Automated Classification of Dyadic Conversation Scenarios using Autonomic Nervous System Responses.

Two people's physiological responses become more similar as those people talk or cooperate, a phenomenon called physiological synchrony. The degree of synchrony correlates with conversation engagement and cooperation quality, and could thus be used to characterize interpersonal interaction. In this study, we used a combination of physiological synchrony metrics and pattern recognition algorithms to automatically classify four different dyadic conversation scenarios: two-sided positive conversation, two-sided negative conversation, and two one-sided scenarios. Heart rate, skin conductance, respiration and peripheral skin temperature were measured from 16 dyads in all four scenarios, and individual as well as synchrony features were extracted from them. A two-stage classifier based on stepwise feature selection and linear discriminant analysis achieved a four-class classification accuracy of 75.0% in leave-dyad-out crossvalidation. Removing synchrony features reduced accuracy to 65.6%, indicating that synchrony is informative. In the future, such classification algorithms may be used to, e.g., provide real-time feedback about conversation mood to participants, with applications in areas such as mental health counseling and education. The approach may also generalize to group scenarios and adjacent areas such as cooperation and competition.

The folk psychiatry model: Developing a measure of lay perceptions of PTSD.

Whereas existing data verify the importance of support networks in facilitating resilience following trauma, the sociocultural perceptions of posttrauma difficulties that provide context for these interactions remain largely unexplored. Folk psychiatry models propose that lay explanations of mental illness can be quantified along distinct moralizing, medicalizing, and psychologizing dimensions. The current project aimed to develop a trauma-specific measure capturing lay explanations of posttraumatic stress disorder (PTSD) based on this framework. Data were collected from three samples of Mechanical Turk respondents (N1 = 367; N2 = 365; N3 = 401) as well as an independent sample of university students (N4 = 311). Factor analysis of the final, 13-item Folk Psychiatry Measure-PTSD (FPM-P) indicated close fit of a correlated three-factor model in MTurk and student respondents. Across samples, moralizing beliefs about PTSD (e.g., people with PTSD lack a moral compass) evidenced moderate-to-strong correlations with general attitudes toward those with mental illness, including positive associations with authoritarianism, social restrictiveness, blame, anger, and perceived dangerousness. Negative associations with benevolence and support for community-based care were also noted. Medicalizing beliefs (e.g., PTSD is caused by a chemical imbalance) demonstrated more modest associations with negative attitudes, as noted through weak correlations with increased authoritarianism, anger, and lower benevolence toward those experiencing psychological difficulties. Finally, psychologizing explanations (e.g., people with poor relationships and low social support are at greater risk of developing PTSD) evidenced weak but positive associations with benevolence and pity for those with mental health concerns. Implications and cultural-based nuances of the scale are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Trauma cognitions as intervening variables in the relation of chronic child abuse and thwarted interpersonal needs.

OBJECTIVE: Chronic childhood trauma is consistently linked to negative mental health outcomes in adulthood, but research exploring specific paths of risk remains limited. The aims of the current study were to examine trauma cognitions as intervening variables in the relation of chronic victimization with perceived burdensomeness and thwarted belongingness, variables implicated in transdiagnostic risk for psychopathology. METHOD: Semistructured interviews were used to identify university students reporting exposure to systematic physical and/or sexual violence prior to age 18 (n = 101) versus those experiencing other Criterion-A events (n = 254). Trauma cognitions (self, world, and self-blame) and thwarted interpersonal needs (burdensomeness and thwarted belongingness) were measured using scores from the posttrauma cognitions inventory (PTCI) and the Interpersonal Needs Questionnaire-10 (INQ-10). Path models in these cross-sectional data were evaluated to assess the indirect effects of chronic abuse on burdensomeness and thwarted belongingness through self, world, and blame cognitions. RESULTS: An initial model indicated associations of chronic victimization on self (p = .044) and world (p = .005) scales of the PTCI and a unique effect of self-beliefs on INQ-10 burdensomeness (p < .001). An indirect effect of abuse on burdensomeness through self-beliefs was supported (p = .050). A second model identified direct effects of PTCI self (p < .001) and world (p < .001) scores on thwarted belongingness as well as an indirect effect of chronic abuse on belongingness through world beliefs (p = .026). CONCLUSIONS: While typically assessed within the context of posttraumatic stress disorder, results suggest that shifts in fundamental beliefs about the self and the world may have more general impacts on perceptions of burdensomeness and belonging in survivors of early, systematic abuse. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Development and Validation of the Disclosure Expectancy Scale.

