Racial Microaggressions Mediate the Association Between Posttraumatic Stress and Alcohol Use Among Women of Color Experiencing Intimate Partner Violence.

Objective: Women of Color (WoC) experiencing intimate partner violence (IPV) have elevated rates of posttraumatic stress disorder (PTSD) and alcohol use and related harm (e.g., increased alcohol use and negative consequences). This secondary data analysis assessed the role of racial microaggressions in the association between PTSD and alcohol use and related harm among WoC experiencing IPV. Methods: Participants were 103 WoC currently experiencing IPV and using substances (Mage=40.39, 51.5% Black) who were recruited from the community and completed assessments of PTSD, racial microaggressions, and alcohol use and related harm. Results: Assumptions of Inferiority (e.g., intelligence; B = 1.44, SE = 0.90, 95% CI [0.10, 3.54]) and Environmental Microaggressions (e.g., portrayal in media; B = 1.88, SE = 1.03, 95% CI [0.28, 4.30]) explained the association between PTSD and alcohol use and related harm. Conclusions: Findings underscore the influence of specific microaggressions in the relation between PTSD and alcohol use and related harm among WoC experiencing IPV.

Prison or treatment? Gender, racial, and ethnic inequities in mental health care utilization and criminal justice history among incarcerated persons with borderline and antisocial personality disorders.

OBJECTIVE: Borderline and antisocial personality disorders are characterized by pervasive psychosocial impairment, disproportionate criminal justice involvement, and high mental health care utilization. Although some evidence suggests that systemic bias may contribute to demographic inequities in criminal justice and mental health care among persons experiencing these mental health conditions, no research to date has explicitly examined such differences. HYPOTHESES: Women and White persons would be more likely to endorse internalizing symptoms and have a more extensive history of mental health service utilization, whereas men, persons from minoritized racial groups, and persons identifying as Hispanic/Latino would be more likely to endorse externalizing symptoms and have more extensive histories of involvement with the criminal justice system. METHOD: This study examined gender, racial, and ethnic differences in symptom presentation, criminal justice history, and mental health care utilization in a sample of 314 adults with comorbid borderline and antisocial personality disorders enrolled in prison-based substance use treatment programs in the United States. RESULTS: Results suggested that men with these personality disorders were more likely to have early extensive criminal justice involvement, whereas women and White people had more extensive mental health treatment histories. Women were also more likely to endorse a range of internalizing symptoms, and White and non-Hispanic participants were more likely to endorse a history of reckless behavior. Notably, however, many associations-particularly, racial differences in symptom presentation and mental health utilization history and gender differences in symptom presentation-did not persist after we controlled for preincarceration employment and educational attainment. CONCLUSION: Results highlight a range of gender, racial, and ethnic inequities in criminal justice involvement and mental health utilization among this high-risk high-need population. Findings attest to the likely impact of societal, structural, and systemic factors on trajectories of persons affected by this comorbidity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An investigation of laboratory-based positive and negative emotional suppression in relation to posttraumatic stress disorder symptom clusters.

BACKGROUND: Emotional suppression is a clinically significant aspect of emotion regulation with robust associations to psychopathology, including posttraumatic stress disorder (PTSD). Despite the fast-growing body of literature highlighting the role of positive emotion regulation difficulties in the development and maintenance of PTSD, extant work on emotional suppression and PTSD has almost exclusively focused on the role of negative emotions. OBJECTIVE: The present study aimed to advance this literature by examining the associations between PTSD symptom clusters and participants' use of state emotional suppression during a laboratory task designed to elicit negative or positive emotions. METHOD: Participants were 108 community women (Mage = 39.55; 33% Black/African American) currently experiencing intimate partner violence (IPV) by a male partner and using substances. Participants were interviewed using a structured diagnostic assessment for PTSD and reported on state emotional intensity and emotional suppression following idiographic negative or positive emotion inductions. RESULTS: Results of the moderation analyses showed that, when controlling for state emotional intensity, women experiencing clinical levels of PTSD symptom Clusters B (intrusive recollections), D (negative alterations in cognitions and mood), and E (alterations in arousal and reactivity) were significantly more likely to utilize emotional suppression, but only in the context of positive-not negative-emotions. CONCLUSIONS: Findings provide evidence for a link between PTSD and positive emotional suppression among women currently experiencing IPV by a male partner and using substances, highlighting positive emotional suppression as a potential target in PTSD treatment for IPV populations with comorbid substance use concerns. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

A systematic meta-epidemiologic review on nonabstinence-inclusive interventions for substance use: inclusion of race/ethnicity and sex assigned at birth/gender.

