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1.
Stress ; 27(1)2024.
Article in English | MEDLINE | ID: mdl-39022295

ABSTRACT

Objective: People living with HIV (PLWH) experience high rates of childhood trauma exposure, which is a significant risk factor for the development of posttraumatic stress disorder (PTSD). Because Black Americans living in urban environments are exposed to high levels of trauma, suffer from chronic PTSD, and are at increased risk for HIV infection, it is important to understand how HIV status interacts with childhood maltreatment to influence PTSD symptom severity and underlying psychophysiology. Methods: The current cross-sectional study assessed whether HIV status interacts with childhood maltreatment to influence PTSD symptom severity and heart rate variability during a dark-enhanced startle (DES) task in 88 Black women with (n=30) and without HIV (n=58). Results: HIV was associated with greater PTSD symptom severity only in women with low levels of childhood maltreatment (p=.024). Startle potentiation during DES was highest in women living without HIV and with high childhood maltreatment (p=.018). In women who had experienced low levels of childhood maltreatment, respiratory sinus arrhythmia (RSA) was lower during the dark phase of DES in women living without HIV than women living with HIV (WLWH), (p=.046). RSA during the light phase of DES was lower in WLWH than in women living without HIV (p=.042). Conclusion: In the current sample of Black women, HIV status was associated with PTSD symptom severity in a manner dependent on level of childhood maltreatment, suggesting that HIV status may be an important factor to consider for behavioral and pharmacological treatment strategies for PTSD. Additionally, HIV status is associated with lower percent potentiation to darkness and lower RSA during the light phase of DES, suggesting physiological mechanisms by which HIV may contribute to PTSD symptoms in individuals exposed to low levels of childhood maltreatment.


Subject(s)
Adult Survivors of Child Abuse , Black or African American , HIV Infections , Heart Rate , Reflex, Startle , Stress Disorders, Post-Traumatic , Humans , Female , Stress Disorders, Post-Traumatic/physiopathology , Stress Disorders, Post-Traumatic/psychology , Heart Rate/physiology , Adult , Cross-Sectional Studies , Reflex, Startle/physiology , HIV Infections/physiopathology , HIV Infections/psychology , Adult Survivors of Child Abuse/psychology , Middle Aged , Severity of Illness Index , Psychophysiology , Respiratory Sinus Arrhythmia/physiology
2.
Aggress Behav ; 50(3): e22149, 2024 05.
Article in English | MEDLINE | ID: mdl-38757986

ABSTRACT

Aggression is a costly public health problem with severe and multi-faceted negative consequences and thus, identifying factors that contribute to aggression, particularly in understudied populations, is necessary to develop more effective interventions to reduce the public health cost of aggression. The goal this study was to test whether difficulties regulating emotions moderated the association between posttraumatic stress disorder (PTSD) symptoms and aggression in a community sample of predominantly Black females with high levels of trauma exposure. Furthermore, we explored unique relations between PTSD symptom clusters and distinct subscales of difficulties regulating emotions and aggression. The sample included 601 community participants recruited from an urban public hospital. Symptoms were assessed using self-report measures including the Difficulties in Emotion Regulation Scale (DERS) and Behavioral Questionnaire-Short. Regression analyses were conducted using PTSD symptoms and total DERS to test their interaction as predictors for aggression (using BQ-Short). We found that higher levels of PTSD arousal symptoms and difficulty controlling impulses when upset were positively related to aggression. We also conducted an exploratory analysis to examine the association between PTSD symptom clusters using the Alternative Symptom Clusters hybrid model. The results suggest that some PTSD symptoms (externalizing behavior) and some emotion dysregulation processes (difficulties controlling impulses when upset), relate to aggression in independent, rather than multiplicative ways. These results offer insights for new directions of research that focuses on the independent association between specific emotion dysregulation processes and PTSD symptoms on aggression.


