From posttraumatic stress symptoms to suicidal ideation among military veterans: Pathways founded on meaning in life and gratitude.

Military veterans experience higher rates of suicidal ideation compared to nonveteran populations. Importantly, suicidal ideation often precedes and predicts fatal and nonfatal suicide attempts, and thus it is critical to better understand factors that increase risk for suicidal ideation to inform suicide prevention efforts in this population. One key predictor of suicidal ideation is exposure to traumatic experiences and their sequelae, particularly posttraumatic stress symptoms (PTSS). However, little work has explored how deficits in well-being contribute to this association among veterans. We tested two aspects of well-being-meaning in life and gratitude-as potential mechanisms underlying the pathway from PTSS to suicidal ideation among 7,388 men and women veterans who recently separated from service. A parallel mediation analysis revealed significant paths from more severe PTSS to more frequent suicidal ideation through diminished meaning in life, B = 0.005, SE = 0.001, 95% CI [0.004, 0.007], and gratitude, B = 0.001, SE = 0.001, 95% CI [< 0.001, 0.002]. Gender differences were also observed. Although the results related to meaning in life appeared to replicate across gender, pathways involving gratitude differed among men and women. Overall, our findings suggest that helping veterans build meaning and appreciation in everyday life may be a proactive and holistic approach to suicide prevention.

Meaning in life following service among post-9/11 military veterans: A latent growth mixture model analysis.

Meaning in life refers to the "sense made of, and significance felt regarding, the nature of one's being and existence." Meaningful living promotes well-being, resilience, and personal growth. Yet, much remains unknown about how meaning changes over time and determinants of meaning, particularly during major life transitions. We identified distinct trajectories of meaning using latent growth mixture models and examined prospective predictors of class membership in a military veteran cohort assessed at multiple time points throughout the first 3 years after leaving service. Three trajectories were identified: consistently high meaning (89.5%; n = 7025), diminishing meaning (6.1%; n = 479), and strengthening meaning (4.4%; n = 348). Veterans with greater posttraumatic stress symptoms, depression symptoms, and moral injury experienced increased odds of a less adaptive trajectory (i.e. diminishing and/or strengthening vs. consistently high meaning), whereas veterans who reported greater psychological resilience, community relationship satisfaction, and intimate relationship satisfaction experienced lower odds of a less adaptive trajectory. Several gender differences were also observed. Results provide insight into veteran subgroups that are more likely to experience lower meaning after leaving military service and thus may benefit from additional support to reduce their risk for poor longer-term health and well-being outcomes.

Learning from adversity: What the COVID-19 pandemic can teach us about family resiliency.

The present study aimed to characterize the immediate impacts of the COVID-19 pandemic on families with preschool age children and to identify pre-pandemic factors that explained unique family experiences. We leveraged an ongoing longitudinal study of relatively well-resourced community families who had reported on family functioning prior to the pandemic and completed surveys 6 months after pandemic onset. Both parents of dual parenting households endorsed significant hardships as a direct result of the pandemic (e.g., disrupted family routines, challenges at work); however, families also reported aspects of flourishing (i.e., experiencing positive outcomes in response to adversity) such as spending more time together as a family. Families were prone to greater hardships and fewer opportunities for growth to the extent that parents were lower in psychological resources (i.e., greater stress and internalizing symptoms, poor well-being) and were not on the same page as a couple (i.e., interparental discord, low quality coparenting) prior to pandemic onset. Finally, greater pandemic hardships predicted poorer parental mental health, greater family dysfunction, and elevated child psychopathology, controlling for pre-pandemic levels. Parents who reported more family flourishing from the pandemic had a stronger interparental relationship. Results are intended to inform theories of family stress and family interventions that can be tailored to promote resiliency (i.e., adaptation to challenging life events) and prevent dysfunction when families face rapid change and adjustment and high degrees of uncertainty and stress.

Alcohol Use Before Sexual Violence and Cognitive Appraisals: Differential Associations With Barriers to Help-Seeking.

The current study examined two cognitive appraisals-labeling (identifying an unwanted sexual experience as sexual violence) and self-blame-as potential mechanisms between survivor alcohol use before sexual violence and three help-seeking barriers (minimization, negative treatment, and social-emotional barriers) among non-service-seeking sexual violence survivors. Participants were 141 undergraduate women who completed self-report measures. Three parallel mediation models were tested. Survivors who were drinking were more likely to label their victimization as sexual violence and, in turn, perceived fewer minimization and greater social-emotional barriers. Further, survivors who were drinking blamed themselves more and, in turn, perceived greater negative treatment and social-emotional barriers.

