Practice-based evidence for spiritually integrated psychotherapies: Examining trajectories of psychological and spiritual distress.

The aims of this practice-based evidence study were to (a) examine clients' trajectories of psychological and spiritual distress over the course of spiritually integrated psychotherapies (SIPs) and (b) explore the role of varying types of spiritual interventions in these outcomes. In total, 164 practitioners of SIPs from 37 settings in a practice-research network administered the Clinically Adaptive Multidimensional Outcome Survey (Sanders et al., 2018) at each session with 1,227 clients and reported their use of theoretical orientations and spiritual interventions on an after-session summary checklist. Focusing on sessions over an initial 12-week period, latent growth curve modeling analyses revealed that clients, on average, experienced significant reduction of psychological distress during their engagement in SIPs with improvements occurring most sharply in the first month. Further, other findings revealed a salient reciprocal interplay with spiritual distress throughout treatment, such that clients who were struggling with their religious faith and/or spirituality were more psychologically distressed and displayed a more attenuated and gradual pattern of symptom reduction. In such cases, clinicians frequently utilized spiritual interventions involving basic skills (e.g., spiritual assessment), virtues (e.g., discuss self-control), and religious attachment (e.g., encourage acceptance of divine love) that were uniquely associated with clients' rate and duration of decline in psychological and spiritual distress. The present findings affirm the routine effectiveness of SIPs along with highlighting the potential value of certain spiritual interventions in supporting holistic recovery among clients who want clinicians to be culturally responsive to their spiritual and/or religious identities. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Examining the outcomes and acceptability of a peer-led spiritual intervention for moral injury in a veteran service organization.

The purpose of this proof-of-concept study was to examine the outcomes and acceptability of a spiritual intervention for moral injury led by veteran peers in a Veteran Service Organization (VSO), called "Heroes to Heroes." From baseline to 1-year follow-up, 101 veterans who participated in the intervention completed the evaluation surveys at four time points assessing psychological outcomes (moral injury, posttraumatic stress disorder [PTSD] symptoms, and life satisfaction), spiritual outcomes (spiritual struggles and spiritual transcendence), and their perceived helpfulness of the program. In addition, we conducted four focus groups with six to eight alumni to more fully understand veterans' views and experiences of the program. Focusing on the longitudinal surveys, latent growth modeling analyses revealed veterans generally improved across the psychological and spiritual outcomes in the study. Specifically, veterans reported steady decreases in moral injury outcomes, PTSD symptoms, and spiritual struggles along with increased life satisfaction and spiritual transcendence over the 1-year period. An inductive content analysis of veterans' responses to open-ended items in the surveys and focus group interviews revealed four possible mechanisms or facilitators of these outcomes: (a) social connectivity and belonging (e.g., shared vulnerability and camaraderie); (b) behavioral engagement in core aspects of their spirituality (e.g., sacred practices and visiting sacred places); (c) spiritual transformation and growth (e.g., closeness with God and divine forgiveness); and (d) appreciation for diversity (e.g., religious and military). Overall, these findings affirm the potential effectiveness and acceptability of the VSO's peer-led spiritual intervention for promoting the holistic healing among veterans who are contending with emotional and spiritual wounds of war. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Checking the scales: A psychometric evaluation of the Weight Concerns Scale in a sample of college-aged cisgender men from the United States.

Historically, western societies have considered body image issues to predominantly affect young, White women. While in recent years men's body image issues have been increasingly highlighted by researchers and the media alike, many instruments currently used to identify clinically significant body image disturbances were developed and validated with samples solely of women and/or girls. One such measure, Killen et al.'s (1994) Weight Concerns Scale (WCS), was initially validated in a sample of adolescent girls. The WCS has yet to be validated in samples of men, despite being used in large national surveys of college men and women (e.g., the Healthy Minds Study; HMS) used to inform resources on college campuses. Accordingly, we used structural equation modeling to conduct invariance testing between college student cisgender men's (n = 2,248) and women's (n = 4,733) responses on the WCS via the HMS. Through the use of two different approaches of invariance testing, evidence for metric noninvariance of two of the five items was identified, and all five items evidenced a response pattern that favored women over men. Additionally, removing noninvariant items on the WCS impacted the moderating effect of gender with indicators of depression, anxiety, and eating disorder symptomology. These findings suggest that the use of the WCS may not be appropriate for use in a cis-male sample without modification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Positive and negative psychosocial factors related to healthy and unhealthy weight control among nursing students.

