Social problem-solving in intimate partner violence victims: Exploring the relative contributions of shame and PTSD symptoms.

OBJECTIVE: This study examined the contributions of shame and posttraumatic stress disorder (PTSD) symptoms to two dimensions of social problem-solving. METHOD: A sample of 426 women who were seeking mental health assistance following experiences of intimate partner violence completed self-report and clinician measures. Separate path analyses were conducted for problem orientation and problem-solving styles. RESULTS: In the model examining problem orientation, higher levels of shame were significantly associated with lower levels of positive problem orientation (f2 = 0.32) and higher levels of negative problem orientation (f2 = 0.92), with large effects noted. PTSD symptoms were significantly, positively associated with negative problem orientation (f2 = 0.3, large effect). When examining problem-solving styles, shame showed a significant negative association with rational style (f2 = 0.08, small effect) and significant positive associations with impulsive style (f2 = 0.45, large effect) and avoidant style (f2 = 0.48, large effect). PTSD symptoms did not return significant associations with any of the three problem-solving styles. CONCLUSION: Results indicate that shame holds notable associations with both dimensions of social problem-solving, relative to PTSD symptoms, and are discussed in light of current models of post-trauma functioning. Implications for clinical care and early intervention efforts are highlighted.

Understanding the role of COVID-19-related workplace stress and institutional betrayal on mental health in nurses: Some heroes wear scrubs.

This study examined the association of three specific COVID-19-related workplace stressors (percentage of nursing work with COVID-positive [COVID+] patients, number of COVID-19-related patient deaths witnessed, and living separately from family for safety) and their associations with posttraumatic stress symptoms (PTSS) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among 391 nurses (93.6% White, 93.4% utilize she/her pronouns). Cross-sectional data were collected via an online survey. Institutional betrayal (i.e., the perception that an institution failed to protect a member who depends on and trusts it) was examined as a moderator of these associations. Although institutional betrayal was not a significant moderator in the three individual models, it held small-to-medium-sized positive main effects with PTSS and symptoms of GAD and MDD in both the individual and combined models. In the individual models, the percentage of nursing work with COVID+ patients was significantly positively associated with all three mental health conditions, f2 = .019-.195, whereas it only showed a significant effect with PTSS in the combined model, f2 = .138. Living separately from family was significantly positively associated with PTSS and MDD symptoms in both the individual, f2 = .037 and .015, respectively, and combined models, f2 = .025 and .013, respectively. Number of patient deaths held a significant positive association with PTSS alone, f2 = .022, in the individual model only. The findings are discussed in light of ways in which health care settings can better support and prioritize mental health among nursing staff.

Predictors of treatment completion in group psychotherapy for male veterans with posttraumatic stress disorder.

Group therapy is a frequently used therapy format for posttraumatic stress disorder (PTSD). However, factors contributing to treatment completion remain understudied. The current study examined predictors of treatment completion, defined as having completed 10 out of 14 sessions within 16 weeks, in veterans with PTSD who engaged in a hybrid efficacy-effectiveness randomized controlled trial of group psychotherapy for PTSD. Veterans (N = 198) were randomly assigned to 14 sessions of either group cognitive behavioral treatment (GBCT; n = 98) or group present-centered treatment (GPCT; n = 100). Four primary domains of predictors were examined, encompassing sociodemographic factors, the severity of PTSD and comorbid conditions, modifiable predictors, and treatment condition. Multilevel binomial logistic regression models following the Fournier analysis approach were used to examine significant predictors within domains, which were then included in a final model. Overall, 70.7% of participants completed treatment (GCBT = 61.6%, GPCT = 79.8%). Participants in the GPCT condition were 2.389 times, 95% CI [1.394, 4.092], more likely to complete treatment than those in the GCBT condition. Older age, a higher income and level of educational attainment, more lifetime and current mental health diagnoses, and higher use of positive reappraisal ER skills predicted treatment completion. Higher levels of depressive symptoms, cumulative trauma burden, and use of positive refocusing ER skills predicted treatment noncompletion. These findings are discussed in the context of current clinical and research practices for examining treatment noncompletion, with attention to the inclusion of translational predictors.

Alcohol Use and Mental Health Symptoms in Nurses during the Early Months of COVID-19.

