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Despite the life-threatening nature of many cardiac conditions, patients often report perceived posttraumatic growth (PPTG) in their recovery. To date, this research remains scattered across the literature, and no systematic review across cardiac patient populations is available. To understand the state of the literature on PPTG in cardiac patients, we conducted a systematic scoping review, aiming to (a) describe patient populations included, (b) characterize associations between PPTG and mental and physical health indices, (c) identify potential psychosocial resources that moderate or mediate the effects of a cardiac condition on PPTG, and (d) describe and critique study methodologies. A systematic search was conducted on June 21, 2021, using the PubMed and PsycInfo databases. Two authors independently screened the results for eligibility and resolved discrepancies before extracting study data. We identified 21 studies that met the search and eligibility criteria (i.e., original, peer-reviewed, English language). Most studies focused on a single cardiac condition (61.9%), with myocardial infarction the most common. PPTG was studied in relation to myriad mental health and physical health indices. The findings suggested that appraisal and coping may mediate and psychosocial resources (e.g., social support) may moderate the effects of a cardiac condition on PPTG. The generalizability of results is limited, as most studies employed a cross-sectional design with mostly male and majority White samples. Future research would benefit from studying PPTG in more diverse cardiac populations, assessing appraisals of the cardiac condition as traumatic, measuring posttraumatic depreciation in tandem with PPTG, and conducting prospective studies.

There is a need for more research on minority stress theory (MST) with sexual and gender minority (SGM) adolescents of color, because of their disproportionate risk for depression.We recruited 1,627 SGM adolescents of color in the United States to complete measures assessing lesbian, gay, bisexual, transgender, and queer (LGBTQ) climate, LGBTQ microaggressions within one's ethnoracial community, internalized LGBTQ stigma, stress management ability, and depressive symptoms. Using structural equation modeling, a hybrid measurement-structural model was tested, indicating good model fit.Multiple significant indirect pathways linking LGBTQ climate and depressive symptoms emerged. A less positive LGBTQ climate was associated with more microaggression-related stress, more internalized LGBTQ stigma, and worse stress management ability, all of which were associated with greater depressive symptoms. A serial mediation with more microaggression-related stress being associated with greater internalized LGBTQ stigma approached significance.Our findings generally support MST processes in terms of depressive symptoms in SGM adolescents of color, suggesting that psychosocial interventions targeting these processes may have meaningful implications for the mental health of this vulnerable group. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Objective Post-9/11 military deployment is commonly reported as stressful and is often followed by psychological distress after returning home. Yet veterans also frequently report experiencing meaningful military engagement (MME) that may buffer detrimental effects of military stressors. Focusing on the under-investigated topic of association of MME with post-deployment psychological adjustment, this study tests gender differences in MME and post-deployment outcomes. Method This cross-sectional study examined the relationship of MME with deployment stressors, subsequent psychological distress (posttraumatic stress symptoms (PTSS) and depression), and gender among 850 recent-era U.S. veterans (41.4% female). Results On average, both male and female veterans reported high MME. Greater MME was associated with less PTSS and depression following combat and general harassment, and more depression after sexual harassment. For men only, MME associated with less PTSS after sexual harassment. Conclusions MME is high among post-9/11 veterans, but its stress-buffering effects depend on gender and specific stressor exposure.

BACKGROUND: High blood pressure is the most common chronic condition among US veterans. Blood pressure control is essential to preventing and managing cardiovascular diseases. While depressive symptoms are a known risk factor for uncontrolled blood pressure and veterans experience high rates of depressive symptoms, no research has examined the relationship between depressive symptoms and blood pressure control among US veterans. OBJECTIVE: We examined whether moderately severe-to-severe depressive symptoms, compared to none-to-minimal, are associated with higher risk of uncontrolled blood pressure among US veterans. DESIGN: We analyzed a population-based sample of veterans from the National Health and Nutrition Examination Survey (2013–2016). Logistic regression models were adjusted for marital status, age, and body mass index. All analyses were weighted; results are generalizable to US veterans. PARTICIPANTS: A sample of 864 veterans was analyzed, representing approximately 18.8 million US veterans. MAIN MEASURES: Depressive symptoms were assessed by the Patient Health Questionnaire-9. Uncontrolled blood pressure was defined as average systolic blood pressure ≥ 130 and/or diastolic blood pressure ≥ 80. KEY RESULTS: For depressive symptoms, 78.2% (SE = 1.6) of US veterans had none-to-minimal, 18.2% (SE = 1.2) had mild-to-moderate, and 3.5% (SE = 0.8) had moderately severe-to-severe. Forty-three percent (SE = 3.0) of US veterans had uncontrolled blood pressure. Moderately severe-to-severe depressive symptoms, compared to none-to-minimal, were associated with lower risk for uncontrolled blood pressure (aOR = .28, 95% CI [.09, .85]). Mild-to-moderate depressive symptoms were not associated with blood pressure control (aOR = .98, 95% CI [.59, 1.65]). CONCLUSIONS: US veterans with moderately severe-to-severe depressive symptoms were less likely to have uncontrolled blood pressure than veterans with none-to-minimal symptoms. Future research should examine factors unique to veterans that may explain findings opposite of the hypothesized relationship between depressive symptoms and blood pressure control.

