associated with trait resilience and PTSD experience, could explain the difference in risk. This study aimed to explore the relationship between ER ability, ER flexibility, context sensitivity, resilience, and PTSD. METHODS: Data from N = 563 trauma exposed UK residents was used in a latent profile analysis (LPA) and membership in the resultant profiles was explored in a logistic regression of sociodemographics, resilience, and PTSD symptomology. RESULTS: Analysis showed 2 latent profiles (High Flexibility, Low Flexibility) typified by emotion regulation ability and context sensitivity. Members of the Low Flexibility profile were more likely to be younger, male, endorsing less trait resilience, and experiencing negative cognition/mood and hyperarousal PTSD symptomology. CONCLUSIONS: Difficulties in ER ability and flexibility could be improved with targeted learning in a therapeutic or home setting, potentially increasing trait resilience after trauma exposure and reducing PTSD distress.

A path to post-trauma resilience: a mediation model of the flexibility sequence.

Background: Psychological resilience has grown in popularity as a topic of study in psychotraumatology research; however, this concept remains poorly understood and there are several competing theories of resilience. Objective: This study sought to assess the support for one proposed theory of resilience: the flexibility sequence. Method: This study use secondary data analysis of panel survey data (N = 563). Participants were aged 18 years or over and based in the UK. A series of sequential mediation models was used to test the flexibility sequence theory as a proposed pathway of resilience on mental health outcomes (post-traumatic stress disorder, anxiety, and depression) among a trauma-exposed sample from the UK. Results: The 'feedback' component of the proposed flexibility sequence components was associated with reduced symptom severity with all outcomes, whereas 'context sensitivity' and 'repertoire' were significantly associated only with depression as an outcome. When indirect mediation pathways were modelled via the flexibility sequence, statistically significant effects were observed for all outcomes under investigation. Conclusions: These findings support the theorized flexibility sequence pathway of resilience, suggesting that the combination of these skills/processes performs more favourably as a framework of resilience than any in isolation. Further research into more elaborate associations and feedback loops associated with this pathway is warranted.

Antecedentes: La resiliencia psicológica ha ganado popularidad como tema de estudio en la investigación en psicotraumatología, sin embargo este concepto sigue siendo poco comprendido. Hay varias teorías de resiliencia que compiten entre sí, sin embargo este estudio buscó evaluar el apoyo para una teoría propuesta: la Secuencia de Flexibilidad.Metodología: Este estudio utilizó análisis de datos secundarios de datos de encuestas de panel (N=563, los participantes tenían más de 18 años y residían en el Reino Unido). Se utilizaron una serie de modelos secuenciales para probar la teoría de Secuencia de Flexibilidad como una vía propuesta de Resiliencia en los resultados de salud mental (TEPT, Ansiedad y Depresión) entre una muestra del Reino Unido expuesta a traumas.Resultados: Se encontró que el componente de Retroalimentación de los componentes de la Secuencia de Flexibilidad propuesta se asoció con una reducción de la gravedad de los síntomas en todos los resultados y la Sensibilidad al Contexto y Repertorio se asociaron significativamente solo con Depresión como resultado. Cuando las vías de mediación indirecta se modelaron a través de la Secuencia de Flexibilidad, se observaron efectos estadísticamente significativos para todos los resultados bajo investigación.Discusión: Estos hallazgos respaldan el camino de Resiliencia teorizado de Secuencia de Flexibilidad, lo que sugiere que la combinación de estas habilidades/procesos funciona más favorablemente como una estructura de resiliencia que cualquiera de forma aislada. Se justifica una mayor investigación sobre asociaciones más elaboradas y circuitos de retroalimentación asociados con esta vía.

Exploring complex-PTSD comorbidity in trauma-exposed Northern Ireland veterans.