OBJECTIVE: The current study examined associations of symptoms of posttraumatic stress disorder [PTSD], depression, and generalized anxiety disorder [GAD] with alcohol consumption and drinking to cope in a sample of 310 nurses during the first six months of the COVID-19 pandemic. METHOD: Using a cross-sectional design, nurses completed online surveys. RESULTS: Over 50% of the sample reported alcohol misuse and 12.2% reported drinking to cope. Further, 38.7% reported elevated symptoms of PTSD, 29.7% moderate-to-high symptoms of depression, and 56.8% elevated symptoms of GAD symptoms. Hierarchical regression analyses were conducted to examine how mental health symptoms were associated with alcohol outcomes, controlling for age, gender pronouns, education, and race. No significant predictors emerged for alcohol consumption. Significant associations of symptoms of PTSD and depression were found for drinking to cope, such that higher levels of mental health symptoms were associated with greater endorsement of drinking to cope. CONCLUSION: Results are discussed in light of increasing prevention and support services for nurses.

The role of negative cognitions in co-occurring posttraumatic stress disorder and depression: Examination of interpersonal and noninterpersonal trauma survivors.

OBJECTIVE: To examine negative cognitions underlying both posttraumatic stress disorder (PTSD) and depression following trauma. METHOD: A mixed-gender motor vehicle accident (N = 297, Mage = 43.49 years) sample and a female intimate partner violence (N = 242, Mage = 36.95 years) sample was cross-sectionally studied at research clinics of two universities. RESULTS: When diagnostic groups (PTSD+/-, depression+/-) were studied, no significant interactions were noted for any of the three forms of negative cognitions (negative thoughts about the self, negative thoughts about the world, and self-blame) in either sample. When continuous ratings of PTSD and depression were studied, the results showed that negative thoughts about the self were linked to both PTSD and depression. CONCLUSION: Findings suggest that it may be beneficial to target negative thoughts about the self when treating PTSD and depression together.

The Association Between Posttraumatic Negative Self-Conscious Cognitions and Emotions and Maladaptive Behaviors: Does Time Since Trauma Exposure Matter?

Negative beliefs about the self, self-blame, guilt, and shame have been consistently linked to emotional problems, such as posttraumatic stress disorder and depression, following trauma exposure. To expand understanding of the potential role of negative self-conscious cognitions and emotions in other forms of posttrauma maladjustments, such as maladaptive behaviors, the current study examined the associations between these cognitions and emotions with dissociation, alcohol use, and avoidant problem-solving. As a secondary goal, the influence of time since trauma exposure was considered given recent data suggesting that some posttraumatic responses require lengthier time following trauma to become salient. Multiple-group analysis was conducted in two groups of female survivors of intimate partner violence (IPV): women whose IPV experiences occurred within 3 months prior to assessment (early posttrauma phase [EPP]; n = 67) and those whose experiences occurred 12 months or more prior to assessment (chronic posttrauma phase [CPP]; n = 145). The results suggested model invariance. Posttraumatic negative self-conscious cognitions and emotions were significantly correlated with dissociation (EPP group: ß = .61, p < .001 and CPP group: ß = .48, p < .001), alcohol use (EPP group: ß = .31, p = .014 and CPP group: ß = .30, p < .001), and avoidant problem-solving (EPP group: ß = .58, p < .001 and CPP group: ß = .56, p < .001). The findings highlight the importance of negative self-conscious cognitions and emotions in posttrauma maladjustment and support intervening in these domains shortly after trauma exposure.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) La asociación entre cogniciones y emociones negativas auto-conscientes postraumáticas y comportamientos maladaptativos: ¿Influye el Tiempo desde la Exposición al Trauma? COGNICIONES/EMOCIONES Y COMPORTAMIENTOS MALADAPTATIVOS Las creencias negativas acerca de sí mismo, la autoinculpación, la culpa y la vergüenza han sido consistentemente asociados a problemas emocionales, tales como el trastorno de estrés postraumático y la depresión, luego de la exposición a trauma. Para expandir la comprensión del rol potencial de las cogniciones y emociones negativas auto-conscientes en otras formas de inadaptación post-trauma, como comportamientos maladaptativos, el presente estudio examinó las asociaciones entre esas cogniciones y emociones con disociación, uso de alcohol, y estilo evitativo de resolución de problemas. Como un objetivo secundario, se consideró la influencia del tiempo desde la exposición al trauma dados los datos recientes que sugieren que algunas respuestas post-traumáticas requieren un mayor tiempo luego del trauma para hacerse salientes. Se realizó un análisis de grupos múltiples en dos grupos de mujeres sobrevivientes de violencia de pareja (IPV, por su sigla en inglés); aquellas cuyas experiencias de IPV ocurrieron en los últimos 3 meses (fase temprana post-trauma [FTP]; n = 67) y aquellas cuyas experiencias ocurrieron hace 12 meses o más (fase crónica post-trauma [FCP]; n = 145). Los resultados sugirieron invariancia del modelo. Las cogniciones y emociones negativas auto-conscientes se correlacionaron significativamente con disociación (grupo EPP: ß = .61, p < .001 y grupo CPP: ß = .48, p < .001), uso de alcohol (grupo EPP: ß = .31, p = .014 y grupo CPP: ß = .30, p < .001), y estilo evitativo de resolución de problemas (grupo EPP: ß = .58, p < .001 y grupo CPP: ß = .56, p < .001). Los hallazgos destacan la importancia de las emociones y cogniciones negativas auto-conscientes en la inadaptación postrauma y apoyan la intervención en esos dominios prontamente luego de la exposición a trauma.

