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The co-occurrence of posttraumatic symptoms (PTS) and impulsivity is associated with higher levels of risky and self-destructive behaviors and consequent safety and health risks. Trauma-related shame (TRS) may influence the association between PTS and impulsivity such that engaging in impulsive behaviors may serve to cope with emotional distress. Alternatively, TRS may motivate a deliberate consideration of behaviors (i.e., less impulsivity) to prevent further cognitive and emotional distress.The goal of the current study was to examine the influence of TRS on the associations between PTS and impulsivity facets (lack of premeditation, lack of perseverance, negative urgency, positive urgency, sensation seeking).Data were collected from 506 community individuals who endorsed lifetime sexual trauma (Findings indicated that TRS moderated associations between PTS and impulsivity facets of lack of perseverance,Findings suggest that in the context of PTS, TRS may reduce certain forms of impulsivity, potentially as a means to self-protect against further cognitive and emotional distress. Findings have important implications for understanding how individuals regulate and respond to shame in the context of PTS. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

In the present study, we used an experimental paradigm with subjective and objective assessments to further explicate the role of positive emotion dysregulation on risky behavior. Participants were 151 community women currently experiencing intimate partner violence and using substances (age: M = 40.81 years; 30.5% Black). Participants were randomly assigned to positive, negative, and neutral idiographic emotion inductions. Subjective (state self-report) and objective (high-frequency heart rate variability [hfHRV], skin conductance response, and salivary cortisol) markers of emotion dysregulation were assessed, following which participants completed subjective (state urges for substances) and objective (Balloon Analogue Risk Task) measures of risky behavior. Results showed that (a) greater self-reported state emotion dysregulation and lower hfHRV predicted more urges for substances in the positive (vs. negative and neutral) emotion-induction condition and (b) lower hfHRV predicted more behavioral risk-taking propensity in the positive (vs. neutral) emotion-induction condition. These findings provide additional support for the influence of positive emotion dysregulation on risky behavior.

Post-traumatic stress disorder (PTSD) is characterized by substantial disruptions in sleep quality, continuity, and depth. Sleep problems also may exacerbate PTSD symptom severity. Understanding how PTSD and sleep may reinforce one another is critical for informing effective treatments.In a sample of 452 World Trade Center 9/11 responders (mean age = 55.22, 89.4% male, 66.1% current or former police), we examined concurrent and cross-lagged associations between PTSD symptom severity, insomnia symptoms, nightmares, and sleep quality at 3 time points ∼1 year apart. Data were analyzed using random intercept cross-lagged panel models.PTSD symptom severity and sleep variables were relatively stable across time (intraclass correlation coefficients: 0.63 to 0.84). Individuals with more insomnia symptoms, more nightmares, and poorer sleep quality had greater PTSD symptom severity, on average. Within-person results revealed that greater insomnia symptoms and nightmares at Time 1 were concurrently associated with greater PTSD symptoms at Time 1. Insomnia symptoms were also concurrently associated with PTSD symptoms at Times 2 and 3, respectively. Cross-lagged and autoregressive results revealed that PTSD symptoms and nightmares predicted nightmares at the next timepoint.Overall, results suggest PTSD and sleep problems may be linked at the same point in time but may not always influence each other longitudinally. Further, individuals who experience more sleep disturbances on average may suffer from more debilitating PTSD. Evidence-based treatments for PTSD may consider incorporating treatment of underlying sleep disturbances and nightmares.

Evidence links posttraumatic stress disorder (PTSD) symptoms to positive autobiographical memory characteristics. To extend this research, we uniquely utilized micro-longitudinal data to examine (1) the trajectory of PTSD symptom count across 30 days; and (2) if more vividness and accessibility of retrieved positive memories at the daily level predicted decreases in the trajectory of PTSD symptom count across 30 days. The current study was a secondary data analysis of a larger study. The sample included 74 women who reported physical or sexual victimization in the past 30 days by their current male partner and reported the use of alcohol and/or drugs during that time ( Mage = 39.68 years; 37.80% with diagnostic PTSD; 43.2% White; 37.8% Black or African American). They completed thrice daily measures of PTSD symptoms and positive memory characteristics (vividness and accessibility) across 30 days. Results of the random effects longitudinal multilevel model indicated that, on average, the relation between PTSD symptom count and positive memory vividness was positive and statistically significant (0.19, 95% Confidence Interval [CI] [0.2, 0.35]); and the relation between PTSD symptom count and positive memory accessibility was positive and statistically significant (0.31, 95% CI [0.15, 0.47]). The relationship between PTSD symptom count and positive memory vividness/accessibility (i.e., slopes) varied significantly across participants, with a wide range of positive and negative regression coefficients. Future research needs to investigate why and how positive memory vividness and accessibility may relate to trajectories of PTSD symptoms over time, with potential clinical implications for positive memory interventions addressing PTSD.