Background: Complex posttraumatic stress disorder (CPTSD) describes the results of complex, prolonged, and/or inescapable trauma, and is typified by avoidance, re-experiencing, sense of threat, affect dysregulation, negative self-concept, and interpersonal disturbances. Additionally, CPTSD is highly comorbid with other common psychopathologies. Objectives: A study was conducted in a trauma-exposed UK Armed Forces Veteran population resident in Northern Ireland (N = 638, NI) to determine the prevalence of CPTSD and comorbid associations. Methods: Data from the Northern Ireland Veterans Health and Wellbeing Study (NIVHWS), including self-report data describing traumatic stress, depression, anxiety, and suicidality, were used in a latent class analysis to identify distinct profiles of symptomology in the sample, and in a multinomial logistic regression to identify comorbidities associated with class membership. Results: Three distinct classes emerged: a low endorsement 'baseline' class (36%), a 'Moderate Symptomatic' class (27%), and a high endorsement 'Probable CPTSD' class (37%). Both the Moderate Symptomatic and CPTSD classes were predicted by cumulative trauma exposure. Depression was highly comorbid (OR = 23.06 in CPTSD), as was anxiety (OR = 22.05 in CPTSD) and suicidal ideation (OR = 4.32 in CPTSD), with suicidal attempt associated with the CPTSD class (OR = 2.51). Conclusions: Cases of probable CPTSD were more prevalent than cases of probable posttraumatic stress disorder (PTSD) without Difficulties in Self-Organisation (DSO) symptoms in a UK Armed Forces veteran sample, were associated with repeated/cumulative trauma, and were highly comorbid across a range of psychopathologies. Findings validate previous literature on CPTSD and indicate considerable distress and thus need for support in UK Armed Forces veterans resident in NI.

Antecedentes:El trastorno de estrés postraumático complejo (TEPT-C) describe los resultados de un trauma complejo, prolongado y/o inevitable; y se caracteriza por la presencia de evitación, re-experimentación, sensación de amenaza, desregulación afectiva, un autoconcepto negativo y alteraciones en las relaciones interpersonales. Adicionalmente, el TEPT-C es altamente comórbido con otras psicopatologías frecuentes.Objetivos: Se realizó un estudio en una población de veteranos de las Fuerzas Armadas del Reino Unido expuestos a trauma residentes en Irlanda del Norte (N=638, NI) para determinar la prevalencia del TEPT-C y las asociaciones comórbidas.Métodos: Los datos del Estudio de Salud y Bienestar en Veteranos de Irlanda del Norte (NIVHWS, por sus siglas en inglés), incluidos datos de auto-reportes describiendo la presencia de estrés traumático, depresión, ansiedad y suicidalidad, fueron utilizados en un análisis de clases latentes para identificar distintos perfiles de sintomatología en la muestra y en una regresión logística multinomial para identificar las comorbilidades asociadas con la pertenencia a cada clase.Resultados: Surgieron tres clases distintas: una clase de "línea base" de bajo respaldo (36%), una clase de "sintomático moderado" (27%) y una clase de "TEPT-C probable" de alto respaldo (37%). La exposición acumulativa a trauma predijo tanto las clases de sintomático moderado como la del TEPT-C probable. La depresión fue altamente comórbida (OR=23.06 en TEPT-C), así como la ansiedad (OR=22.05 en TEPT-C) y la ideación suicida (OR=4.32 en TEPT-C), con intento de suicidio asociado a la clase de TEPT-C (OR=2.51).Conclusiones: Los casos de TEPT-C probable fueron más prevalentes que los casos de trastorno de estrés postraumático (TEPT) sin síntomas de alteraciones en la autoorganización (AAO) en una muestra de veteranos de las Fuerzas Armadas del Reino Unido. Asimismo, los casos de TEPT-C probable se asociaron a la exposición a trauma repetido/acumulativo y fueron altamente comórbidos con una variedad de psicopatologías. Los hallazgos validan la literatura previa concerniente al TEPT-C e indican una angustia considerable y, por lo tanto, demuestran la necesidad de soporte en los veteranos de las Fuerzas Armadas del Reino Unido residentes en Irlanda del Norte.