Background: Minoritized racial/ethnic and sex assigned at birth/gender groups experience disproportionate substance-related harm. Focusing on reducing substance-related harm without requiring abstinence is a promising approach.Objectives: The purpose of this meta-epidemiologic systematic review was to examine inclusion of racial/ethnic and sex assigned at birth/gender in published studies of nonabstinence-inclusive interventions for substance use.Methods: We systematically searched databases (PubMed and PsycINFO) on May 26, 2022 following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria. Articles were eligible for inclusion if they: 1) reported in English language, 2) had a primary goal of investigating a nonabstinence-inclusive intervention to address substance use, 3) used human subjects, and 4) only included adults aged 18 or older. Two coders screened initial articles and assessed eligibility criteria of full text articles. A third consensus rater reviewed all coding discrepancies. For the remaining full-length articles, an independent rater extracted information relevant to study goalsResults: The search strategy yielded 5,759 records. 235 included articles remained. Only 73 articles (31.1%) fully reported on both racial/ethnic and sex assigned at birth/gender, and only seven articles (3.0%) reported subgroup analyses examining treatment efficacy across minoritized groups. Nine articles (3.8%) mentioned inclusion and diversity regarding both racial/ethnic and sex assigned at birth/gender in their discussion and four articles (1.7%) broadly mentioned a lack of diversity in their limitationsConclusion: Findings highlight that little is known about nonabstinence-inclusive interventions to address substance use for individuals from minoritized racial/ethnic and sex assigned at birth/gender groups.

Longitudinal examination of borderline personality disorder symptoms and drug use: The influence of negative and positive emotion dysregulation.

Borderline personality disorder (BPD) is associated with greater substance use. Emotion dysregulation has been implicated in both BPD and substance use, yet there is limited research examining the role of emotion dysregulation in the BPD-substance use relation. We examined the independent and interactive associations of BPD symptoms and emotion dysregulation in reported drug use over 1 year. Participants (N = 143) were over-recruited for BPD, assessed via interview, and completed measures of negative and positive emotion dysregulation. Drug use frequency was assessed with monthly surveys over a 1-year period. Results demonstrated interrelations among BPD symptoms and both negative and positive emotion dysregulation. However, when modeling BPD and emotion dysregulation together, only higher BPD symptoms were associated with more frequent drug use. Findings support the relation of BPD symptoms and emotion dysregulation but suggest that emotion dysregulation may not account for drug use frequency above and beyond BPD in community-recruited populations.

Predicting Completion of Ecological Momentary Assessments Among Substance-Using Women Experiencing Intimate Partner Violence.

Noncompletion of ecological momentary assessment (EMA) surveys is a common issue and may yield bias in results if not properly handled. Using data observed at scheduled times as well as data retrieved later to fill missing responses, this study aims to investigate predictors of EMA completion, including demographic characteristics, time-related factors, and momentary experiences/behaviors. Data were from a 30-day EMA study including 145 women currently experiencing intimate partner violence (IPV) and using substances. The average rate of EMA completion was initially 51.4% at the scheduled times and increased to 72.6% after incorporating data from later-retrieved surveys. Participants who were younger, had more children, or had lower mean levels of negative affect dysregulation showed lower completion rates. At the momentary survey level, more days into the study and afternoon/evening reports (vs. morning reports) were associated with lower completion; lower levels of negative affect dysregulation, less smoking or alcohol use, and experiencing IPV were linked to lower momentary completion. Implications of the results for handling missing data in EMA are discussed and have important ramifications for future research, practice, and theory.

Beyond the mean: examining associations between intraindividual variability in posttraumatic stress disorder symptoms and posttrauma reckless behaviors.

