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1.
J Autism Dev Disord ; 2020 Mar 13.
Artigo em Inglês | MEDLINE | ID: mdl-32170539

RESUMO

Differential diagnosis of autism spectrum disorder (ASD) among intellectually-able adults often presents a clinical challenge, particularly when individuals present in crisis without diagnostic history. The Personality Assessment Inventory (PAI) is a multiscale personality and psychopathology instrument utilized across clinical settings, but to date there are no published normative data for use of the PAI with adults with ASD. This study provides normative PAI data for adults diagnosed with ASD, with effect size comparisons to the PAI clinical standardization sample and an inpatient sample. Additionally, a discriminant function was developed and cross-validated for identification of ASD-like symptomatology in a clinical population, which demonstrates promise as a screening tool to aid in the identification of individuals in need of specialized ASD assessment.

2.
Psychother Res ; 30(2): 239-250, 2020 02.
Artigo em Inglês | MEDLINE | ID: mdl-30857489

RESUMO

AbstractObjective: Incarcerated individuals have high rates of trauma exposure. IPT reduces posttraumatic stress disorder (PTSD) symptoms in non-incarcerated adults, but has not been examined in prison populations. Moreover, little is known about the mechanisms through which IPT reduces PTSD symptoms. The current study investigated the direct and indirect effects of IPT on PTSD symptoms. We hypothesized that IPT would decrease PTSD symptoms by enhancing social support and decreasing loneliness (theorized IPT mechanisms). Method: A sub-sample of trauma-exposed participants (n = 168) were drawn from a larger randomized trial (n = 181) of IPT for major depressive disorder among prisoners. We examined a series of mediation models using non-parametric bootstrapping procedures to evaluate the indirect effect of IPT on PTSD symptoms. Results: Contrary to hypotheses, the relation between IPT and PTSD symptoms was significantly mediated through improvements in hopelessness and depressive symptoms (mechanisms of cognitive behavioral interventions), rather than through social support and loneliness. Increased social support and decreased loneliness were associated with decreased PTSD symptoms, but IPT did not predict changes in social support or loneliness. Conclusions: IPT may reduce PTSD symptoms in depressed prisoners by reducing hopelessness and depression. (ClinicalTrials.gov number NCT01685294).

3.
Contemp Clin Trials Commun ; 12: 26-31, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30225391

RESUMO

Background: Problems with anger and aggression are highly prevalent in Veterans of multiple war eras, including the most recent conflicts in Afghanistan (Operation Enduring Freedom; OEF) and Iraq (Operation Iraqi Freedom; OIF). The consequences of these problems, such as increased rates of divorce, domestic violence, occupational instability, arrests and incarceration, are often devastating. Despite the seriousness of these problems, relatively little is known about effective treatments for anger in Veterans. Method and design: This paper describes the rationale and study protocol of a randomized controlled trial comparing an adapted cognitive behavioral intervention (CBI) with an active control condition (supportive intervention, SI) for the treatment of anger problems in OEF/OIF Veterans. The sample includes 92 OEF/OIF Veterans, randomized to CBI or SI. Both treatments include 12 weekly, 75-min individual sessions. Participants are assessed at baseline, after sessions 4 and 8, at post-treatment, and at 3 and 6 months post-treatment. Primary outcomes are reduction in anger and aggression; secondary outcomes are improved functioning and quality of life. We hypothesize that CBI will be associated with significantly more improvement than SI on primary and secondary measures. Discussion: Findings from this study will help to address the gap in evidence for effective treatments for anger in Veterans. The use of an active control condition will provide a stringent test of the effects of CBI beyond that of common factors of psychotherapy such as therapeutic relationship, mobilization of hope, and support. Findings have the potential to improve treatment outcomes for Veterans struggling with post-deployment anger problems.