Does a history of childhood abuse moderate the association between symptoms of posttraumatic stress disorder and borderline personality disorder in survivors of intimate partner violence?

OBJECTIVE: This study examined whether a history of childhood abuse (CA) strengthened the association between borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) in the aftermath of intimate partner violence (IPV). This hypothesis arises from clinical literature but has not been examined empirically. We predicted that a history of CA would enhance associations between BPD features and PTSD symptoms. METHOD: Dimensional assessment of both PTSD and BPD was made in a sample of 211 women who sought mental health services following IPV. Two analyses were conducted using clinician-assessed DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, 4th ed.) PTSD symptoms: (a) total score and (b) symptom clusters. RESULTS: Using path analysis, results indicated significant associations between BPD features and PTSD symptoms, but no significant interaction between BPD and CA in either analysis. CONCLUSIONS: Results are discussed given current understanding of comorbidities involving PTSD, with particular attention to potential implications for clinical practice. Areas for future research are proposed.

A Randomized Controlled Trial of Group Cognitive Behavioral Treatment for Veterans Diagnosed With Chronic Posttraumatic Stress Disorder.

Relative to advances in the literature that have examined individual treatment approaches for posttraumatic stress disorder (PTSD), scientific knowledge about group treatment approaches has lagged, resulting in no currently available group treatment for PTSD despite the frequency with which this format is used. Our goal was to build upon the existing literature by examining the efficacy of a group cognitive-behavioral treatment (GCBT) for PTSD relative to group present-centered treatment (GPCT). The sample consisted of 198 male veterans with PTSD who were recruited at two Department of Veteran Affairs medical centers and randomly assigned to either GCBT (n = 98) or GPCT (n = 100); both treatments were 14 sessions. Assessments occurred at baseline, midtreatment, posttreatment, and 3-, 6-, and 12-month follow-ups. Findings indicated significant reductions in PTSD severity and PTSD diagnostic status following treatment for both GCBT, d = 0.97, and GPCT, d = 0.61. In addition, we observed significant reductions for depression symptoms, anxiety symptoms, and functional impairment for both group treatments as well as a reduction in the percentage of veteran participants who met diagnostic status for co-occurring major depression disorder and generalized anxiety disorder. Notably, these treatment gains were maintained at 12-month follow-up. Contrary to expectations, there were no significant differences between treatment conditions. Veterans diagnosed with PTSD were successfully treated using a group approach. Consistent with a growing body of evidence, the findings also suggest GPCT is as equally efficacious as group trauma-focused treatment. The trial was registered at clinicaltrials.gov (NCT01544088).

Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type.

OBJECTIVE: Examine initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. METHOD: One hundred and seventy-eight male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or non-interpersonal) impacted initial levels of alliance or change in alliance over time. RESULTS: Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a non-interpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p > .05), but did not have significantly different initial alliance ratings. CONCLUSIONS: The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance.

Physical injury, PTSD symptoms, and medication use: examination in two trauma types.