BACKGROUND: Although nursing students are educated on the importance of exercising regularly and maintaining a well-balanced diet, many do not practice healthy weight management behaviors, and some even use unhealthy weight loss methods. Yet, little research has examined both positive and negative psychosocial variables related to weight control among nursing students. PURPOSE: The present study aimed to identify the most salient psychosocial variables related to healthy and unhealthy weight control among nursing students. METHOD: Using survey data from 241 nursing students, structural equation modeling was conducted to examine the relative contributions of eight interrelated psychosocial variables, including constructs from a strengths perspective (health-specific hope, health self-efficacy, social support, and body satisfaction) and from a deficit perspective (depression, anxiety, weight perception, and barriers to physical activity). RESULTS: Results showed that the degree to which individuals perceive themselves to be overweight was related to both healthy and unhealthy weight control. Aside from weight perception, health self-efficacy produced the strongest association with healthy weight control, and anxiety produced the strongest association with unhealthy weight control. The structural model explained 23 % of the variance in healthy weight control and 29 % of the variance in unhealthy weight control. CONCLUSIONS: These findings emphasize the need for tailored, integrated weight management interventions for nursing students that equip them with effective anxiety management skills and build self-efficacy.

A Psychometric Pilot Study Examining the Functions of Suicidal Communications Using IRT and Factor Analysis.

BACKGROUND: Suicide prevention, an important public health issue, relies on suicidal communications to identify and intervene with those at risk. Scant research tests explicit theories of suicidal communication impeding applications to prevention science. The current study pilots a new measure assessing the functions of suicidal communications using factor analysis and item response theory. METHODS: MTurk workers (n = 898) completed an anonymous survey. The original scale included 35 items refined using exploratory and confirmatory factor analysis, bifactor modeling, and item response theory. RESULTS: The initial EFA identified a two-correlated-factor solution. The two-correlated-factor and unidimensional models yielded a poor fit. A bifactor model yielded a borderline to acceptable fit. The final four items were identified using a bifactor model and item response theory graded response models capturing ambivalence resolution defined as behaviors aimed to aid in suicide decision making. The final model yielded an excellent fit: 𝝌2(2) = 1.81, CFI (1.00), TLI (1.00), RMSEA (0.00), and SRMR (0.01). CONCLUSIONS: There may be one function of suicidal communications. Disclosure may elicit connection and reasons for living that serve as barriers to suicide and resolve ambivalence. Key limitations include convenience sampling and limited validity measures. Future research should partner with participants to improve scale and theory development efforts.

She Asked for It: Hardcore Porn, Sexism, and Rape Myth Acceptance.

The present study examined pornography viewing, rape myth acceptance, and sexist attitudes. Data came from 392 male and 903 female participants. Multigroup SEM indicated neither pornography viewing, nor hardcore pornography viewing, were related to rape myth acceptance when controlling for sexist attitudes among men. Wald tests indicated hostile sexism to be a significantly stronger predictor of all rape myths examined compared to pornography viewing or hardcore pornography viewing in men and women. Latent variable interaction analyses suggested hardcore pornography viewing as a significant exacerbating factor for the relationship between hostile sexism and "she asked for it" rape myths across genders.

Masculinity and compliance with Centers for Disease Control and Prevention recommended health practices during the COVID-19 pandemic.

