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1.
Depress Anxiety ; 38(9): 882-885, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34469042

RESUMO

INTRODUCTION: The ongoing coronavirus disease 2019 (COVID-19) pandemic is a globally significant crisis with a rapid spread worldwide, high rates of illness and mortality, a high degree of uncertainty, and a disruption of daily life across the sociodemographic spectrum. The clinically relevant psychological consequences of this catastrophe will be long-lasting and far-reaching. There is an emerging body of empirical literature related to the mental health aspects of this pandemic and this body will likely expand exponentially. The COVID-19 pandemic is an example of a historic catastrophe from which we can learn much and from which the field will need to archive, interpret, and synthesize a multitude of clinical and research observations. METHODS: In this commentary, we discuss situations and contexts in which a diagnosis of posttraumatic stress disorder (PTSD) may or may not apply within the context of diagnostic and statistical manual of mental disorders, fifth edition (DSM-5) criteria. RESULTS: Our consensus is that a COVID-related event cannot be considered traumatic unless key aspects of DSM-5's PTSD Criterion A have been established for a specific type of COVID-19 event (e.g., acute, life-threatening, and catastrophic). CONCLUSION: The application of a more liberal interpretation of Criterion A will dilute the PTSD diagnosis, increase heterogeneity, confound case-control research, and create an overall sample pool with varying degrees of risk and vulnerability factors.


Assuntos
COVID-19 , Transtornos de Estresse Pós-Traumáticos , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Pandemias , SARS-CoV-2 , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia
2.
Psychiatry Res ; 301: 113974, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33979763

RESUMO

Effective posttraumatic stress disorder (PTSD) pharmacotherapy is needed. This 12-week randomized multicenter trial evaluated efficacy and safety of TNX-102 SL, a bedtime sublingual formulation of cyclobenzaprine, in patients with military-related PTSD randomized to TNX-102 SL 2.8 mg or 5.6 mg, or placebo. Primary analysis comparing change from baseline in Clinician-Administered PTSD Scale-5 score between 2.8 mg (n=90) and placebo (n=92) was not significant. Secondary analysis of 5.6 mg (n=49) vs placebo demonstrated a mean difference of -4.5 units, p=.05, or, accounting for missing data by multiple imputation, -5.0 units, p=.03. Clinician Global Impression - Improvement responder rate was greater in 5.6 mg than placebo (p=0.04), as was mean functional improvement in Sheehan Disability Scale social domain (p=.03) and trended in work domain (p=.05). Post-hoc analyses showed early sleep improvement predicted improvement in PTSD after 12 weeks for TNX-102 SL (p<.01), not for placebo. Most common administration site reaction in TNX-102 SL groups was oral hypoaesthesia (5.6 mg, 36%; 2.8 mg, 39%; placebo, 2%), while most common systemic adverse event was somnolence (5.6 mg, 16%; 2.8 mg, 12%; placebo, 6%). This provides preliminary evidence that TNX-102 SL 5.6 mg reduces PTSD symptoms, improves sleep and psychosocial function, and is well tolerated. Clinicaltrials.gov Identifier: NCT02277704.


Assuntos
Militares , Transtornos de Estresse Pós-Traumáticos , Amitriptilina/análogos & derivados , Método Duplo-Cego , Humanos , Sono , Transtornos de Estresse Pós-Traumáticos/tratamento farmacológico
3.
JAMA Netw Open ; 4(2): e2036733, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33538826

