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1.
Fam Process ; 63(1): 315-330, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-36720198

RESUMO

In the context of service member posttraumatic stress disorder (PTSD) symptoms, intimate partners may experience pressure to take over parenting roles and run interference between the service member and the children; that is, to engage in partner accommodation focal to parenting. The current study quantitatively assessed potential pressures to engage in parenting accommodation (PPEPA) in a sample of 207 female partners married to male service members with at least one child in the home and the convergence of PPEPA with service member PTSD symptoms, general partner accommodation, couple functioning, parenting, and child functioning. Partners' reports of PPEPA were associated with higher levels of service member PTSD symptoms and partners' general accommodation of PTSD symptoms. When controlling for service member PTSD symptoms and general partner accommodation, partner reports of PPEPA still accounted for unique variance in lower parenting alliance (as reported by both service member and partner), lower levels of service members' reports of closeness with children in the home, higher levels of harsh parenting by both the service member and partner, and greater child behavioral difficulties. Findings support PPEPA as related to partners' accommodative responses to PTSD but demonstrating unique associations with parenting alliance, parenting, and child outcomes. Parenting interventions in the context of PTSD may benefit from conjoint or family approaches that attend to the intersection of PTSD and broader family functioning, including pressures to engage in accommodation focal to the parenting domain.


Assuntos
Militares , Transtornos de Estresse Pós-Traumáticos , Criança , Humanos , Masculino , Feminino , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Poder Familiar , Relações Interpessoais , Cônjuges
2.
BMC Public Health ; 23(1): 1749, 2023 09 08.
Artigo em Inglês | MEDLINE | ID: mdl-37679746

RESUMO

BACKGROUND: Amidst the COVID-19 pandemic, there has been growing concern about the declining mental health and healthy behaviors compared to pre-pandemic levels. Despite this, there is a lack of longitudinal studies that have examined the relationship between health behaviors and mental health during the pandemic. In response, the statewide COVIDsmart longitudinal study was launched. The study's main objective is to better understand the effects of the pandemic on mental health. Findings may provide a foundation for the identification of public health strategies to mitigate future negative impacts of the pandemic. METHODS: Following online recruitment in spring of 2021, adults, ages 18 to 87, filled out social, mental, economic, occupational, and physical health questionnaires on the digital COVIDsmart platform at baseline and through six monthly follow-ups. Changes in the participant's four health behaviors (e.g., tobacco and alcohol consumption, physical activity, and social media use), along with sex, age, loneliness score, and reported social and economic (SE) hardships, were analyzed for within-between group associations with depression and anxiety scores using Mixed Models Repeated Measures. RESULTS: In this study, of the 669 individuals who reported, the within-between group analysis indicated that younger adults (F = 23.81, p < 0.0001), loneliness (F = 234.60, p < 0.0001), SE hardships (F = 31.25, p < 0.0001), increased tobacco use (F = 3.05, p = 0.036), decreased physical activity (F = 6.88, p = 0.0002), and both positive and negative changes in social media use (F = 7.22, p = 0.0001) were significantly associated with worse depression scores. Additionally, females (F = 6.01, p = 0.015), younger adults (F = 32.30, p < 0.0001), loneliness (F = 154.59, p < 0.0001), SE hardships (F = 22.13, p < 0.0001), increased tobacco use (F = 4.87, p = 0.004), and both positive and negative changes in social media use (F = 3.51, p = 0.016) were significantly associated with worse anxiety scores. However, no significant changes were observed in the within-between group measurements of depression and anxiety scores over time (p > 0.05). Physical activity was not associated with anxiety nor was alcohol consumption with both depression and anxiety (p > 0.05). CONCLUSIONS: This study demonstrates the longitudinal changes in behaviors within the context of the COVID-19 pandemic. These findings may facilitate the design of preventative population-based health approaches during the COVID-19 pandemic or future pandemics.