BACKGROUND/OBJECTIVES: Posttrauma reckless behaviors have been linked to the onset and exacerbation of posttraumatic stress disorder (PTSD) symptoms. However, PTSD symptoms fluctuate across time, triggered by environmental stimuli in daily life, referred to as (intraindividual) variability in PTSD symptoms. DESIGN: We utilized experience sampling methods to investigate associations between engagement in posttrauma reckless behaviors and variability in PTSD symptoms and the moderating role of emotion dysregulation in this association. METHODS: Data from 166 trauma-exposed university students (Mage = 21.43 ± 5.07, 85.4% women) were collected between January 2019 to August 2020. Participants completed baseline and follow-up surveys to assess engagement in posttrauma reckless behaviors and daily surveys (10-days) to assess variability in PTSD symptoms. Results. Analyzes indicated greater baseline engagement in posttrauma reckless behaviors was associated with greater 10-day variability in PTSD symptoms (ß = 0.23, p = .031), and baseline emotion dysregulation moderated this association (ß = -0.33, p = .003). Additionally, greater 10-day variability in PTSD symptoms was associated with greater follow-up engagement in posttrauma reckless behaviors (ß = 0.14, p = .045). CONCLUSIONS: Findings substantiate the interplay between engagement in posttrauma reckless behaviors and daily fluctuations in PTSD symptoms and support therapeutically targeting both engagement in posttrauma reckless behaviors and emotion dysregulation to impact PTSD symptoms.

Concordance of Posttraumatic Stress Disorder Symptoms Assessed via Retrospective Report Versus Experience Sampling Methods in Community Women Experiencing Intimate Partner Violence.

Posttraumatic stress disorder (PTSD) is one of the most prominent negative health consequences that women experiencing intimate partner violence (IPV) may develop. However, research on PTSD among women experiencing IPV has largely relied on retrospective reporting methods, which are vulnerable to bias and may consequently misrepresent PTSD symptoms. This study evaluated the concordance between PTSD symptoms assessed via retrospective self-report and experience sampling methods (ESM), which involve repeated within-day sampling of experiences in near real-time and in natural environments. Community women (N = 134) experiencing IPV (Mage = 40.7, 30.4% Black) responded to ESM surveys three times a day for 30 days and then completed a follow-up interview. Retrospective self-report of PTSD symptoms, which were assessed during the follow-up interview, were compared to ESM reports of PTSD symptoms. Retrospective reports of PTSD symptoms were significantly different from PTSD symptoms reported during the ESM period, but most closely resembled peak PTSD symptoms. Notably, retrospective reports of PTSD symptoms were significantly different, with a very large effect size, from average PTSD symptoms reported during the ESM period. Discordance scores were significantly negatively associated with the number of days on which any IPV occurred, suggesting that as the frequency of IPV experiences increased, differences between retrospective PTSD symptoms and each ESM symptom pattern decreased. This study provides an important contribution to the literature by highlighting meaningful differences in PTSD symptoms assessed via retrospective self-report versus ESM and the role of IPV context. Findings emphasize the importance of utilizing ESM in PTSD research with women experiencing IPV.

Role of Alexithymia in the Association Between Childhood Abuse and Risk Perception for Sexual Victimization in College Women.

Sexual victimization is prevalent among college women with a history of childhood abuse (CA), which some research suggests is linked to impaired risk perception for sexual victimization or difficulties identifying and responding to unwanted sexual advances. Alexithymia is one construct yet to be examined in the association between CA and risk perception for sexual victimization. The purpose of this study was to elucidate the associations between CA, alexithymia, and risk perception for sexual victimization in a sample of college women with a history of CA. Participants included 294 undergraduate women with a history of childhood emotional, physical, and/or sexual abuse (Mage = 20.6, 80.6% White). An a priori path analysis was conducted to examine whether alexithymia indirectly explains the association between CA and risk perception for sexual victimization (i.e., comprising two related constructs, including threat detection and behavioral response to threat). Supplementary analyses were conducted post hoc to examine potential differences across CA subtypes (emotional, physical, and sexual). Alexithymia indirectly explained the relationship between CA and threat detection, and behavioral response to threat. However, indirect effects were negative, suggesting that undergraduate women with more severe CA and alexithymia identify sexual assault threat cues and intentions to "leave" a hypothetical sexual assault scenario sooner rather than later. The same pattern of results was observed for emotional and physical (but not sexual) CA when examining their indirect effects on threat detection, and for emotional CA when examining behavioral response to threat. Findings contribute to the literature on sexual victimization by clarifying the role of alexithymia in risk perception for sexual victimization. Results also highlight the potential utility of increasing emotional literacy among college women with a history of CA (and especially emotional abuse) to facilitate adaptive responding to unwanted sexual advances.

The impact of exposure to physical and sexual violence on opioid consequences among trauma-exposed individuals recruited from the community who use opioids.