OBJECTIVE: It has been documented that men are suffering more severe illnesses and deaths in the coronavirus disease 2019 (COVID-19) pandemic than women, which is thought to be due to a combination of biological and behavioral factors, paralleling men's greater morbidity and mortality overall. The present study tested and found support for four hypotheses regarding a model of the relationships between traditional masculinity ideology (TMI) and Centers for Disease Control and Prevention (CDC) recommended COVID-19 practices (CDC adherence), as mediated by conformity to several masculine norms and moderated by conspiratorial attitudes toward the pandemic (conspiratorial attitudes). METHOD: Data were collected online from a convenience sample of U.S. men that was selected to be nationally representative in terms of race/ethnicity and region of residence (N = 306; Mean age 41.79; SD = 15.90). RESULTS: Conditional process modeling was used to test the model, revealing moderated mediation relationships between masculinity variables and CDC adherence conditional on conspiratorial attitudes. TMI was indirectly and inversely related to CDC adherence through conformity to playboy norms. These effects were strongest at high values of conspiratorial attitudes. Pursuit of status norms were associated with more CDC adherence but only at low levels of conspiratorial attitudes. CONCLUSION: The present study identified masculinity factors that are linked with men's CDC adherence to the CDC recommended practices during the COVID-19 pandemic, and the relationships among them. Future research should confirm the mediation results in a longitudinal or experimental study. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Self-Persuasion: An Experimental Evaluation of a Sexual Aggression Preventive Intervention for U.S. College Men.

Grounded in the self-persuasion paradigm (an indirect persuasion approach, which places people in situations that motivate them to change their behavior), this study evaluated a brief, online intervention to reduce sexual aggression perpetration and increase prosocial bystander behaviors among heterosexual male college students (N = 241) in the United States. Students were randomly assigned to three conditions: (a) a self-persuasion intervention, (b) a social norms control condition, and (c) a control condition focusing on sense of belongingness. The self-persuasion intervention integrated three social psychological theoretical perspectives on attitudinal and behavioral change-cognitive dissonance (e.g., creating a personalized video message for incoming male college freshmen to explain the importance of consent in sexual contact), self-affirmation (e.g., reflecting on one's core values and how they are congruent with sexual consent), and personal relevance (e.g., writing about personally relevant reasons to always seek consent when having sexual contact). Participants in the self-persuasion condition reported greater prosocial bystander behaviors (e.g., intervening in situations to prevent sexual aggression) 6 months after the intervention as compared with those in the other two conditions; however, there were no significant difference in the rate of self-reported sexual aggression perpetration across conditions. The positive effect of the self-persuasion intervention on prosocial bystander behaviors was mediated by reduced self-perceived likelihood to commit sexual aggression and moderated by in-group solidarity with other college students. That is, the intervention had the most positive effect on prosocial bystander behaviors among participants with a lower sense of in-group solidarity. These findings are discussed in light of the promise of self-persuasion for future sexual aggression prevention work.

Undergraduate versus graduate nursing students: Differences in nutrition, physical activity, and self-reported body mass index.

ObjectiveThis study compared self-reported nutrition, physical activity, and body mass index (BMI) in undergraduate versus graduate nursing students.ParticipantsRespondents included 233 undergraduate and 230 graduate nursing students in a Southeastern public university.MethodsThe study was an exploratory, descriptive, cross-sectional comparison administered via online questionnaire including self-reported demographics, nutritional intake, physical activity, and BMI.ResultsUndergraduates reported exercising more than graduate students. Graduate students reported consuming significantly more vegetables than undergraduates; however, more graduate students self-reported BMIs in overweight and obese categories than undergraduates.ConclusionsFindings provide a foundational understanding that interventions or educational programs to improve self-care behaviors of nursing students should be tailored depending on the educational level of the students. Educators must establish self-care skills within nursing students at all levels to help them preserve their health in the fast-paced, strenuous, and stressful work of all echelons of nursing upon completion of the educational program.