Physical injury is prevalent across many types of trauma experiences and can be associated with posttraumatic stress disorder (PTSD) symptoms and physical health effects, including increased medication use. Recent studies suggest that PTSD symptoms may mediate the effects of traumatic injury on health outcomes, but it is unknown whether this finding holds for survivors of different types of traumas. The current study examined cross-sectional relationships between injury, PTSD, and pain and psychiatric medication use in 2 trauma-exposed samples, female survivors of motor vehicle accidents (MVAs; n = 315) and intimate partner violence (IPV; n = 167). Data were obtained from participants at 2 trauma research clinics who underwent a comprehensive assessment of psychopathology following the stressor. Regression with bootstrapping suggested that PTSD symptoms mediate the relationship between injury severity and use of pain medications, R(2)  = .11, F(2, 452) = 28.37, p < .001, and psychiatric medications, R(2)  = .06, F(2, 452) = 13.18, p < .001, as hypothesized. Mediation, however, was not moderated by trauma type (ps > .05). Results confirm an association between posttraumatic psychopathology and medication usage and suggest that MVA and IPV survivors alike may benefit from assessment and treatment of emotional distress after physical injury.

Latent Profiles of Co-occurring Sexual Problems and Posttraumatic Stress Symptoms Among Young Women Exposed to Sexual Violence.

Sexual dysfunctions (SDs) have been noted to occur following exposure to sexual violence although how these conditions covary with other mental health conditions, particularly posttraumatic stress disorder symptoms (PTSS), is relatively understudied. The current study examined patterns of co-occurring SDs and PTSS in a sample of 328 college-aged, female-identified survivors of adolescent/early adulthood sexual assault (ASA). Latent profile analysis was used to examine patterns of symptom endorsement of various types of SDs and PTSS at the symptom cluster level. Four profiles were identified: asymptomatic (41.2% of sample), sexually distressed + intrusions (24.7%), co-occurring (21%), and PTSS (13.1%). Profiles were compared to one another on various characteristics of sexual assault and social reactions from others following assault disclosure. Results indicated that those in the co-occurring symptom and PTSS profiles reported more severe ASA and more unsupportive social responses relative to the sexually distressed + intrusions and asymptomatic profiles. The asymptomatic profile was significantly less likely to have experienced rape relative to the other three profiles and was less likely to report instances where a close other treated them in a negative manner following assault disclosure. Results are discussed in light of mental health needs for young women who have experienced ASA, with implications discussed for future research and clinical services for university students.

Examining the Content Validity of the Measure of Psychologically Abusive Behaviors: A Qualitative Approach.

The content validity of the Measure of Psychologically Abusive Behaviors (MPAB) was examined via qualitative content analysis of interviews conducted with 262 women who experienced intimate partner violence. Data were coded using MPAB categories and items. Approximately 73.4% of the data were represented by the MPAB at both the category and severity levels; half of the data mapped onto "severe" items. At the category level, 12.3% of the data did not map onto the MPAB; 15.5% of the data mapped onto a category but did not match a severity level. Results support the content validity of the MPAB.

Do latent profiles of self-reported anxiety, depression, and PTSD map onto clinician ratings? An examination with intimate partner violence survivors.

OBJECTIVE: Studies exploring latent profiles of mental health in trauma survivors have largely relied on self-report, making it unclear whether these patterns correspond with clinician-assessed psychopathology. The purpose of the current study was to examine latent profiles of self-reported PTSD, depression, and anxiety in a sample of 387 women who had experienced intimate partner violence (IPV) and investigate whether profiles mapped onto clinician-rated measures of the same outcomes. METHOD: Participants completed a series of semi-structured interviews and self-report measures assessing PTSD, depression, and anxiety. RESULTS: Latent profile analyses revealed a 3-profile solution characterized by Low (22.48 %), Moderate (37.98 %), and High (39.53 %) self-reported symptomology. Clinician ratings were significant predictors of membership in the low vs. moderate vs. high symptomology profiles. However, normalized means showed discrepancies between self-report and clinician assessment regarding which issue was rated most severe. CONCLUSIONS: Results suggest that while latent modeling approaches relying on self-report may adequately approximate common underlying patterns of psychopathology, they have limitations in identifying which disorders are most salient for clinical intervention.

Treatment of PTSD in older adults: Do cognitive-behavioral interventions remain viable?