Interpersonal violence and opioid use disorder are significant and intersecting public health concerns in the USA. The current study evaluated the consequences associated with opioid use (e.g., physical, social, interpersonal, intrapersonal, and impulse control) as a function of a history of exposure to interpersonal trauma, specifically physical and sexual violence. Participants were 84 trauma-exposed individuals recruited from the community who use opioids (M age = 43.5 50% men; 55% white). Whereas no significant differences emerged in the consequences of opioid use based on a history of physical violence, individuals with a history of sexual violence demonstrated higher levels of impulsive consequences of opioid use compared to individuals without a history of sexual violence. These data highlight the importance of considering the role of exposure to sexual violence in the context of opioid use disorder treatment.

Experimental Investigation of the Influence of Positive Emotion Dysregulation on Risky Behavior Following Idiographic Emotion Inductions.

An experimental paradigm with subjective and objective assessments was used to further explicate the role of positive emotion dysregulation on risky behavior. Participants were 151 community women currently experiencing intimate partner violence and using substances (Mage = 40.81, 43.0% white). Participants were randomly assigned to positive, negative, and neutral idiographic emotion inductions. Subjective (state self-report) and objective (high frequency heart rate variability [hfHRV], skin conductance response, and salivary cortisol) markers of emotion dysregulation were assessed, following which participants completed subjective (state urges for substances) and objective (Balloon Analogue Risk Task) measures of risky behavior. Results showed (a) greater self-reported state emotion dysregulation and lower hfHRV predicted more urges for substances in the positive (versus negative and neutral) emotion induction conditions; and (b) lower hfHRV predicted more behavioral risk-taking propensity in the positive (versus neutral) emotion induction condition. Findings provide additional support for the influence of positive emotion dysregulation on risky behavior.

Open Label Pilot Study on Posttrauma Health Impacts of the Processing of Positive Memories Technique (PPMT).

Processing of Positive Memories Technique (PPMT) was proposed as a novel intervention for posttraumatic stress disorder (PTSD). PPMT comprises of 5 sessions focused on identifying and processing positive memories. As an open label pilot study, we explored PPMT's effects on PTSD severity, depression severity, affect and cognitive processes, and therapeutic alliance. A sample of 12 trauma-exposed participants seeking services at a University Psychology Clinic participated in 5 PPMT sessions (Mage=29.25 years; 58.30% women). We used the reliable change indices and clinically significant change score approach. The following number of participants showed statistically reliable changes: 9 participants for PTSD severity (8 recovered/improved); 6 participants for depression severity (5 improved); 5 participants for positive affect levels (2 recovered/improved); 9 participants for negative affect levels (8 recovered); 9 participants for posttrauma cognitions (7 recovered/improved); 5 participants for positive emotion dysregulation (4 recovered); 11 participants for number of retrieved positive memories (3 recovered); and 5 participants for therapeutic alliance (4 recovered). PPMT may impact certain posttrauma targets more effectively (PTSD, depression, negative affect, posttrauma cognitions). PPMT may be more helpful in improving regulation rather than levels of positive affect. PPMT, if supported in further investigations, may add to the clinician tool-box of PTSD interventions.

Ground-up approach to understanding the impacts of historical trauma in one reserve-dwelling first nations community.

OBJECTIVE: First Nations peoples experience disproportionate health inequities compared to most non-Indigenous populations. Historical trauma is one factor that has received growing attention in relation to health inequities among First Nations populations. The goal of the present study was to improve understanding of the specific forms, impacts, and mechanisms of transmission of events that lead to historical trauma and the historical trauma response in First Nations peoples. METHOD: Five focus groups were conducted among adult members of one First Nations community in Canada (N = 34; 70.4% female). RESULTS: Conventional content analysis revealed the numerous forms that historical trauma take in this First Nations community; individual-, familial-, community-, and societal-level impacts of historical trauma; and ways in which historical trauma has been transmitted in this community. Loss of culture, alcohol use, and parenting were major themes identified across these domains. CONCLUSIONS: Findings provide important information on the experience of historical trauma in one First Nations community, highlighting the roles of loss of culture; alcohol use; and parenting in the forms, impacts, and transmission of historical trauma. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Role of Emotion Dysregulation in the Association Between Substance Use Stigma and Depressive Symptoms Among Trauma-Exposed, Substance-Using Individuals.