Although the disclosure of traumatic experiences is believed to influence trajectories of post-trauma recovery, less is known about individual differences that affect survivors' motivation to share. The current project describes the development and evaluation of the Disclosure Expectancy Scale (DExS), a novel instrument intended to assess survivors' expectations about the potential risks and benefits of disclosure. Items targeting both positive and negative expectancies were generated based on existing research and the authors' clinical experience with various survivor populations. Preliminary analyses in trauma-exposed undergraduates (N = 359) offer support for hypothesized positive and negative expectancy dimensions with evidence for the convergent and discriminant validity of scores. Subsequent evaluation in active-duty, help-seeking military personnel (N = 35) provides further evidence of validity based on correlations with relevant clinical measures. A final regression demonstrating unique effects of initial disclosure expectancies on post-traumatic stress disorder (PTSD) severity following trauma-focused treatment highlights the predictive validity of DExS scores.

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).

Trauma and aggression: Evaluating the influence of primed hostility and survivor sex.

OBJECTIVES: The relation between posttrauma symptoms and aggression is an area of growing interest in the larger clinical literature. The current project looked to examine the impact of primed hostility on aggressive responding in men and women with and without a history of prior trauma. DESIGN: Experimental aggression paradigm assessed in a 2 (Group) × 2 (Sex) × 2 (Prime) mixed factorial ANOVA. METHODS: Trauma-naïve participants (N = 52) and survivors reporting active symptoms (N = 43) were exposed to hostile and neutral lexical primes in what was presented as a reaction time task played against an unseen 'opponent'. In actuality, 'wins' and 'losses' during the task were assigned by an automated system. The intensity of an aversive sound blast delivered by participants to the supposed opponent in trials the participant 'won' served as an index of behavioural aggression. RESULTS: Repeated-measures ANOVA identified a between-by-within interaction of exposure group and lexical prime (p = .010; η p 2  = .070), with trauma-exposed participants (p = .002, Δ = .30), but not controls (p = .159, Δ = .11), demonstrating elevations in aggression subsequent to hostile priming. A sex by prime interaction (p = .001; η p 2  = .117) similarly indicated elevated aggression following hostile priming in men (p = .007, Δ = .58) as compared to women (p = .062, Δ = .10). CONCLUSIONS: Results offer preliminary support for the association of situationally primed hostility and biological sex with aggressive responding in survivors reporting active symptoms.

The effects of blood in self-injurious cutting: Positive and negative affect regulation.

OBJECTIVE: Seeing one's own blood may be a factor in affect regulation in nonsuicidal self-injury (NSSI). This study examined changes in a negative (NA) and positive affect (PA) in response to a finger prick eliciting a small drop of participants' blood. METHODS: Two groups (NSSI; N = 56 and Control; N = 70) of undergraduate students were randomly assigned to receive a finger prick and look at blood, receive a finger prick and not look at blood, or receive a sham finger prick. Following a mood induction, participants completed the PANAS three times: Time 1 (pre mood-induction, baseline), Time 2 (post-mood induction), and Time 3 (post-finger prick condition), and a Pain Severity Scale. RESULTS: A significant three-way interaction revealed that the NSSI: Blood Group had an increased positive effect between Time 2 and Time 3. CONCLUSION: Blood serves an important function in NSSI and requires additional research to fully understand the relationship.

Public beliefs about trauma and its consequences: Profiles and correlates of stigma.

