The role of avoidance in modulating single prolonged stress effects on emotional memory in male and female rats.

The incidence of post traumatic stress disorder (PTSD) is greater in women than men, but mechanisms via which this difference manifests remain under explored. The single prolonged stress (SPS) rodent model of traumatic stress has been used to identify mechanisms through which traumatic stress leads to deficits in retaining extinction (a core PTSD symptom), but has been mostly utilized in male model systems. Recent studies have observed that SPS leads to changes in persistent fear memory in female rats, though these results are variable. This variability could be driven by changes in behavioral strategy in females during extinction, but this possibility has not been sufficiently explored. To address this, we examined the impact of SPS on freezing and avoidance (a core PTSD symptom) during extinction in male and female rats. In male rats, SPS enhanced acquisition of conditioned freezing, but did not enhance freezing during extinction training or testing. SPS also decreased avoidance during extinction training, but not extinction testing. In female rats, SPS had no impact on conditioned freezing. Avoidance was not observed in control rats, but emerged in SPS/female rats during extinction testing. Furthermore, avoidance was negatively correlated with freezing in female rats (high avoidance associated with lower freezing), but this relationship was disrupted with SPS. The results suggest that introducing avoidance during extinction negates SPS effects on extinction retention in male and female rats, control/female rats engage in avoidance to regulate fear expression, and this relationship is disrupted with SPS.

Distinguishing clinical and simulated dissociative identity disorder using the Miller Forensic Assessment of Symptoms Test.

BACKGROUND: Individuals with dissociative identity disorder (DID) experience severe and broad-ranging symptoms which can be associated with elevations on measures designed to detect feigning and/or malingering. Research is needed to determine how to distinguish genuine DID from simulated DID on assessment measures and validity scales. OBJECTIVE: This study examined whether the Miller Forensic Assessment of Symptoms Test (M-FAST), a screening measure of malingering, could differentiate between individuals with DID and DID simulators. METHOD: Thirty-five individuals with clinical, validated DID were compared to 88 individuals attempting to simulate DID on the M-FAST. A MANCOVA compared the two groups on total M-FAST score and subscales. Univariate ANCOVA's examined differences between the groups. A series of logistic regressions were conducted to determine whether group status predicted the classification of malingering. Utility statistics evaluated how well the M-FAST discerned clinical and simulated DID. RESULTS: The M-FAST correctly classified 82.9% of individuals with DID as not malingering when using the suggested cut-off score of six. However, utilizing a cut-off score of seven correctly classified 93.6% of all participants and maintained adequate sensitivity (.96) but demonstrated increased specificity (.89). CONCLUSIONS: The M-FAST shows promise in distinguishing genuine DID when the cut-off score is increased to seven. This study adds to the growing body of literature identifying tests that can adequately distinguish clinical from simulated DID. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Prospective mental health effects of intimate partner stalking among women veterans.

OBJECTIVE: Women veterans are disproportionately affected by intimate partner violence (IPV). Within the civilian literature, intimate partner stalking (IPS) is a common, uniquely deleterious form of IPV; the present study seeks to prospectively examine the psychological effects of IPS among women veterans. METHOD: Women veterans (n = 266) were recruited using the KnowledgePanel, a probability-based survey panel; participants completed surveys at time 1 (T1) and at time 2 (T2) follow-up 18 months later. Women responded to questionnaires assessing IPV and IPS experiences, and symptoms of posttraumatic stress disorder (PTSD), depression, and anxiety. RESULTS: At T1, 54.5% of women reported lifetime IPV, of whom 64.1% reported IPS; at T2, 49.2% reported past-year IPV, of whom 7.6% experienced past-year IPS. Bivariately, women in the T1 IPS group reported higher T2 PTSD, depression, and anxiety symptoms than the T1 IPV only and no IPV groups. In a multivariate model, there remained indirect effects of T1 IPS on T2 PTSD symptoms, when other forms of violence (i.e., T1 and T2 IPV, MST, IPS) were controlled. CONCLUSIONS: When added to models including other forms of IPV, women who experienced IPS reported increased risk for PTSD symptoms, which predicted heightened PTSD symptoms over time. Providers treating women veterans should assess for experiences of IPS as an additional form of IPV and address PTSD to prevent the development of subsequent comorbid psychopathology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The utility of the Structured Inventory of Malingered Symptomatology for distinguishing individuals with Dissociative Identity Disorder (DID) from DID simulators and healthy controls.