Despite the well-documented association between experiences of substance use stigma and adverse mental health outcomes, little is known about the mechanisms underlying this association. Utilizing a community sample of substance-using adults who have experienced at least one traumatic event in their lifetime, the current study examined the role of dysregulation stemming from both negative and positive emotions in the relation between substance use stigma and depressive symptoms. Community participants (N = 320, 46.9% women) completed self-report measures of substance-use-related stigma experiences, negative and positive emotion dysregulation, and depressive symptoms. Results showed that, adjusting for gender and substance use severity, substance use stigma was positively associated with emotion dysregulation, which in turn related to depressive symptoms. Substance use stigma was also found to be indirectly associated with depressive symptoms through emotion dysregulation, suggesting that emotion dysregulation accounted for the significant association between substance use stigma and depressive symptoms. These findings provide initial support for the role of emotion dysregulation as a mechanism through which stigma operates to undermine the mental health of substance-using, trauma-exposed individuals. Results underscore the potential utility of targeting emotion dysregulation in intervention efforts that are designed to facilitate stigma coping among individuals who use alcohol and/or drugs.

Longitudinal Investigation of Bidirectional Relations Between Childhood Trauma and Emotion-Driven Impulsivity in the Adolescent Brain Cognitive Development Study.

OBJECTIVE: Exposure to childhood trauma is associated with numerous adverse mental health consequences. Addressing important gaps in the existing research, the proposed study clarifies the longitudinal and bidirectional associations between childhood trauma and both negative and positive emotion-driven impulsivity. METHOD: This study utilized a sample of 11,872 9- to 10-years-olds recruited from 21 research sites across the United States from the Adolescent Brain Cognitive Ddevelopment (ABCD) Study. Childhood trauma was assessed at one- and two-year follow-ups. Negative and positive urgency were assessed at baseline and two-year follow-up. Cross-lagged panel models evaluated the longitudinal and bidirectional associations between childhood trauma and both negative and positive emotion-driven impulsivity. RESULTS: Findings showed that earlier childhood trauma was associated with higher levels of later negative (ß = 0.133, p < .001) and positive (ß = 0.125, p < .001) emotion-driven impulsivity. Further, higher levels of earlier positive (ß = 0.033, p < .006), but not negative (ß = 0.010, p = .405), emotion-driven impulsivity were associated with later childhood trauma. Finally, the strength of the relations between childhood trauma and emotion-driven impulsivity did not differ by sex (ΔX2 = 10.228, p > .05). DISCUSSION: Identification of both negative and positive emotion-driven impulsivity among children exposed to trauma may serve as a point of intervention to reduce subsequent risk for deleterious health outcomes.

Ecological investigation of the co-occurrence of posttraumatic stress disorder symptoms and cannabis use among community women experiencing intimate partner violence.

BACKGROUND: Women experiencing intimate partner violence (IPV) are at increased risk for developing hazardous patterns of cannabis use. Research suggests that women experiencing IPV use cannabis to cope with posttraumatic stress disorder (PTSD) symptoms. To advance research, we used experience sampling methods to explicate the within-day concurrent and proximal relations between PTSD symptom clusters and cannabis use among women experiencing IPV. METHOD: Participants were 145 community women (M age = 40.66, 41.6% white, 31.4% Black, 10.9% Hispanic or Latina, 8% American Indian/Alaska Native, 5.8% Bi-/multi-racial) experiencing IPV and using substances who completed three surveys a day for 30 days. RESULTS: Externalizing behavior (OR = 1.37, 95% CI [1.15, 1.65], p < 0.001) and dysphoric arousal (OR = 1.27, 95% CI [1.09, 1.49], p = 0.002) PTSD symptom clusters were associated with cannabis use reported in the same survey period. Results from the lagged models found no proximal associations between PTSD symptom clusters and cannabis use. CONCLUSIONS: Results highlight the acute effects of externalizing behavior and dysphoric arousal PTSD symptoms on cannabis use among women experiencing IPV. These findings may inform prevention and intervention efforts for cannabis use in this population.

The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5: A Systematic Review of Existing Psychometric Evidence.

The PTSD Checklist for DSM-5 (PCL-5) is a widely used self-rated measure of DSM-5 PTSD symptoms. The goal of this systematic review was to synthesize research on the psychometric properties of the PCL-5 to guide clinical and research applications. We focused on reliability, validity, factor structure, optimal cutoff scores, and sensitivity to clinical change indices. A systematic review of the literature following PRISMA guidelines was conducted using PubMed, PsycINFO, CINAHL, and PTSDpubs with search terms capturing selected psychometric indices of the PCL-5. The inclusion criteria were: peer-reviewed publication in English; primary focus on the PCL-5 psychometrics; empirical study; and study with adult samples. The search yielded 265 studies; 56 papers (amounting to 64 studies) met inclusion criteria and were reviewed. Findings generally indicated evidence for: acceptable internal consistency and test-retest reliability; construct validity; a 7-factor Hybrid Model; recommended cutoff scores between 31-33; and ability to index sensitivity to clinical change. To further advance knowledge and applications of the PCL-5, we need more research on abbreviated versions of the PCL-5, bifactor modeling as applied to the PCL-5, as well as on PCL-5 item difficulty estimates, discrimination parameters, and clinical change score estimates.