Public stereotypes about trauma exposure and its likely consequences have the potential to influence levels of support extended to survivors in the larger community. The current project sought to examine unique profiles of stereotype endorsement both within and across participants sampled from distinct populations. Trauma-related stereotypes involving symptom course, dangerousness, employability, social functioning, predictability, character, and treatment need were examined in undergraduate (N 1 = 404; N 2 = 502) and MTurk (N 3 = 364) samples. Sympathizing [low overall endorsement], Fearful [high overall endorsement], Pejorative [high endorsement + moralizing beliefs], Safety-Focused [intermediate endorsement + dangerousness], and Performance-Focused [intermediate endorsement + employability] groups were replicated in latent profile models across all samples. Stereotype profiles demonstrated hypothesized associations with general perspectives of mental illness although support for consistent relations with respondent characteristics (e.g., sex; personal exposure to trauma; reported exposure in friends/family) was limited. Data suggest that trauma stereotypes are endorsed at high frequencies in the general community and conform to systematic patterns of prejudice that may be overlooked in more global assessments of stigma.

Automatic Estimation of Interpersonal Engagement During Naturalistic Conversation Using Dyadic Physiological Measurements.

Physiological responses of two interacting individuals contain a wealth of information about the dyad: for example, the degree of engagement or trust. However, nearly all studies on dyadic physiological responses have targeted group-level analysis: e.g., correlating physiology and engagement in a large sample. Conversely, this paper presents a study where physiological measurements are combined with machine learning algorithms to dynamically estimate the engagement of individual dyads. Sixteen dyads completed 15-min naturalistic conversations and self-reported their engagement on a visual analog scale every 60 s. Four physiological signals (electrocardiography, skin conductance, respiration, skin temperature) were recorded, and both individual physiological features (e.g., each participant's heart rate) and synchrony features (indicating degree of physiological similarity between two participants) were extracted. Multiple regression algorithms were used to estimate self-reported engagement based on physiological features using either leave-interval-out crossvalidation (training on 14 60-s intervals from a dyad and testing on the 15th interval from the same dyad) or leave-dyad-out crossvalidation (training on 15 dyads and testing on the 16th). In leave-interval-out crossvalidation, the regression algorithms achieved accuracy similar to a 'baseline' estimator that simply took the median engagement of the other 14 intervals. In leave-dyad-out crossvalidation, machine learning achieved a slightly higher accuracy than the baseline estimator and higher accuracy than an independent human observer. Secondary analyses showed that removing synchrony features and personality characteristics from the input dataset negatively impacted estimation accuracy and that engagement estimation error was correlated with personality traits. Results demonstrate the feasibility of dynamically estimating interpersonal engagement during naturalistic conversation using physiological measurements, which has potential applications in both conversation monitoring and conversation enhancement. However, as many of our estimation errors are difficult to contextualize, further work is needed to determine acceptable estimation accuracies.

Interpersonal Functioning and Trauma: The Role of Empathy in Moderating the Association of PTSD and Interpersonal Functioning.

Research demonstrates consistent associations between symptoms of posttraumatic stress disorder (PTSD) and reductions in interpersonal functioning. Moderators of this association, however, remain relatively unexplored. The current study aimed to examine the extent to which aspects of empathic responding may influence the relation between PTSD symptom dimensions and interpersonal functioning in students exposed to significant trauma. Participants (N = 94, 85.1% female, 86.2% White/Non-Hispanic) completed an initial screening to assess for trauma exposure and associated symptoms of PTSD. Interpersonal functioning and dimensions of empathic responding were measured using a series of self-report and lab-based tasks. Hierarchical regression models provided evidence for a consistent association between post-trauma arousal-reactivity and reductions in interpersonal functioning. Results also indicated a moderating effect of affective empathy (ß = -.37, p = .010, f2 = .086). Simple slopes and Johnson-Neyman plots identified an association between arousal-reactivity and functioning at low (ß = 1.57, p < .001, f2 = .301) versus high (ß = .31, p = .417, f2 = .008) levels of empathic response to a positively valenced film. Results offer preliminary support for a potential buffering effect of affective empathy on interpersonal functioning in individuals reporting chronic, trauma-related symptoms.

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.

Problematic driving in former service members: An evaluation of the Driving Behavior Survey in veterans with posttraumatic stress disorder.