Background: Individuals with dissociative identity disorder (DID) have complex symptoms consistent with severe traumatic reactions. Clinicians and forensic assessors are challenged by distinguishing symptom exaggeration and feigning from genuine symptoms among these individuals. This task may be aided by administering validity measures. Objective: This study aimed to document how individuals with DID score on the Structured Inventory of Malingered Symptomatology (SIMS). The second objective was to compare coached DID simulators and healthy controls to DID patients on the SIMS's total score and subscales. The third objective was to examine the utility rates of the SIMS in distinguishing simulated DID from clinically diagnosed DID. Method: We compared SIMS data gathered from participants from two Dutch sites, one Swiss site and one U.S. site. Sixty-three DID patients were compared to 77 coached DID simulators and 64 healthy controls on the SIMS. A multivariate analysis compared the groups on the SIMS total scores and subscales, and post-hoc Games Howell tests and univariate ANOVAs examined differences between the groups. Utility statistics assessed the accuracy of the SIMS in distinguishing clinical from simulated DID. Results: DID simulators scored significantly higher than DID individuals and healthy controls on every SIMS subscale as well as the total score. The majority (85.7%) of the individuals with DID scored above the cut-off, which is typically interpreted as indicative of possible symptom exaggeration. DID individuals scored higher than the healthy controls on every subscale except Low Intelligence, even after controlling for dissociation. The subscales and items most frequently endorsed by the DID group are consistent with symptoms associated with complex trauma exposure and dissociative reactions. The SIMS total score had a sensitivity of 96% but an unacceptably low specificity of 14%. Conclusions: The findings indicate that the instrument is not accurate in assessing potential symptom exaggeration or feigning in DID.

Antecedentes: Los individuos con trastorno de identidad disociativo (TID) tienen síntomas complejos consistentes con reacciones traumáticas severas. Los clínicos y evaluadores forenses se enfrentan al reto de distinguir la exageración de los síntomas y la simulación de los síntomas genuinos entre estos individuos. Esta tarea puede verse facilitada por la administración de medidas de validez.Objetivo: Este estudio tuvo como objetivo documentar la puntuación de los individuos con TID en el Inventario Estructurado de Sintomatología Simulada (SIMS). El segundo objetivo era comparar los simuladores de TID entrenados y los controles sanos con los pacientes de TID en la puntuación total y las subescalas del SIMS. El tercer objetivo fue examinar los índices de utilidad del SIMS para distinguir el TID simulado del TID diagnosticado clínicamente.Método: Se compararon los datos de la SIMS obtenidos de participantes de dos centros holandeses, un centro suizo y un centro estadounidense. Se compararon 63 pacientes de TID con 77 simuladores de TID entrenados y 64 controles sanos en el SIMS. Un análisis multivariante comparó los grupos en las puntuaciones totales y subescalas de la SIMS, y las pruebas post-hoc de Games Howell y los ANOVAs univariantes examinaron las diferencias entre los grupos. Las estadísticas de utilidad evaluaron la precisión de la SIMS para distinguir el TID clínico del simulado.Resultados: Los simuladores de TID obtuvieron puntuaciones significativamente más altas que los individuos con TID y los controles sanos en cada subescala del SIMS, así como en la puntuación total. La mayoría (85,7%) de los individuos con TID puntuaron por encima del punto de corte, que suele interpretarse como indicativo de una posible exageración de los síntomas. Los individuos con TID puntuaron más alto que los controles sanos en todas las subescalas excepto en Inteligencia baja, incluso después de controlar la disociación. Las subescalas y los ítems más frecuentemente respaldados por el grupo de TID son consistentes con los síntomas asociados con la exposición al trauma complejo y las reacciones disociativas. La puntuación total del SIMS tuvo una sensibilidad del 96% pero una especificidad inaceptablemente baja del 14%.Conclusiones: Los resultados indican que el instrumento no es preciso para evaluar la potencial exageración o simulación de los síntomas en el TID.