Impacts of repeated retrieval of positive and neutral memories on posttrauma health: An investigative pilot study.

BACKGROUND AND OBJECTIVES: Evidence indicates that positive memory processes play a role in the etiology and maintenance of posttraumatic stress symptoms (PTSS) and related posttrauma health indicators. To extend this research, the current pilot study examined if repeated retrieval of positive vs. neutral memories was associated with (1) less PTSS and depression severity; and (2) improved affect and cognitions (fewer posttrauma cognitions, more positively-valenced affect, less negatively-valenced affect, less negative affect interference, less anhedonia, retrieval of more positive specific memories, retrieval of fewer negative specific memories). METHODS: Twenty-five trauma-exposed participants were randomly assigned to a positive or neutral memory task condition. They participated in four weekly experimental sessions facilitated by an experimenter virtually; each consecutive session was separated by 6-8 days. We conducted mixed between-within subjects ANOVAs to examine study hypotheses. RESULTS: No interaction effects were significant. There were significant main effects of time on PTSS and depression severity, posttrauma cognitions, positively-valenced and negatively-valenced affect, and negative affect interference. LIMITATIONS: We used self-report measures, small and non-clinical sample with limited demographic diversity, and virtual format; did not record memory narratives; and did not have a trauma memory condition. CONCLUSIONS: Based on pilot data, our findings suggest that individuals who retrieve positive or neutral memories repeatedly may report less PTSS and depression severity, fewer posttrauma cognitions, and improved affect. Results provide an impetus to examine impacts of and mechanisms underlying memory interventions (beyond a sole focus on negatively-valenced memories) in trauma work.

Positive Affect Processes and Posttraumatic Stress Disorder Symptoms: Findings from an Open Label and Uncontrolled Pilot Study using the Positive Memory Processing Technique.

Recently, a five-session Processing of Positive Memories Technique (PPMT) was proposed as a novel intervention for posttraumatic stress disorder (PTSD). One purported outcome of and mechanism underlying PPMT's effects on PTSD is improved positive affect processes. In this uncontrolled pilot study, we examined whether PPMT was associated with decreases in PTSD severity; and whether changes in positive affect levels, reactivity, and dysregulation related to changes in PTSD severity across sessions. The sample included 16 trauma-exposed participants seeking services at a University Psychology Clinic (Mage=27.44 years; 68.80% women). Multilevel linear growth models examined the main effects of each positive affect variable and their interactions with time on PTSD severity. PTSD severity decreased across PPMT treatment in each model (bs=-0.43 to -0.33; d=-0.03; ps<.001-0.008). There was a main effect of positive emotion dysregulation (b=1.16, d=0.11; p=0.009), but not of positive affect levels (p=0.821) or reactivity (p=0.356) on PTSD severity. However, positive affect processes did not modify the trajectory of PTSD severity across treatment. Regarding PTSD symptom clusters, there was an interaction between positive affect levels and time on alterations in arousal and reactivity (AAR) cluster severity (b=-0.01, p=0.036); individuals with positive affect levels 1 SD above the mean (b=-0.18, p<0.01) and at the mean (b=-0.10, p=0.01) had greater decreases in AAR cluster severity across treatment compared to individuals with positive affect levels 1 SD below the mean (b=-0.02, p=0.710). Findings suggest that PPMT may relate to improved PTSD symptoms; and that positive affect levels/dysregulation may be worthwhile targets for future investigations.

The Impact of Physical and Sexual Violence on Opioid Consequences among Trauma- exposed Individuals Recruited from the Community who Use Opioids.

Interpersonal violence and opioid use disorder are significant and intersecting public health concerns in the United States. The current study evaluated the consequences associated with opioid use as a function of history of interpersonal trauma, specifically physical and sexual violence. Participants were 84 trauma-exposed individuals recruited from the community who use opioids (M age = 43.5 50% men; 55% white). Whereas no significant differences emerged in the consequences of opioid use based on a history of physical violence, individuals with a history of sexual violence demonstrated higher levels of impulsive consequences of opioid use compared to individuals without a history of sexual violence. These data highlight the importance of considering the role of sexual violence in the context of opioid use disorder treatment.