Assuntos
COVID-19 , Pandemias , Adulto , Feminino , Humanos , COVID-19/epidemiologia , Depressão/epidemiologia , Estudos Longitudinais , Virginia/epidemiologia , Ansiedade/epidemiologia
3.
J Trauma Stress ; 36(3): 567-578, 2023 06.
Artigo em Inglês | MEDLINE | ID: mdl-36991577

RESUMO

Talking with others about traumatic experiences (i.e., trauma disclosure) has been associated with increased posttraumatic growth (PTG). Although this association indicates the value of disclosing, there is evidence that external pressure to disclose can hinder the benefits of trauma disclosure. The aim of the current study was to examine the influence of pressure to disclose on the association between trauma disclosure and PTG. People who had experienced a traumatic event and disclosed their trauma to a close other were recruited using Amazon's Mechanical Turk (N = 208). Participants completed measures of trauma exposure, trauma disclosure, pressure to disclose, PTG, posttraumatic stress symptoms, and response to disclosure. The results indicated that the linear association between trauma disclosure and PTG was quadratically moderated by pressure to disclose, ηp 2 = .025. Pressure to disclose strengthened the positive association between trauma disclosure and PTG from low, B = 0.818 (SE = 0.267), to moderate levels of pressure, B = 2.109 (SE = 0.471). However, when pressure was high, the association between disclosure and PTG was not significant, B = -1.19 (SE = 1.327). These findings indicate that a moderate amount of pressure to disclose may facilitate the positive impact of disclosure on PTG, yet a high amount of pressure may impede the positive association between disclosure and PTG. This research furthers understanding of the nuances of trauma disclosure and how close others' involvement in disclosure can impact the process of PTG for trauma survivors.


Assuntos
Crescimento Psicológico Pós-Traumático , Transtornos de Estresse Pós-Traumáticos , Humanos , Revelação , Emoções , Sobreviventes , Adaptação Psicológica
4.
Fam Process ; 2023 Sep 22.
Artigo em Inglês | MEDLINE | ID: mdl-37740530

RESUMO

Military families face many difficulties, including a parent deploying to a warzone and the subsequent risk of returning with symptoms of posttraumatic stress disorder (PTSD). Symptoms of PTSD are associated with parenting difficulties; however, little is known about how PTSD symptoms may be associated with emotion socialization (ES), a set of processes crucial to children's emotional well-being. This project investigated observed ES behaviors in deployed and non-deployed parents in a sample of 224 predominantly White, non-Hispanic National Guard/Reserve (NG/R) families with deployed fathers, non-deployed mothers, and a child between the ages of 4 and 13. Parents completed self-report questionnaires and families engaged in videotaped parent-child discussions, which were coded for three types of ES behaviors. Latent profile analyses of the coded behaviors identified five profiles of parental ES: Balanced/Supportive, Balanced/Limited Expression, Unsupportive/Distressed, Unsupportive/Positive, and Involved/Emotive/Angry. Multinomial logistic regressions of each parent's profile membership on fathers' PTSD symptoms revealed no significant associations, while additional analyses including additional family factors revealed that greater father PTSD symptoms were associated with a greater likelihood of mothers being in the Balanced/Supportive profile compared to the Balanced/Limited Expression profile, particularly when children displayed average to low levels of emotion during discussion tasks. No other significant associations with PTSD symptoms were detected. Overall, in contrast to the hypotheses, the majority of these findings indicated that PTSD symptoms did not play a significant role in parental ES behaviors.

5.
Am J Fam Ther ; 50(3): 280-294, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35602589

RESUMO

The provision and receipt of emotional support demonstrates benefits for relationships; however, little research has investigated how either global or day-to-day spousal support influences marital stability. This project assessed how global perception of support from a partner and daily provision and receipt of emotional support over 1 week contributed to divorce 10 years later, accounting for demographic covariates. There were no significant associations of support variables with future divorce. Greater education attainment was the only factor significantly associated with decreased risk for divorce. Results suggest that despite potential short-term benefits, global and daily support may not predict long-term marital stability.

6.
Fam Process ; 59(3): 1261-1274, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-31254284

RESUMO

To minimize potential distractions for deployed military service members (SMs), some nondeployed romantic partners have reported engaging in protective buffering, or intentionally withholding information or concerns to protect their deployed partner. This study assessed the associations of protective buffering and psychological distress and marital satisfaction for military couples during and after deployment. Additionally, the study explored whether protective buffering was related to SM reports of being distracted during deployment by family matters. A total of 54 couples provided data before, during, and after an Army deployment. In multilevel models, higher protective buffering by partners was associated with higher psychological distress and lower marital satisfaction for both SMs and partners during, but not after, deployment. Additionally, partners reported frequent use of protective buffering during deployment; however, protective buffering was not significantly correlated with family related distraction for SMs during deployment. Limitations and implications of these findings are discussed.