The effects of rumination, distraction, and gratitude on positive and negative affect.

In a series of classic quasi-experiments, Lyubomirsky, Nolen-Hoeksema, and colleagues demonstrated the negative effects of rumination (vs. distraction) among people with depression. Across five studies, we attempted to replicate the former studies, as well as extend them by adding a third condition, gratitude, and the measurement of positive affect. We measured baseline depression severity and then randomly assigned people to a rumination, distraction, or gratitude condition. Pre- and post-manipulation, we measured depressed mood and positive and negative affect. We also explored whether manipulation-induced changes in affect related to construal of events, problem-solving, and thoughts about future behaviors (i.e., thought-action repertoires). As expected, both the distraction and gratitude conditions dampened negative affect (compared to the rumination condition), and the negative effects of the rumination condition were stronger among people relatively higher in baseline depression (compared to the distraction condition). Also as expected, the gratitude condition promoted positive affect when compared to the rumination and distraction conditions, an effect that was unmoderated by baseline depression. Furthermore, gratitude-induced changes in positive affect uniquely related to more positive construal of events, as well as higher positivity and lower negativity in thought-action repertoires. In sum, we found strong evidence that positive affect-above and beyond negative affect-facilitates healthy thought patterns, and we provide support for the idea that increasing positive affect should be a direct goal of treatments for depression, in addition to reducing negative affect. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Promoting resilience to depression among couples during pregnancy: The protective functions of intimate relationship satisfaction and self-compassion.

Pregnancy, while often marked by joy, may pose considerable risk for depression among parents. Against a backdrop of adverse life events, expectant parents may be even more vulnerable to developing symptoms of depression during the prenatal period. Thus, it is critical to identify sources of resilience that might facilitate a successful transition to parenthood among couples who have a history of adversity. Prior work suggests that interpersonal and intrapersonal factors associated with resilience, such as intimate relationship satisfaction and self-compassion (i.e., self-kindness, common humanity, and mindfulness), have the potential to attenuate prenatal depression among couples with a history of stressful life experiences. We tested this possibility in a sample of 159 couples navigating pregnancy. As predicted, a greater number of prior stressful life experiences was associated with increased depression symptom severity for both mothers and fathers. However, moderation analyses revealed the positive link between cumulative stressful life experiences and depression symptom severity was attenuated among mothers who reported greater self-compassion in the form of feelings of common humanity, and fathers who reported higher levels of intimate relationship satisfaction and self-compassion in the form of mindfulness. Findings suggest enhancing intimate relationship satisfaction and self-compassion among expectant couples may be valuable in attenuating prenatal depression among those with a greater history of adversity.

Resilience to Suicidal Ideation Among U.S. Military Veterans with Posttraumatic Stress: Results from the National Health and Resilience in Veterans Study.

Veterans with combat exposure experience high rates of posttraumatic stress symptoms (PTSS) and associated suicidal ideation. The current study examined whether social support (i.e., social connectedness and social engagement) and protective psychological factors (i.e., resilience and altruism) moderated the relation between PTSS and suicidal ideation severity in a sample of 149 U.S. military combat veterans who served in the Vietnam War or Operation Enduring Freedom/Operation Iraqi Freedom/Operation New Dawn (OEF/OIF/OND). Consistent with expectations, initial PTSS were positively associated with concurrent and three-year follow-up severity of suicidal ideation. Moderation analyses revealed the relation between initial PTSS and concurrent suicidal ideation severity was no longer significant at above average levels of social connectedness, social engagement, and psychological resilience. Further, the relation between initial PTSS and suicidal ideation severity three years later continued to be buffered by above average levels of social engagement. Results suggest social connectedness, psychological resilience, and social engagement help moderate initial severe thoughts of suicide linked to PTSS, while social engagement might be the strongest protective factor against severe suicidal ideation over time. Empirically-supported prevention and treatment efforts enhancing social engagement may help promote resilience to severe PTSS-related suicidal ideation among veterans from Vietnam and OEF/OIF/OND combat eras.

Mindful Awareness Promotes Resilience: Buffered Links Among Childhood Sexual Abuse Severity, Goal-Directed Emotion Dysregulation, and Psychopathology.

