Temporal Stability of Self-Reported Trauma Exposure on the Life Events Checklist for DSM-5.

The Life Events Checklist for DSM-5 (LEC-5) is a comprehensive screening instrument used to detect exposure to a range of potentially traumatic events. Despite its widespread use, research assessing the psychometric properties of scores on the LEC-5-and trauma exposure more broadly-is scarce. Using a large sample of undergraduate students (N = 1,013), we sought to evaluate the reliability of trauma exposure reporting on the LEC-5 across 8- (N = 379) and 12-week (N = 343) intervals. Reliability estimates were examined for trauma exposure type (e.g., experiencing, witnessing), traumatic event type (e.g., sexual assault), and index trauma (i.e., "worst event") reporting. Reliability was more stable for events that were directly experienced, intraclass correlation coefficients (ICCs) = .62-64, than events that were witnessed, ICCs = .47-.52, or learned about, ICCs = .48-.53. Test-retest agreement was fair to good for reports of sexual assault, physical assault, transportation accidents, natural disasters, and other sexual experiences, κs = .49-.72, but only when individuals directly experienced these events. By contrast, across both assessment intervals, the agreement was attenuated, all κs < .40, for events that individuals witnessed or learned about regardless of event type. For index events, only sexual assault and sudden accidental or violent deaths were consistently reported with a fair or better agreement, κs = .42-.64. These findings suggest that reliable trauma reporting varies largely based on the nature of the traumatic event, yielding important implications for the assessment of DSM-5 Criterion A and posttraumatic stress disorder.

Posttraumatic Stress Disorder Symptom Network Structures: A Comparison Between Men and Women.

This study estimated gender differences in the posttraumatic stress disorder (PTSD) symptom network structure (i.e., the unique associations across symptoms) using network analysis in a Latin American sample. Participants were 1,104 adults, taken from epidemiological studies of mental health following natural disasters and accidents in Mexico and Ecuador. Symptoms of DSM-IV PTSD were measured dichotomously with the Spanish version of the Composite International Diagnostic Interview. We estimated the PTSD symptom network of the full sample and in male and female subsamples as well as indices of centrality, the stability and accuracy of the modeled networks, and communities of nodes within each network. The male and female networks were compared statistically using the Network Comparison Test (NCT). Results indicated strength centrality was the only stable centrality measure, with correlation stability (CS) coefficients of .59, .28, and .44 for the full, male, and female networks, respectively. We found the most central symptoms, measured by strength centrality, were loss of interest and flashbacks for men; and concentration impairment, avoiding thoughts/feelings, and physiological reactivity for women. The NCT revealed that the global structure (M = 0.84), p = .704, and global strength (S = 5.04), p = .556, of the male and female networks did not differ significantly. Although some gender differences in the most central symptoms emerged, thus offering some evidence for gender differences pending replication in larger samples, on the whole, our results suggest that once PTSD develops, the way the symptoms are associated does not differ substantially between men and women.

Factor Structure and Psychometric Properties of the Peritraumatic and Posttraumatic Emotions Questionnaires Among Active Duty Military Personnel With Posttraumatic Stress Disorder.

The Peritraumatic Emotions Questionnaire (Peri-TEQ) and Posttraumatic Emotions Questionnaire (Post-TEQ) are self-report measures of emotions experienced during and after a traumatic event, respectively. The factor structure and psychometric properties of the Peri- and Post-TEQ were investigated among 474 military personnel with posttraumatic stress disorder (PTSD) following deployment. Exploratory factor analysis and confirmatory factor analysis were conducted to test the factor structure of the scales. Internal consistency, composite reliability, convergent validity, and discriminant validity were also assessed. Four factors were identified for the Peri-TEQ (Fear, Humiliation, Anger, and Sadness), and three factors were identified for the Post-TEQ (Fear, Anger-Hurt, and Humiliation). The full scales and all subscales demonstrated adequate-to-good internal consistency, Cronbach's αs = .722-.893. The subscales demonstrated adequate-to-good composite reliability, Cronbach's αs = .763-.861. The Peri- and Post-TEQ demonstrated good convergent validity with measures of PTSD symptoms, rs = .229-.601, ps < .001, and depressive symptoms, rs = .284-.470, ps < .001, and good discriminate validity with measures of resilience, ps = .116-.940, and unit cohesion, Peri-TEQ, p = .304 and Post-TEQ, r = -.123, p = .008. The Humiliation subscales demonstrated good convergent validity with guilt cognitions, rs = .315-.341, ps < .001, and the Anger subscales demonstrated good convergent validity with state anger, rs = .260-.347, ps < .001. The Peri- and Post-TEQ are reliable, valid self-report measures of emotions during and in response to remembering a trauma. The results support the use of these measures in research investigating trauma-related emotions.