RESUMO

Importance: Posttraumatic stress disorder (PTSD) is a serious mental health disorder that can be effectively treated with empirically based practices. PTSD screening is essential for identifying undetected cases and providing patients with appropriate care. Objective: To determine whether the Primary Care PTSD screen for the Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (PC-PTSD-5) is a diagnostically accurate and acceptable measure for use in Veterans Affairs (VA) primary care clinics. Design, Setting, and Participants: This cross-sectional, diagnostic accuracy study enrolled participants from May 19, 2017, to September 26, 2018. Participants were recruited from primary care clinics across 2 VA Medical Centers. Session 1 was conducted in person, and session 2 was completed within 30 days via telephone. A consecutive sample of 1594 veterans, aged 18 years or older, who were scheduled for a primary care visit was recruited. Data analysis was performed from March 2019 to August 2020. Exposures: In session 1, participants completed a battery of questionnaires. In session 2, a research assistant administered the PC-PTSD-5 to participants, and then a clinician assessor blind to PC-PTSD-5 results conducted a structured diagnostic interview for PTSD. Main Outcomes and Measures: The range of PC-PTSD-5 cut points overall and across gender was assessed, and diagnostic performance was evaluated by calculating weighted κ values. Results: In total, 495 of 1594 veterans (31%) participated, and 396 completed all measures and were included in the analyses. Participants were demographically similar to the VA primary care population (mean [SD] age, 61.4 [15.5] years; age range, 21-93 years) and were predominantly male (333 participants [84.1%]) and White (296 of 394 participants [75.1%]). The PC-PTSD-5 had high levels of diagnostic accuracy for the overall sample (area under the receiver operating characteristic curve [AUC], 0.927; 95% CI, 0.896-0.959), men (AUC, 0.932; 95% CI, 0.894-0.969), and women (AUC, 0.899, 95% CI, 0.824-0.974). A cut point of 4 ideally balanced false negatives and false positives for the overall sample and for men. However, for women, this cut point resulted in high numbers of false negatives (6 veterans [33.3%]). A cut point of 3 fit better for women, despite increasing the number of false positives. Participants rated the PC-PTSD-5 as highly acceptable. Conclusions and Relevance: The PC-PTSD-5 is an accurate and acceptable screening tool for use in VA primary care settings. Because performance parameters will change according to sample, clinicians should consider sample characteristics and screening purposes when selecting a cut point.


Assuntos
Aceitação pelo Paciente de Cuidados de Saúde , Atenção Primária à Saúde , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Veteranos/psicologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Área Sob a Curva , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Questionário de Saúde do Paciente , Curva ROC , Sensibilidade e Especificidade , Fatores Sexuais , Estados Unidos , United States Department of Veterans Affairs , Adulto Jovem
4.
J Trauma Stress ; 2020 Oct 06.
Artigo em Inglês | MEDLINE | ID: mdl-33025677

RESUMO

Although individuals with posttraumatic stress disorder (PTSD) are at an increased risk for suicidal ideation (SI), it is unclear what factors might influence this association. Investigators have hypothesized that posttraumatic cognitions (PTCs), such as self-blame (SB) or negative cognitions about the self (NCAS) or world (NCAW), would play a role, but this has not been investigated empirically. Accordingly, we evaluated a model in which the association between PTSD symptoms and SI was moderated by PTCs in a sample of trauma-exposed undergraduate students (N = 410). To identify the specific source of this hypothesized moderation effect, we ran the moderation model separately for PTSD total severity, PTSD total severity without the cognition-related items, and each of four DSM PTSD symptom clusters in combination with each of three types of PTCs (i.e., NCAS, NCAW, SB), accounting for quadratic effects. The results revealed that NCAW moderated the positive association between all six of the PTSD variables and SI, f2 s < .01 to .04. Analyses of simple slopes generally revealed strong positive associations between PTSD symptoms with SI at high levels of NCAW, no associations at moderate levels, and negative associations at low levels. We also found one statistically significant quadratic effect when examining avoidance and NCAW. In contrast, neither NCAS nor SB emerged as a significant moderator in any of our regression models. These findings highlight the importance of addressing PTCs-particularly NCAW-in trauma survivors.

5.
Assessment ; : 1073191120954915, 2020 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-32887535

RESUMO

The Posttraumatic Cognitions Inventory (PTCI) is one of the most widely used measure of posttraumatic cognitions. The original factor analysis of the PTCI provided evidence for a three-factor model of negative cognitions about self, world, and self-blame. However, subsequent research has failed to replicate this factor structure without removing multiple items. Given these inconsistent findings, we examined the PTCI factor structure in a sample of trauma-exposed undergraduates (n = 868). First, we conducted a series of four confirmatory factor analyses (CFAs) based on previously published models of the PTCI and a modified model based on previously removed items, all which indicated poor fit. Next, we conducted a CFA of the recently published three-factor PTCI-9, which approached adequate fit. We then replicated the CFA of the PTCI-9 in a second independent sample (n = 971), finding a similar pattern of near adequate fit. These findings highlight the need to revise the PTCI. In addition, results indicate the promising nature of the PTCI-9 as an alternative measure of posttraumatic cognitions.