Objectives: Childhood sexual abuse is linked to long-term consequences, including depression and anxiety in adulthood. Although considerable progress has been made to understand mechanisms that may account for this relation, such as emotion dysregulation, less attention has been given to protective factors that may mitigate it. One such protective factor might be mindful awareness. Those who act with awareness in daily living tend to engage in healthy emotion regulation skills when faced with stressors and experience less depression and anxiety. In the current study, we aimed to replicate the positive associations among childhood sexual abuse severity, emotion dysregulation, and psychopathology across time, and also identify a personal strength-in this case, mindful awareness-that might mitigate these effects. Methods: Participants were 491 women recruited from the community who completed self-report assessments at three time points over a 32-month period. Results: A series of moderated mediation models revealed childhood sexual abuse severity predicted later reports of depression and anxiety symptoms through greater emotion dysregulation in the form of difficulties engaging in goal-directed behaviors. As expected, mindful awareness weakened the relation between goal-directed emotion dysregulation and symptoms of depression and anxiety, such that greater levels of mindful awareness fully buffered these effects. Conclusions: Through a better understanding of natural resiliency processes among survivors, we can ultimately encourage continued examination of what might be effective additions to existing treatments for the mental health consequences of trauma and adversity.

Does Gratitude Promote Resilience During a Pandemic? An Examination of Mental Health and Positivity at the Onset of COVID-19.

Researchers have emphasized the detrimental effects of COVID-19 on mental health, but less attention has been given to personal strengths promoting resilience during the pandemic. One strength might be gratitude, which supports wellbeing amidst adversity. A two-wave examination of 201 college students revealed anxiety symptom severity increased to a lesser extent from pre-COVID (January-March 2020) to onset-COVID (April 2020) among those who reported greater pre-COVID gratitude. A similar trend appeared for depression symptom severity. Gratitude was also correlated with less negative changes in outlook, greater positive changes in outlook, and endorsement of positive experiences resulting from COVID-19. Thematic analysis showed "strengthened interpersonal connections" and "more time" were the most commonly reported positive experiences. Overall findings suggest gratitude lessened mental health difficulties and fostered positivity at the onset of the pandemic, but more research is needed to determine whether gratitude and other strengths promote resilience as COVID-19 continues.

Partner Support and Connection Protect Couples During Pregnancy: A Daily Diary Investigation.

Objective: The objective of the current study was to examine associations between daily subjective stress and relationship satisfaction as a function of two protective factors-partner support and connection (i.e., intimacy, passion, and commitment)-among couples during pregnancy. Background: Stress brought into the intimate relationship by each partner is often associated with relational dissatisfaction and discord, referred to as stress spillover. Although much research has focused on risk for poor relational outcomes associated with partner stress, it is equally important to focus on resilience. Method: We examined this phenomenon among 154 couples navigating pregnancy. Couples attended an initial laboratory session and then completed daily diary measures from home across 14 days. Results: Multilevel modeling techniques revealed that higher daily subjective stress than usual was negatively associated with relationship satisfaction that day for fathers and mothers, and partner support and connection attenuated this link to a significant degree. As these protective factors increased, the strength of the negative association between daily stress and relationship satisfaction decreased for both parents. Exploratory analyses showed no significant within-person associations between daily stress and next-day relationship satisfaction at any level of support or connection. Conclusion: These findings add innovative components to the investigation of the spillover process, including the examination of this process among couples during pregnancy, utilization of daily diary methods to study this phenomenon on a micro-level over time, and identification of protective factors mitigating daily stress spillover.

Meaning in life and stress-related drinking: A multicohort study of college students during the COVID-19 pandemic.

During the COVID-19 pandemic, college students have experienced heightened stressors and reported stress-related drinking. To identify potential protective factors among college students, we investigate the possibility that finding meaning and purpose in one's life may lessen the strength of the association between stress and alcohol consumption in a multicohort sample of college students (N = 694; 64.8% women) recruited between November 2019 and September 2021. Consistent with expectations, negative binomial regressions revealed significant interactions, such that higher stress was only associated with more past-month alcohol use among individuals who reported low levels of meaning in life. The buffering role of meaning in life appeared to be robust; interaction results held when investigating both general perceived stress and COVID-specific stress, and did not vary by cohort. Although longitudinal and experimental research are needed, findings indicate that finding meaning and purpose in one's life may help college students to navigate heightened periods of stress with more adaptive coping strategies that do not result in drinking to cope. Findings highlight the potential utility of meaning-promoting strategies in college alcohol interventions.

The need for trauma training: Clinicians' reactions to training on complex trauma.