Introduction Emotion regulation is thought to develop substantially from late adolescence into early adulthood; further, the rate of development purportedly varies based on personal and contextual characteristics. However, little research has explicitly documented this maturation in young adulthood or identified its determinants. We aimed to (1) characterize how adaptive (positive reappraisal, emotional social support-seeking) and maladaptive (suppression, substance use coping) emotion regulation strategies changed over time and (2) predict change in each strategy based on baseline personal, social, and motivational characteristics. Methods We followed a sample of 1578 students entering university in the northeastern United States across their first two years, assessing them four times. Results As expected, social support-seeking increased and suppression decreased. However, contrary to expectations, cognitive reappraisal declined over time while substance use coping increased. Women generally used more adaptive emotion regulation strategies than did men; social engagement and connection and eudaimonic well-being were generally predictive of using more adaptive coping over time. Conclusions Overall, students did not consistently demonstrate maturation to more adaptive emotion regulation and in fact exhibited decrements over the first two years of college. Students’ baseline characteristics accounted for substantial degrees of change in emotion regulation. These findings suggest potentially fruitful directions for interventions to assist college students in developing more adaptive emotion regulation skills.

Detrimental effects of early life stress on cardiovascular health are evident in adolescence. Cardiovascular reactivity and recovery in response to interpersonal stress may be a mechanism. This study aimed to evaluate if adolescent girls with higher early life stress demonstrated greater cardiovascular reactivity and slower recovery to peer rejection. A sample of 92 adolescent girls (age: M = 13.24) self-reported early life stressors. Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were continuously measured before, during, and after a laboratory peer rejection paradigm. Counter to hypotheses, adolescent girls with higher early life stress had lower, not higher, HR during the recovery period. Early life stress was not associated with SBP or DBP recovery. Additionally, early life stress was not associated with SBP, DBP, or HR reactivity. Future research is needed to assess if blunted cardiovascular reactivity to interpersonal rejection during adolescence is a mechanism linking early life stress and later cardiovascular disease risk in women.

Posttraumatic stress disorder (PTSD) symptoms are associated with high blood pressure (BP) and decreased heart rate variability (HRV) at rest and in response to acute stress. Unique contributions of PTSD symptom clusters to cardiovascular responses to stress are rarely investigated. This study tested whether PTSD-related arousal/reactivity drives relationships of higher PTSD symptoms with higher BP and lower HRV during rest, reactivity (stressor-induced change from baseline), and recovery.Using a cross-sectional observational design, we enrolled 84 trauma-exposed community adults (83% female; 68% White; MArousal/reactivity was not associated with BP or HRV reactivity but associated with a higher low (LF) to high (HF) frequency (HF) ratio (LF/HF) during recovery reflecting sympathetic predominance. During the stressor, more avoidance and intrusion were associated with increased diastolic blood pressure (DBP) from baseline; more avoidance was associated with parasympathetic predominance (lower LF/HF); and more negative cognitions/mood was associated with decreased systolic blood pressure (SBP), DBP, and LF from baseline. During recovery, more intrusion and negative cognitions/mood were associated with increased SBP from baseline; less negative cognitions/mood was associated with sympathetic predominance (higher LF/HF).PTSD symptom clusters demonstrated differential relationships with SBP, DBP, and HRV during reactivity and recovery. Findings may inform targeted PTSD symptom reduction interventions for disrupting links between PTSD and CVD risk.