Para minimizar posibles distracciones para miembros del servicio militar (SM) desplegados, algunas parejas románticas no desplegadas han informado que practican la amortiguación protectora, es decir, ocultan información o preocupaciones intencionalmente para proteger a su pareja desplegada. Este estudio evaluó las asociaciones de amortiguación protectora y angustia psicológica y satisfacción conyugal para parejas militares durante y después del despliegue. Además, el estudio exploró si la amortiguación protectora tenía relación con informes de los SM de estar distraídos durante el despliegue por cuestiones familiares. Un total de 54 parejas proporcionó datos antes, durante y después de un despliegue del ejército. En modelos multinivel, una amortiguación protectora mayor por parte de las parejas se asoció a mayor angustia psicológica y menor satisfacción conyugal tanto para los SM como para las parejas durante, pero no después del despliegue. Además, los socios informaron el uso frecuente de amortiguación protectora durante un despliegue; sin embargo, la amortiguación protectora no tuvo una correlación significativa con la distracción por motivos familiares para los SM durante el despliegue. Se discuten las limitaciones e implicaciones de estos hallazgos.


Assuntos
Relações Familiares/psicologia , Destacamento Militar/psicologia , Família Militar/psicologia , Militares/psicologia , Cônjuges/psicologia , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multinível , Angústia Psicológica , Estados Unidos
7.
Fam Process ; 59(2): 525-536, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30615191

RESUMO

To shield a romantic partner from potential distress due to stressors occurring during deployment, service members (SMs) may engage in protective buffering, or withholding information or concerns from a romantic partner. This study utilized data from 54 couples collected before, during, and after a military deployment to assess whether SMs engaged in protective buffering while deployed and the possible associations between buffering and psychological, relationship, and contextual factors. Only 2% of SMs indicated never engaging in protective buffering during a deployment. In bivariate analyses, only partners' psychological distress prior to deployment was significantly associated (negatively) with protective buffering. In multilevel models with time nested within individuals, and individuals nested within couples, higher buffering was associated with less partner distress during deployment, but was also associated with higher SM distress both during and after deployment. In these multilevel models, protective buffering was not significantly associated with SM or partner marital satisfaction.


Para proteger a una pareja romántica del posible distrés debido a factores desencadenantes de estrés que se producen durante la movilización militar, los miembros de las fuerzas armadas pueden adoptar una conducta de atenuación protectora u ocultar información o preocupaciones a una pareja romántica. El presente estudio utilizó datos de 54 parejas recopilados antes, durante y después de una movilización militar para evaluar si los miembros de las fuerzas armadas adoptaron una conducta de atenuación protectora mientras estaban movilizados y las posibles asociaciones entre la atenuación y los factores psicológicos, relacionales y contextuales. Solo el 2% de los miembros de las fuerzas armadas indicaron no haber adoptado nunca una conducta de atenuación protectora durante una movilización militar. En los análisis bivariables, solo el distrés psicológico de las parejas antes de la movilización militar estuvo asociado considerablemente (negativamente) con la atenuación protectora. En los modelos multinivel, con el tiempo localizado dentro de las personas y las personas localizadas dentro de las parejas, una mayor atenuación estuvo asociada con menos distrés de la pareja durante la movilización militar, pero también estuvo asociada con un mayor distrés de los miembros de las fuerzas armadas tanto durante como después de la movilización militar. En estos modelos multinivel, la atenuación protectora no estuvo asociada de forma significativa con la satisfacción conyugal de la pareja o del miembro de las fuerzas armadas.