OBJECTIVES Emotion dysregulation theoretically and empirically explains the link between posttraumatic stress disorder (PTSD) and posttrauma reckless and self-destructive behaviors (RSDBs). METHOD The current study uniquely examined the role of emotion dysregulation in the association between the four heterogeneous PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]) and an overall measure of posttrauma RSDBs. Trauma-exposed participants (n = 411) completed self-report measures assessing PTSD symptoms (PTSD Checklist for DSM-5), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), and engagement in RSDBs (Posttrauma Risky Behaviors Questionnaire). RESULTS Direct and indirect effects were examined using PROCESS Model 4. The bias-corrected bootstrap revealed a significant indirect effect of emotion dysregulation in posttrauma RSDBs' relation with PTSD's intrusions (B = -.13, SE = .04, 95% CI [-.23, -.06]), avoidance (B =.15, SE =.07, 95% CI [.04, .33]), NACM (B =.17, SE =.05, 95% CI [.09, .27]), and AAR (B =.14, SE =.05, 95% CI [.05, .27]). CONCLUSIONS Emotion dysregulation explained associations between the severity of each PTSD symptom cluster and overall posttrauma RSDBs. PTSD treatments targeting emotion dysregulation may help to reduce posttrauma RSDBs for trauma-exposed individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

A fast-growing body of literature linking emotion dysregulation to substance use has almost exclusively relied on cross-sectional designs and has generally failed to assess dysregulation stemming from positive emotions. The current study measured the momentary associations between both negative and positive emotion dysregulation and substance use, as well as the moderating role of post-traumatic stress disorder (PTSD).Micro-longitudinal momentary data were collected three times per day for 30 days using phone-based interactive voice recording.Northeastern United States.A total of 145 community women (M, age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances were recruited from 2018 until 2020.Momentary surveys assessed negative and positive emotion dysregulation and alcohol, drug, and cigarette use. PTSD diagnosis was derived from a structured diagnostic interview.Between-person relations that remained significant after covariate adjustment and correction for multiple testing were found for negative emotion dysregulation and both number of drinks (internal rate of return [IRR] = 1.45; 95% CI = 1.07, 1.93; β = 0.37) and drug use (OR = 3.78; 95% CI = 1.86, 7.69; β = 1.33), and positive emotion dysregulation and number of cigarettes (OR = 1.40; 95% CI = 1.07, 1.82; β = 0.34). Of six interactions tests, PTSD was only shown to moderate the within-person relation between positive emotion dysregulation and drug use, even after controlling for relevant covariates and adjusting for multiple testing (OR = 1.26; 95% CI = 1.04, 1.51; β = 0.23), such that women experiencing intimate partner violence with versus without PTSD were more likely to use drugs when experiencing periods of elevated positive emotion dysregulation.Women experiencing intimate partner violence with higher levels of negative dysregulation relative to others may use more alcohol and be more likely to use drugs. Women experiencing intimate partner violence with higher levels of positive dysregulation relative to others may use more cigarettes. Women experiencing intimate partner violence who also have posttraumatic stress disorder may be more likely to use drugs when experiencing momentary elevated levels of positive emotion dysregulation than those who do not also have posttraumatic stress disorder.

Research examining emotion dysregulation and alcohol use has increased exponentially over the past decade. However, these studies have been limited by their use of cross-sectional designs and narrow definitions of emotion dysregulation. To address these significant gaps in the extant literature, this study utilized state-of-the-art methodology (i.e., experience sampling) and statistics (i.e., dynamic structural equation modeling) to examine potential reciprocal associations between negative and positive emotion dysregulation and alcohol use at the momentary level.Participants were 145 community women (mean age = 40.56, 40.3% white) experiencing intimate partner violence (IPV) and using substances. Surveys assessing negative and positive emotion dysregulation and alcohol use (i.e., number of standard drinks) were administered three times a day for 30 days using phone-based interactive voice recording.Significant contemporaneous effects indicated that negative and positive emotion dysregulation both co-occurred with alcohol use. However, levels of negative and positive emotion dysregulation did not predict later alcohol use, nor did alcohol use predict later levels of negative or positive emotion dysregulation. There was significant variability among participants in cross-lagged effects.Findings showed that negative and positive emotion dysregulation co-occurred with alcohol use and that there was significant interindividual variability in the cross-lagged associations between negative and positive emotion dysregulation and alcohol use. Research using idiographic approaches may identify women experiencing IPV for whom negative and positive emotion dysregulation drive alcohol use and alcohol use drives negative and positive emotion dysregulation.

The co-occurrence of childhood trauma and posttraumatic stress disorder (PTSD) is highly prevalent and clinically significant. Existing research emphasizes the role of emotion regulation in the relation between childhood trauma and PTSD. Yet, research in this area has almost exclusively examined the influence of strategies aimed at regulating negative emotions, such as anger and sadness.To extend existing research, the current study examined underlying roles of strategies for regulating positive emotions (i.e., self- and emotion-focused positive rumination and positive dampening) in the association between childhood trauma severity and PTSD symptoms.Participants were 320 trauma-exposed community individuals who reported past 30-day substance use (Analyses examined whether childhood trauma severity was indirectly related to PTSD symptoms through self-focused positive rumination, emotion-focused positive rumination, and positive dampening.Positive dampening, but not positive self- and emotion-focused positive rumination, indirectly explained associations between childhood trauma severity and PTSD symptoms (These findings highlight the potential utility of targeting positive dampening in the treatment of PTSD symptoms among individuals who use substances with a history of childhood trauma.