The transition to college is a critical developmental window during which eating behaviors are susceptible to dysregulation. Changes in exposure to discrimination contribute to alterations in eating behaviors, which may be exacerbated or attenuated by coping styles. The present longitudinal study examines whether increases in perceived discrimination predict increases in overeating and decreases in eating well during the transition to college. We expect that adaptive coping styles will buffer against, while maladaptive coping styles will exacerbate, the effects of increases in perceived discrimination on increases in overeating and decreases in eating well. First year students (n = 804) were assessed at two time points: the spring before freshman year (Time 1) and one year later during the spring semester of freshman year (Time 2). Two distinct coping styles emerged from a factor analysis: adaptive (active coping, planning, emotional support, positive reframing, acceptance, instrumental support) and maladaptive coping (denial, venting, self-blame, self-distraction). Increases in perceived discrimination, lower adaptive coping, and higher maladaptive coping had main effects for predicting more overeating at Time 2. Among students who reported increases in perceived discrimination, higher use of adaptive coping was associated with less overeating at Time 2 while higher use of maladaptive coping was associated with more overeating. While adaptive and maladaptive coping styles had main effects on eating well, change in perceived discrimination did not. Neither adaptive nor maladaptive coping styles interacted with change in perceived discrimination to predict eating well. Findings inform a gap in the literature about the relationship between discrimination and eating behaviors from a developmental perspective by demonstrating that adaptive and maladaptive coping styles influence the effects of changes in perceived discrimination on overeating during the college transition.

Mechanisms for the association between posttraumatic stress disorder (PTSD) symptoms and cardiovascular diseases remain poorly understood. The present study examined associations among PTSD symptoms, appraisals of a current stressor, baseline cardiovascular indices, and cardiovascular responses to the stressor, including appraisals as a potential mediator of PTSD symptoms and cardiovascular responses. A sample of 125 undergraduates provided information about demographics, physical health, trauma history, and PTSD symptoms. Weight, height, blood pressure (BP), and heart rate (HR) measurements were obtained. During a modified Trier Social Stress Task, appraisals of the stressor were assessed and BP and HR were measured again. Findings suggest that PTSD symptoms are associated with current physical health (resting BP and HR) and more negative appraisals of the stressor; in turn, more negative appraisals were associated with increases in cardiovascular response. In particular, threat appraisal mediated the relationship between PTSD symptoms and increases in systolic BP response.

Objectives US military veterans face many challenges in transitioning to civilian life; little information is available regarding veterans' reintegration experiences over time. The current study characterized veterans' postdeployment stressful life events and concurrent psychosocial wellbeing over one year and determined how stressors and wellbeing differ by demographic factors. Methods Recent Post-911 veterans (n = 402) were assessed approximately every three months for 1 year. Participants were 60% men, primarily White (78%), and 12% Latinx; the average age was 36 years. Results The frequency of stressful events decreased over time but was higher for men and minority-race veterans (independent of time since separation). Veterans reported high mean levels of posttraumatic stress disorder, anxiety, and insomnia symptoms, which improved slightly over time. Minority-race and Latinx veterans had higher symptom levels and slower rates of symptom reduction. Conclusion Veterans remain distressed in their overall transition to civilian life. Interventions to promote resilience and help veterans manage readjustment to civilian life appear urgently needed.

Low distress tolerance (DT), the capacity to withstand aversive emotional or physical states, is associated with adverse psychological and physical functioning. However, we know relatively little about the psychological processes through which low DT results in poor functioning. The present study examined the effects of DT on cognitive appraisals of stress using an experimental stress-induction paradigm in 136 undergraduates. We hypothesized (1) lower DT predicts lower challenge appraisal and higher threat appraisal, and (2) these relationships are strengthened for those with higher trait anxiety. Results partially supported Hypothesis 1 : Lower DT predicted higher threat appraisal, but not challenge appraisal. A significant interaction effect was found between DT and trait anxiety in predicting challenge appraisal, but the relationship was opposite from the direction predicted in Hypothesis 2 , such that individuals with very high trait anxiety and lower DT made higher challenge appraisals. Future research should further examine the relations of DT, trait anxiety, and stress appraisals with respect to psychological well-being in young adults.

Psychological factors have been implicated in STEM persistence but remain poorly understood. In particular, the role of self-regulation—the cognitive, behavioral, and emotional skills that allow individuals to work efficiently toward their desired goals, especially when under stress—has received minimal attention. Psychological factors may be particularly important for persistence by underrepresented minority (URM) students, many of whom face significant barriers to success in STEM. We examined the extent to which self-regulation predicts STEM persistence in 755 STEM students and whether minority status moderated self-regulation’s associations with STEM persistence. We found minimal differences in self-regulation styles between URM and nonunderrepresented minority students. Baseline cognitive-emotional self-regulation predicted intentions to persist in a science career, using alcohol and drugs to cope with stress predicted less persistence in STEM major across the year, and only URM status predicted end-of-year GPA. Cognitive-emotional self-regulation was more strongly related to intentions to persist for URMs, and use of humor coping was related to lower GPA especially for URMs. Future research is needed on self-regulation skills and students’ trajectories of STEM success.