A practice-based evidence investigation of God representations in spiritually integrated psychotherapies.

OBJECTIVE: This practice-based evidence study examined trajectories of God representations and psychological distress among Christians participating in spiritually integrated psychotherapies (SIPs). METHODS: In total, 17 clinicians practicing SIPs in a mid-sized city on the US Gulf Coast implemented session-to-session assessments of these outcomes with 158 clients over a 4-month period and also reported their use of specific spiritual interventions after each session (e.g., affirmed client's divine worth). RESULTS: Multivariate growth modeling revealed clients' psychological distress decreased over the study period whereas authoritarian God representations increased and benevolent God representations remained stable. In addition, clients who increased in benevolent representations of God had a greater likelihood of experiencing alleviation of psychological distress. CONCLUSION: These findings affirm the potential efficacy of SIPs and cultural importance of belief in a benevolent deity as a source of strength, identity, and potential healing among Christians clients who prefer a spiritually integrated approach in psychotherapy.

Sexuality and gender invariance of the PHQ-9 and GAD-7: Implications for 16 identity groups.

BACKGROUND: The Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder-7 (GAD-7) are two commonly used screening tools for depression and anxiety, respectively. Despite the widespread use of these instruments, researchers have yet to examine whether scores may differ as a function of gender identity or sexuality orientation. METHOD: Using data from the 2018 and 2019 National Healthy minds study (N = 46,672), the present study tested each instrument for measurement invariance across 16 gender and sexual minority groups. RESULTS: Multigroup structural equation modeling revealed that several sexual minority groups evidenced questionable fit indices for both measures. Gay men, questioning women, and queer men had unacceptable fit indices for the PHQ-9. Only cisgender heterosexual men and women evidenced residual invariance on the PHQ-9. All gender minority groups evidenced significantly higher factor loadings for item 9 (the self-harm indicator) for the PHQ-9. Most identity groups evidenced scalar or partial scalar invariance for the GAD-7; however, no groups evidenced residual invariance on the GAD-7. LIMITATIONS: Findings may not generalize to non-college student populations. CONCLUSIONS: Researchers should weight means when conducting between group comparisons for groups that failed scalar invariance. Gender and sexual minorities may have inflated scores using the PHQ-9 and GAD-7 cut-offs.

Characteristics of Negative and Positive Mental Health Among Nursing Students in the United States.

BACKGROUND: Researchers have documented significant psychological problems among nursing students, but findings have been inconclusive as to whether nursing students are "at-risk" for mental health problems compared with their non-nursing peers. AIMS: This study examined whether nursing students have unique mental health characteristics compared with students from other professions. METHOD: Undergraduates (N = 18,312; nursing n = 1,399) were selected from the 2016-2017 National Healthy Minds Study. Participants completed the Patient Health Questionnaire-9 (depression), the Generalized Anxiety Disorder-7 (anxiety), and the Flourishing Scale (positive psychology). RESULTS: Nursing students were equally likely to screen positive for depression and anxiety compared with their non-nursing peers. However, when controlling for gender, age, and year in school, multigroup structural equation modeling analyses revealed that female (but not male) nursing students reported significantly higher levels of specific anxiety symptoms and certain psychological strengths than female students from other professions. Nursing students are equally likely to screen positive for depression or anxiety as their non-nursing peers; however, anxiety disorders may reflect symptom profiles unique to nursing students. CONCLUSIONS: Findings suggest a need for tailored screening and interventions to reduce mental health problems and harness psychological strengths unique to nursing students.

Nursing students' resilience, depression, well-being, and academic distress: Testing a moderated mediation model.