Traumatic event (TE) types have been shown to relate to adverse psychological outcomes. However, research in this area has relied almost exclusively on linear analysis and has been limited to Western countries with similar cultural values. Addressing these limitations, this study examined (a) presence and nature of relations between number of TE types and psychological outcomes and (b) minimum number of TE types predicting psychological symptoms in a culturally distinct sample of ex-military members from India.The sample of 144 trauma-exposed Indian ex-military members (Mage = 43.49; 90.90% males) completed a web-based survey.Curvilinear regression analyses indicated quadratic relationships between number of TE types and psychological symptoms (posttraumatic stress disorder [PTSD], depression, and anxiety severity) and resilience. Exploratory analyses showed (a) linear relationships between number of directly experienced TE types and psychological outcomes, (b) quadratic relationships between number of Predominant Death Threat TEs and psychological symptoms, (c) linear relationship between number of Predominant Death Threat TEs and resilience, and (d) linear relationships between other TE categories and psychological outcomes. Nonparametric receiver operating characteristic curve analyses indicated that a threshold of at least 10.5 TE types provided the optimal balance between sensitivity and specificity in classifying participants with (vs. without) probable PTSD, depression, and generalized anxiety disorder. For those reporting directly experienced TE types, this threshold was 2.5-3.5 TE types.Study results enhance an understanding of psychological difficulties faced by Indian ex-military members who have experienced multiple TE types, which can inform psychotherapeutic treatments for this population. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

OBJECTIVE Theoretical and empirical evidence links emotional avoidance to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms. However, few studies have tested whether these findings extend to positive emotional avoidance. Addressing this important gap in the literature, the current study examined the moderating role of PTSD symptom severity in the relation between positive emotional intensity and positive emotional avoidance. METHOD Participants were 465 trauma-exposed veterans recruited from the community (Mage = 38.00, 71.6% male, 69.5% White). RESULTS The interaction between positive emotional intensity and PTSD symptom severity on positive emotional avoidance was significant. Analysis of simple slopes revealed that positive emotional intensity was significantly positively associated with positive emotional avoidance when participants endorsed high, but not low, levels of PTSD symptom severity. CONCLUSIONS Veterans with more severe PTSD symptoms may utilize avoidance strategies in the context of intense positive emotions. These findings may suggest the potential need for addressing positive emotional avoidance in interventions to reduce PTSD symptom severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Introduction Alcohol consumption on college campuses is a major public health concern. Extant literature has identified trauma exposure as a robust risk factor for problematic alcohol use in this at-risk population. However, the mechanisms underlying this association are less well-studied. Research indicates that bodily arousal is a fundamental feature of trauma exposure, and posits that internal stimuli (e.g., heart pounding) at the time of trauma may manifest into conditioned cues that can trigger posttraumatic responding and related symptomatology, including alcohol use. However, past work supporting these assertions has used paradigms purposefully designed to evoke memories of the trauma, making it difficult to ascertain whether the mechanism driving subsequent alcohol craving is the explicit memory cue or the associated bodily arousal. Methods The current study examined whether an implicit, trauma-relevant cue of bodily arousal (via voluntary hyperventilation) – independent of any explicit memory cue – would elicit increased desire to drink among 104 (Mage = 20.30; 61.5% female) trauma-exposed undergraduates. Results Results found no statistically significant difference in change in alcohol craving between the hyperventilation and control tasks. However, secondary analyses indicated that trauma type (i.e., interpersonal/non-interpersonal) may play an influential role in this relationship. More specifically, individuals reporting interpersonal trauma as their most traumatic event evidenced a significantly greater increase in desire to drink following hyperventilation compared to the non-interpersonal index trauma group. Discussion Generally, these findings suggest that bodily arousal may only serve as an implicit, trauma-relevant interoceptive cue that increases desire to drink within a specific subset of trauma-exposed college students (i.e., individuals indexing interpersonal trauma). Replication and extension are needed to further understand the influence of bodily arousal on subsequent alcohol use behavior, which will be critical to PTSD-alcohol use modeling and, ultimately, help in informing prevention- and treatment-oriented intervention efforts aimed at reducing problematic alcohol use on college campuses.

Posttraumatic stress symptoms (PTS) and risky alcohol use (RAU) frequently co-occur among those with a history of sexual assault, and this co-occurrence has been linked to severe psychosocial and functional impairment.The current study examined the roles of negative social reactions to sexual assault disclosure and trauma-related shame in the association between PTS severity and RAU. This was tested by examining the separate and sequential indirect effects of negative social reactions and trauma-related shame in the PTSD-RAU relation among individuals with a history of sexual assault.Data were collected from 235 individuals who endorsed a history of sexual assault (Negative social reactions (Findings suggest that it may be valuable to assess and neutralize negative social reactions to reduce trauma-related shame and subsequent RAU among individuals with a history of sexual assault who experience more severe PTS severity. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Many current treatments for posttraumatic stress disorder (PTSD) emphasize processing and engaging with trauma memories as the key mechanism of therapeutic change. However, promising emerging research indicates links between PTSD symptoms and positive memories. Processing positive memories, to therapeutically impact health outcomes for trauma-exposed individuals, may have several benefits, including (a) increasing access to positive coping mechanisms via activating positive affect and thoughts; (b) addressing avoidance of positive affect and thoughts; and (c) honing skills that will aid in the eventual processing of trauma memories. The present article demonstrates the utility and effects of a novel Processing of Positive Memories Technique (PPMT) with three clients who reported a history of traumatic experiences. We outline the procedures of a 5-session PPMT, that incorporates symptom assessment, detailed imaginal experiencing of positive memories, and processing of associated positive values, affect, strengths, and thoughts. We utilize longitudinal assessment data to demonstrate the clinical benefits of PPMT, such as less PTSD severity, improved mood (e.g., less negative affect), and greater self-esteem. Finally, we discuss treatment considerations based on unique client factors and treatment modalities (i.e., in-person vs. video telehealth).