6.
Behav Res Ther ; 133: 103709, 2020 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-32805616

RESUMO

Individual differences in attentional control may explain null findings and inconsistent patterns of threat-related attentional bias (ABT) that are common in the posttraumatic stress disorder (PTSD) literature. At Time 1 (T1), trauma-exposed community participants (N = 89) completed a clinical interview, self-report measures, and an eye-tracking task developed to assess ABT. Participants completed follow-up assessments online 6 (T2) and 12 (T3) months later. Those with higher PTSD symptoms and deficits in attentional control exhibited a pattern of undercontrol, characterized by attention maintenance on threat and increased arousal. In contrast, those with higher PTSD symptoms and relatively better attentional control exhibited a pattern of overcontrol, characterized by threat avoidance and reduced arousal. These effects were specific to threat stimuli. Among PTSD symptom clusters, symptoms of hyperarousal were of central importance to the observed effects. Results from the longitudinal analysis indicate that both of these patterns of ABT are maladaptive, resulting in symptom maintenance at T2 and T3. These results have implications for (a) reconciling tensions between disparate models of ABT (i.e., vigilance-avoidance vs. attention maintenance), (b) precision medicine based approaches to targeting PTSD-related ABT, and (c) understanding the transdiagnostic role that attentional control may play in influencing ABT expression.

7.
J Anxiety Disord ; 70: 102190, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32106024

RESUMO

The PTSD Checklist (PCL) is a widely used, extensively validated questionnaire for posttraumatic stress disorder (PTSD). The PCL was revised for Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5; Friedman, 2013), and the updated version, the PCL-5, has continued the strong psychometric performance of the original version. To further explore the PCL-5's psychometric properties, we used item response theory (IRT) to examine item difficulty and discrimination parameters in separate samples of trauma-exposed undergraduates (N = 1213) and community members (N = 367). Considering item difficulty, nightmares, flashbacks, and reckless or self-destructive behavior emerged among the most difficult items across samples and internal avoidance emerged as the least difficult items across samples. In terms of item discrimination, inability to experience positive emotions, detachment from others, diminished interest, and negative emotions emerged as highly discriminating items in both samples, and traumatic amnesia and reckless or self-destructive behavior emerged as the least discriminating items in both samples. These results have implications for the divergent conceptualizations of PTSD in DSM-5 versus International Classification of Diseases, 11th Edition (ICD-11; WHO, 2018). Future research should employ IRT in a clinical population.


Assuntos
Lista de Checagem , Manual Diagnóstico e Estatístico de Transtornos Mentais , Classificação Internacional de Doenças , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Adolescente , Adulto , Feminino , Humanos , Masculino , Psicometria , Comportamento Autodestrutivo , Estudantes/psicologia , Inquéritos e Questionários , Adulto Jovem
8.
Assessment ; 27(6): 1116-1127, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31609129

RESUMO

The Detailed Assessment of Posttraumatic Stress (DAPS; Briere, 2001) is a comprehensive questionnaire that assesses posttraumatic stress disorder (PTSD) diagnostic criteria as well as peritraumatic responses and associated problems such as dissociation, suicidality, and substance abuse. DAPS scores have demonstrated excellent reliability, validity, and clinical utility, performing as well or better than leading PTSD questionnaires. The present study was an initial psychometric evaluation of the unreleased DAPS (DAPS-2), revised for Diagnostic and Statistical Manual of Mental Disorders-Fifth edition (DSM-5), in an MTurk-recruited mixed trauma sample (N = 367). DAPS-2 PTSD scale and associated features scales demonstrated high internal consistency and strong convergent and discriminant validity. In confirmatory factor analyses, the DSM-5 four-factor model of PTSD provided adequate fit, but the leading seven-factor model provided superior fit. These results indicate the DAPS-2 is a psychometrically sound measure of DSM-5 PTSD symptoms.