Subject(s)
Aggression , Black or African American , Emotional Regulation , Stress Disorders, Post-Traumatic , Humans , Female , Stress Disorders, Post-Traumatic/psychology , Aggression/psychology , Aggression/physiology , Adult , Emotional Regulation/physiology , Male , Middle Aged , Black or African American/psychology , Black or African American/ethnology , Young Adult , Minority Groups/psychology , Adolescent , Aged
3.
Aggress Behav ; 50(2): e22141, 2024 03.
Article in English | MEDLINE | ID: mdl-38425222

ABSTRACT

Although aggression occurs across a range of disorders, associations between dimensions of psychopathology and self- and other-directed aggression are not well understood. Investigating associations between psychopathology dimensions and aggression helps further understanding about the etiology of aggression, and ultimately, can inform intervention and prevention strategies. This study adopted a multi-method approach to examine associations between internalizing and externalizing dimensions of psychopathology and self- and other-directed aggression as a function of reporter (participant and informant) and modality of aggression measurement (subjective and objective). Participants were an unselected sample of 151 racially diverse adults recruited from the community. Dimensions of psychopathology were assessed using interview and questionnaire reports from participants and collateral informants, and forms of aggression were measured via subjective reports and an objective, laboratory aggression paradigm. Analyses of participant-reported psychological symptom data consistently linked externalizing symptoms to other-directed aggression, and internalizing symptoms to self-directed aggression. Results across informant and participant reporters replicated prior findings showing a significant interaction between internalizing and externalizing dimensions in predicting intimate partner violence. Most other effects in informant models were nonsignificant. The findings uncover consistency in and replicability of relationships between dimensions of psychopathology and certain manifestations of aggression and highlight the importance of examining multiple forms of aggression in etiological research. Examining aggression through a transdiagnostic lens can help us better understand and intervene upon processes implicated in devasting forms of self- and other-directed aggression.


Subject(s)
Aggression , Psychopathology , Adult , Humans , Aggression/psychology
4.
Psychol Med ; 53(11): 5136-5145, 2023 08.
Article in English | MEDLINE | ID: mdl-37650341

ABSTRACT

BACKGROUND: Moral injury exposure (MIE) and distress (MID) may indirectly affect the relationship between trauma exposure and alterations in autonomic regulation [assessed via high-frequency heart rate variability (hfHRV)] in civilians, but this has not been tested in prior research. We conducted two exploratory studies to examine trauma types' associations with MIE and MID among civilian medical patients (Study 1) and explore how these facets may indirectly affect the relationship between trauma type and hfHRV among civilians seeking mental health services (Study 2). METHODS: Participants recruited from a public hospital and/or community advertisements (Study 1, n = 72, 87.5% Black, 83.3% women; Study 2, n = 46, 71.7% Black, 97.8% women) completed measures assessing trauma type, MIE, and MID. In Study 1, trauma types that emerged as significant correlates of MIE and MID were entered into separate linear regression analyses. Trauma types identified were included as predictors in indirect effects models with MIE or MID as the mediator and resting hfHRV (assayed via electrocardiography) as the outcome. RESULTS: Childhood sexual abuse emerged as the only significant predictor of MIE, b = 0.38, p < 0.001; childhood sexual abuse, b = 0.26, p < 0.05, and adulthood sexual assault, b = 0.23, p < 0.05 were significant predictors of MID. Participants with greater MIE and MID demonstrated lower hfHRV. Adulthood sexual assault showed an indirect effect on hfHRV through MID, B = -0.10, s.e. = 0.06, 95%CI (-0.232 to -0.005). CONCLUSIONS: Moral injury was uniquely associated with sexual violence and lower hfHRV in civilians. Data highlight moral injury as a pathway through which autonomic dysregulation may emerge and its salience for trauma treatment selection.


Subject(s)
Mental Health Services , Stress Disorders, Post-Traumatic , Humans , Female , Child , Male , Heart Rate , Autonomic Nervous System , Electrocardiography
5.
J Trauma Stress ; 2023 Dec 06.
Article in English | MEDLINE | ID: mdl-38054549