BACKGROUND AND OBJECTIVES: Research provides robust support for an association between traumatic exposure and emotion dysregulation. Less understood is the relation of emotion dysregulation stemming from positive emotions to traumatic exposure, or the extent to which negative and positive emotion dysregulation may be uniquely related to specific trauma types. DESIGN AND METHODS: The present study explored the associations between negative and positive emotion dysregulation and specific trauma types in a community sample of 433 adults (M age = 43.81, 68.4% women). RESULTS: Results highlighted three main findings: (1) negative and positive emotion dysregulation were significantly higher among individuals with vs. without exposure to six and nine specific trauma types, respectively; (2) negative and positive emotion dysregulation were significantly and positively related to total number of specific traumatic events; and (3) negative emotion dysregulation was significantly higher among individuals with Victimization Traumas in the overall sample as well as the no-PTSD and no-MDD subsamples, and positive emotion dysregulation was significantly lower among individuals with Accidental/ Injury Traumas and Victimization Traumas in the PTSD subsample. CONCLUSIONS: Results underscore the relative and unique roles of negative and positive emotion dysregulation in trauma types; these findings may inform future research.

Although the majority of research and clinical interventions focused on posttraumatic stress disorder (PTSD) centers on traumatic memories, recent literature suggests the importance of considering emotionally laden memories more broadly among trauma-exposed individuals. Specifically, trauma-exposed individuals have difficulties retrieving positive and negative memories, and interventions focused on enhancing the retrieval of both traumatic and positive memories benefit overall well-being. These findings led to the development of a novel Processing of Positive Memories Technique (PPMT) for PTSD. As the next step in treatment development, PPMT was piloted among 12 trauma-exposed community members seeking therapeutic or assessment services at a university psychology clinic. In this study, we summarize participants' quantitative and qualitative feedback on the content, format, and feasibility of PPMT. Next, we outline proposed formative changes that are critical to the iterative refinement of PPMT, based on the obtained feedback to enhance its scalability, feasibility, and effectiveness. Within clinical practice, PPMT, as implemented in this study, may be feasible, and there may be potential benefits to incorporating positive memory processing using PPMT.

Strengthening Family Coping Resources (SFCR), a multi-family group intervention tailored to families experiencing traumatic stress, is associated with improved post-traumatic stress disorder (PTSD) symptoms and family functioning. To further SFCR research, we examined (1) SFCR’s effects on caregiver PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], alterations in arousal and reactivity); and (2) whether effects differed by caregiver trauma type (interpersonal versus non-interpersonal; intrafamilial versus extrafamilial). Forty-two caregivers of primarily low socioeconomic status reporting trauma histories completed SFCR treatment. Significant decreases in PTSD intrusion, avoidance, and NACM subscale scores emerged from pre- to post-SFCR; there were no differences in subscale score changes by trauma type categorization. Findings support SFCR as a promising treatment for reducing PTSD severity among caregivers reporting diverse traumas.

Psychopathology, cyberpsychology, and mass media theories link psychological symptoms, such as posttraumatic stress disorder (PTSD), to increased media and technology usage (MTU). Given limited research in this area, we uniquely examined if specific MTU facets were associated with PTSD symptom severity.A sample of 404 socioeconomically diverse adults (Hierarchical multiple regression analyses indicated that, controlling for depression severity, greater frequency of TV viewing (Study findings suggest that the extent of MTU behaviors (especially extent of TV use, media sharing, and online friendships) are important to examine in trauma-exposed individuals with PTSD symptoms. Results generalize to trauma-exposed community members and are considered within the context of current MTU theories. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Posttraumatic Stress Disorder (PTSD) Checklist for DSM-5 (PCL-5) is frequently used to assess PTSD symptoms. Extending its psychometric investigations across distinct samples (United States and India), the aims of the present study included investigating the item characteristics, person fit, and differential item functioning (DIF) across the two samples.We (a) conducted item analysis using the graded response model to examine item characteristics (thresholds and discrimination parameters) and (b) examined person fit to determine participants' response patterns. The U.S. sample included 176 trauma-exposed individuals seeking mental health treatment, and the Indian sample included 148 trauma-exposed ex-military personnel.Results indicated low discrimination for Item 8 and low but acceptable discrimination for Item 17 for the U.S. and Indian samples, respectively. Across both samples, the most unused response categories were the middle-point or extreme (higher severity) categories (all response categories were better utilized in the Indian sample), and half the participants exhibited person misfit. Supplemental DIF analysis indicated that five items exhibited DIF indicating potential item bias; however, effect sizes for DIF were negligible.Although the PCL-5 demonstrated strong psychometric properties and showed promise for use across the samples differing on cultural and demographic characteristics, some of the items and the number of categories used to measure them could be revisited to create a more efficient instrument. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