Despite high levels of traffic-related mortality, injury, and impairment among former service members, measures validated to assess problematic driving in this population remain limited. The current study examined characteristics of the Driving Behavior Survey (DBS) in male veterans (76.3% White; age: M = 56.4, SD = 12.3) meeting criteria for PTSD. Confirmatory factor analyses indicated acceptable fit of a 3-factor model specifying dimensions of anxiety-based performance deficits, exaggerated safety/caution, and hostile/aggressive driving behavior. Concurrent associations with indices of anxiety, depression, trauma history, and clinician-rated PTSD were consistent with small (r = .10-.29) to medium (r = .30-.49) effects. Discriminative validity was noted through elevations in performance deficit (d = .26), safety/caution (d = .50), and hostile/aggressive (d = .39) scales relative to published data from student drivers. Scores comparable to civilian motorists with accident-related PTSD help to qualify the severity of problematic driving behavior in trauma-exposed veterans.

A Brief Measure of Interpersonal Interaction for 2-Player Serious Games: Questionnaire Validation.

BACKGROUND: Competitive and cooperative serious games have become increasingly popular in areas such as rehabilitation and education and have several potential advantages over single-player games. However, they are not suitable for everyone, and the user experience in competitive and cooperative serious games depends on many factors. One important factor is the verbal interaction between players, but the effect of this factor has not been extensively studied because of the lack of a validated measurement tool. OBJECTIVE: This paper aimed to validate a brief questionnaire that measures the verbal interaction between 2 players of a serious game. The questionnaire consists of 8 questions pertaining to the amount of conversation, its valence (positive or negative emotion), and its game relatedness. METHODS: The questionnaire was validated with 30 pairs of participants who played a competitive serious game for 10 min while being recorded with cameras. The questionnaire was filled out by both participants, an in-person observer, and 2 members of our research group who watched the videos. Results from these raters were used to develop questionnaire instructions, and the finalized questionnaire was given to 2 additional raters who were trained on 5 videos and then rated the other 25 videos independently. RESULTS: The questionnaire's interrater reliability is excellent for the amount of conversation and its game relatedness (intraclass correlation coefficients [ICCs] above 0.9). Interrater reliability is fair to good for conversation valence (ICCs between 0.4 and 0.7). We believe that the lower interrater reliability for valence is primarily because of a limited spread of valence values in our sample. Furthermore, questionnaire ratings were significantly correlated with players' personality characteristics (eg, amount of conversation was correlated with extraversion) and pressure/tension experienced in the competitive game. CONCLUSIONS: The validated questionnaire has the potential to be a useful tool for studying user experience in competitive and cooperative serious games. Furthermore, it could be adapted for other applications such as entertainment games. However, it has only been validated with unimpaired university students in a 2-player competitive serious game and should next be validated with different target populations (eg, stroke survivors) and different game designs (eg, cooperative games).

Interpersonal needs and suicide risk: The moderating roles of sex and brooding.

OBJECTIVES: This paper tested two moderators, brooding and participant sex, on the respective relations between thwarted belongingness (TB), perceived burdensomeness (PB), and suicide risk. METHOD: Using a cross-sectional design in a sample of undergraduates (N = 278), two hierarchical regression models examining the three-way interaction between brooding, sex, and either TB or PB on suicide risk were conducted. RESULTS: A significant two-way interaction of brooding and TB was detected, but no moderating effect of sex was observed. There was a significant three-way interaction of brooding, sex, and PB on suicide risk. CONCLUSIONS: High levels of TB and brooding produce increased suicide risk across sexes. The relation between PB and suicide risk is dependent on brooding for females but not males.

Behavioral inhibition and posttrauma symptomatology: Moderating effects of safety behaviors and biological sex.