ABSTRACT

In the United States, racism is theorized to exert its negative effects on Black individuals' mental health by triggering a response known as "race-based traumatic stress" (RBTS), a multidimensional construct comprising seven clusters of symptoms that can occur following exposure to race-based traumatic events (e.g., racial discrimination, racist incidents): depression, intrusion, anger, hypervigilance, physical symptoms, (low) self-esteem, and avoidance. However, little is known about which symptoms and clusters are strongest and most influential in the maintenance of RBTS. Network analysis is a powerful tool for understanding the etiology of traumatic stress, but it has not yet been applied to the examination of this construct. The present study aimed to identify the symptoms most central to RBTS and examine associations between symptoms and symptom clusters. Participants (N = 1,037) identified as Black, and lived in the United States (Mage = 45.12 years, range: 18-82 years) and completed the Race-Based Traumatic Stress Symptom Scale-Short Form (RBTSSS-SF). Regularized partial correlation networks were estimated using R/RStudio. The cluster- and item-level networks demonstrated adequate centrality stability, CS = .44. The depression and physical symptoms clusters were the most central nodes in the cluster network. Feelings of meaninglessness, experiencing mental images of the event, and physical trembling were the most central items within the item-level network. These findings offer insights and implications for assessing and treating symptoms of RBTS in Black adults in the United States who are exposed to race-based traumatic events.

6.
J Couns Psychol ; 70(3): 258-275, 2023 Apr.
Article in English | MEDLINE | ID: mdl-35604716

ABSTRACT

One critical role counseling psychologists can play in dismantling anti-Blackness and eradicating systemic racism is to build on the field's strength in understanding individual-level processes (i.e., systems are created and maintained by individual actors). Drawing on antiracism scholarship, we aimed to better understand how colorblind racial ideology (CBRI), or the denial and minimization of race and racism, may serve as a barrier to engaging in antiracist praxis. Specifically, we conducted a meta-analysis to determine if color evasion (ignoring race) and power evasion (denying structural racism) CBRI were differentially associated with anti-Blackness and processes linked to antiracism. Findings based on 375 effects drawn from 83 studies with more than 25,000 individuals suggest different effects based on CBRI type. As hypothesized, we found that power evasion CBRI was related to increased endorsement of anti-Black prejudice (r = .33) and legitimizing ideologies (r = .24), and negatively associated with a range of other variables associated with antiracism, including social justice behaviors (r = -.31), multicultural practice competencies (r = -.16), diversity openness (r = -.28), and racial/ethnocultural empathy (r = -.35). Consistent with theory, color evasion CBRI was related to increased diversity openness (r = .12). We discuss limitations of our study, as well as outline future directions for research and practice to focus on the role of CBRI in sustaining and perpetuating anti-Blackness and systemic racism. Thus, this meta-analysis has implications for pushing the field of counseling psychology to build the bridge between individual ideologies and creating structural change. (PsycInfo Database Record (c) 2023 APA, all rights reserved).


Subject(s)
Racism , Humans , Racism/psychology , Social Behavior , Cultural Diversity , Antiracism , Social Justice
7.
Fam Process ; 2023 Nov 14.
Article in English | MEDLINE | ID: mdl-37962033

ABSTRACT

In response to highly publicized instances of overt racial injustice, there has been a recent resurgence of interest and commitment to identifying processes through which anti-racist behaviors develop among White individuals. One particularly important context in which anti-racist behaviors can develop is within families and as a result of childrearing. Theories of anti-racism typically neglect the role of families and family science research typically neglects a focus on anti-racist parenting outcomes. To further research and applied work on fostering anti-racism within White families, this paper introduces a new integrative model called routes to effective anti-racist parenting (REAP). The model draws on theories from various fields, including family science and social psychology, and uses a metaphor of nurturing a plant to explain the nuanced, multi-faceted approaches to anti-racist parenting. The model incorporates factors related to the "pot" (i.e., fundamental values and structure necessary to contain more specific anti-racist skills and behaviors), "soil" (i.e., characteristics that define anti-racist commitment), "seeds" (i.e., direct transmission of anti-racism skills), and "environment" (i.e., influential external factors). Finally, we describe the intended benefits that can be reaped from this intentional approach to anti-racist parenting. The REAP model contributes to the family science literature by providing an empirically grounded theoretical model describing the roles that parents can play in children's anti-racist development.