OBJECTIVES: Posttraumatic stress disorder (PTSD) is characterized in part by negative alterations of cognition or mood, including alterations in emotional expressivity, or the extent to which one outwardly displays emotions. Yet, research in this area has relied on predominantly White samples and neglected to consider the potential role of gender, despite there being demonstrated gender differences in both PTSD symptom severity and emotional expressivity, separately. The goal of the current study was to fill a critical gap in the literature by examining the moderating role of gender in the relation between PTSD symptom severity and emotional expressivity in a sample of trauma-exposed Black adults. METHODS: Participants were 207 Black individuals enrolled in a historically Black university in the Southern United States (68.6% female; M(age) = 22.32 years). RESULTS: Findings provided support for the moderating role of gender in the association between PTSD symptom severity and emotional expressivity. Specifically, greater PTSD symptom severity was inversely related to emotional expressivity among trauma-exposed Black males and positively associated with emotional expressivity among trauma-exposed Black females. DISCUSSION: These results suggest the potential need for gender-specific assessment and treatment techniques for PTSD symptom severity among trauma-exposed Black college students.

The scoping review examines and summarises the available knowledge base on intervention techniques focused on positive memories. An iterative series of PsycInfo and Medline searches was conducted u...

Background Posttraumatic stress disorder (PTSD) symptoms are common in the immediate aftermath of a trauma, but it is their persistence over time that leads to a diagnosis. This pattern highlights the critical role of symptom maintenance to understanding and treating the disorder. Relatively few studies have explored whether PTSD symptoms may be interacting or triggering one another to worsen and maintain the disorder, a dynamic we refer to as “symptom cascades.” Additionally, little work has tested in real-time how other maintenance factors, such as stress, contribute to such events in daily life. Methods The present study in a group (N = 202) of World Trade Center (WTC) responders oversampled for PTSD tested day-to-day temporal associations among PTSD symptom dimensions (i.e., intrusions, avoidance, numbing, and hyperarousal) and stress across one week. Results Longitudinal models found hyperarousal on a given day predicted increased PTSD symptoms the next day, with the effect sizes almost double compared to other symptom dimensions or daily stress. Intrusions, in contrast, showed little prospective predictive effects, but instead were most susceptible to the effects from other symptoms the day before. Avoidance and numbing showed weaker bidirectional effects. Limitations Findings are from a unique population and based on naturalistic observation. Conclusions Results are consistent with the idea of symptom cascades, they underscore hyperarousal's strong role in forecasting short-term increases in PTSD (even more than stress per se) and they raise the prospect of highly specific ecological momentary interventions to potentially disrupt PTSD maintenance in daily life.

Emotion dysregulation is associated with increased risk for suicidal thoughts and behaviors (STBs) and nonsuicidal self-injury (NSSI). However, research in this area has focused almost exclusively on dysregulation stemming from negative emotions. The present study aimed to address this gap in the literature by examining the associations between the specific domains of positive emotion dysregulation and both STBs and NSSI. Participants included 397 trauma-exposed community adults (Mage = 35.95; 57.7% female; 76.8% White). Results demonstrated significant associations between positive emotion dysregulation and both STBs and NSSI. In particular, higher levels of nonacceptance of positive emotions were found to be significantly related to risk for STBs (versus no risk), higher severity of STBs, and history of NSSI (versus no history). Findings suggest positive emotion dysregulation may play an important role in the etiology and treatment of both STBs and NSSI among trauma-exposed individuals.

Posttraumatic stress disorder (PTSD) symptoms have been linked to sleep disturbances. Limited work has explored how positive affect processes may account for this relationship. Advancing research in this area, we utilized a multi-study design to investigate the role of positive affect processes (levels of positive affect, positive emotionality, hedonic deficits, negative affect interference) in the PTSD-sleep association.Data from 149 trauma-exposed firefighters (MPositive affect levels (b = 0.03, 95 % confidence interval [CI] [0.01, 0.06]; firefighter sample), positive emotionality (b = 0.07, CI [0.03, 0.13]; community sample), and negative affect interference (b = 0.06, CI [0.01, 0.14]; community sample) significantly accounted for the associations between PTSD symptom severity and sleep disturbances controlling for the effects of gender and age.Findings highlight the role of positive affect processes in the link between PTSD and sleep, and support addressing positive affect processes as potential targets in clinical interventions for co-occurring PTSD-sleep problems.