AIM: Academic distress is a leading cause of attrition among nursing students. The present study tested a positive psychology-oriented model detailing the potential links between nursing students': (a) psychological resilience; (b) depressive symptoms; (c) intrapersonal well-being; (d) interpersonal well-being; and (e) academic distress. Additionally, we tested whether the academic benefits of resilience were conditional upon nursing students' perceptions of their campus climate as supportive of mental health and well-being. DESIGN: A correlational, cross-sectional design was employed. METHOD: Nursing students (N = 933) were selected from the national 2017-2018 Healthy Minds Study (HMS). Students completed measures of resilience, depressive symptoms, intrapersonal well-being (flourishing), interpersonal well-being (belonging), and academic distress. RESULTS: Conditional process modelling tested depression, belonging, and flourishing as mediators of the associations between resilience and academic distress variables. Furthermore, perceptions of campus climate were included as potential moderators of these mediation effects. Results indicated that the protective academic benefits of resilience were primarily explained by decreases in depression but that this effect was strongest for nursing students with negative perceptions of their campus climate. CONCLUSION: Findings highlight the psychological and academic benefits of greater resilience and the moderated mediation results suggest that such benefits were conditional on the broader campus climate. IMPACT: Nurse educators and policymakers should consider addressing contextual factors, such as campus climate, in addition to resilience training in their efforts to reduce the negative academic impacts of mental health problems and stress in nursing school.

Are Playboy (and girl) Norms Behind the Relationship Problems Associated with Pornography Viewing in Men and Women?

Research has indicated that pornography viewing is related to romantic relationship problems. However, the correlations across past studies have been small. We tested a model in which playboy norm conformity (i.e. desires to have frequent sex with multiple partners) functions as a confound between pornography viewing constructs on three romantic relationship wellbeing indicators: Relationship satisfaction, relationship commitment, and infidelity proclivity. Results from men (n = 286) and women (n = 717) indicated that the significant inverse correlations between relationship satisfaction and relationship commitment with pornography viewing constructs becomes non-significant when playboy norm conformity is accounted. Further, the positive relationship between pornography viewing and infidelity proclivity also becomes non-significant in women (no initial connection between pornography viewing and infidelity proclivity was found in men). Though conformity to playboy norms was more strongly related to all romantic relationship wellbeing indicators across genders, pornography viewing frequency was still significantly inversely correlated with relationship satisfaction for women; though the effect size was small. Moderation analyses suggested that pornography viewing frequency was more strongly inversely correlated with relationship satisfaction for women than men. Cumulatively, our results suggest conformity to playboy norms is a significant confounding variable between pornography viewing and romantic relationship wellbeing.

Revisiting the paradox of hope: The role of discrimination among first-year Black college students.

The psychology of hope is used to conceptualize how college students successfully meet their personal and professional goals and ultimately persist to graduation. However, limited evidence has suggested that high levels of hope might have a paradoxical effect for Black college students when faced with experiences of discrimination. The present study examined the moderation effects of hope on the associations between experiences of discrimination and perceptions of stress and academic integration among a sample of 1st-year U.S. Black college students (N = 203) partly derived from secondary data. Structural equation modeling revealed inverse associations between hope and stress, as well as positive associations between hope and academic integration. However, latent variable moderation revealed that students with high levels of hope had the strongest positive associations between discrimination and stress, thus supporting a paradoxical effect. By contrast, the negative association between discrimination and academic integration emerged for only students with low levels of hope. Results suggest the psychological and academic benefits of hope are complex. Specifically, in the context of discrimination experiences, hope may have a paradoxical effect for Black students' mental health while still retaining a positive and buffering effect for their academic integration. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Characteristics of and Factors Influencing College Nursing Students' Willingness to Utilize mHealth for Health Promotion.

More than half of practicing nurses have suboptimal physical or mental health. Impaired health is associated with a 76% higher likelihood that nurses will make medical errors. Improving the health habits of nursing students is essential to shaping and sustaining health prior to joining the workforce. Technology such as mobile health applications holds great promise in facilitating behavioral change and encouraging healthy habits in nursing students. Identifying the predictors of willingness to use mobile health is essential to creating mobile health applications that will engage nursing students and promote sustainable usage. Evaluation of psychological, attitudinal, and health-related correlates of mobile health can highlight predictors of willingness to use mobile health, which can influence nursing students' utilization and long-term engagement with mobile health applications. Analysis of these correlates shows that psychological attributes, such as hope, play a role in the willingness to use and may facilitate engagement in the utilization of a mobile health application. Development of a mobile health application that increases hope and helps establish healthy habits may enable nursing students to remain healthy throughout their lives, creating a new generation of happier, healthier nurses and, ultimately, improving safety for patients under their care.