8.
Am J Community Psychol ; 72(1-2): 116-126, 2023 09.
Article in English | MEDLINE | ID: mdl-37434412

ABSTRACT

Experiencing racism is linked to lower subjective social status (SSS), defined as one's perception of their position in society. SSS is influenced by power, prestige, and objective socioeconomic status (SES). Previous findings suggest that race-related stress may be related to adverse mental health outcomes through SSS in Black Americans, a population that has been deeply affected by continuing legacies of oppression. The current study examines the indirect association between race-related stress and posttraumatic stress disorder (PTSD) and depression symptoms through SSS in a community sample of largely trauma-exposed Black Americans (N = 173). Hierarchical regression analyses indicated that overall race-related stress significantly predicted lower SSS, higher PTSD symptoms, and higher depression symptoms. Analyses also revealed indirect effects of cultural race-related stress on PTSD and depression symptoms through SSS after controlling for SES. Results suggest that the experience of race-related stress, particularly cultural race-related stress, which involves the degradation and disparagement of one's culture and worldview, is associated with more severe PTSD and depression symptoms potentially due to these experiences decreasing Black Americans' SSS. Findings support the need for systemic intervention strategies to disrupt the cultural oppression of Black Americans and improve the societal value and mental health of this population.


Subject(s)
Depression , Social Status , Stress Disorders, Post-Traumatic , Stress, Psychological , Humans , Black or African American , Depression/epidemiology , Racism , Social Class , Stress Disorders, Post-Traumatic/epidemiology , Stress, Psychological/epidemiology , Psychological Trauma/epidemiology
9.
J Clin Psychol Med Settings ; 30(4): 791-803, 2023 12.
Article in English | MEDLINE | ID: mdl-36715813

ABSTRACT

The properties and utility of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) remain unstudied in community-based populations. This study evaluates the performance of the PC-PTSD-5 to determine whether it can be used as a brief alternative to the PTSD Checklist for DSM-5 (PCL-5) in a large public hospital in the southeastern United States. Participants (N = 422; 92.7% Black; 85.8% female; Mage = 42.0 years, SDage = 13.4 years) completed the PCL-5 and PC-PTSD-5 after recruitment from medical clinic waiting rooms and admission lists. Using chance-corrected test quality indices and item response theory (IRT) analyses, we determined optimal cut-scores for screening and examined item performance. Approximately 45.0% of the sample screened positive for probable DSM-5 PTSD using the PCL-5. The PC-PTSD-5 demonstrated high internal consistency and strong associations with PCL-5 scores (total, r = .79; items, rs = .51-.61). A cut-score of one was optimally sensitive for screening (κ[1] = .96), and a cut-score of four had the highest quality of probable efficiency (κ[.5] = .66) for detecting self-reported DSM-5 PTSD on the PCL-5. IRT analyses indicated Item 1 (nightmares, intrusive memories) provided the most information, and other items may not be incrementally useful for this sample. Findings provide preliminary support for the use of the PC-PTSD-5 as a brief alternative to the PCL-5 among chronically trauma-exposed patients in the public healthcare setting.


Subject(s)
Stress Disorders, Post-Traumatic , Humans , Female , Adult , Adolescent , Male , Stress Disorders, Post-Traumatic/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Southeastern United States , Checklist , Primary Health Care
10.
J Trauma Dissociation ; 24(5): 692-711, 2023.
Article in English | MEDLINE | ID: mdl-37387238

ABSTRACT

Appraisal of trauma is a critical factor in the development of impairing post-traumatic stress symptoms, such as dissociation. Individuals may appraise trauma as morally injurious (i.e., moral injury exposure [MIE]) and experience subsequent moral distress related to this exposure (i.e., moral injury distress [MID]). To date, however, investigation into the relations between moral injury appraisals and dissociation has been limited, particularly within community populations. This study investigated MIE and MID in relation to six facets of dissociation (disengagement, depersonalization, derealization, memory disturbances, emotional constriction, identity dissociation) in a sample of trauma-exposed community members (n = 177, 58.2% Black, 89.3% female) recruited from a public hospital and/or community advertisements. Participants completed measures assessing trauma exposure, MIE, MID, dissociation, and posttraumatic stress disorder (PTSD) symptoms. Partial correlation analyses revealed that after controlling for PTSD symptoms, MIE was correlated with disengagement, r = .23, p ≤ .025, and depersonalization, r = .25, p ≤ .001, and MID was correlated with depersonalization, r = .19, p ≤ .025. Sex moderated each association, with stronger associations observed for female participants. Findings suggest that moral injury appraisals are linked to more severe dissociative symptoms among female civilians, and as such, may need to be specifically targeted in empirically supported treatments.