Amazon's Mechanical Turk (MTurk) appears to be a reliable resource for studying clinical populations and accessing hard-to-reach populations. Recent research suggests that MTurk may also be a viable option for military recruitment.The goal of the current study was to examine the utility of collecting clinical data on military samples recruited via MTurk.Participants were 535 military veterans (Findings indicate that rates of military traumas and mental health diagnoses were higher than published comparisons; posttraumatic stress disorder (PTSD) and depression symptoms were found to be higher than values found in a nationally representative sample, lower than a treatment-seeking sample, and comparable to a MTurk-recruited military sample. Alcohol misuse was found to be higher than both nationally representative and treatment-seeking samples. Psychometric analyses indicated support for convergent validity of measures, and confirmatory factor analysis results demonstrated that empirically supported factor models of PTSD were replicated in the current sample; the hybrid model demonstrated the best fit.Our findings support the utility of MTurk for collecting clinical data on military samples. Increasing access to and recruitment of military samples is important for advancing the field of military psychology. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Topic. Limited research has examined trauma and posttraumatic stress disorder (PTSD) among Asian Indians in the U.S. Thus, we (1) synthesize literature on trauma, PTSD, disparities in treatment for PTSD, the burden of untreated PTSD, and culturally-adapted (CA) PTSD interventions; and (2) discuss recommendations for clinicians/researchers working with this population. Method. We searched two databases using keywords related to Asian Indians, PTSD, and interventions. Of 238 identified articles, we used content from 26 articles to inform our review. Findings. Asian Indians report traumatic experiences before, during, or after immigration to the U.S. and consequential PTSD symptoms. Further, Asian Indians in the U.S. are disproportionately impacted by socio-cultural and economic determinants of poor mental health (e.g., shame/stigma associated with seeking mental health services, few culturally-responsive services), which may contribute to the under-reporting of PTSD and (interpersonal) traumas and less willingness to seek treatment. Additionally, CA PTSD interventions tailored to Asian Indians in the U.S. have not been developed. Socio-cultural considerations that can inform CA PTSD interventions for Asian Indians include: causal conditions (e.g., culturally-rooted beliefs about trauma/PTSD), intervening conditions/barriers (e.g., emotional inhibition), and mitigating/coping strategies (e.g., religious/spiritual practices, cultural idioms of distress). These considerations influence clinician/treatment preferences (e.g., solution-oriented and structured therapy, less emotional exposure). Lastly, we outline recommendations for clinicians/researchers: (1) need for national studies on trauma, PTSD, treatment utilization, and the burden of untreated PTSD; (2) consideration of immigration-related experiences influencing PTSD; (3) consideration of socio-cultural elements for CA PTSD interventions; and (4) need for culturally-valid PTSD assessments.

Alcohol misuse is a serious and pervasive problem among US military Veterans. The commission or omission of acts that transgress important moral standards, known as potentially morally injurious events (PMIEs), has been theoretically and empirically linked to alcohol misuse in this population. Emotion dysregulation has been implicated in the pathogenesis of alcohol misuse and may be relevant in the context of PMIEs. The goal of this study was to examine the roles of negative and positive emotion dysregulation in the relation between PMIEs and alcohol misuse. Participants were a community sample of US military Veterans who were predominantly white (69.5%) and male (71.6%), with a mean age of 38.00. The interaction between PMIEs and both negative and positive emotion dysregulation (separately) significantly predicted alcohol misuse. Simple slopes tests revealed that the relation between PMIEs and alcohol misuse was only significant at high levels of negative and positive emotion dysregulation. Findings underscore the potential utility of targeting both negative and positive emotion dysregulation in alcohol misuse interventions for military Veterans experiencing PMIEs.

OBJECTIVE There are ethnic-racial differences in the prevalence of posttraumatic stress disorder (PTSD). However, the factors underlying these differences are not well studied or understood. The goal of this study was to explore the relation of strength of ethnic-racial identity to PTSD. Specifically, we examined whether strength of ethnic-racial identity was indirectly related to PTSD symptom severity through positive and negative emotional avoidance. METHOD Participants were 401 trauma-exposed community individuals (Mage = 43.86 years; 70.1% female; 23.4% Asian, 23.7% Black, 25.1% Hispanic, 25.4% White). RESULTS Within the overall sample of ethnic-racial minorities, the indirect effect of strength of ethnic-racial identity on PTSD symptom severity through the pathways of both positive and negative emotional avoidance was significant. However, these findings were not replicated within each of the specific racial-ethnic subsamples. Specifically, while strength of ethnic-racial identity was indirectly associated with PTSD symptom severity through both positive and negative emotional avoidance in the Black subsample, this indirect effect was only significant through the pathway of positive emotional avoidance in the Hispanic subsample, and was nonsignificant in the Asian and White subsamples. CONCLUSIONS Results underscore ethnic-racial differences in the way in which strength of ethnic-racial identity impacts PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Objective Although research has established a link between posttraumatic stress disorder (PTSD) symptoms and suicidal thoughts and behaviors (STBs), little is known about factors that may accentuate this relation. This study evaluated the influences of negative and positive emotion dysregulation on the association between PTSD symptoms and STBs among veterans. Methods Four-hundred and sixty-five trauma-exposed military veterans in the community (Mage = 38.00, 71.4% male, 69.5% White) completed online questionnaires. Results Negative emotion dysregulation did not moderate the relation between PTSD symptoms and STBs. Results showed significant interactive effects of PTSD symptoms and positive emotion dysregulation on STBs, such that PTSD symptoms were more strongly related to STBs at high (vs. low) levels of positive emotion dysregulation. This effect was sustained across domains of positive emotion dysregulation. Conclusions Findings suggest a potential need to consider positive emotion dysregulation in the assessment and treatment of STBs among veterans with PTSD symptoms.