4.
Alcohol Clin Exp Res ; 42(3): 500-507, 2018 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-29281858

RESUMO

BACKGROUND: Phosphatidylethanol (PEth) is a direct biomarker for alcohol that is formed shortly after alcohol use and may remain detectable in blood for weeks after alcohol consumption. There is little research on alcohol use factors that influence PEth elimination, especially among women. METHODS: Data were collected from 116 alcohol use-disordered women who were recently incarcerated. We used a 2-part model with logistic and linear components to examine whether alcohol consumption in the 2 weeks prior to incarceration and days since last alcoholic drink (operationalized as abstinence days prior to incarceration + days incarcerated) were associated with PEth detectability (>8 ng/ml) and level (ng/ml) in blood. RESULTS: Participants reported drinking an average of 10 drinks per day in the 2 weeks prior to incarceration. Days since last drink was negatively associated with PEth level (odds ratio [OR] = 0.97, 95% confidence interval [CI] = 0.93; 0.99) and being PEth detectable (OR = 0.96, 95% CI = 0.91; 0.99). Quantity of alcohol consumed prior to jail admission was associated with PEth detection (OR = 1.08; 95% CI = 1.03; 1.16), but not PEth level. CONCLUSIONS: Days since last alcoholic drink and drinks per day both influenced PEth detectability, but only days since last drink predicted PEth level among a large sample of women with alcohol use disorder in the criminal justice system.


Assuntos
Abstinência de Álcool , Consumo de Bebidas Alcoólicas/sangue , Glicerofosfolipídeos/sangue , Prisões , Adolescente , Adulto , Feminino , Humanos , Modelos Lineares , Modelos Logísticos , Pessoa de Meia-Idade , Razão de Chances , Adulto Jovem
5.
Psychol Trauma ; 10(4): 411-418, 2018 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28981318

RESUMO

OBJECTIVE: Childhood maltreatment is an increasingly established predictor of psychological problems. However, limited research addresses pathways though which childhood maltreatment influences the mental health of military personnel following deployment. The current study investigated the direct, and indirect through emotional numbing, relations between childhood maltreatment and psychological distress of recently deployed veterans. METHOD: For a sample of 131 predominantly White, male Operation Iraqi Freedom/Operation Enduring Freedom members of U.S. Army National Guard and Reserve units, a path model was used to test the direct and indirect (through numbing) roles of childhood maltreatment on distress. RESULTS: Results showed that childhood maltreatment was not significantly directly associated with psychological distress one-year post-deployment but was indirectly related to distress by way of emotional numbing symptoms. CONCLUSIONS: Our findings suggest that childhood maltreatment may serve to influence returning veterans' experiences of psychological distress indirectly through increased emotional numbing following deployment. The importance of attending to emotional numbing symptoms among veterans with experiences of childhood maltreatment after deployment is highlighted. (PsycINFO Database Record


Assuntos
Adultos Sobreviventes de Eventos Adversos na Infância/psicologia , Emoções , Estresse Psicológico , Veteranos/psicologia , Exposição à Guerra , Adulto , Campanha Afegã de 2001- , Humanos , Guerra do Iraque 2003-2011 , Masculino , Estudos Retrospectivos
6.
Psychiatry Res ; 258: 78-82, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-28988123

RESUMO

Research has suggested that the co-occurrence of PTSD in individuals with OCD is associated with more severe symptoms and less responsivity to empirically supported treatment as compared to individuals with OCD and no history of PTSD. However, much of this work has been limited by non-empirical case report design, cross-sectional and retrospective analyses, or small sample sizes. The current study extended this research by comparing the clinical characteristics of individuals with OCD with and without a lifetime PTSD diagnosis in a large, naturalistic, longitudinal sample over the course of seven years. At baseline, individuals with comorbid lifetime PTSD reported significantly more severe symptoms of OCD (including symptom levels and insight), lower quality of life, and higher rates of comorbid lifetime mood and substance use disorders than participants without lifetime PTSD. Further, individuals with comorbid OCD and lifetime PTSD reported significantly more severe OCD symptoms over the course of seven years than those without lifetime PTSD. These results are largely consistent with the existing literature and support the need to consider PTSD symptoms in the assessment and treatment of OCD.