Subject(s)
Stress Disorders, Post-Traumatic , Humans , Female , Male , Stress Disorders, Post-Traumatic/psychology , Dissociative Disorders/psychology , Emotions
11.
Subst Use Misuse ; 57(4): 603-612, 2022.
Article in English | MEDLINE | ID: mdl-35068316

ABSTRACT

Dysregulated behaviors (e.g., alcohol and drug use, aggression, self-harm, gambling, binge eating) occur frequently and can be severely costly to individuals and society. Yet, little is known about the construct of dysregulated behaviors, including (a) whether it is distinct from related constructs such as compulsive behaviors and sensation-seeking, (b) whether its components share common correlates (e.g., impulsigenic traits, reward sensitivity, and emotion dysregulation), and (c) identify and describe patterns of dysregulated behaviors. To address these gaps in the literature, this study used variable-centered and person-centered analyses in a racially diverse sample of undergraduates (n = 338). In support of evidence distinguishing dysregulated behaviors from related constructs, correlational analysis indicated that the associations with compulsive behaviors were small and nonsignificant. In terms of construct validity, we found relatively strong and consistent evidence for impulsigenic traits across dysregulated behaviors but relatively inconsistent evidence for associations with reward sensitivity and emotion dysregulation. Finally, person-centered analysis indicated the presence of three classes characterized by high dysregulated behavior, low dysregulated behavior, and aggressive self-harm behavior. The likelihood of being classified in these classes differed considerably based on impulsigenic traits and emotion dysregulation. These results may have implications for the classification and treatment of dysregulated behaviors. Taken together, this study advances our understanding of dysregulated behaviors and sets the stage for further theory development and hypothesis testing regarding the onset, maintenance, and treatment of dysregulated behaviors.Supplemental data for this article is available online at https://doi.org/10.1080/10826084.2022.2026966 .


Subject(s)
Self-Injurious Behavior , Substance-Related Disorders , Aggression/psychology , Humans , Reward , Students/psychology
12.
Cultur Divers Ethnic Minor Psychol ; 28(4): 544-556, 2022 Oct.
Article in English | MEDLINE | ID: mdl-34570550

ABSTRACT

Although numerous studies have documented an association between racial discrimination and internalizing psychopathology symptoms, there is a lack of empirical work that establishes cognitive and emotional mechanisms through which racial discrimination is associated with specific transdiagnostic mental health outcomes (i.e., anxious arousal and low positive affect) among Black Americans. OBJECTIVE: The goal of this study was to test a new etiological model of how racial discrimination is associated with anxious arousal and low positive affect. The overarching model posits that racial discrimination will be associated with anxious arousal and low positive affect through prolonged activation of race-related stress processes (i.e., anticipatory race-related fear and race-related rumination), the effects of which are conditioned on attention bias to threat. METHOD: A total of 326 Black participants (72.4% women) completed the study. RESULTS: For anxious arousal, the indirect effect of racial discrimination through anticipatory race-related fear depended on degree of attention bias, with the effect only reaching statistical significance at mean and relatively higher levels of attention bias to threat. For low positive affect, the indirect effect of racial discrimination through race-related rumination only reached a statistical significance at mean and relatively lower levels of attention bias to threat. CONCLUSIONS: Racial discrimination is indirectly associated with anxious arousal and low positive affect through the effects of anticipatory race-related fear and race-related rumination, respectively. Implications for etiology and treatment of anxious arousal and low positive affect are discussed. (PsycInfo Database Record (c) 2022 APA, all rights reserved).