Assuntos
Adaptação Psicológica , Destacamento Militar/psicologia , Família Militar/psicologia , Militares/psicologia , Estresse Ocupacional/psicologia , Adulto , Feminino , Humanos , Estudos Longitudinais , Masculino , Casamento/psicologia , Angústia Psicológica , Ensaios Clínicos Controlados Aleatórios como Assunto , Autorrevelação , Cônjuges/psicologia , Estados Unidos
8.
Mil Psychol ; 32(6): 432-440, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-38536280

RESUMO

Military deployments are known to be stressful for both military service members (SMs) and their romantic partners. Little is known about how coping strategies used during deployment may relate to one's own and one's partner's relationship satisfaction following deployment. This project investigated the retrospective report of how 154 SMs and their romantic partners coped with deployment-related stress, using previously established coping constructs of problem-focused, emotion-focused, and avoidance coping. Examination of relative associations of coping strategies and mental health symptoms with SMs' and partners' relationship satisfaction showed that partners' emotion-focused coping was positively related to both SMs' and partners' relationship satisfaction, whereas partners' avoidance was negatively related to both their own and SMs' relationship satisfaction. Results highlight the importance of partner coping within military couples and point to potential strategies for coping with deployment that are associated with enhanced relationship functioning after deployment.

9.
J Trauma Stress ; 32(2): 323-329, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-30892736

RESUMO

Service members and veterans (SM/Vs) with posttraumatic stress disorder (PTSD) can receive significant benefits from social support by a spouse or romantic partner. However, little is known about how providing support impacts partners. This study sought to identify (a) how provision of support is associated with partners' daily negative and positive affect and (b) how SM/Vs' PTSD symptom severity might moderate such associations. In a 14-day daily-diary study that assessed 64 couples in which one member was an SM/V with PTSD symptoms, partners reported nightly on whether or not they provided instrumental support and/or emotional support that day as well as their current negative and positive affect. Multilevel modeling showed that the provision of emotional and instrumental support were both significantly related to partners' lower levels of negative affect, f 2 = 0.09, and higher levels of positive affect, f 2 = 0.03, on that same day but not the next day. The positive same-day effects were seen if any support was given, with no additive effects when both types of support were provided. Severity of SM/V PTSD moderated the association between provision of emotional support and lower same-day negative affect such that the association was significant only when PTSD symptoms were more severe. Overall, these findings indicate that support provision to a partner with PTSD is associated with improved affect for the romantic partner providing support. However, given that only same-day affect was associated with support, the findings may also suggest that positive affect increases the provision of support.


Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Apoyo a un Cónyuge con Estrés Postraumático Militar: Asociaciones de la vida diaria con el Afecto de las Parejas EL APOYO A UNA ESPOSA CON SÍNTOMAS DE TEPT Los miembros del servicio y los veteranos (SM/Vs en sus siglas en inglés) con Trastorno de Estrés Postraumático (TEPT) pueden recibir significativos beneficios del apoyo social por parte de un cónyuge o pareja romántica. Sin embargo, poco se sabe acerca de cómo el hecho de proporcionar apoyo impacta a las parejas. Este estudio buscó identificar (a) cómo la provisión de apoyo está asociado con el afecto negativo y positivo diario de las parejas y (b) cómo la severidad de los síntomas TEPT de SM/Vs podría moderar tales asociaciones. En un estudio diario de 14 días que evaluó 64 parejas en las que un miembro era un SM/V con síntomas de TEPT, las parejas informaron cada noche sobre si proporcionaron o no apoyo instrumental y/o apoyo emocional ese día, como también informaron sobre su afecto negativo y positivo actual. El modelo multinivel mostró que la provisión del apoyo emocional e instrumental se relacionaron significativamente tanto con los niveles más bajos de afecto negativo, f2 = 0.09, y niveles más altos de afecto positivo, f2 = 0.03, en ese mismo día, pero no el día siguiente. Los efectos positivos del mismo día se observaron si se brindó cualquier tipo de apoyo, sin efectos adicionales cuando se proporcionaron ambos tipos de apoyo. La severidad del TEPT en SM/V moderó la asociación de la provisión de apoyo emocional con un afecto negativo más bajos en el mismo día, de modo que la asociación fue significativa solo cuando los síntomas del TEPT fueron más severos. En general, estos hallazgos indican que proveer apoyo a una pareja con TEPT se asocia con una mejora en los afectos en la pareja romántica que brinda apoyo. Aunque dado que solo el afecto del mismo día fue asociado con apoyo, los hallazgos también pueden sugerir que un afecto positivo incrementa la provisión de apoyo.