Perceived discrimination and academic distress among Latinx college students: A cross-lagged longitudinal investigation.

Although the empirical link between experience of racism and academic concerns has been documented, researchers have not used a cross-lagged longitudinal design to disentangle the temporal relations between perceived discrimination and academic outcomes among Latinx college students. It is important to identify whether perceived discrimination predicts greater academic concerns or whether academic concerns predict higher levels of sensitivity to rejection and, therefore, increased self-reports of discrimination. To address this gap in the empirical literature, the present study tested a cross-lagged model to investigate the temporal relations between Latinx college students' perceived discrimination and academic distress while controlling for the effects of depression. Participants were 203 Latinx college students from a Southwestern U.S. public university who completed the same questionnaires at 2 time points, 1 year apart. The authors found that a cross-lagged model exhibited superior fit to a model with only autoregressive paths (e.g., Time 1 academic distress predicting Time 2 academic distress). Only one cross-lagged effect was significant: Time 1 perceived discrimination positively predicted academic distress at Time 2, although the reverse was not true. The practical implications of these findings for the prevention of discrimination and academic distress on college campuses are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Validation of the Expressions of Moral Injury Scale-Military version-Short Form.

Military personnel may encounter morally injurious events that lead to emotional, social, and spiritual suffering that transcend and/or overlap with mental health diagnoses (e.g., post-traumatic stress disorder [PTSD]). Advancement of scientific research and potential clinical innovation for moral injury (MI) requires a diversity of measurement approaches. Drawing on results from the bifactor model in Currier et al.'s (2017) psychometric evaluation of the Expressions of Moral Injury Scale-Military version (EMIS-M), this study validated a four-item short form of the instrument with two samples of veterans with a history of war-zone service. Namely, despite the reduced number of items, the EMIS-M-Short Form (SF) yielded favourable internal consistency and comparable levels of convergent validity with theoretically related constructs (e.g., PTSD and struggles with morality and ultimate meaning) as the full-length version. Notwithstanding the possible utility of distinguishing between self- and other-directed forms of MI, factor analytic results further revealed that the EMIS-M-SF was best conceptualized with a unidimensional factorial model that might allow for a general assessment of MI-related outcomes. Overall, these initial results suggest that the EMIS-M-SF may hold promise as a short, reliable, and valid assessment of overall outcomes related to a possible MI.

Masculine gender role stress and self-stigma of seeking help: The moderating roles of self-compassion and self-coldness.

Many college men express stigma of seeking psychological help, possibly due to masculine gender role socialization proscribing help seeking. However, not every man who buys into restrictive masculine roles expresses self-stigma of seeking help, suggesting the presence of potential moderating variables. The present study examined self-compassion and self-coldness as potential moderating variables on the associations between men's masculine gender role stress and self-stigma of seeking help. College men (N = 777) were recruited via e-mail to participate in a brief online survey. Structural equation modeling revealed that masculine gender role stress was positively associated with self-stigma and self-coldness but was negatively associated with self-compassion. Both self-compassion and self-coldness were significant moderators. Men with low levels of self-compassion evidenced the strongest positive associations between masculine gender role stress and self-stigma, whereas men with low (but not high) self-coldness evidenced positive associations with self-stigma. These findings highlight differences between self-compassion and self-coldness and suggest that high levels of self-compassion may be a protective factor in reducing the associations between rigid masculinities and men's stigma of seeking help. By contrast, men with extremely negative and critical self-views may be likely to report stigma of seeking help regardless of their endorsement of rigid masculinities. Intervention and prevention implications include helping men enhance their self-compassion. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Temporal Associations Between Moral Injury and Posttraumatic Stress Disorder Symptom Clusters in Military Veterans.