Assuntos
Transtorno Obsessivo-Compulsivo/epidemiologia , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Comorbidade , Feminino , Humanos , Estudos Longitudinais , Masculino , Transtornos do Humor/epidemiologia , Transtornos do Humor/psicologia , Transtorno Obsessivo-Compulsivo/diagnóstico , Qualidade de Vida , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Fatores de Tempo , Adulto Jovem
7.
J Nerv Ment Dis ; 205(7): 531-541, 2017 07.
Artigo em Inglês | MEDLINE | ID: mdl-28604417

RESUMO

Trauma and posttraumatic stress disorder (PTSD) symptomatology have been associated with suicidality, including ideation and behavior. The current investigation evaluated, in acute-care psychiatric inpatients, the mediating role of perceived (self-reported) distress tolerance in the association between PTSD symptom severity and suicidality, defined as a) suicidal ideation, intent, or behavior leading to current psychiatric hospitalization; b) self-reported severity of suicidal desire; and c) percentage of days of suicidality during current hospitalization. Participants were composed of 105 adults (55.2% women; mean age, 33.9; SD, 10.9) admitted to a public psychiatric acute-care inpatient hospital in a large metropolitan area; 52.3% of the participants were hospitalized for suicidality. Results indicated that PTSD symptom severity (and severity of each PTSD symptom cluster) may exert an indirect effect on suicidality, specifically suicidality as a basis for current hospital admission and self-reported severity of suicidal desire, through perceived distress tolerance. Effects were documented after controlling for theoretically relevant covariates.


Assuntos
Adaptação Psicológica/fisiologia , Hospitalização , Hospitais Psiquiátricos , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Estresse Psicológico/fisiopatologia , Ideação Suicida , Tentativa de Suicídio/psicologia , Adulto , Feminino , Humanos , Pacientes Internados , Masculino , Pessoa de Meia-Idade , Autorrelato , Adulto Jovem
8.
Brain Behav ; 7(5): e00681, 2017 05.
Artigo em Inglês | MEDLINE | ID: mdl-28523223

RESUMO

BACKGROUND: Abnormalities in fear extinction and recall are core components of posttraumatic stress disorder (PTSD). Data from animal and human studies point to a role of the ventromedial prefrontal cortex (vmPFC) in extinction learning and subsequent retention of extinction memories. Given the increasing interest in developing noninvasive brain stimulation protocols for psychopathology treatment, we piloted whether transcranial direct current stimulation (tDCS) during extinction learning, vs. during consolidation of extinction learning, might improve extinction recall in veterans with warzone-related PTSD. METHODS: Twenty-eight veterans with PTSD completed a 2-day Pavlovian fear conditioning, extinction, and recall paradigm. Participants received one 10-min session of 2 mA anodal tDCS over AF3, intended to target the vmPFC. Fourteen received tDCS that started simultaneously with extinction learning onset, and the remaining 14 participants received tDCS during extinction consolidation. Normalized skin conductance reactivity (SCR) was the primary outcome measure. Linear mixed effects models were used to test for effects of tDCS on late extinction and early extinction recall 24 hr later. RESULTS: During early recall, veterans who received tDCS during extinction consolidation showed slightly lower SCR in response to previously extinguished stimuli as compared to veterans who received tDCS simultaneous with extinction learning (p = .08), generating a medium effect size (Cohen's d = .38). There was no significant effect of tDCS on SCR during late extinction. CONCLUSIONS: These preliminary findings suggest that testing the effects of tDCS during consolidation of fear extinction may have promise as a way of enhancing extinction recall.