Assuntos
Afeto , Relações Interpessoais , Cônjuges/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Feminino , Humanos , Masculino , Militares/psicologia , Parceiros Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/terapia , Inquéritos e Questionários , Veteranos/psicologia
10.
Fam Process ; 58(4): 908-919, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-30216445

RESUMO

Romantic partners' accommodation of trauma survivors' posttraumatic stress disorder (PTSD) symptoms (e.g., taking on tasks, survivors avoid participating in social withdrawal) is associated with lower relationship satisfaction for both partners and survivors. Little is known about associations of partner accommodation with other aspects of relationship functioning, like intimacy. Sixty-four male military veterans with at least subclinical PTSD and their partners participated in a 2-week daily diary study. Veterans completed nightly measures of PTSD symptoms, while female partners completed nightly measures of accommodating behaviors performed that day. Both partners reported feelings of intimacy each night. Multilevel models revealed that accommodation was significantly, negatively associated with feelings of intimacy, with stronger effects for partners (t = -8.70) than for veterans (t = -5.40), and stronger effects when veterans had lower (t = -7.43) rather than higher (t = -5.20) levels of daily PTSD symptoms. Therapists should consider accommodating behaviors as a potential impediment to relationship intimacy, particularly when veterans have less severe symptoms of PTSD. Accommodating behaviors are an ideal treatment target in behavioral couple therapies.


La adaptación de las parejas románticas a los síntomas del trastorno por estrés postraumático (TEPT) de los sobrevivientes de traumas (p. ej.: hacerse cargo de tareas que los sobrevivientes evitan, participar en el aislamiento social) está asociada con una menor satisfacción con la relación tanto para las parejas como para los sobrevivientes. Se sabe poco acerca de las asociaciones de la adaptación de la pareja con otros aspectos del funcionamiento de la relación, como la intimidad. Sesenta y cuatro militares veteranos con al menos TEPT subclínico y sus parejas participaron en un estudio de registro diario de dos semanas. Los veteranos completaron mediciones nocturnas de los síntomas de TEPT, mientras que las parejas femeninas completaron mediciones nocturas de conductas de adaptación realizadas ese día. Ambas parejas informaron sentimientos de intimidad cada noche. Los modelos multinivel revelaron que la adaptación estuvo asociada considerablemente y negativamente con sentimientos de intimidad, con efectos más fuertes para las parejas (t = −8.70) que para los veternos (t = −5.40), y con efectos más fuertes cuando los veteranos tuvieron niveles más bajos (t = −7.43), en lugar de más altos, (t = −5.20) de síntomas diarios de TEPT. Los terapeutas deben sopesar las conductas de adaptación como un posible impedimento para la intimidad en la relación, particularmente cuando los veteranos tienen síntomas menos graves de TEPT. Las conductas de adaptación son el objetivo ideal del tratamiento en las terapias conductuales de pareja.


Assuntos
Adaptação Psicológica , Família Militar/psicologia , Parceiros Sexuais/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Feminino , Humanos , Relações Interpessoais , Masculino , Pessoa de Meia-Idade , Análise Multinível , Satisfação Pessoal , Comportamento Sexual/psicologia , Cônjuges/psicologia
11.
J Trauma Dissociation ; 19(4): 403-416, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29601287

RESUMO

Trauma in general, and sexual assault in particular, is associated with serious mental health and functional problems. The quality of sexual satisfaction/function may be particularly impacted by sexual assault, and such sexual problems may account for some of the broader mental health and functioning impairments in sexual assault survivors. Accordingly, we examined self-reports of sexual health and mental health in a sample of 255 female veterans in committed, monogamous relationships who provided data regarding sexual assault (n = 153) or nonsexual trauma (n = 102). Trauma type was not associated with differences in sexual function, but sexual trauma was associated with significantly lower sexual satisfaction, greater posttraumatic stress disorder (PTSD) and depressive symptoms, and higher suicidal ideation. Furthermore, the indirect effect of trauma type on all mental health outcomes was significant via sexual satisfaction but not via sexual function. Finally, trauma type moderated the association of sexual function with suicidality, such that the association was significantly positive in those with a history of sexual assault but nonsignificant in those with nonsexual trauma. These results suggest that (1) female veterans' experience of sexual assault is related to sexual satisfaction, which in turn is related to mental health outcomes, and (2) a history of sexual assault may increase the importance of sexual functioning with regard to suicidality.