OBJECTIVE: Academic training programs for mental health professionals rarely include comprehensive instruction on trauma, consequently leaving clinicians inadequately prepared to provide trauma treatment. The present study sought to: (a) ascertain what percentage of participants had received training in complex trauma and dissociation; (b) examine pre- and posttraining differences in knowledge related to complex trauma populations; and (c) investigate changes in participants' competence and empathy in working with survivors. METHOD: We examined self-reported changes in knowledge, competence, and empathy regarding individuals with complex trauma among mental health professionals who attended a complex trauma training workshop. Participants provided feedback about previous trauma training experience and areas of additional trauma training that they perceived would be beneficial. RESULTS: Prior to completing the program, 68% of participants reported feeling inadequately trained to assess trauma and 75% felt inadequately trained to treat trauma. Ten percent had not received training in complex trauma and 30% had not received training in treating patients with dissociative symptoms. Participants showed significant increases in knowledge and self-reported competence following the training. They suggested that learning about dissociation and dissociative disorders was the most helpful information gained and that learning more techniques and skills for complex trauma populations would improve their ability to treat this group. CONCLUSIONS: The majority of participants felt inadequately trained to treat clients who have experienced complex trauma and experienced dissociation. They reported the trauma training as beneficial in that it increased their sense of knowledge and competence about treating trauma-exposed individuals. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Parenting behaviors of mothers with posttraumatic stress: The roles of cortisol reactivity and negative emotion.

Although posttraumatic stress disorder (PTSD) is associated with negative family outcomes, including parenting challenges, little is known about the biological and emotional processes that might underlie this association. The present project addressed this gap by examining associations between maternal PTSD and parenting behaviors in a lab setting. We expected that PTSD would be associated with more ineffective parenting behaviors and that negative emotion and cortisol reactivity would mediate this relation. A total of 78 mothers and their toddler-aged children completed a task designed to elicit parental responses to typical instances of child misbehavior. Salivary cortisol was collected from mothers prior and subsequent to the lab paradigm and mothers provided ratings of their experienced emotion while viewing a video of the interaction. Contrary to hypotheses, cortisol reactivity did not mediate associations between PTSD and parenting. However, findings suggest that PTSD is associated with greater permissive parenting behaviors, and mothers with even subthreshold symptoms of PTSD may experience more negative emotion during challenging parent-child interactions that ultimately interferes with parenting. Mothers with PTSD may benefit from interventions that focus on modifying the intensity of their negative emotions in the context of child misbehavior to more effectively set limits in everyday discipline encounters. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Resilience to suicidal ideation among college sexual assault survivors: The protective role of optimism and gratitude in the context of posttraumatic stress.

OBJECTIVE: Posttraumatic stress symptoms related to sexual assault have been linked to greater suicidal ideation, yet little is known about protective factors that may weaken this link and reduce thoughts of suicide in the context of posttraumatic stress. Drawing on the broaden-and-build theory of positive emotions and prior research, psychological strengths associated with resilience, such as optimism and gratitude, have the potential to be associated with attenuated suicidal ideation among sexual assault survivors. METHOD: We tested this possibility in a sample of 425 undergraduate women who reported unwanted sexual experiences during adolescence or adulthood. RESULTS: A linear regression analysis revealed that greater sexual assault-related posttraumatic stress symptoms in the past month were associated with greater concurrent suicidal ideation. However, moderation analyses revealed the link between assault-related posttraumatic stress and suicidal ideation was attenuated for individuals higher in optimism and gratitude. Further, at the highest levels of optimism and gratitude, there was no longer a significant association between posttraumatic stress and suicidal ideation. CONCLUSIONS: Given optimism and gratitude are modifiable strengths that individuals can develop and grow over time, these results suggest boosting optimism and gratitude may be a valuable way to attenuate thoughts of suicide in interventions for college women who have experienced sexual assault. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Is the COVID-19 Pandemic a High-Risk Period for College Student Alcohol Use? A Comparison of Three Spring Semesters.