Subject(s)
Racism , Female , Humans , Male , Racism/psychology , Black or African American/psychology , Anxiety , Arousal , Black People
13.
J Clin Psychol ; 78(6): 1220-1239, 2022 06.
Article in English | MEDLINE | ID: mdl-34862625

ABSTRACT

OBJECTIVE: A large body of research has shown that alcohol use, drug use, aggression, and self-harm often co-occur within the same individuals, suggesting the possibility of shared etiologies. Research has yet to determine the factor structure of these dysregulated behaviors. METHODS: Participants (Mage = 40.33; 74% women) completed self-report and interview-based measures of dysregulated behaviors (alcohol use, drug use, aggression, and self-harm), emotion dysregulation, maladaptive personality traits, and symptoms of DSM disorders (e.g., borderline personality disorder [BPD], depression). RESULTS: Results showed support for a bifactor model (i.e., all indicators load on a common dysregulated behavior factor and on unique alcohol, drug, aggression, and self-harm factors), which provided a better fit to the data than other models. In line with our hypotheses, the general dysregulated behavior factor was positively associated with emotion regulation difficulties, negative affect, and BPD symptoms. CONCLUSIONS: These results have implications for several areas of psychopathology and intervention research.


Subject(s)
Borderline Personality Disorder , Emotional Regulation , Self-Injurious Behavior , Substance-Related Disorders , Adult , Aggression/psychology , Borderline Personality Disorder/diagnosis , Borderline Personality Disorder/epidemiology , Female , Humans , Male , Self Report
14.
J Ethn Subst Abuse ; 21(1): 174-196, 2022.
Article in English | MEDLINE | ID: mdl-32065558

ABSTRACT

The study explored associations among childhood abuse, post-traumatic stress symptoms (PTSS), and alcohol misuse in a sample of low-income African-American women (N = 172). Using bootstrapping techniques, a mediation effect was found of childhood physical and emotional abuse on alcohol misuse via PTSS symptom severity, avoidance, and hyperarousal, as well as for childhood sexual abuse on alcohol misuse via PTSS symptom severity and hyperarousal. Our results suggest that PTSS indicators, particularly symptom severity and hyperarousal, may be important mechanisms underlying the association of experiences of abuse during childhood and alcohol misuse in adulthood.


Subject(s)
Alcoholism/etiology , Child Abuse/ethnology , Child Abuse/psychology , Stress Disorders, Post-Traumatic , Adult , Black or African American , Alcoholism/epidemiology , Alcoholism/ethnology , Alcoholism/psychology , Child , Female , Humans , Stress Disorders, Post-Traumatic/epidemiology , United States/epidemiology
15.
Psychosom Med ; 83(9): 949-958, 2021.
Article in English | MEDLINE | ID: mdl-34747582

ABSTRACT

OBJECTIVE: Race-related lifetime stress exposure (LSE) including racial discrimination, trauma, and stressful life events have been shown to contribute to racial health disparities. However, little is known about associations between race-related stressors and premature biological aging that confer the risk of adverse health outcomes. Even less is known about the mechanisms through which race-related stressors may be associated with accelerated aging. Early evidence suggests psychological processes such as anger, and particularly the internalization of anger, may play a role. METHODS: In a community sample of predominantly low-income Black adults (n = 219; age = 45.91 [12.33] years; 64% female), the present study examined the association of race-related LSE (as defined by exposure to racial discrimination, trauma, and stressful life events) and epigenetic age acceleration through anger expression. RESULTS: Internalized and externalized anger expression were each significantly associated with LSE and age acceleration. Although LSE was not directly associated with age acceleration (ΔR2 = 0.001, p = .64), we found that greater LSE was indirectly associated with age acceleration through increases in internalized, but not externalized, anger (indirect effect: ß = 0.03, standard error = 0.02, 95% confidence interval = 0.003 to 0.08; total effect: ß = 0.02, 95% confidence interval = -0.25 to 0.31). CONCLUSIONS: These results suggest race-related LSE may elicit the internalization of anger, which, along with the externalization of anger, may initiate detrimental epigenetic alterations that confer the risk of adverse health outcomes. These findings lay the groundwork for longitudinal studies of the association between race-related stress and racial health disparities.