Objective The relationship between posttraumatic stress disorder (PTSD) and anger is well established. However, further investigation into the underlying mechanisms of this PTSD-anger relationship is needed. Rumination, a construct with a known association to PTSD symptoms, theoretically may mediate this PTSD-anger relationship. Design We conducted a mediational model using self-report measures of PTSD symptoms, rumination, and anger reactions from a nonclinical, trauma-exposed sample (N = 339) through Amazon's Mechanical Turk. Results Rumination mediated overall PTSD symptoms and anger reactions, controlling for age and gender identity. Further analyses examined this mediating role between PTSD subscale scores and anger. Rumination mediated all PTSD subscales and anger when modeled separately. After adjusting for other PTSD symptoms, only 2 subscales' relationship with anger remained mediated by rumination: negative alterations in cognitions/mood and physiological arousal. Conclusions Rumination should be assessed in the context of PTSD and anger symptoms, specifically physiological arousal and negative moods/cognitions symptoms in PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

OBJECTIVES. We examined moderating effects of positive emotion dysregulation and fear of positive emotions in the relation between posttraumatic stress disorder (PTSD) severity and positive memory count. METHOD. Participants were 205 trauma-exposed community individuals (M(age)=35.44; 61.50% female). RESULTS. Moderation analyses indicated interaction effects of PTSD severity with non-acceptance of positive emotions (b = −.01, p = .002) and difficulties with goal-directed behaviors when experiencing positive emotions (b = −.01, p = .006) on positive memory count. CONCLUSIONS. Greater PTSD severity was associated with more specific positive memories when individuals reported less non-acceptance of positive emotions and fewer difficulties engaging in goal-directed behaviors in the context of positive emotions. Greater PTSD severity was associated with fewer specific positive memories when individuals reported greater non-acceptance of positive emotions and greater difficulties engaging in goal-directed behaviors in the context of positive emotions. Results support addressing positive emotion dysregulation in memory-focused interventions for PTSD.

Posttraumatic stress disorder (PTSD) is highly prevalent, with recent evidence suggesting that 8.30%, or approximately 27 million Americans according to the recent U.S. Census data (2018), will develop PTSD in their lifetime (Kilpatrick et al., 2013). Unsurprisingly, PTSD is both widely researched and a key consideration in clinical practice. One important clinical and empirically-established correlate of PTSD is engagement in reckless and self-destructive behaviors (RSDBs; Lusk, Sadeh, Wolf, & Miller, 2017; Tull, Weiss, & McDermott, 2015; Weiss, Tull, Sullivan, Dixon-Gordon, & Gratz, 2015). Among theoretical explanations for the PTSD-RSDB link, the disinhibition viewpoint indicates that individuals with PTSD may have difficulties inhibiting rewarding RSDBs (Casada & Roache, 2005); the emotion dysregulation perspective indicates that individuals engage in RSDBs to reduce the negative affect or increase the blunted positive affect characteristic of PTSD (Baker, Piper, McCarthy, Majeskie, & Fiore, 2004); and the cognitive explanation suggests the trauma’s effects on decreasing attention span and information processing capacity may increase the likelihood of impulsive RSDBs (Ben-Zur & Zeidner, 2009). Of clinical salience, engagement in RSDBs among trauma-exposed samples has a detrimental impact on physical and mental health outcomes. For instance, in a study of veterans receiving treatment for PTSD, a significant number of deaths were related to RSDBs such as substance misuse and suicide (Drescher, Rosen, Burling, & Foy, 2003). Additionally, another study found that engagement in RSDBs was associated with greater psychological, emotional, and behavioral problems (Contractor, Weiss, Dranger, Ruggero, & Armour, 2017). With this empirical, theoretical, and clinically-significant foundation, the E2 symptom assessing posttrauma RSDBs was added to the DSM-5 PTSD diagnostic criteria (American Psychiatric Association, 2013). However, the lack of a comprehensive (yet brief) validated screening measure to assess E2 poses a barrier to its measurement and consideration in treatment. In fact, existing assessments of PTSD’s E2 criterion lack clinical utility and empirical support in a number of ways. First, the assessment of PTSD’s E2 criterion in adults has relied either on a single-item (E2 symptom) included in PTSD assessments or requires a time-intensive battery of multiple distinct measures of a range of specific RSDBs (e.g., substance use, aggressive behaviors). With evidence supporting the co-occurrence of RSDBs (Cooper, 2002) representing an underlying unified latent factor (Shaw, Wagner, Arnett, & Aber, 1992; Weiss, Tull, Dixon-Gordon, & Gratz, 2016), using multiple RSDB measures may have less utility than a measure assessing a unified RSDB construct. Second, one could use existing comprehensive risky behavior measures such as the Risky Impulsive and Self-Destructive Questionnaire (Sadeh & Baskin-Sommers, 2017), the Risky Behaviors Questionnaire (Weiss et al., 2016), and the Risk-Taking Behavior Scale (Pat-Horenczyk et al., 2007). However, these are lengthy (e.g., 38, 29, and 87 items), assess more than just frequency of engaging in RSDBs (e.g., functionality of RSDBs), and/or are restricted to a specific developmental period (e.g., adolescence). Further, these measures do not include items to specifically examine posttrauma manifestations of RSDBs, a necessary criterion for evaluating PTSD’s E2. Indeed, while the types of RSDBs may be similar among trauma-exposed and non-trauma-exposed samples, there is a demonstrated uniqueness in the presentation, function, and course of RSDBs among trauma-exposed populations. For instance, trauma-exposed individuals may functionally engage in RSDBs as an emotion regulation strategy to cope with PTSD symptoms/distress (Marshall-Berenz, Vujanovic, & MacPherson, 2011; Weiss et al., 2015; Weiss, Tull, Viana, Anestis, & Gratz, 2012), implying their onset after trauma/PTSD symptoms. Given the aforementioned limitations of existing measures, we need a comprehensive (yet brief enough to ensure clinical utility) and validated screening measure to examine the unidimensional E2 criterion. We developed the Posttrauma Risky Behaviors Questionnaire (PRBQ) to assess extent of engagement in posttrauma RSDBs and examined its factor structure, reliability, and validity (content, convergent, construct, incremental) in a trauma-exposed community sample recruited via Amazon’s MTurk platform. We further replicated this factor structure and examined its validity (construct and convergent) with a different trauma-exposed sample of college students (Hinkin, 1998; Holmbeck & Devine, 2009). We hypothesized good psychometric properties and ability to represent distinct RSDBs as a unidimensional construct.