Tracking the Irish adult population during the first year of the COVID-19 pandemic: A methodological report of the COVID-19 psychological research consortium (C19PRC) study in Ireland.

The COVID-19 Psychological Research Consortium (C19PRC) study was established to determine the impact of the COVID-19 pandemic on the population of multiple countries. Here, we provide a methodological overview, cohort profile, data access, and summary of key findings from the Republic of Ireland arm of the C19PRC study. A longitudinal internet panel survey was designed to collect data from a nationally representative sample of Irish adults (N = 1041) who were tracked from March/April 2020 to March/April 2021. Quota sampling methods were used to produce a sample that was representative of the population with respect to sex, age, and regional distribution. Data were collected in five waves, and new participants were recruited at follow-up waves to cover sample attrition and produce nationally representative samples at various points during the first year of the pandemic. A comprehensive battery of measures was used throughout the project to assess an array of sociodemographic, political, social, psychological, physical health, COVID-19, and mental health variables. Analyses were conducted to compare sample characteristic to known population parameters from available census data. These analyses showed that the sample was representative of the general adult population of Ireland on the three quota variables and was reasonable representative of the population across a diverse range of sociodemographic variables. These data representative the first and only nationally representative, longitudinal survey of the mental health of the Irish population. These data are made freely available to interested users (https://osf.io/2huzd/files/) and the findings of this study provide a methodological basis for the future use of these data.

Changes in PTSD, depression, and generalized anxiety before and during the COVID-19 pandemic in Ireland.

BACKGROUND: : In this study, we compared the prevalence of posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) before and during the COVID-19 pandemic across nationally representative samples of Irish adults. METHODS: : Participants were sampled in February 2019 (N = 1,020), April 2020 (N = 1,041), May 2020 (N = 1,032), and December 2020 (N = 1,100) using the same self-report measures. RESULTS: : The prevalence of PTSD significantly increased from 12.5% in 2019 to 18.0% in April 2020, to 22.0% in May, and returning to 17.6% in December 2020. PTSD increases were most consistently observed in males, those aged 18-34 years, those without a university qualification, and those living in the Leinster region of Ireland, where the capital city of Dublin is located. There were no significant changes in the prevalence of depression or GAD. LIMITATIONS: : The 2020 samples were not completely independent of one another and while the analysis took this into account, this bias cannot be completely removed. CONCLUSIONS: : These findings show an increase in PTSD during the initial stages of the COVID-19 pandemic compared to the pre-pandemic period and suggest specificity in mental health responses to the COVID-19 pandemic.

Trajectories of change in internalizing symptoms during the COVID-19 pandemic: A longitudinal population-based study.

BACKGROUND: Longitudinal data indicates that the mental health of the general population may not have been as badly affected by the COVID-19 pandemic as some had feared. Most studies examining change in mental health during the pandemic have assumed population homogeneity which may conceal evidence of worsening mental health for some. In this study, we applied a heterogeneous perspective to determine if there were distinct groups in the population characterised by different patterns of change in internalizing symptoms during the pandemic. METHODS: Self-report data were collected from a nationally representative sample of Irish adults (N = 1041) at four time-points between April and December 2020. RESULTS: In the entire sample, mean levels of internalizing symptoms significantly declined from March to December 2020. However, we identified four distinct groups with different patterns of change. The most common response was 'Resilience' (66.7%), followed by 'Improving' (17.9%), 'Worsening' (11.3%), and 'Sustained' (4.1%). Belonging to the 'Worsening' class was associated with younger age, city dwelling, current and past treatment for a mental health problem, higher levels of empathy, and higher levels of loneliness. LIMITATIONS: Sample attrition was relatively high and although this was managed using robust statistical methods, bias associated with non-responses cannot be entirely ruled out. CONCLUSION: The majority of adults experienced no change, or an improvement in internalizing symptoms during the pandemic, and a relatively small proportion of adults experienced a worsening of internalizing symptoms. Limited public mental health resources should be targeted toward helping these at-risk individuals.