Subject(s)
Black or African American , Racism , Adult , Black or African American/psychology , Aging , Anger , Epigenesis, Genetic , Female , Humans , Male , Middle Aged , Racism/psychology , Stress, Psychological/complications
16.
Bipolar Disord ; 23(2): 186-195, 2021 03.
Article in English | MEDLINE | ID: mdl-32579284

ABSTRACT

Individuals with bipolar disorder are at increased risk of dying by suicide compared to healthy controls and those with unipolar depression. Previous studies show that depressive symptoms and mixed episodes of mania and depression are related to suicide. However, most of these studies adopt a variable-centered approach to understanding how specific symptoms relate to suicidal ideation, without addressing how these symptoms and symptom profiles relate to suicidal behaviors. OBJECTIVES: Using latent class analysis, this study adopts a person-centered approach to examine whether subtypes of patients with bipolar disorder differ in their levels of suicidal ideation and behaviors. METHODS: A total of 150 patients from a behavioral health outpatient clinic were recruited. Latent classes were generated based on self reports of their depressive and manic symptoms. RESULTS: Five classes of patients with bipolar disorder were identified, namely, a minimal symptom, mania, moderately depressed, severely depressed, and mixed depression-mania subtypes. Those in the severely depressed and mixed depression-mania groups reported significantly higher levels of suicidal ideation and behaviors compared to the other groups. CONCLUSIONS: Our findings provide further support for the strong relationship between depressive symptoms and suicidality. These findings are significant as they shed light on the different suicide risk profiles among a heterogenous group of patients with bipolar disorder. Name of clinical trial: Suicidal Behavior in Patients Diagnosed with Bipolar Disorder: The Roles of Biological and Childhood and Adult Environmental Risk Factors. ClinicalTrials.gov Identifier: NCT02604277.


Subject(s)
Bipolar Disorder , Depressive Disorder , Suicide , Adult , Bipolar Disorder/complications , Bipolar Disorder/epidemiology , Child , Humans , Latent Class Analysis , Suicidal Ideation
17.
Alcohol Clin Exp Res ; 45(1): 38-50, 2021 01.
Article in English | MEDLINE | ID: mdl-33206387

ABSTRACT

BACKGROUND: Knowledge of how drinking motives are differentially associated with alcohol use (e.g., frequency, quantity) and drinking problems is critical in understanding risky drinking and the development of alcohol use disorder. The purpose of this paper was to use meta-analytic techniques to answer 2 overarching questions: (a) Which types of drinking motives (i.e., enhancement, coping, social, conformity) are most strongly associated with alcohol use and drinking problems? and (b) What are the most likely mechanisms (alcohol use or drinking problems) through which motives may be indirectly associated with outcomes? METHOD: A comprehensive literature search identified 229 studies that met inclusion criteria (254 samples; N = 130,705) with a subset containing longitudinal data (k = 5; N = 6283). Data were analyzed using 2-stage meta-analytic structural equation modeling. RESULTS: Results showed that both enhancement and coping motives were the strongest predictors of drinking problems, but only enhancement motives were the strongest predictor of alcohol use. Enhancement and social motives were indirectly associated with alcohol use through drinking problems and with drinking problems through alcohol use, whereas coping motives were only indirectly associated with alcohol use through drinking problems, although the results differed for cross-sectional and longitudinal data. CONCLUSION: Overall, findings from this meta-analysis provide evidence that drinking motives differentially predict alcohol use outcomes through unique direct and indirect pathways.


Subject(s)
Alcohol Drinking/psychology , Alcohol-Related Disorders/etiology , Motivation , Adaptation, Psychological , Alcohol-Related Disorders/psychology , Humans
18.
J Trauma Stress ; 34(3): 675-686, 2021 06.
Article in English | MEDLINE | ID: mdl-33440052

ABSTRACT

Engaging in posttraumatic avoidance behaviors after a traumatic incident is associated with posttraumatic stress disorder (PTSD) outcomes. Given the inherent limitations in the scope of the two-item assessment of posttraumatic avoidance used in commonly administered measures of PTSD symptoms, the 25-item Posttraumatic Avoidance Behaviour Questionnaire (PABQ) was developed to assess a range of avoidance behaviors, including avoidance of visual and sensory reminders, trauma-related thoughts, and agoraphobia, as well as avoidance related to the home, sleep, and social interaction. However, the PABQ's utility is limited by its lack of (a) construct validity and (b) validation in diverse samples. To address these limitations, we examined the psychometric properties of PABQ scores in a sample of trauma-exposed Black women (N = 601, M age = 41 years). Confirmatory factor analyses indicated that the original seven-factor model fit the data well when Item 8 was excluded, χ2 (231, N = 602) = 497.86, RMSEA = .04, 90% CI [.04, .05], CFI = .99, TLI = .989, WRMR = .939, but reliability estimates were variable (i.e., Cronbach's αs = .70-.91). In addition, we found support for convergent validity, clinical validity, and incremental validity. These results provide evidence for the psychometric strengths of the PABQ in minority samples and suggest that it is a valid assessment of posttraumatic avoidance in Black women.