BACKGROUND AND OBJECTIVES. Most individuals experience multiple potentially traumatizing events (PTEs); hence, it is important to consider count and types of PTEs (polytraumatization) related to post-trauma health. Notably, no research has examined polytraumatization typologies in relation to positive memory count and phenomenology. We examined (1) latent subgroupings of individuals based on PTE endorsements; and (2) relation of optimal latent class solution to positive memory count and phenomenology. DESIGN. Participants were 203 trauma-exposed adults (M(age) = 35.40; 61.10% females); we used PTEs endorsed on the Life Events Checklist for DSM-5 as indicators for analyses. RESULTS. Latent class analyses indicated a three-class solution differing in quantity and quality of PTE types: Low Experience, Predominant Interpersonal PTEs, and Predominant Non-Interpersonal PTEs. Further, more positive memories predicted membership in the Low Experience vs. other classes; greater sensory details of a positive memory predicted membership in the Low Experience vs. the Predominant Interpersonal PTEs Classes; and greater accessibility of a positive memory predicted membership in the Predominant Interpersonal PTEs vs. the Predominant Non-Interpersonal PTEs Classes. CONCLUSIONS. Results indicated three meaningful subgroups endorsing differing levels/types of PTEs; count, sensory details, and accessibility of positive memories, pending further investigation, may differentiate these subgroups.

Background and Objective. A growing body of literature indicates a significant contribution and role of positive and negative emotions (specifically expressivity) in post-traumatic stress disorder's (PTSD) symptomatology. The current study examined the facet-level relationships between emotional expressivity and PTSD. Specifically, we investigated which emotional expressivity dimension (impulse strength, negative emotional expressivity, and positive emotional expressivity) most strongly related to DSM-5 PTSD symptom clusters severity (intrusions, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity). Methods. The sample of 123 trauma-exposed participants seeking mental health treatment completed the PTSD Checklist for DSM-5 (PCL-5) and the Berkeley Expressivity Questionnaire (BEQ). Results. Results of multivariate multiple regression analysis indicated that only intensity of emotion and difficulty in controlling such emotions (i.e., impulse strength) was strongly related to all four PTSD symptom clusters. The valence of emotional expressivity (positive or negative) was not related to any of the PTSD symptom clusters. Conclusions. Study findings highlight the role of emotional expressivity, specifically impulse strength, in PTSD's symptomatology and may inform guidelines for emotion-focused clinical work for trauma-exposed individuals with PTSD symptoms.

The Posttraumatic Stress Disorder Checklist (PCL) is widely used in research and clinical settings to assess posttraumatic stress disorder (PTSD) symptomatology, including to examine PTSD symptoms/severity across diverse groups. However, the validity of these studies depends on the degree to which the PCL captures a conceptually equivalent construct of PTSD across the compared groups. This study examined the factor structure and invariance of PTSD as assessed by the PCL for DSM-5 (PCL-5) across a sample of trauma-exposed students (n = 412) and trauma-exposed participants recruited online through Amazon’s Mechanical Turk (MTurk; n = 346) platform. Participants from both samples completed the Stressful Life Events Screening Questionnaire (exposure to traumatic events) and the PCL-5. Using confirmatory factor analysis (CFA), we examined the factor structure of the DSM-5 and five alterative models of PTSD separately in both samples. We then tested measurement invariance of the DSM-5 and the optimal model of PTSD across these samples. All PTSD models fit the data well; however, the Hybrid model provided a significantly better fit for both samples. Both the Hybrid and DSM-5 models of PTSD demonstrated invariance for item mappings on factors (configural), factor loadings (metric), intercepts (scalar), and error variances (residual). Our findings support the stability, applicability, and meaningful comparisons of the PCL-5 assessed DSM-5 and Hybrid model factors across samples of trauma-exposed students and MTurk participants.

Existing literature has provided support for an association between posttraumatic stress disorder (PTSD) and emotion dysregulation. However, few studies have examined the relation between PTSD and emotion dysregulation that stems from positive emotions. Moreover, the role of trauma exposure, per se, on positive emotion dysregulation is unknown. Addressing these limitations, the current study compared levels of positive emotion dysregulation among (a) individuals without trauma exposure, (b) trauma-exposed individuals without probable PTSD, and (c) trauma-exposed individuals with probable PTSD. Participants were 400 community-dwelling individuals (M age = 43.76 years, 68.6% female; 24.2% Asian, 23.7% Black, 24.5% Hispanic, 27.6% White). Lower levels of positive emotion dysregulation were found among trauma-exposed participants without probable PTSD compared to trauma-exposed participants with probable PTSD, ds = 0.66–0.73, and unexposed participants, ds = 0.58–0.64. The present findings suggest the potential protective role of low levels of positive emotion dysregulation following trauma exposure. If replicated in longitudinal studies, these results may indicate the utility of enhancing skills for regulating positive emotions among individuals at risk for trauma exposure.