BACKGROUND: There has been widespread concern that the COVID-19 pandemic may be a high-risk time for alcohol use among heavy drinking populations such as college students. Initial efforts to evaluate changes in college drinking have not yet accounted for typical drinking patterns within a semester. METHODS: To fill this gap, we evaluated how college student drinking patterns changed with the onset of restrictions related to the COVID-19 pandemic during spring 2020 relative to spring 2018 and 2019. Participants were 1,365 college students aged 19 and older, including 895 students who reported past-month alcohol use. Daily drinking data were extracted from an online Timeline Followback survey. RESULTS: Negative binomial hurdle models revealed that, with the onset of the COVID-19 pandemic in spring 2020, college student drinkers did not increase their drinking frequency as was typical in late spring semester, and the number of drinks per occasion declined substantially (28% reduction), greater than the change observed from early to late spring 2018 (3% reduction) or spring 2019 (8% increase). This reduction in drinking quantity in spring 2020 was larger for college student drinkers who moved residences because of the pandemic (49% reduction) than students who did not move (21% reduction). Perceptions in pandemic-related changes in drinking also revealed that 83.5% of college student drinkers self-reported that their drinking stayed the same or decreased. CONCLUSIONS: Findings suggest that, on average, college students drank less-not more-during the onset of the COVID-19 pandemic and highlight the importance of living situation in college student drinking behavior. More research is needed to assess alcohol use in other universities, as this information could be utilized in norms-based interventions to further reduce drinking in students who remain at risk.

Intimate Partner Violence Among Patients With Dissociative Disorders.

Childhood trauma is common among survivors and perpetrators of intimate partner violence (IPV). Although symptoms of posttraumatic stress disorder (PTSD) and dissociative disorders (DDs) are predictors of IPV victimization and perpetration, few studies explore IPV among those with DDs. The present study examined IPV and symptoms as predictors among participants in the Treatment of Patients With Dissociative Disorders (TOP DD) Network study, an educational intervention for individuals with DDs and their clinicians. Both clinicians and patients reported on patients' history of physical, emotional, and sexual IPV as both victims and perpetrators. Patients self-reported dissociative, posttraumatic (PTSD), and emotion dysregulation symptoms, as well as IPV-specific dissociative symptoms. According to patients and clinicians, patients were frequently victims of IPV, most commonly emotional IPV. Dissociative symptoms predicted IPV exposure, whereas dissociative and emotion dysregulation symptoms predicted IPV-specific dissociative symptoms.

Posttraumatic Stress and Parenting Behaviors: The Mediating Role of Emotion Regulation.

Purpose: Maternal trauma has been linked with problematic parenting, including both harsh and permissive behaviors. However, little is known about mechanisms accounting for this association. The current study examined the potential impact of posttraumatic stress disorder (PTSD) and emotion regulation on dysfunctional parenting behaviors in a sample of community mothers. We hypothesized a mediation model wherein PTSD would be associated with dysfunctional parenting (i.e., lax and overreactive behaviors) indirectly through deficits in maternal emotion regulation. Method: Seventy-eight community mothers of 18- to 36-month-old children were administered the Clinician Administered PTSD Scale for DSM-5 (CAPS-5) and 19 mothers met criteria for PTSD. Mothers also completed self-report measures of difficulties with emotion regulation and maternal laxness and overreactivity in parenting. Results: Results revealed that emotion dysregulation fully mediated relations between PTSD status and lax (but not overreactive) parenting behaviors. Compared to mothers without PTSD, those with PTSD reported greater lax parenting behaviors indirectly through greater emotion dysregulation. Conclusions: Mothers with PTSD may struggle to parent assertively when trauma symptoms interfere with emotion regulation abilities. The current study highlights the need to design interventions focused on helping trauma-exposed mothers manage distress, ultimately aiming to enhance parenting effectiveness and improve child outcomes.

Coverage of child maltreatment and adult trauma in graduate psychopathology textbooks.

OBJECTIVE: Undergraduate psychology textbooks often present trauma, particularly child maltreatment (CM) and its consequences, inadequately or inaccurately. Adequate education about CM and adult trauma (AT) is crucial because they are prevalent and their health impacts are widespread and enduring. Furthermore, mental health professionals are called upon to treat disorders and problematic behaviors associated with trauma yet have often not received adequate knowledge and training about trauma and its treatment. This is the first study to investigate the adequacy and accuracy of the coverage of CM and AT in graduate psychology psychopathology textbooks. METHOD: To address this gap, we reviewed and scored 10 graduate psychology psychopathology textbooks to determine the adequacy, completeness, and balance in their coverage of CM and AT. RESULTS: There was a surprisingly wide range of scores, with some textbooks presenting little research on trauma or unbalanced coverage of trauma-related debates. Even the texts that earned the highest scores could more fully address trauma and/or provide more balanced discussion of debates. CONCLUSIONS: Graduate textbooks would benefit from increased attention to, and more balanced coverage of, CM and AT. (PsycINFO Database Record (c) 2019 APA, all rights reserved).