Assuntos
Saúde Mental , Militares/psicologia , Delitos Sexuais/psicologia , Disfunções Sexuais Psicogênicas/psicologia , Sexualidade/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Depressão/psicologia , Feminino , Humanos , Parceiros Sexuais , Ideação Suicida , Inquéritos e Questionários , Estados Unidos
12.
J Nerv Ment Dis ; 205(4): 294-299, 2017 04.
Artigo em Inglês | MEDLINE | ID: mdl-27918324

RESUMO

Relatives' criticism of, hostility toward, and emotional overinvolvement (EOI) with patients are predictive of treatment response and relapse. Although these constructs have been linked to relatives' attributions for patient problems, little research has yet evaluated attributions for specific types of problems. This study examined event-specific attributions (i.e., attributions specifically for either disorder-related [DR] or non-DR problems) in relatives of patients with anxiety disorders. Relatives made more illness attributions (attributing problems to a patient's disorder) than controllable attributions (attributing problems to factors controllable by patients) for DR events, with the reverse pattern for non-DR events. Criticism and hostility were associated primarily with controllability attributions for non-DR events. In contrast, the presence of EOI was associated with illness attributions for non-DR events. Family-based interventions for anxiety disorders might need to focus on relatives' controllability attributions for a broad range of patient behaviors and on reducing tendencies to attribute non-DR problems to patients' disorders.


Assuntos
Emoções Manifestas , Relações Familiares/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Transtorno Obsessivo-Compulsivo/psicologia , Transtorno de Pânico/psicologia , Adulto , Comorbidade , Hostilidade , Humanos , Pessoa de Meia-Idade , Adulto Jovem
13.
Fam Process ; 56(4): 915-925, 2017 12.
Artigo em Inglês | MEDLINE | ID: mdl-27610953

RESUMO

Extensive research has evaluated potential negative effects of military deployments on romantic relationships. Comparatively few studies have examined potential positive effects of such deployments. In stressful situations, benefit finding (BF) has been found to be linked with better functioning on both individual and interpersonal levels. This study reports on deployment-related BF in a sample of 67 male service members (SMs) who deployed at least once since 9/11/2001 and their wives. Couples completed measures of marital satisfaction at baseline (an average of 1 year postdeployment) and follow-up 4-6 months later. At follow-up, SMs also provided data on symptoms of posttraumatic stress, and both partners provided reports of deployment-related BF. Multivariate path analysis controlling for SMs' PTSD symptom severity revealed that wives' BF was positively associated with increases in SMs' relationship satisfaction. These findings suggest that wives' responses to deployment may be more influential than SMs' responses to deployment on military couples' relationships. This pattern indicates that support for spouses during deployments is essential; furthermore, such support should include an emphasis on trying to facilitate personal growth in spouses.


Assuntos
Desenvolvimento Humano , Casamento/psicologia , Família Militar/psicologia , Militares/psicologia , Satisfação Pessoal , Cônjuges/psicologia , Adulto , Feminino , Seguimentos , Humanos , Relações Interpessoais , Masculino , Análise Multivariada , Doenças Profissionais/psicologia , Testes Psicológicos , Transtornos de Estresse Pós-Traumáticos/psicologia , Estresse Psicológico/psicologia , Inquéritos e Questionários , Estados Unidos
14.
J Nerv Ment Dis ; 204(11): 832-839, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26998694

RESUMO

Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.


Assuntos
Ansiedade/psicologia , Transtornos Dismórficos Corporais/psicologia , Depressão/psicologia , Transtorno Obsessivo-Compulsivo/psicologia , Vergonha , Ideação Suicida , Adulto , Ansiedade/diagnóstico , Ansiedade/epidemiologia , Transtornos Dismórficos Corporais/diagnóstico , Transtornos Dismórficos Corporais/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Transtorno Obsessivo-Compulsivo/diagnóstico , Transtorno Obsessivo-Compulsivo/epidemiologia , Fatores de Risco , Autorrelato , Suicídio/psicologia , Inquéritos e Questionários , Adulto Jovem , Prevenção do Suicídio
15.
J Trauma Stress ; 29(4): 332-9, 2016 08.
Artigo em Inglês | MEDLINE | ID: mdl-27459310

RESUMO

Perceived social support is negatively associated with severity of posttraumatic stress disorder (PTSD), but the literature lacks data about specific sources of support. Using 2 service member (SM) samples (n = 207 and 465), this study examined perceived support from family/friends and the broader public. SMs perceived high support from both sources. In multivariate regressions, perceived support from the broader public was not significantly associated with severity of PTSD symptoms, but it demonstrated a nearly identical effect size (ß = -.21) as support from family/friends (ß = -.23) in a sample of active duty and National Guard/Reserve SMs. We found that, SMs perceived high levels of support from the broader public, with modest evidence that such perceptions may relate to severity of PTSD.