War zone veterans who experience posttraumatic stress disorder (PTSD) symptoms might struggle with co-occurring cognitive, emotional, and behavioral expressions of suffering that align with conceptual definitions of moral injury (MI). However, given that PTSD is a multidimensional condition, disentangling the apparent interplay with MI may inform clinical practice and research. This study incorporated a cross-lagged design to explore temporal associations between self- and other-directed outcomes related to MI and severity of DSM-5 PTSD symptom clusters while accounting for depressive symptoms. Drawing on the Expressions of Moral Injury Scale-Military Version in a community sample of 182 previously deployed veterans, MI-related outcomes were linked with severity of PTSD symptom clusters at two assessments spaced apart by 6 months, rs = .58-.62. Of possible models for conceptualizing the temporal nature of these associations, structural equation modeling analyses revealed a cross-lagged primary MI model best fit veterans' responses. Within this model, veterans' self-directed MI at Time 1 predicted greater PTSD symptoms at the 6-month follow-up. However, an equivalent cross-lagged path also emerged between Time 1 PTSD Cluster D symptoms and self-directed MI at Time 2, suggesting the value of a reciprocal MI model for this symptom domain. In contrast, other-directed outcomes of MI were not linked with PTSD in the presence of other variables. Overall, these findings support the prognostic value of assessing for MI-related outcomes among veterans who might be struggling with PTSD symptomatology, particularly with respect to self-directed problems associated with enduring moral distress.

Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Asociaciones temporales entre daño moral y grupos sintomáticos de TEPT en veteranos militares ASOCIACIONES TEMPORALES ENTRE DAÑO MORAL Y TEPT Los veteranos en zona de guerra que experimentan síntomas de trastorno de Estrés Postraumático (TEPT) pueden tener dificultades con las expresiones de sufrimiento cognitivas, emocionales y conductuales concomitantes que se alinean con las definiciones conceptuales de daño moral (DM). Sin embargo, dado que el TEPT es una condición multidimensional, desenredar la interacción aparente con el DM puede informar la práctica clínica y la investigación. Este estudio incorporo un diseño cruzado para explorar las asociaciones temporales entre los resultados auto-dirigidos y dirigidos por otros relacionados con el DM y la gravedad de los grupos sintomáticos de TEPT del DSM-5 mientras se toman en consideración los síntomas depresivos. Basándose en las Escala de Expresiones de Daño Moral - Versión Militar en una muestra comunitaria de 182 veteranos previamente desplazados, los resultados relacionados con DM estuvieron ligados con la severidad de los grupos sintomáticos de TEPT en las dos evaluaciones, espaciadas por 6 meses, rs = .58 -.62. De los posibles modelos para conceptualizar la naturaleza temporal de estas asociaciones, el análisis de modelos de ecuaciones estructurales revelo que un modelo de DM primario cruzado se adapta mejor a las respuestas de los veteranos. Dentro de este modelo, los veteranos con DM auto-dirigido en el momento 1 predijeron más síntomas de TEPT a los 6 meses de seguimiento. Sin embargo, tambien surgió un camino cruzado equivalente entre el tiempo 1 del grupo sintomático D de TEPT y DM auto-dirigido en el tiempo 2, sugiriendo el valor de un modelo de DM recíproco para este dominio de síntomas. En contraste, los resultados de DM dirigido a otros no estuvieron ligados con TEPT en la presencia de otras variables. En general, estos hallazgos apoyan el valor pronóstico de la evaluación de los resultados relacionados con DM entre veteranos que podrían estar luchando con sintomatología de TEPT, particularmente con respecto a los problemas auto-dirigidos asociados con sufrimiento moral duradero.