Assuntos
Extinção Psicológica/fisiologia , Medo/psicologia , Memória/fisiologia , Córtex Pré-Frontal/fisiopatologia , Transtornos de Estresse Pós-Traumáticos/fisiopatologia , Estimulação Transcraniana por Corrente Contínua/métodos , Adulto , Idoso , Condicionamento Clássico/fisiologia , Eletroencefalografia , Estudos de Viabilidade , Humanos , Masculino , Rememoração Mental/fisiologia , Pessoa de Meia-Idade , Projetos Piloto , Córtex Pré-Frontal/fisiologia , Veteranos/psicologia , Veteranos/estatística & dados numéricos
9.
Am J Orthopsychiatry ; 87(2): 157-165, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28206803

RESUMO

Military service members have an increased risk of developing mental health (MH) problems following deployment to Iraq or Afghanistan, yet only a small percentage seek mental health treatment. The aim of the present study was to explore patterns of MH service utilization within the first 12 months following return from combat deployment. Participants were 169 service members who had returned from war-zone deployment in either Iraq or Afghanistan and had assessments covering a 12-month period following their homecoming. The authors first examined the prevalence of mental health diagnoses and engagement with mental health treatment (e.g., visits to the emergency room, inpatient hospitalization, individual therapy, group therapy, family or couple therapy, medication appointments, and self-help). Regression analyses explored whether distress, functioning, diagnoses, or social support predicted treatment use. Findings indicated that 28 of 50 military service members (56%) who met diagnostic criteria for a mental health disorder accessed services in the year following their return from deployment. Individual treatment was the most common modality, and those with major depressive disorder (MDD) reported the most treatment contacts. Social support was not associated with use of mental health services. Baseline functioning and psychiatric distress predicted entry into treatment whereas only psychiatric distress predicted amount of mental health service use in the 12-month postdeployment period. Findings highlight the need for enhanced strategies to link those reporting psychiatric distress with MH treatment services and increase community connectedness regardless of whether they meet full criteria for a mental health diagnosis. (PsycINFO Database Record


Assuntos
Campanha Afegã de 2001- , Guerra do Iraque 2003-2011 , Serviços de Saúde Mental/estatística & dados numéricos , Militares/psicologia , Adulto , Transtorno Depressivo Maior/terapia , Humanos , Masculino , Prevalência , Guerra
10.
Compr Psychiatry ; 72: 13-17, 2017 01.
Artigo em Inglês | MEDLINE | ID: mdl-27693886

RESUMO

BACKGROUND: According to data from epidemiological and clinical samples, there are elevated rates of posttraumatic stress disorder (PTSD) among patients with bipolar disorder (BD). However, little is known about the clinical correlates that may distinguish patients with BD and comorbid PTSD from those without comorbid PTSD. The present study sought to elucidate those differences and examine factors, such as psychosis, history of suicide attempts, and comorbid personality disorders, which may predict comorbid PTSD in patients with BD-I. METHODS: We conducted a retrospective chart review of 230 psychiatric inpatients with BD-I. RESULTS: Patients with BD-I and comorbid PTSD were significantly more likely to be female, to be depressed (vs. manic), to have a comorbid personality disorder, and to have a history of suicide attempt. Also, BD-I patients with PTSD were significantly less likely to present for their inpatient hospital stay with psychosis. These effects remained significant after controlling for mood episode polarity, suggesting that findings were not fully explained by the higher incidence of depression in the comorbid PTSD group. CONCLUSIONS: Patients with BD-I and comorbid PTSD appear to be a high risk population with need for enhanced monitoring of suicidality. Clinical implications of these findings are discussed.


Assuntos
Transtorno Bipolar/epidemiologia , Transtorno Bipolar/psicologia , Hospitalização/tendências , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Tentativa de Suicídio/psicologia , Adulto , Transtorno Bipolar/diagnóstico , Comorbidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos da Personalidade/diagnóstico , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Transtornos Psicóticos/diagnóstico , Transtornos Psicóticos/epidemiologia , Transtornos Psicóticos/psicologia , Estudos Retrospectivos , Transtornos de Estresse Pós-Traumáticos/diagnóstico
11.
Psychol Trauma ; 9(Suppl 1): 19-24, 2017 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-27929311