Assuntos
Militares/psicologia , Apoio Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Campanha Afegã de 2001- , Análise de Variância , Família/psicologia , Feminino , Amigos/psicologia , Humanos , Guerra do Iraque 2003-2011 , Masculino , Militares/estatística & dados numéricos , Índice de Gravidade de Doença , Inquéritos e Questionários , Estados Unidos
16.
J Trauma Dissociation ; 16(2): 197-210, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-25587844

RESUMO

Many service members experience symptoms of posttraumatic stress disorder (PTSD) after deployment. PTSD can vary widely in its presentation and associated features, such as comorbid conditions. Research has shown that veterans with PTSD and an internalizing personality profile are more likely to experience internalizing comorbidity (e.g., anxiety, depression), whereas veterans with PTSD and an externalizing personality profile are more likely to experience externalizing comorbidity (e.g., substance abuse, aggression). To date, however, this research has been limited by a focus on diagnosable disorders and personality categories. In a nonclinical sample of 224 National Guard/Reserve service members who had served since 2001, we explored whether personality traits (measured continuously) moderated associations of PTSD symptom severity with the severity of internalizing (depression, anxiety) and externalizing (alcohol abuse, aggression) symptoms. Results showed that the association of PTSD with anxiety was stronger when extraversion was lower (corresponding to an internalizing personality profile). Moreover, the association of PTSD with alcohol abuse was stronger when extraversion was high and conscientiousness was low (corresponding to an externalizing personality profile). Surprisingly, this association was also stronger when extraversion was low and conscientiousness was high. Results offer additional insights into prior research on personality and comorbidity.


Assuntos
Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/psicologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Comorbidade , Feminino , Humanos , Masculino , Inventário de Personalidade , Prevalência , Escalas de Graduação Psiquiátrica , Autorrevelação , Utah/epidemiologia
17.
J Trauma Stress ; 27(1): 116-9, 2014 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-24515538

RESUMO

Posttraumatic stress disorder (PTSD) is a common mental health concern for returning service members. Social support is a robust predictor of resiliency and recovery from PTSD; however, barriers to seeking support are understudied. PTSD and anticipated enacted stigma from family and friends were explored as correlates of the likelihood of seeking support among 153 Iraq/Afghanistan U.S. service members. Results showed that PTSD (r = -.31, p < .001) and anticipated enacted stigma (r = -.22, p ≤ .01) were negatively associated with likelihood of seeking support. Post hoc analyses showed that only dysphoria (r = -.32, p < .001) was significantly related to the likelihood of seeking support after accounting for anticipated enacted stigma and other PTSD clusters. Implications of these findings and ways to increase likelihood of seeking support are discussed.


Assuntos
Militares/psicologia , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Estigma Social , Transtornos de Estresse Pós-Traumáticos/psicologia , Adulto , Sintomas Afetivos/psicologia , Campanha Afegã de 2001- , Humanos , Guerra do Iraque 2003-2011 , Masculino , Índice de Gravidade de Doença , Transtornos de Estresse Pós-Traumáticos/terapia , Adulto Jovem
18.
J Trauma Stress ; 27(3): 283-90, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24823939

RESUMO

Research has consistently linked symptoms of posttraumatic stress disorder (PTSD) with relationship distress in combat veterans and their partners. Studies of specific clusters of PTSD symptoms indicate that symptoms of emotional numbing/withdrawal (now referred to as negative alterations in cognition and mood) are more strongly linked with relationship distress than other symptom clusters. These findings, however, are based predominantly on samples of male veterans. Given the increasing numbers of female veterans, research on potential gender differences in these associations is needed. The present study examined gender differences in the multivariate associations of PTSD symptom clusters with relationship distress in 465 opposite-sex couples (375 with male veterans and 90 with female veterans) from the National Vietnam Veterans Readjustment Study. Comparisons of nested path models revealed that emotional numbing/withdrawal symptoms were associated with relationship distress in both types of couples. The strength of this association, however, was stronger for female veterans (b = .46) and female partners (b = .28), compared to male veterans (b = .38) and male partners (b = .26). Results suggest that couples-based interventions (e.g., psychoeducation regarding emotional numbing symptoms as part of PTSD) are particularly important for both female partners of male veterans and female veterans themselves.