Yoga interventions are heterogeneous and vary along multiple dimensions. These dimensions may affect mental and physical health outcomes in different ways or through different mechanisms. However, most studies of the effects of yoga on health do not adequately describe or quantify the components of the interventions being implemented. This lack of detail prevents researchers from making comparisons across studies and limits our understanding of the relative effects of different aspects of yoga interventions. To address this problem, we developed the Essential Properties of Yoga Questionnaire (EPYQ), which allows researchers to objectively characterize their interventions. We present here the reliability and validity data from the final phases of this measure-development project. Analyses identified fourteen key dimensions of yoga interventions measured by the EPYQ: acceptance/compassion, bandhas, body awareness, breathwork, instructor mention of health benefits, individual attention, meditation and mindfulness, mental and emotional awareness, physicality, active postures, restorative postures, social aspects, spirituality, and yoga philosophy. The EPYQ demonstrated good reliability, as assessed by internal consistency and test-retest reliability analysis, and evidence suggests that the EPYQ is a valid measure of multiple dimensions of yoga. The measure is ready for use by clinicians and researchers. Results indicate that, currently, trained objective raters should score interventions to avoid reference frame errors and potential rating bias, but alternative approaches may be developed. The EPYQ will allow researchers to link specific yoga dimensions to identifiable health outcomes and optimize the design of yoga interventions for specific conditions.

Objectives Yoga demonstrates beneficial effects in many populations, yet our understanding of how yoga brings about these effects is quite limited. Among the proposed mechanisms of yoga are increasing psychological resources (mindfulness, body consciousness, self-transcendence, spiritual peace, and social connectedness) that may bring about salutary effects on emotional wellbeing. Further, yoga is a complex practice comprising meditation, active and restorative postures, and breathwork; however little is known about how different components may affect mechanisms. We aimed to determine how an acute session of yoga (and its specific components) related to pre- to post- session changes in proposed mechanisms (psychological resources) and whether those changes were associated with positive changes in emotions. Design 144 regular yoga practitioners completed measures of mindfulness, body consciousness, self-transcendence, social connectedness, spiritual peace, and exercise-induced emotions (positive engagement, revitalization, tranquility, exhaustion) immediately before and after a yoga session (N = 11 sessions, each a different type of yoga). Perceived properties of each yoga session, exercise exertion and engagement with the yoga teacher were assessed immediately following the session. Results Pre-to post- yoga, levels of positive emotions (engagement, tranquility and revitalization) increased while exhaustion decreased. Further, all psychological resources increased and closely tracked improved emotions. Additionally, aspects of the yoga session correlated with changes in psychological resources (mechanisms) and emotions. Conclusions Yoga may influence multiple psychological mechanisms that influence emotional well-being. Further, different types of yoga may affect different mechanisms. Results can inform yoga interventions aiming to optimize effects through specific mechanisms such as mindfulness or spirituality.

The present study tests predictions from the Tripartite Integration Model of Social Influences (TIMSI) concerning processes linking social interactions to social integration into science, technology, engineering, and mathematics (STEM) communities and careers. Students from historically overrepresented groups in STEM were followed from their senior year of high school through their senior year in college. Based on TIMSI, we hypothesized that interactions with social influence agents (operationalized as mentor network diversity, faculty mentor support, and research experiences) would promote both short- and long-term integration into STEM via social influence processes (operationalized as science self-efficacy, identity, and internalized community values). Moreover, we examined the previously untested hypothesis of reciprocal influences from early levels of social integration in STEM to future engagement with social influence agents. Results of a series of longitudinal structural equation model-based mediation analyses indicate that, in the short term, higher levels of faculty mentorship support and research engagement, and to a lesser degree more diverse mentor networks in college promote deeper integration into the STEM community through the development of science identity and science community values. Moreover, results indicate that, in the long term, earlier high levels of integration in STEM indirectly influences research engagement through the development of higher science identity. These results extend our understanding of the TIMSI framework and advance our understanding of the reciprocal nature of social influences that draw students into STEM careers.

People living with congestive heart failure (CHF) often experience increasing levels of depressive symptoms and declining quality of life with disease progression. Religiousness/spirituality (R/S) may mitigate these declines, but whether it does so above and beyond provision of social support has not been tested. 191 patients with CHF (64% male; Mage = 68.6 years) completed surveys at baseline and 6 months later. Four mental and physical outcomes were examined: depressive symptoms, positive states of mind, mental health-related quality of life, and physical health-related quality of life. Controlling for demographics and baseline health status, higher levels of spiritual peace and social support each uniquely predicted increased positive states of mind, only social support predicted improved physical health-related quality of life, neither spiritual peace nor social support predicted change in mental health-related quality of life, and only spiritual peace predicted reduced levels of depressive symptoms across 6 months. R/S may play an important role distinct from social support in promoting well-being in people with CHF. Future research should examine the efficacy of attending to patients’ R/S and developing interventions towards that end.