OBJECTIVES: Behavioral inhibition is a trait-level factor associated with posttraumatic stress. Safety behaviors may impact this link by interfering with anxiety habituation. The current study examined the unique and interactive effects of behavioral inhibition, safety behaviors, and participant sex on posttrauma symptom clusters. METHOD: Participants (N = 131; 75.6% female; M = 19.9 years) completed a trauma history interview and questionnaires assessing behavioral inhibition, safety behavior, and posttrauma symptom severity. RESULTS: Safety behaviors were associated with intrusion (partial correlations [pr] = 0.319), avoidance (pr = 0.274), cognition-mood (pr = 0.274), and arousal-reactivity (pr = 0.538) symptoms (all p ≤ 0.001). An interaction of sex and safety behaviors was noted for avoidance (p = 0.047, pr = -0.159) with a significant relation observed only among women ( p < 0.001, pr = 0.442). Safety behaviors also moderated the link between behavioral inhibition and arousal-reactivity (p = 0.002, pr = 0.272) with inhibition predicting symptoms at high levels of safety behavior (p = 0.024, pr = 0.171). CONCLUSION: Trauma-related safety behaviors are associated with greater posttrauma symptoms and evidence differential effects across individual symptom domains.

PTSD and anger: Evaluation of an indirect effect model in a civilian trauma sample.

BACKGROUND AND OBJECTIVES: Theoretical models propose that PTSD symptoms and subjective anger are indirectly associated through hostile attribution bias, physiological reactivity, and aggressive psycho-motor scripts (Chemtob, Novaco, Hamada, Gross, & Smith, 1997). Originally developed to account for symptoms observed in military personnel, proposed anger mechanisms have received limited attention in civilian populations. The current study looked to evaluate the generalizability of Chemtob et al.'s model in trauma-exposed university students (N = 152). METHODS: Trauma exposure and corresponding symptoms were assessed during an initial screening procedure. Hostile attributions and aggressive scripts were examined prior to a laboratory-based anger induction procedure. Physiological reactivity was monitored throughout the provocation task. Ratings of subjective anger and anger recovery were completed following the induction period. Relations of post-trauma symptoms with subjective anger through hypothesized anger processes were examined using bootstrapped estimates of indirect effects. RESULTS: A significant indirect effect of PTSD severity on state-level anger was noted for hostile attribution bias (ab = 0.020, 95% CI [0.002, 0.041]) and a marginal effect through aggressive inclinations (ab = 0.015, 95% CI [-0.001, 0.039]). Data failed to provide evidence for physiological reactivity as an intervening variable. Trauma symptoms did not moderate anger recovery following the provocation task. LIMITATIONS: Induction of anger in a sub-clinical sample may limit tests of hypothesized effects and the generalizability of the present findings. CONCLUSIONS: Results indicate the proposed model may be applicable beyond combat trauma samples and suggest potential anger-related targets for PTSD treatment.

Development and Evaluation of the Perpetration-Induced Distress Scale for Measuring Shame and Guilt in Civilian Populations.

Although the topic of moral injury (MI) has been garnering increasing attention in recent years within military populations, research has rarely applied the concept to civilian contexts. Extant literature on distinct acts of perpetration or transgressions suggests similar emotional, cognitive, and behavioral patterns of distress associated with appraisals of wrongdoing. However, the absence of a psychometrically sound measure to detect and quantify pathological levels of distress associated with perpetrating harm against others has hindered additional research from being conducted on the topic. The current research presents the Perpetration-Induced Distress Scale (PIDS) as a valid and reliable measurement of distress associated with MI within civilian contexts. Factor analytic techniques revealed a two-factor solution characterized by perpetration-induced distress related to maladaptive reactions to shame (seven items) and guilt/self-blame (seven items). The PIDS demonstrated favorable temporal stability over a 1-week period as well as excellent internal reliability. Further, the PIDS evidenced convergent validity with functional impairment, posttraumatic stress disorder, and existing scales of shame and guilt; associations were large (rs = 0.62-0.87). The development of the PIDS represents one of the first studies to measure MI within a civilian population and indicates evidence that additional research on the topic is warranted.

Stability of reported trauma over extended intervals: Initial evaluation of an exposure screening protocol.