The literature examining trauma among older adults is growing, but little is known about the efficacy of empirically supported interventions for PTSD within this population. Clinical writing on this topic often implies that cognitive-behavioral treatments may be ineffective or inappropriate for older adults with PTSD given physical and/or cognitive vulnerabilities. Review of the limited research in this area, however, provides little support for the claim that cognitive-behavioral interventions are ineffective in treating PTSD among the elderly. In an effort to explicate specific issues related to treatment process and outcome among older survivors of trauma, a case series is presented outlining the treatment of three older adults within the context of a structured, cognitive-behavioral group intervention. Observations from this case series suggests that cognitive-behavioral interventions continue to be useful in treating PTSD with this population. Specific treatment issues unique to older adults are explored and recommendations for future research are discussed.

Sexual Functioning and Satisfaction Among College Survivors of Sexual Violence: Examining PTSD Symptoms and Sexual Schemas.

Decreased sexual functioning is prevalent among female survivors of sexual violence yet psychological factors that contribute to sexual impairments in this population are understudied. To extend research in this area, the current study examined two psychological factors as they relate to sexual functioning concerns among 148 female survivors of sexual violence: severity of posttraumatic stress symptoms (PTSSs) and sexual self-schemas. Four domains of sexual functioning were examined: sexual desire, sexual arousal, sexual satisfaction, and orgasm functioning. It was predicted that PTSSs would be associated with a more negative sexual schema, which in turn, would be associated with decreased sexual functioning across the four domains. Using path analysis, PTSSs were found to be indirectly associated with decreased sexual satisfaction (b = -.08, SEb = .04, p = .035), sexual arousal (b = -.01, SEb = .001, p = .02), and reduced orgasm functioning (b = -.01, SEb = .001, p = .002). Results also supported significant direct paths from PTSS to all sexual functioning variables. These results support that negative sexual self-schemas may be relevant to the co-association of PTSSs and reductions in sexual functioning and satisfaction.

Interacting with a friend after a trauma film reduces anxiety and intrusive memories.

OBJECTIVE: Interpersonal factors have been linked with psychological adjustment to trauma, but how interpersonal factors influence trauma response is still unclear. Experimental paradigms such as the trauma film paradigm offer a valuable approach for studying this complex dynamic. However, few studies have used the trauma film paradigm to examine the interpersonal context of trauma response, and no studies have incorporated friends into the trauma film paradigm. The purpose of the current study was to examine how inclusion of a friend influenced reactions to a trauma analog. METHOD: One hundred young adult females were randomized to watch a brief stressful film of a sexual assault either with or without a friend and the Friend Present condition was given an opportunity to interact following the film. Participants were evaluated on distress during the film, skin conductance, anxiety and negative affect immediately postfilm (preinteraction) and 5 minutes later (postinteraction), and intrusive memories over a three-day period. RESULTS: No differences were found between conditions on skin conductance or subjective distress during the film. However, the Friend Present condition experienced a greater reduction in state anxiety from preinteraction to postinteraction and greater decreases in intrusive memories over the three-day period. CONCLUSIONS: Findings show the inclusion of a friend mitigated trauma-related stress reactions and suggest that interacting with a friend aided in adaptive processing of the stressor. Findings indicate that additional work is needed to examine how platonic relationships can be targeted to improve prevention and intervention efforts in trauma-related outcomes. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Using Social Support Matter in the Association of Post-Traumatic Cognitions and Perceived Social Support? Comparison of Female Survivors of Intimate Partner Violence With and Without a History of Child Abuse.

The association between high levels of post-traumatic stress disorder (PTSD) symptoms and low levels of perceived social support is well-documented in the trauma literature; research on processes that may underlie this association is less common. The current study examined negative attitudes about using social support as a potential link between negative post-traumatic cognitions about the world and self, one aspect of PTSD, and perceived social support in two groups of female survivors of intimate partner violence: those who had a history of child abuse (n = 153; IPV/CA+) and those who did not (n = 96; IPV/CA-). Negative attitudes about using social support were found to be an important link between negative post-traumatic cognitions and social support for both groups. IPV survivors with a history of child abuse had higher levels of negative post-traumatic cognitions about the world (d = .32) and self (d = .33), greater negative attitudes about using social support (d = .35), and lower perceived social support from family (d = .48), compared with IPV survivors without a history of child abuse. These results support the relevance of negative attitudes about using social support as one important factor in the relationship between PTSD symptoms and social support in interpersonal trauma survivors and highlight the impact that negative attitudes about using social support can have on the trauma survivor's functioning.