We examined religious/spiritual (RS) coping from the Survey of Experiences of Returning Veterans (SERV) Study, 630 participants who reported on their demographics, combat exposure, use of positive and negative RS coping, posttraumatic stress disorder (PTSD) symptoms and perceived posttraumatic growth (PPTG). PTSD symptoms and PPTG were inversely correlated. As hypothesized, negative RS coping was inversely associated with PPTG and positively with PTSD, while positive RS coping was related only to PPTG. Although we expected that RS coping would buffer relations between combat exposure and both PTSD and PPTG, we found only one moderator effect and it was opposite our hypothesized direction: Those with high combat exposure and high positive RS coping had the highest PTSD symptomatology. These results suggest, among veterans with combat exposure, negative RS coping is associated with higher PTSD symptomatology, while positive RS coping is generally associated with higher PPTG as well as higher PTSD for those with high combat exposure.

Many theorists posit that religiousness/spirituality (RS) may change after trauma. However, empirical findings regarding RS following trauma are inconclusive. The present study examined the relationship between potentially traumatic events (PTEs) and current RS by considering the cumulative effect of PTEs and multiple dimensions of RS. In our sample of 245 undergraduates (60% female, 79% White), there were no differences in RS between participants who did and did not have PTEs. When analysed as a continuous variable, the number of PTEs was positively correlated with many RS dimensions (i.e., daily spiritual experiences, religious strain, religious comfort, provident and challenging God images, belief in God) but not all (i.e., organised religious involvement, belief in afterlife, benevolent God image). These results suggest that PTEs relate distinctly to different aspects of RS and that examining multiple dimensions of RS may be a more informative way of studying this association.

Objective Pain and post-traumatic stress disorder (PTSD) symptoms are strongly correlated in veteran populations. Arguments for which one condition predicts or worsens the other condition have gone in both directions. However, research addressing this issue has been primarily limited to cross-sectional studies rather than examinations of a potential bidirectional relationship between pain interference and PTSD symptoms over time. In addition, no studies have examined deployment injury status as potentially moderating this bidirectional effect in veterans. To address these gaps in the literature, the present longitudinal study examined whether there is a bidirectional relationship between pain interference and PTSD symptoms in a sample of male and female veterans returning from Operation Iraqi Freedom, Operation Enduring Freedom, or Operation New Dawn (N = 729) and whether deployment injury status moderates this relationship. Methods Participants completed phone interviews regarding pain interference and PTSD symptoms at three time points, each three months apart. Results Pain interference at Time 1 predicted worse PTSD symptoms at Time 2 for the subset of veterans who sustained injuries during deployment (n = 381) but not for veterans with pain interference who did not sustain injuries (n = 338). From Time 1 to Time 3, elevations in PTSD symptoms were mediated by pain interference for injured veterans; in contrast, PTSD symptoms did not appear to drive changes in pain interference in either group. Conclusions These results indicate that physical symptom management should be a crucial target of psychological intervention for returning veterans with PTSD symptoms and deployment-related injuries.

Psychological trauma has implications for many aspects of physical health, including preventive health behaviours (PHBs). However, whether trauma exposure additionally contributes to PHBs above and beyond the effects of posttraumatic stress disorder (PTSD) symptoms remains unclear. In this systematic review, 32 studies were analysed to characterise: (1) the relationships between trauma exposure and PHBs, (2) the relationships between PTSD symptoms and PHBs, (3) the unique associations between trauma exposure and PHBs, independent of PTSD symptoms, and (4) the unique associations between PTSD symptoms and PHBs, independent of trauma exposure. Findings were variable across the three examined PHBs (physical activity, diet, medical screening) when only trauma exposure or PTSD symptoms were taken into account. Clearer relationships emerged between trauma exposure and PHBs when PTSD symptoms were taken into account, demonstrating that trauma exposure is related to PHB engagement above and beyond the effects of PTSD symptoms. Additionally, PTSD symptoms shared unique associations with physical activity and screening frequency, which were not explained by trauma exposure. Our review reveals that teasing apart the effects of trauma exposure and PTSD symptoms on PHBs brings greater clarity to the strength and direction of these associations.