9.
Psychol Serv ; 17(2): 187-194, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-30299150

RESUMO

This study validated the Brief Inventory of Psychosocial Functioning (B-IPF), an abridged version of the 80-item Inventory of Psychosocial Functioning (IPF; Bovin et al., 2018). The B-IPF-a 7-item self-report questionnaire that assesses posttraumatic stress disorder (PTSD)-related psychosocial functional impairment-was developed for use in settings in which the full IPF would be too time intensive to administer. In this study, we examined the psychometric properties of the B-IPF among a sample of 362 veterans recruited from 2 Veterans Affairs hospitals. The B-IPF demonstrated high internal consistency (Cronbach's alpha = .84) and adequate test-retest reliability (r = .65, p < .001). The B-IPF was strongly correlated with the IPF (r = .71, p < .01) and had higher correlations with measures of mental health impairment and quality of life (all rs > ∥.50∥; all ps < .001) than with a measure of physical health impairment (i.e., the Physical Component Summary; r = -.34; p < .001), which demonstrated strong construct validity. In addition, the B-IPF displayed strong criterion-related validity, with higher correlations with a PTSD symptom measure, (r = .63, p < .05), and measures of other internalizing disorders (all rs > .44; all ps < .05) and a lower correlation with a measure of an externalizing disorder (r = .14; p < .05). These results indicate that the B-IPF is a reliable and valid instrument for assessing PTSD-related impairment. The strong psychometric properties of the instrument, in addition to its length, make it ideal for settings in which time is a factor. (PsycInfo Database Record (c) 2020 APA, all rights reserved).


Assuntos
Escalas de Graduação Psiquiátrica/normas , Psicometria/normas , Funcionamento Psicossocial , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estados Unidos , United States Department of Veterans Affairs , Veteranos
10.
Psychol Assess ; 31(1): 46-58, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30113182

RESUMO

[Correction Notice: An Erratum for this article was reported online in Psychological Assessment on Nov 19 2018 (see record 2018-60122-001). In the article, the affiliations of multiple authors were incorrectly listed in the author byline and author note. For Daniel J. Lee, Michelle J. Bovin, Denise M. Sloan, Terence M. Keane, and Brian P. Marx, the affiliations should have read "National Center for PTSD, Boston, Massachusetts; VA Boston Healthcare System, Boston, Massachusetts; and Department of Psychiatry, Boston University School of Medicine." For author Paula P. Schnurr, the affiliations should have read "National Center for PTSD, White River Junction, Vermont; Department of Psychiatry, Geisel School of Medicine at Dartmouth." All versions of this article have been corrected.] The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) 4-factor model of posttraumatic stress disorder (PTSD) has demonstrated adequate fit in several confirmatory factor analysis (CFA) studies. Although several alternative measurement models have demonstrated better fit, there is no consensus yet on the best model, and newly proposed models lack sufficient construct validation. Notably, these studies have relied exclusively on questionnaire data, and thus their findings may be attributable to a method effect. This study examined the factor structure of DSM-5 PTSD symptoms using both questionnaire and interview data to determine the impact of assessment method on factor structure and construct validity of alternative model symptom clusters. Participants (N = 380) were veterans who completed the PTSD Checklist for DSM-5 (PCL-5; Weathers et al., 2013) and the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers et al., 2013). Fit was similar across models. However, the seven-factor Hybrid model (Armour et al., 2015) fit best. Limited evidence of a method effect was observed. Results of construct validity analyses were mixed; some of the newly proposed symptom clusters demonstrated hypothesized differential associations with external correlates, but others did not. These findings suggest that results of previous DSM-5 PTSD CFAs supporting the Hybrid model are not attributable to a method effect. However, observed limited difference in model fit and mixed construct validity evidence raise concerns regarding the value of parsing DSM-5 symptom clusters. Constructs implied by the new factors in the more complex measurement models of PTSD require greater explication and construct validation. (PsycINFO Database Record (c) 2018 APA, all rights reserved).


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Escalas de Graduação Psiquiátrica/normas , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto , Idoso , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Estatísticos , Reprodutibilidade dos Testes , Transtornos de Estresse Pós-Traumáticos/classificação , Transtornos de Estresse Pós-Traumáticos/fisiopatologia
11.
J Abnorm Psychol ; 127(6): 541-547, 2018 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-30102064

RESUMO

Network theory, which conceptualizes psychiatric disorders as networks of interacting symptoms, may provide a useful framework for understanding psychopathology. However, questions have arisen regarding the stability and generalizability of network analytic methods, with some researchers arguing that symptom networks have limited replicability. The aim of this study was to evaluate assessment modality as one possible source of instability in the estimation of posttraumatic stress disorder (PTSD) symptom networks. We estimated two cross-sectional DSM-5 PTSD symptom networks in 378 U.S. veterans: one using data from a clinician-rated assessment instrument (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and one using data from a self-rated questionnaire (the PTSD Checklist for DSM-5; PCL-5). We calculated centrality indices, conducted community structure analyses, and compared the strength and structure of the networks. The CAPS-5 and PCL-5 symptom networks were highly similar, challenging the notion that network methods produce unreliable results due to estimations consisting primarily of measurement error. Furthermore, each network contained distinct symptom communities that only partially overlapped with the DSM-5 PTSD symptom clusters. These findings may provide guidance for future revisions of the DSM, suggest hypotheses about how PTSD symptoms interact, and inform recent debate about replicability of psychopathology symptom networks. (PsycINFO Database Record