Cognitive Emotion Regulation Strategies Associated With the DSM-5 Posttraumatic Stress Disorder Criteria.

Maladaptive cognitive emotion regulation strategies have been proposed to contribute to the maintenance of posttraumatic stress disorder (PTSD). Prior work has focused on the relationship between these strategies and PTSD as a whole, rather than on how they are related to each PTSD symptom cluster. The purpose of the current study was to determine whether cognitive emotion regulation strategies are predictive of certain PTSD symptom clusters under the Diagnostic and Statistical Manual of Mental Disorders 5th ed. (DSM-5; American Psychiatric Association, 2013) criteria (intrusive thoughts, avoidance, negative alterations in cognitions and mood, and hyperarousal). Participants included 365 treatment-seeking, active-duty military personnel with PTSD. The negative alterations in cognitions and mood cluster were associated with dysfunctional cognitions: greater negative cognitions about the self, negative cognitions about the world, and self-blame, as well as catastrophizing (Rc2 = .519). The negative alterations in cognitions and mood cluster did not show a strong relationship with blaming others, possibly due to the complex nature of self- and other-blame in this primarily deployment-related PTSD sample. Finally, the intrusive thoughts cluster was associated with catastrophizing (Rc2 = .211), suggesting an association between frequent intrusive memories and excessively negative interpretation of those memories.

Resting respiratory sinus arrhythmia and posttraumatic stress disorder: A meta-analysis.

Respiratory sinus arrhythmia (RSA) has been examined as a psychophysiological marker of stress vulnerability. Research indicates that low resting RSA is associated with physical and mental health problems, including posttraumatic stress disorder (PTSD). Some research suggests that people diagnosed with PTSD have lower RSA than people without PTSD, but findings have been mixed and the overall magnitude of this effect is unknown, indicating the need for a comprehensive meta-analysis. This meta-analysis examined the association between PTSD and baseline RSA in 55 studies, including 12 unpublished studies, with a total sample size of 6689. Studies were included if they used a PTSD measure, a baseline measure of RSA, and involved humans. Studies were excluded if they were not available in English, did not present quantitative data, presented duplicate data, were a case series, or did not provide results required for computing an effect size. The meta-analysis indicated there is a small but significant association between PTSD and RSA (g = -0.26; 95% CI = -0.35, -0.16) with moderate heterogeneity. Moderator analyses suggested that effects are larger for adults than for children and for DSM-5 PTSD measures than for non-DSM referenced measures. We found some evidence for publication bias among the meta-analysis findings. Overall, there is a small but reliable association between PTSD and lower resting RSA, providing support for further research examining the complex relationship between parasympathetic activity and PTSD.

Examination of posttraumatic stress disorder symptom networks using clinician-rated and patient-rated data.

Network theory, which conceptualizes psychiatric disorders as networks of interacting symptoms, may provide a useful framework for understanding psychopathology. However, questions have arisen regarding the stability and generalizability of network analytic methods, with some researchers arguing that symptom networks have limited replicability. The aim of this study was to evaluate assessment modality as one possible source of instability in the estimation of posttraumatic stress disorder (PTSD) symptom networks. We estimated two cross-sectional DSM-5 PTSD symptom networks in 378 U.S. veterans: one using data from a clinician-rated assessment instrument (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and one using data from a self-rated questionnaire (the PTSD Checklist for DSM-5; PCL-5). We calculated centrality indices, conducted community structure analyses, and compared the strength and structure of the networks. The CAPS-5 and PCL-5 symptom networks were highly similar, challenging the notion that network methods produce unreliable results due to estimations consisting primarily of measurement error. Furthermore, each network contained distinct symptom communities that only partially overlapped with the DSM-5 PTSD symptom clusters. These findings may provide guidance for future revisions of the DSM, suggest hypotheses about how PTSD symptoms interact, and inform recent debate about replicability of psychopathology symptom networks. (PsycINFO Database Record

Psychiatric Symptoms and Barriers to Care in HIV-Infected Individuals Who Are Lost to Care.

Past studies of barriers to HIV care have not comprehensively assessed psychiatric symptoms, and few have assessed barriers to care among people living with HIV (PLWH) who are lost to care (LTC). We examined psychiatric symptoms, barriers to HIV care, and immune functioning in PLWH who were retained in care (RIC; n = 21) or LTC (n = 21). Participants completed diagnostic interviews for posttraumatic stress disorder (PTSD) and other psychiatric disorders, self-report measures of HIV risk behaviors and psychiatric symptoms, and a blood draw to assess viral load. Compared to RIC participants, LTC participants met criteria for a greater number of psychiatric disorders and reported greater depressive symptoms and more barriers to HIV care. There were no group differences in PTSD severity, risk behaviors, or viral load, suggesting that LTC individuals experience greater psychiatric problems and perceive more barriers to care than RIC participants, but are not less likely to have achieved viral suppression.