Systematic Review of Dispositional Mindfulness and Posttraumatic Stress Disorder Symptomology: A Targeted Examination of Avoidance.

High rates of nonresponse to evidence-based treatment for posttraumatic stress disorder (PTSD) have fueled the search for improved intervention. Evidence suggests that improvements in dispositional mindfulness (i.e., tendency to attend to the present with nonjudgment and nonreactivity) may help reduce PTSD symptoms. While some research suggests that transdiagnostic mindfulness-based interventions particularly target avoidance symptoms, the association between dispositional mindfulness and avoidance has yet to be systematically examined. To address this gap, we examined peer-reviewed studies that reported quantitative associations between avoidance and dispositional mindfulness among trauma-exposed adults, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2009 guidelines. Sixteen studies were identified for final review from PsycINFO and PubMed databases. Results suggest that mindfulness has a weak relationship with effortful avoidance. This weak relationship may be obscured in studies where effortful avoidance is measured among other symptoms (e.g., anhedonia). Mindfulness appeared to have stronger associations with symptoms of hyperarousal and negative alterations in cognition and mood. An important clinical implication is that high effortful avoidance may manifest among patients who report strong mindfulness skills. It may be helpful for clinicians to carefully assess how mindfulness is being used to cope.

Posttraumatic Stress Disorder Symptoms, Intimate Partner Violence, and Relationship Functioning: A Meta-Analytic Review.

This meta-analysis was the first study of which we are aware to investigate the association between Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) PTSD symptom clusters and parent, child, family, and marital/partner functioning problems (e.g., intimate partner violence [IPV] and intimacy). Of the 23 studies that met inclusion criteria, the sample was predominantly male (83.8%), Caucasian (65.0%), and from the military (98.9%). The average age was 43.65 years old (SD = 6.27); the average sample size was 397.4 (SD = 416.9; total N = 9,935). PTSD symptom clusters were assessed primarily by self-report (87.0%), with 8.7% using a rating by a clinician. We used fixed analysis following Fisher's r to z transformation and an unbiased weighing and summing of effect sizes within samples and across studies. We found a small association between hyperarousal and IPV (z = .20). We also found two moderate associations for the emotional numbing and avoidance symptom clusters: (a) with parent, child, and family functioning (z = .32, z = .28, respectively); and (b) with intimacy problems (z = .35, z = .42, respectively). We found two large associations for emotional numbing: marital and parent problems (z = .47) and parent, child, and family functioning problems (z = .32, respectively). Our findings suggested that treatments aim to lessen the effect on those who have close relationships with the individual with PTSD.

Racial Differences in the Transactional Relationship Between Depression and Alcohol Use From Elementary School to Middle School.

OBJECTIVE: The aim of this investigation was to test hypothesized reverse prospective relationships between alcohol consumption and depressive symptomatology as a function of race among youth. METHOD: In a two-wave prospective study, 328 European American, 328 African American, and 144 Hispanic American youth were studied at the end of fifth grade (last year of elementary school) and the end of sixth grade (first year of middle school). RESULTS: A positive correlation was observed between alcohol consumption and depressive symptoms among all youth. However, the predictive relationship differed based on race. For European American and Hispanic American youth, depressive symptom levels at the end of elementary school predicted alcohol consumption at the end of the first year of middle school, but the converse relationship was not observed. For African American youth, the opposite pattern was found. Alcohol consumption at the end of elementary school predicted depressive symptom levels at the end of the first year of middle school, and the converse relationship was not observed. CONCLUSIONS: These findings suggest the possibility that etiological relationships between depression and alcohol use vary by race, thus highlighting the importance of considering race when studying the risk process.

Anger, hostility, internalizing negative emotions, and intimate partner violence perpetration: A meta-analytic review.

Prior reviews have identified elevated trait anger as a risk factor for intimate partner violence (IPV) perpetration. Given that 10 years have passed since the last comprehensive review of this literature, we provide an updated meta-analytic review examining associations among anger, hostility, internalizing negative emotions, and IPV for male and female perpetrators. One hundred and five effect sizes from 64 independent samples (61 studies) were included for analysis. IPV perpetration was moderately associated with the constructs of anger, hostility, and internalizing negative emotions. This association appeared stronger for those who perpetrated moderate to severe IPV compared to those who perpetrated low to moderate IPV, and did not vary across perpetrator sex, measurement method, relationship type, or perpetrator population. Implications and limitations of findings were reviewed in the context of theoretical models of IPV, and future directions for empirical and clinical endeavors were proposed.

Psychopathy and the prediction of alcohol-related physical aggression: the roles of impulsive antisociality and fearless dominance.

BACKGROUND: It is well established that individual difference factors modulate aggression under the acute effects of alcohol. In this investigation, we tested the hypothesis that one core dimension of psychopathy, Impulsive Antisociality, would modulate intoxicated aggression, whereas another dimension, Fearless Dominance, would not. METHODS: Participants were 516 young social drinkers (253 men and 263 women). Psychopathy was measured using the Psychopathic Personality Inventory (PPI; Lilienfeld and Andrews, 1996). Following the consumption of either an alcohol or a placebo beverage, aggression was measured with a task in which participants administered and received electric shocks to/from a fictitious opponent under the guise of a competitive reaction-time task. RESULTS: Hierarchical regression analyses supported our hypothesis: Impulsive Antisociality predicted aggression under alcohol, whereas Fearless Dominance did not. CONCLUSIONS: Persons who tend to endorse antisocial and impulsive externalizing behaviors appear to be at greater risk for aggression under the acute influence of alcohol.

Recent advances in understanding the personality underpinnings of impulsive behavior and their role in risk for addictive behaviors.

Impulsivity has been a widely explored construct, particularly as a personality-based risk factor for addictive behaviors. The authors review evidence that (a) there is no single impulsivity trait; rather, there are at least five different personality traits that dispose individuals to rash or impulsive action; (b) the five traits predict different behaviors longitudinally; for example, the emotion-based urgency traits predict problematic involvement in several risky behaviors and sensation seeking instead predicts the frequency of engaging in such behaviors; (c) the traits can be measured in preadolescent children; (d) individual differences in the traits among preadolescent children predict the subsequent onset of, and increases in, risky behaviors including alcohol use; (e) the traits may operate by biasing the learning process, such that high-risk traits make high-risk learning more likely, thus leading to maladaptive behavior; (f) the emotion-based urgency traits may contribute to compulsive engagement in addictive behaviors; and (g) there is evidence that different interventions are appropriate for the different trait structures.