Moderators of PTSD symptom change in group cognitive behavioral therapy and group present centered therapy.

To examine moderators of change during group-based intervention for Posttraumatic Stress Disorder (PTSD), multilevel models were used to assess trajectories of symptom clusters in male veterans receiving trauma focused Group Cognitive Behavioral Treatment (gCBT; N = 84) or non-trauma focused Group Present Centered Therapy (gPCT; N = 91; Sloan et al., 2018). Separate models were conducted for symptom clusters in each intervention, examining pre-treatment PTSD symptoms, pre-treatment depression severity, age, index trauma, and outcome expectancies as potential moderators. Unconditioned growth models for both gCBT and gPCT showed reductions in intrusions, avoidance, negative cognitions/mood, and arousal/reactivity (all p < .001). Distinct moderators of recovery emerged for each treatment. Reductions in avoidance during gCBT were strongest at high levels of pre-treatment PTSD symptoms (low PTSD: p = .964, d = .05; high PTSD: p < .001, d = 1.31) whereas positive outcome expectancies enhanced reductions in cognitions/mood (low Expectancy: p = .120, d = .50; high Expectancy: p < .001, d = 1.13). For gPCT, high levels of pre-treatment depression symptoms negatively impacted change in both intrusion (low depression: p < .001, d = .96; high depression: p = .376, d = .22) and arousal/reactivity (low depression: p < .001, d = .95; high depression: p = .092, d = .39) symptoms. Results support the importance of examining trajectories of change and their moderators for specific treatments, particularly when contrasting trauma focused and non-trauma focused treatments.

Factor Structure of the Communication Patterns Questionnaire in Violence-Exposed Women.

Understanding and addressing violence among intimate partners requires sound assessment of their communication patterns. In prior research, the 35-item, self-report Communication Patterns Questionnaire (CPQ) has been used to assess communication patterns in violent relationships. To date, psychometric analysis of the CPQ has been examined only among nonviolent couples; no studies have examined the psychometric properties of this measure in a sample of survivors of intimate partner violence (IPV). Using confirmatory factor analysis, the present study evaluated the factor structure of the CPQ in a sample of women survivors of IPV who sought mental health assessments at a university research clinic. Analyses suggested that a modified three-factor solution (constructive communication [CC], self-demand/partner withdraw [SDPW], partner demand/self-withdraw [PDSW]) provided good fit in our sample. Internal consistency estimates for each of the modified scales were acceptable and exceeded reported coefficients in prior IPV studies. Significant bivariate correlations among modified scales, and between communication patterns and aggressive behaviors, provided initial validity evidence for the CPQ scales in our sample. We found CC to be negatively associated with partner psychological aggression, PDSW to be positively associated with all forms of partner aggression and respondent psychological aggression, and SDPW to be positively associated with respondent physical and psychological aggression. The results of this study indicate that the CPQ may be an appropriate measure for assessing communication patterns in violent relationships; however, modified scoring procedures should be used. We contextualize our results within existing models of IPV and address clinical, cultural, and contextual issues in communication patterns assessment.

Exploring ambivalent rape acknowledgment and posttraumatic stress symptoms among college women who have experienced rape: What's in a name?

The present study explored rape acknowledgment among 131 college women survivors of rape utilizing three subgroups: acknowledged rape, unacknowledged rape, and ambivalent acknowledgment. Posttraumatic stress disorder (PTSD) symptom clusters and parameters of victimization and were compared between the subgroups. Of the participants, 28.2 % were classified as ambivalent rape acknowledgment, 49.6 % as acknowledged rape, and 22.1 % as unacknowledged rape. Across all four PTSD symptom clusters, the ambivalent acknowledgment group had significantly higher PTSD symptoms than the unacknowledged group. With the exception of hyperarousal symptoms, PTSD symptoms did not differ between the acknowledged and ambivalent acknowledgment groups. With regard to potential group differences in exposure to various rape tactics (i.e., physical force, threat, incapacitation), the acknowledged group indicated (a) exposure to a greater number of rape tactics relative to the other groups, (b) higher likelihood of endorsing rape via threat than the ambivalent acknowledgment group, and (c) more frequent endorsement of forcible rape than the unacknowledged group. Results are discussed in light of screening methods to assess for PTSD symptoms among rape survivors, as well as the recent changes to the Title IX law regarding sexual misconduct reports on college campuses.