The reliability and validity of reported exposure to significant trauma is critical to research evaluating outcomes following serious and distressing life events. The current study examined the reliability of reported exposure to disaster, fire, transportation accidents, physical assault, and sexual assault across 5- (N = 251), 12- (N = 223), and 24-month (N = 109) intervals in undergraduates completing a screening measure of probable trauma (N = 3,045). Concordance with later responses to an alternate checklist and events assessed via clinical interview was examined in a subset of participants (N = 274). Five-month reliabilities ranged from good to fair (κ = .40-.71) and were similar to 1-2 week retest estimates in the extant literature. Reliabilities for fire, accidents, and sexual assault remained stable over 12- and 24-month intervals. Coefficients for disaster and physical assault decreased over time. Agreement with the alternate checklist was fair to excellent in those completing the follow-up assessment (κ = .51-.87). Concordance with interview-based trauma was acceptable for accidents (κ = .52) and sexual violence (κ = .82) but poor for disaster, fire, and physical assault (κ = .34-.38). Specificity, negative predictive power, and negative likelihood ratios suggest checklists may hold utility in ruling out previous trauma. Sensitivities indicate that screening instruments may broadly capture individuals experiencing traumatic life events although positive predictive power was limited except in the prediction of traffic accidents and sexual assault. Variability across domains suggests that the properties of checklist measures could be better conceptualized at the level of individual exposure events. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The pattern of symptom change during prolonged exposure therapy and present-centered therapy for PTSD in active duty military personnel.

BACKGROUND: Few studies have investigated the patterns of posttraumatic stress disorder (PTSD) symptom change in prolonged exposure (PE) therapy. In this study, we aimed to understand the patterns of PTSD symptom change in both PE and present-centered therapy (PCT). METHODS: Participants were active duty military personnel (N = 326, 89.3% male, 61.2% white, 32.5 years old) randomized to spaced-PE (S-PE; 10 sessions over 8 weeks), PCT (10 sessions over 8 weeks), or massed-PE (M-PE; 10 sessions over 2 weeks). Using latent profile analysis, we determined the optimal number of PTSD symptom change classes over time and analyzed whether baseline and follow-up variables were associated with class membership. RESULTS: Five classes, namely rapid responder (7-17%), steep linear responder (14-22%), gradual responder (30-34%), non-responder (27-33%), and symptom exacerbation (7-13%) classes, characterized each treatment. No baseline clinical characteristics predicted class membership for S-PE and M-PE; in PCT, more negative baseline trauma cognitions predicted membership in the non-responder v. gradual responder class. Class membership was robustly associated with PTSD, trauma cognitions, and depression up to 6 months after treatment for both S-PE and M-PE but not for PCT. CONCLUSIONS: Distinct profiles of treatment response emerged that were similar across interventions. By and large, no baseline variables predicted responder class. Responder status was a strong predictor of future symptom severity for PE, whereas response to PCT was not as strongly associated with future symptoms.

Exploring the relation between posttraumatic stress disorder and interpersonal outcomes: The role of social acknowledgment and trauma type.

OBJECTIVES: Research demonstrates consistent relations between posttrauma symptoms and interpersonal dysfunction. The current study examined the extent to which perceptions of community rejection account for the relation between posttraumatic stress disorder (PTSD) and interpersonal outcomes in students exposed to assaultive and nonassaultive trauma. METHOD: Participants (N = 137; 66.4% female; M = 20 years) completed a trauma history interview, questionnaires assessing symptom severity, social disapproval, and interpersonal outcomes. RESULTS: Assault survivors (n = 83) reported greater symptoms (d = 0.57), disapproval (d = 0.80), and social impairment (d = 0.51) relative to the nonassault group (n = 54). However, regression analyses indicated stronger associations between PTSD and community disapproval in survivors of nonassaultive (ß = 0.69; p < 0.001) versus assaultive (ß = 0.34; p < 0.001) events. Indirect effects of PTSD on perceived support and interpersonal functioning through social disapproval were also larger for nonassaultive versus assaultive groups (p < 0.05). CONCLUSION: Despite greater dysfunction among assault survivors, perceptions of disapproval may be a more salient factor for interpersonal dynamics following nonassaultive trauma.