Subject(s)
Avoidance Learning , Stress Disorders, Post-Traumatic , Adult , Factor Analysis, Statistical , Female , Humans , Psychometrics , Reproducibility of Results , Stress Disorders, Post-Traumatic/diagnosis , Surveys and Questionnaires
19.
J Couns Psychol ; 68(1): 27-37, 2021 Jan.
Article in English | MEDLINE | ID: mdl-32271033

ABSTRACT

Additional research is needed on the link between racial discrimination and depressive symptoms over time as well as the risk and resilience moderators that influence this link. One understudied factor that may exacerbate this link is perseverative cognition-chronic activation of stress-related cognitive representations. However, race-specific activism, like Black Lives Matter (BLM) activism, may attenuate this association. Given this, the current study investigated autoregressive and cross-lagged associations between racial discrimination and depressive symptoms across two time points over 6 months. We also tested if perseverative cognition and two domains of Black Lives Matter activism-support and behavior-moderated the cross-lagged associations between racial discrimination and depressive symptoms. Using data from 232 African Americans, findings revealed a significant cross-lagged effect of Time 1 racial discrimination on Time 2 depressive symptoms (but no cross-lagged effect of T1 depressive symptoms on T2 racial discrimination). This cross-lagged effect was moderated by both perseverative cognition and support for BLM activism such that the association between Time 1 racial discrimination was only associated with Time 2 depressive symptoms at lower levels of perseverative cognition and lower levels of BLM support. (PsycInfo Database Record (c) 2021 APA, all rights reserved).


Subject(s)
Black or African American/psychology , Cognition/physiology , Depression/psychology , Mental Health , Racism/psychology , Students/psychology , Black or African American/ethnology , Depression/ethnology , Emotions/physiology , Female , Follow-Up Studies , Humans , Male , Mental Health/ethnology , Mental Health/trends , Racism/ethnology , Racism/trends , Young Adult
20.
J Clin Psychol ; 77(3): 587-606, 2021 03.
Article in English | MEDLINE | ID: mdl-32762085

ABSTRACT

BACKGROUND: The Difficulties in Emotion Regulation Scale (DERS) is commonly used to assess dimensions of emotion dysregulation, including emotion nonacceptance, limited strategies, and difficulty with goal-directed behavior, impulse control, and emotional clarity. Despite considerable work examining the DERS' factor structure, reliability, and validity, there is limited psychometric support for its use with Black women. OBJECTIVES: (1) Examine the factor structure of the DERS; (2) Compare fit of short-form versions; and (3) Assess whether scores differ based on diagnoses. METHOD: Sample consisted of Black women (n = 667) recruited in urban, community hospital setting. RESULTS: The DERS-18 correlated traits model without awareness demonstrated the best fit, χ2 (80) = 261.09, root mean square error of approximation = 0.06 [0.05, 0.07], comparative fit index = 0.99, Tucker Lewis Index = 0.98, weighted root mean square residual = 0.89. Additionally, those with current diagnoses of posttraumatic stress disorder (PTSD) or major depressive disorder (MDD) reported higher dysregulation (vs. lifetime/no diagnoses). Further, women with comorbid PTSD/MDD reported greater dysregulation (vs. single disorder/no diagnoses). CONCLUSIONS: This study provides evidence supporting the model fit, reliability, and validity of the DERS-18 for Black women.


Subject(s)
Black People/psychology , Depressive Disorder, Major/psychology , Emotional Regulation , Psychometrics , Stress Disorders, Post-Traumatic/psychology , Adolescent , Adult , Affective Symptoms/psychology , Aged , Female , Humans , Middle Aged , Reproducibility of Results , Young Adult
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