RESUMO

OBJECTIVE: It is well established that exposure to combat is a risk factor for posttraumatic stress disorder (PTSD). The experiences of military personnel serving in combat zones vary widely however, leading to increased attention to the impact of different types of combat trauma. The present study examined the relationships among 3 conceptually based categories of combat exposure with 4 PTSD symptom clusters (reexperiencing, avoidance, numbing, and hyperarousal) and symptoms of guilt, depression, and anxiety. METHOD: Participants were 206 National Guard and Reserve members who had recently returned from deployment to Iraq or Afghanistan. RESULTS: As hypothesized, findings from a multivariate multiple linear regression analysis showed that exposure to personal life threat predicted symptoms of hyperarousal, and exposure to death or severe injury of others predicted symptoms of depression. Hypotheses that personal life threat would predict anxiety symptoms, exposure to death or injury of others would predict numbing, and having killed would predict guilt were not supported. CONCLUSIONS: The relative degree of exposure to life threat and death/loss events in a war-zone may impact the development of different types of symptoms. These findings highlight the importance of considering different types of trauma exposure in future research. (PsycINFO Database Record


Assuntos
Transtornos de Estresse Pós-Traumáticos , Veteranos/psicologia , Exposição à Guerra , Adulto , Campanha Afegã de 2001- , Ansiedade/epidemiologia , Nível de Alerta , Depressão/epidemiologia , Feminino , Culpa , Humanos , Guerra do Iraque 2003-2011 , Modelos Lineares , Masculino , Análise Multivariada , Fatores de Risco , Transtornos de Estresse Pós-Traumáticos/epidemiologia
12.
Subst Use Misuse ; 51(12): 1587-1592, 2016 10 14.
Artigo em Inglês | MEDLINE | ID: mdl-27484392

RESUMO

BACKGROUND: The concurrent use of marijuana and other substances among emerging adults (ages 18-25) is a major public health problem. This study examined if there are distinct subtypes of emerging adult marijuana users and if these are associated with demographic and substance use variables. METHODS: The design was a cross-sectional interview with a community sample of 1,503 emerging adults in the northeastern U.S. who reported last month marijuana use. We used latent class analysis (LCA) to identify distinct subtypes of emerging adults who used additional substances and examined predictors of the latent classes. RESULTS: We identified three distinct classes of emerging adults who use substances: "mostly smokers" (those who primarily use marijuana and nicotine), "moderate users" (those who primarily use marijuana and/or heavy episodic alcohol), and "polysubstance users." Polysubstance users had higher probabilities of use of all assessed substances (e.g. cocaine, opiates, sleep medications, stimulants, synthetic marijuana, and inhalants) than the other two groups. Not being currently enrolled in school and male gender were associated with mostly smokers and polysubstance users group status. CONCLUSIONS: We identified a distinct group of emerging adult marijuana users who primarily smoke marijuana and cigarettes, suggesting that there could be a shared vulnerability for risk of co-occurrence.


Assuntos
Fumantes , Consumo de Bebidas Alcoólicas , Estudos Transversais , Usuários de Drogas , Humanos , Masculino , Fumar Maconha
13.
Brain Stimul ; 9(4): 529-36, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27037186

RESUMO

BACKGROUND: Exposure-based therapy parallels extinction learning of conditioned fear. Prior research points to the ventromedial prefrontal cortex as a potential site for the consolidation of extinction learning and subsequent retention of extinction memory. OBJECTIVE/HYPOTHESIS: The present study aimed to evaluate whether the application of non-invasive transcranial direct current stimulation (tDCS) during extinction learning enhances late extinction and early recall in human participants. METHODS: Forty-four healthy volunteers completed a 2-day Pavlovian fear conditioning, extinction, and recall paradigm while skin conductance activity was continuously measured. Twenty-six participants received 2 mA anodal tDCS over EEG coordinate AF3 during extinction of a first conditioned stimulus. The remaining 18 participants received similar tDCS during extinction of a second conditioned stimulus. Sham stimulation was applied for the balance of extinction trials in both groups. Normalized skin conductance changes were analyzed using linear mixed models to evaluate effects of tDCS over late extinction and early recall trials. RESULTS: We observed a significant interaction between timing of tDCS during extinction blocks and changes in skin conductance reactivity over late extinction trials. These data indicate that tDCS was associated with accelerated late extinction learning of a second conditioned stimulus after tDCS was combined with extinction learning of a previous conditioned stimulus. No significant effects of tDCS timing were observed on early extinction recall. CONCLUSIONS: Results could be explained by an anxiolytic aftereffect of tDCS and extend previous studies on tDCS-induced modulation of fear and threat related learning processes. These findings support further exploration of the clinical use of tDCS.