Assuntos
Transtornos de Estresse Pós-Traumáticos/diagnóstico , Autoavaliação Diagnóstica , Manual Diagnóstico e Estatístico de Transtornos Mentais , Humanos , Masculino , Pessoa de Meia-Idade , Teoria Psicológica , Psicometria , Transtornos de Estresse Pós-Traumáticos/classificação , Veteranos/psicologia
12.
J Anxiety Disord ; 58: 70-77, 2018 08.
Artigo em Inglês | MEDLINE | ID: mdl-30055470

RESUMO

Evidence suggests that posttraumatic stress (PTS) disorder (PTSD) symptom presentations may vary as a function of index trauma type. Network analysis was employed in the present study to examine differences in PTS symptom centrality (i.e., the relative influence of a symptom on the network), and PTS symptom associations across three trauma types: motor vehicle accident (MVA), sexual assault (SA), and sudden accidental/violent death of a loved one (SAD). The final sample comprised 554 female undergraduates who had experienced a MVA (n = 226), SA (n = 222), or SAD (n = 106) per Diagnostic Statistical Manual-Fifth Edition (DSM-5) criteria. Within the pooled network, anhedonia and dysphoria emerged as the most central symptoms, while trauma-related amnesia was the least central. The SA network was largely consistent with the DSM-5 conceptualization of PTSD. In contrast, the SAD network was the least consistent with the DSM-5 conceptualization of PTSD, and centrality estimates for the SAD network were inconsistent with the MVA and SA networks. Findings of the current study suggest a need to consider index trauma type as an important factor in the ontology of PTSD. Findings also add to the ongoing discussions about the suitability of SAD as a PTSD-relevant trauma type and about the importance of trauma-related amnesia as a PTSD symptom.


Assuntos
Modelos Psicológicos , Transtornos de Estresse Pós-Traumáticos/classificação , Transtornos de Estresse Pós-Traumáticos/psicologia , Acidentes de Trânsito/psicologia , Anedonia , Transtorno Depressivo Maior/complicações , Transtorno Depressivo Maior/psicologia , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Delitos Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/complicações , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adulto Jovem
13.
J Trauma Stress ; 31(3): 448-453, 2018 06.
Artigo em Inglês | MEDLINE | ID: mdl-29958338

RESUMO

Posttraumatic growth, defined as positive transformation following trauma, is commonly measured using the Posttraumatic Growth Inventory (PTGI; Tedeschi & Calhoun, 1996) and is postulated to comprise five distinct domains: Changes in Relationships, Life Possibilities, Personal Strength, Spirituality, and Appreciation of Life. However, research has indicated that the model fit is not good and the factors are highly intercorrelated. Further, no studies have formally examined the heterogeneity of correlations of the five factors with external constructs. In an effort to examine the construct validity of the five-factor model of the PTGI, the present study aimed to examine the degree to which the theorized five factors demonstrate meaningful differential associations with relevant external correlates. Participants were 400 undergraduate students who reported having experienced a stressful event and completed the Life Events Checklist for DSM-5, PTGI, Posttraumatic Stress Disorder Checklist for DSM-5, Grit Scale-12, Connor-Davidson Resilience Scale-10, and Work and Social Adjustment Scale. We found few instances of significant differentiation, and effect sizes for pairwise comparisons were generally small, Cohen's qs = 0.01-0.35. Although factor analytic evidence suggests there are five distinct underlying constructs, our results indicated that these factors do not significantly differ in their associations with external correlates. Implications for use of the PTGI and future research directions are discussed.