Assuntos
Relações Interpessoais , Fatores Sexuais , Cônjuges/psicologia , Transtornos de Estresse Pós-Traumáticos/psicologia , Veteranos/psicologia , Adulto , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Psicológicos , Transtornos de Estresse Pós-Traumáticos/terapia , Estados Unidos , Guerra do Vietnã
19.
J Youth Adolesc ; 43(4): 612-28, 2014 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23975354

RESUMO

Depression has a heightened prevalence in adolescence, with approximately 15 % of adolescents experiencing a major depressive episode by age 18. Depression in adolescence also poses a risk for future distress and impairment. Despite treatment advances, many adolescents relapse after initial remission. Family context may be an important factor in the developmental trajectory of adolescent depression, and thus in enhancing treatment. This study examined concurrent change over time in adolescent and maternal depressive symptoms in the context of the Treatment of Resistant Depression in Adolescents study. Participants were 334 adolescents (mean age: 16; SD: 1.6; 70 % female, 84 % Caucasian), and their mothers (n = 241). All adolescents were clinically depressed when they entered the study and had received previous selective serotonin reuptake inhibitor (SSRI) treatment. Adolescents received acute treatment for 12 weeks and additional treatment for 12 more weeks. Adolescent depression and suicidal ideation were assessed at 0, 6, 12, 24, 48 and 72 weeks, while maternal depressive symptoms were assessed at 0, 12, 24, 48 and 72 weeks. Latent basis growth curve analyses showed a significant correlation over 72 weeks between trajectories of maternal and adolescent depressive symptoms, supporting the hypothesis of concurrent patterns of change in these variables. The trajectories were correlated more strongly in a subsample that included only dyads in which mothers reported at least one depressive symptom at baseline. Results did not show a correlation between trajectories of maternal depressive symptoms and adolescent suicidal ideation. These findings suggest that adolescent and maternal depressive symptoms change in tandem, and that treatment for adolescent depression can benefit the wider family system. Notably, most mothers in this sample had subclinical depressive symptoms. Future research might explore these trajectories in dyads with more severely depressed mothers.


Assuntos
Comportamento do Adolescente/psicologia , Transtorno Depressivo/psicologia , Relações Mãe-Filho/psicologia , Mães/psicologia , Inibidores Seletivos de Recaptação de Serotonina/uso terapêutico , Adolescente , Criança , Transtorno Depressivo/tratamento farmacológico , Feminino , Humanos , Masculino , Escalas de Graduação Psiquiátrica , Ideação Suicida
20.
AJPM Focus ; 3(1): 100171, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38293250

RESUMO

Introduction: Firearm sales and firearm-related injuries and deaths increased during the pandemic. Little is known about motivations for firearm purchasing in response to the COVID-19 pandemic and the mental health status of first-time purchasers. The purpose of this study was to estimate the association between firearm purchasing in response to the COVID-19 pandemic and anxiety symptoms, depressive symptoms, and stress. Methods: The authors analyzed data from a survey that approximated a nationally representative sample of American adults (N=3,528) who either did not own firearms (n=2,327) or purchased firearms for the first time in response to the pandemic (n=240). Self-reported stress, depressive symptoms, and anxiety symptoms were determined using standardized self-assessment questionnaires (Perceived Stress Scale, Patient Health Questionnaire, and Depression Anxiety Stress Scale, respectively). Using multivariable logistic regression, the association between firearm purchasing and each mental health measure were assessed after controlling for demographics and other determinants. Results: In each model, first-time firearm owners were more likely to be younger, live in urban areas, believe the government does too much for its citizens, stay home, stock up on items, and keep their children at home. First-time owners had significantly higher odds of anxiety and depressive symptoms than non-owners (AOR=1.05; 95% CI=1.04, 1.07 and AOR=1.15; 95% CI=1.04, 1.26, respectively). Conclusions: First-time firearm purchasers report higher depressive and anxiety symptoms than non-owners, suggesting that there may be a risk of suicide and other related firearm violence.

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