Assuntos
Condicionamento Clássico/fisiologia , Extinção Psicológica/fisiologia , Medo/fisiologia , Estimulação Transcraniana por Corrente Contínua/métodos , Adolescente , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Adulto Jovem
14.
Mil Med ; 181(2): 161-6, 2016 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-26837085

RESUMO

OBJECTIVES: Unwanted sexual stressors experienced by military men and women are associated with a host of negative physical and mental health problems. Government officials are making it a priority to put a stop to these unwanted sexual experiences. However, the measure typically used measures sexual stressors much better for women than for men. The purpose of the present study was to test the factor structure of an alternative measure, the Sexual Harassment Inventory (SHI), to examine whether sexual stressors experienced by men correspond to women's experiences. METHODS: We used three preexisting datasets in which the SHI was used to assess active and former military members' sexual stressor experiences. We conducted an exploratory factor analysis to identify women's response patterns and a confirmatory factor analysis to determine whether men's response patterns corresponded to women's. RESULTS: Findings showed that the SHI has evidence of factorial validity in female service members and adequate, but not exceptional, factorial fit for male service members. CONCLUSIONS: It is imperative that more work be done to better understand how men experience and perceive potential military sexual stressors and how those perceptions and experiences compare to women's.


Assuntos
Militares/psicologia , Assédio Sexual/psicologia , Veteranos/psicologia , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores Sexuais , Inquéritos e Questionários , Estados Unidos
15.
Addict Behav ; 55: 5-14, 2016 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-26735913

RESUMO

Posttraumatic Stress Disorder (PTSD) is frequently comorbid with alcohol use disorders (AUD; Calabrese et al., 2011; McFall, Mackay, & Donovan, 1992). Among several explanations for this comorbidity, the most empirically supported is the self-medication theory which postulates that substances are used to medicate PTSD-related distress (Keane & Wolfe, 1990; Khantzian, 1985; Stewart, 1996). The current study examines the effects of trauma-related distress on alcohol use (total drinking days, drinks per drinking day, heavy drinking days) in a sample of 127 trauma-exposed Veterans following deployment to Iraq or Afghanistan. The dysphoria symptoms of PTSD were used as an indicator of distress, and examined as a moderator in the relationship between intrusion symptoms of PTSD and alcohol use. The proposed moderation model was tested using cross-sectional data from the first month following return from deployment, and at 6 months and at 12 months post-deployment. Results showed that dysphoria symptoms significantly moderated relations between intrusions and total drinking days and heavy drinking days at one month post-deployment; however, a significant pattern was not demonstrated at 6 months and 12 months. Further, dysphoria did not moderate the relation between intrusion symptoms and drinks per drinking day at the three time points. Theoretical and clinical implications are subsequently discussed.