Assuntos
Acontecimentos que Mudam a Vida , Inventário de Personalidade , Crescimento Psicológico Pós-Traumático , Adaptação Psicológica , Adolescente , Adulto , Análise Fatorial , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Psicometria , Adulto Jovem
14.
Psychol Serv ; 15(2): 216-229, 2018 May.
Artigo em Inglês | MEDLINE | ID: mdl-29723024

RESUMO

This study describes the three-phase development and validation of the Inventory of Psychosocial Functioning (IPF), an 80-item, self-report measure of posttraumatic stress disorder (PTSD)-related psychosocial functional impairment. In Phase I, we conducted 12 focus groups with male and female veterans (n = 53) to identify and operationalize the domains of psychosocial impairment associated with PTSD. This information was used to develop the IPF. We subsequently evaluated the psychometric properties of the newly developed inventory in Phases II (n = 276) and III (n = 368) using two independent samples of veterans. We found that the overall IPF score demonstrated stronger correlations with measures of mental health-related impairment (all rs > |.39|; all ps < .05) and weaker correlations with measures of physical health-related impairment (all rs < |.29|; all ps < .05). Overall IPF scores were most strongly associated with PTSD and other disorders associated with the anxious-misery factor of the three-factor model of psychiatric comorbidity (all rs > .56; all ps < .05) and less strongly associated with disorders associated with the fear factor (all rs < .48; all ps < .05) and the externalizing factor (r = .16; p < .05). The IPF demonstrated strong test-retest reliability (r = .77; p < .05). Our results suggest that the IPF is a valid and reliable measure of PTSD-related psychosocial functional impairment. (PsycINFO Database Record


Assuntos
Ajustamento Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Idoso , Feminino , Grupos Focais , Humanos , Masculino , Saúde Mental , Pessoa de Meia-Idade , Psicometria
15.
J Anxiety Disord ; 54: 17-23, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-29421368

RESUMO

Despite the factor analytic support for the seven-factor hybrid model (Armour et al., 2015) of posttraumatic stress disorder (PTSD), little research has examined the degree to which newly established symptom clusters (i.e., negative affect, anhedonia, dysphoric arousal, anxious arousal, externalizing behavior) functionally and meaningfully differ in their associations with other clinical phenomena. The aim of the current study was to examine the degree to which newly established PTSD symptom clusters differentially relate to co-occurring psychopathology and related clinical phenomena through Wald testing using latent variable modeling. Participants were 535 trauma-exposed undergraduates who completed the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5; Weathers et al., 2013) and Personality Assessment Inventory (PAI; Morey, 1991). As expected and in line with results from previous studies, significant heterogeneity emerged for dysphoric arousal, anxious arousal, and externalizing behavior. However, there was less evidence for the distinctiveness of negative affect and anhedonia. Results indicate that only some of the newly established symptom clusters significantly differ in their associations with related clinical phenomena and that the hybrid model might not provide a meaningful framework for understanding which PTSD symptoms relate to associated features. Limitations include a non-clinical sample and reliance on retrospective self-report assessment measures.


Assuntos
Afeto/fisiologia , Anedonia/fisiologia , Ansiedade/psicologia , Nível de Alerta/fisiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Adolescente , Adulto , Lista de Checagem , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Modelos Psicológicos , Estudos Retrospectivos , Autorrelato , Transtornos de Estresse Pós-Traumáticos/psicologia , Estudantes , Adulto Jovem
16.
Psychol Assess ; 30(3): 383-395, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28493729

RESUMO

The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record


Assuntos
Manual Diagnóstico e Estatístico de Transtornos Mentais , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Saúde dos Veteranos , Veteranos/psicologia , Adulto , Idoso , Feminino , Humanos , Entrevistas como Assunto , Masculino , Pessoa de Meia-Idade , Psicometria , Reprodutibilidade dos Testes , Transtornos de Estresse Pós-Traumáticos/psicologia
17.
Suicide Life Threat Behav ; 48(1): 105-115, 2018 02.
Artigo em Inglês | MEDLINE | ID: mdl-28261858

RESUMO

This study used the interpersonal-psychological theory of suicide to explore the relationships among DSM-5 posttraumatic stress disorder (PTSD) symptom clusters derived from the six-factor anhedonia model and facets of acquired capability for suicide (ACS). In a sample of 373 trauma-exposed undergraduates, most PTSD symptom clusters were negatively associated with facets of ACS in bivariate correlations, but the anhedonia cluster was positively associated with ACS in regression models. Structure coefficients and commonality analysis indicated that anhedonia served as a suppressor variable for the other symptom clusters. Our findings further elucidate the complex relationship between specific PTSD symptom clusters and ACS.


Assuntos
Anedonia , Transtornos de Estresse Pós-Traumáticos , Suicídio , Transtornos Relacionados a Trauma e Fatores de Estresse , Adulto , Manual Diagnóstico e Estatístico de Transtornos Mentais , Feminino , Humanos , Masculino , Modelos Psicológicos , Escalas de Graduação Psiquiátrica , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/psicologia , Estudantes/psicologia , Suicídio/prevenção & controle , Suicídio/psicologia , Transtornos Relacionados a Trauma e Fatores de Estresse/diagnóstico , Transtornos Relacionados a Trauma e Fatores de Estresse/psicologia
18.
Curr Opin Psychol ; 14: 122-126, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-28813310

RESUMO

Posttraumatic stress disorder (PTSD) was substantially redefined for DSM-5, with significant changes in nosology, definition of a traumatic stressor, and number and nature of symptom criteria. These updates, motivated by decades of empirical findings and clinical observation, provide better coverage of the full range of trauma-related clinical presentations while maintaining backward compatibility with previous versions of PTSD. Nonetheless, they have been criticized as being unwarranted, creating excessively complex criteria, and generating unacceptable levels of diagnostic discordance. However, when the goals and expectable effects of the DSM-5 PTSD revision process are considered in light of a growing number of relevant studies, the DSM-5 PTSD criteria perform well and represent a valuable incremental step in the ongoing evolution of the PTSD construct.

19.
J Pers Assess ; 99(1): 56-66, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-27564399

RESUMO

Emotion regulation (ER) strategy use has been identified as a transdiagnostic predictor of the development, maintenance, and recovery from several forms of psychopathology. However, the ER strategy use literature relies primarily on self-report measures that have several important limitations. This article describes the development and initial psychometric evaluation of a novel clinician-administered measure of ER strategy use, the Semi-Structured Emotion Regulation Interview (SERI; Lee, Weathers, & Sloan, 2016 ). The SERI was developed in a construct validation framework with emphasis on a multistage content validity process. The SERI assesses frequency and efficacy (i.e., proximal change in the targeted emotion) of 9 strategies in regulation of a specified emotion type and intensity (e.g., severe anxiety) during the past 30 days. Undergraduates (N = 68) completed a battery of self-report measures and a subsequent interview. Frequency and efficacy of each strategy was assessed separately with respect to regulation of moderate and severe anxiety and anger. Each of the assessed strategies demonstrated excellent discriminant validity. Associations between SERI and self-report measures of ER strategy use varied by target emotion type and intensity for some strategies, but not others. Implications and suggestions for future research are described.


Assuntos
Sintomas Afetivos/psicologia , Ansiedade/psicologia , Ajustamento Emocional , Autorrelato , Ira , Emoções , Humanos , Determinação da Personalidade , Psicometria , Psicopatologia , Estudantes/psicologia
20.
Psychol Trauma ; 9(5): 553-560, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27929309

RESUMO

OBJECTIVE: Posttraumatic growth (PTG), or multidimensional positive change following a traumatic event (TE), is conceptualized as qualitatively distinct from growth following a nontraumatic stressful event (NTSE; Tedeschi & Calhoun, 2004; Zoellner & Maercker, 2006). However, the degree to which PTG is a trauma-specific phenomenon has yet to be established. Although research indicates that individuals who experience TEs endorse greater PTG than those who experience NTSEs (Kastenmüller et al., 2012; Tedeschi & Calhoun, 1996), factorial invariance and latent mean differences in PTG between these groups have yet to be examined. Accordingly, the aim of the present study was to extend previous findings by examining the factorial invariance of the Posttraumatic Growth Inventory (PTGI) across groups whose worst stressor was a Diagnostic and Statistical Manual of Mental Disorders (5th ed. [DSM-5]; American Psychiatric Association, 2013) Criterion A event or a non-Criterion A event. METHOD: Participants were 644 undergraduates who reported experiencing a stressful event and completed the Life Events Checklist for DSM-5 (LEC-5) and PTGI. RESULTS: Results indicated that the previously identified 5-factor model of the PTGI provided the best fit, although fit was mediocre. A higher order model significantly worsened model fit and thus was rejected. Unexpectedly, strong factorial invariance and equivalence of latent means were found, indicating that the factor structure and latent means of PTG were identical across groups. CONCLUSIONS: Findings indicate that PTG might not be qualitatively or quantitatively distinct from growth due to NTSEs, and TEs and NTSEs elicit similar levels of PTG. Limitations include cross-sectional design. (PsycINFO Database Record


Assuntos
Acontecimentos que Mudam a Vida , Estresse Psicológico/etiologia , Adaptação Psicológica , Adolescente , Adulto , Estudos Transversais , Análise Fatorial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Inquéritos e Questionários , Adulto Jovem
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