Assuntos
Transtornos Relacionados ao Uso de Álcool/epidemiologia , Transtornos Relacionados ao Uso de Álcool/psicologia , Transtorno Depressivo/epidemiologia , Transtorno Depressivo/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Campanha Afegã de 2001- , Consumo de Bebidas Alcoólicas/psicologia , Comorbidade , Feminino , Seguimentos , Humanos , Guerra do Iraque 2003-2011 , Masculino , Estados Unidos/epidemiologia , Veteranos/psicologia , Veteranos/estatística & dados numéricos
16.
Int J Prison Health ; 11(2): 64-74, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26062658

RESUMO

PURPOSE: Antisocial personality disorder (ASPD) and psychopathy are similar, but distinct, psychiatric conditions that are common in male and female inmates; a segment of the population with high rates of trauma exposure. It is unclear whether specific types of lifetime trauma are associated with ASPD and psychopathy in incarcerated women and men. Furthermore, the unique roles of post-traumatic stress disorder (PTSD) symptom severity and trauma victimization in antisocial personality disturbance are not well-understood. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH: This study investigated associations between trauma variables (different kinds of traumatic experiences and PTSD) and antisocial personality variables (ASPD and psychopathy) in a sample of incarcerated women and men who participated in a randomized clinical trial for major depressive disorder. In total, 88 incarcerated men and women were assessed for ASPD diagnosis, psychopathy severity, PTSD symptom severity, and history of physical, sexual, and crime-related trauma. Regression analyses predicted ASPD or psychopathy from trauma variables, controlling for gender. FINDINGS: Physical trauma was the only form of trauma that was significantly related to psychopathy. Physical trauma and crime-related trauma were associated with ASPD. PTSD symptom severity was not associated with psychopathy or ASPD. ORIGINALITY/VALUE: There are associations between some kinds of lifetime trauma exposure and current ASPD/psychopathy in the target sample, but these associations do not appear to be mediated through current PTSD symptoms.


Assuntos
Transtorno da Personalidade Antissocial/psicologia , Vítimas de Crime/psicologia , Transtorno Depressivo Maior/psicologia , Abuso Físico/psicologia , Delitos Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Transtorno da Personalidade Antissocial/epidemiologia , Crime/psicologia , Vítimas de Crime/estatística & dados numéricos , Transtorno Depressivo Maior/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Abuso Físico/estatística & dados numéricos , Prisioneiros/psicologia , Fatores Sexuais , Delitos Sexuais/estatística & dados numéricos , Transtornos de Estresse Pós-Traumáticos/epidemiologia
17.
Psychol Trauma ; 7(3): 286-294, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25961120

RESUMO

This study examined relations among experiential avoidance, state dissociation during writing, cognitive-emotional processing, and posttraumatic stress in the context of an expressive writing task among 58 undergraduate females who were students at a large midwestern university that had recently experienced a mass shooting. Experiential avoidance significantly predicted reported suppression during the writing task. Additionally, posttraumatic stress symptoms (PTSS) at the time of the writing task were significantly associated with state dissociation, suppression, and the use of positive emotion words during the writing. Finally, at the zero-order level, prospective PTSS were associated with state dissociation and suppression during the earlier writing task. However, in a full regression model, only experiential avoidance and PTSS at the time of the writing task significantly predicted prospective PTSS. Supplemental analyses suggest processes may operate differently across levels of exposure. Findings from the present study provide further support for the role of experiential avoidance, state dissociation during writing, and cognitive-emotional processing in predicting PTSS. Additionally, experiential avoidance may play an important role in how individuals use cognitive-emotional processing to narrate a traumatic event.


Assuntos
Narração , Transtornos de Estresse Pós-Traumáticos/etiologia , Estudantes/psicologia , Universidades , Violência/psicologia , Redação , Transtornos Dissociativos , Feminino , Armas de Fogo , Humanos , Estudos Longitudinais , Psicolinguística , Testes Psicológicos , Análise de Regressão , Autorrelato , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto Jovem
18.
J Addict Dis ; 33(3): 202-9, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25115183

RESUMO

The most widely used illicit drug in the United States continues to be marijuana, and its use among emerging adults continues to increase. Marijuana use can result in a range of negative consequences and has been associated with other drug use in adolescents and emerging adults. This study examined the relationship between marijuana use frequency and the use of six other drug classes (opiates, cocaine, stimulants, hallucinogens, inhalants, and sleep medications) among emerging adults. A cross-sectional interview design was used with a community sample of 1,075 emerging adults in the northeastern United States. Using logistic regression analysis controlling for age, ethnicity, gender, and frequency of binge alcohol, daily marijuana use was found to be associated with a significant increase in the expected odds of opiate, cocaine, stimulant, hallucinogen, inhalant, and tobacco use. The findings identify a subgroup of emerging adult marijuana users-those who use daily-that may be vulnerable to additional negative consequences associated with polysubstance use.


Assuntos
Fumar Maconha/psicologia , Transtornos Relacionados ao Uso de Substâncias/psicologia , Adolescente , Adulto , Consumo de Bebidas Alcoólicas/epidemiologia , Estudos Transversais , Humanos , Fumar Maconha/epidemiologia , Massachusetts/epidemiologia , Análise de Regressão , Rhode Island/epidemiologia , Fumar/epidemiologia , Transtornos Relacionados ao Uso de Substâncias/epidemiologia , Adulto Jovem
19.
Women Health ; 54(8): 796-815, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-24965256

RESUMO

Incarcerated women, in comparison to nonincarcerated women, are at high risk for sexually transmitted infections (STIs) and many have experienced interpersonal violence. The psychological construct of emotional dysregulation-which includes heightened intensity of emotions, poor understanding of emotions, negative reactivity to emotion state, inability to control behaviors when experiencing emotional distress, and maladaptive emotion management responses-is a possible pathway to explain the link between interpersonal violence exposure and STI risk. The present study examined maladaptive emotion management responses for emotional dysregulation (i.e., avoidance and numbing, and dissociation) occurring in the context of risky sexual behavior. We collected qualitative data from 4 focus groups with a sample of n = 21 incarcerated women (aged 18+ years) from urban facilities in New England. Qualitative data were analyzed using a thematic analysis approach. Findings indicated that incarcerated women reported engaging in a variety of maladaptive responses for emotion management during sexual encounters. These maladaptive responses for emotion management appear to increase sexual risk behaviors and alter women's ability to implement STI protective behaviors, such as sexual negotiation and condom use. Preventive interventions to reduce sexual risk behaviors should incorporate strategies to promote emotional regulation among incarcerated women with histories of interpersonal violence.


Assuntos
Emoções , Relações Interpessoais , Prisioneiros/psicologia , Assunção de Riscos , Comportamento Sexual/psicologia , Violência/psicologia , Adolescente , Adulto , Feminino , Grupos Focais , Humanos , New England , Prisioneiros/estatística & dados numéricos , Prisões , Pesquisa Qualitativa , Sexo sem Proteção , População Urbana , Adulto Jovem
20.
J Anxiety Disord ; 28(3): 310-7, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-24647406

RESUMO

This study aimed to determine the unique impact of PTSD symptoms, beyond other frequently examined factors on physical and mental health functioning in a sample of returning veterans. Assessments of 168 returning OEF/OIF veterans conducted an average of six months following return from deployment included measures of emotional disorders and the Short Form (36) Health Survey. Hierarchical multiple regressions revealed significant, unique contribution of Clinician-Administered PTSD Scale (CAPS) score above all other predictors in the model (demographics, severity of trauma exposure, physical injury, substance abuse and depressive symptoms), for both the physical (8%) and mental (6%) health aggregate scores, along with significant prediction of physical health (4-10%) and mental health (3-7%) subscale scores. The only other significant predictors were age for physical health scores, and depressive symptoms for mental health scores. PTSD criterion B (re-experiencing) symptoms uniquely predicted reduced physical health functioning and higher experience of bodily pain, while criterion D (hyperarousal) symptoms uniquely predicted lower feelings of energy/vitality and poorer perceptions of emotional health.


Assuntos
Campanha Afegã de 2001- , Guerra do Iraque 2003-2011 , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Feminino , Inquéritos Epidemiológicos , Humanos , Masculino , Pessoa de Meia-Idade , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos Relacionados ao Uso de Substâncias , Veteranos/estatística & dados numéricos
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