Regional brain electrical activity in posttraumatic stress disorder after motor vehicle accident.

This study examined whether patients with posttraumatic stress disorder (PTSD) related to motor vehicle accidents (MVAs) would show an abnormal pattern of electroencephalographic (EEG) alpha asymmetries, which has been proposed for particular types of anxiety. Patients with PTSD (n = 22) or subsyndromal PTSD (n = 21), traumatized controls without PTSD (non-PTSD with MVA; n = 21), and healthy controls without MVA (n = 23) underwent measurement of EEG activity during baseline and exposure to a neutral, a positive, a negative, and an accident-related picture. Differences in brain asymmetry between groups were observed only during exposure to trauma-related material. PTSD and subsyndromal PTSD patients showed a pattern of enhanced right anterior and posterior activation, whereas non-PTSD with MVA participants showed the opposite pattern. Furthermore, posterior asymmetry in nontraumatized healthy controls varied with gender, with female participants showing a pattern of higher right posterior activation. The results support the hypothesis that symptomatic MVA survivors are characterized by a pattern of right hemisphere activation that is associated with anxious arousal and symptoms of PTSD during processing of trauma-specific information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-evaluative appraisals of coping capability and posttraumatic distress following motor vehicle accidents.

This study tested the importance of coping self-efficacy (CSE) perceptions and change in perceptions of CSE for recovery from motor vehicle accident (MVA) trauma. Data were collected 7 days following the accident (Time 1; n = 163), 1 month after the accident (Time 2; n = 91), and 3 months after the accident (Time 3; n = 70). Early changes in CSE (i.e., from Time 1 to Time 2) predicted posttraumatic distress at 3 months after MVA trauma, even after controlling for Time 1 or Time 2 posttraumatic distress and other trauma-related variables (i.e., accident responsibility, litigation involvement, and peritraumatic dissociation). Early changes in CSE perceptions, however, neither moderated nor mediated the effects of early posttraumatic distress (Time 1) on 3-month posttraumatic distress. Time 2 CSE levels, however, did mediate the relationship between acute posttraumatic distress (Time 1) and 3-month posttraumatic distress (Time 3). These findings highlight the importance of early interventions aimed at strengthening self-efficacy after MVA trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Moderators of the relation between perceived and actual posttraumatic growth.

Although numerous studies suggest that most people report posttraumatic growth (PTG) following traumatic events, the relations between measures of self-reported PTG and actual pre- to posttrauma growth are small (Frazier et al., 2009). The purpose of the current study was to investigate moderators of the relation between perceived and actual growth. Participants were undergraduates who had experienced a traumatic event between Time 1 and Time 2 (2 months later; n = 122) and a matched no-trauma comparison group (n = 122). Participants completed self-report measures of perceived growth (Posttraumatic Growth Inventory; Tedeschi & Calhoun, 1996) at Time 2, actual growth from Time 1 to Time 2 (Frazier et al., 2009), and 4 potential moderators (i.e., distress and life satisfaction at Time 2 and neuroticism and self-esteem at Time 1 pre-event). The moderator analyses suggested that, in the trauma group, perceived growth was more strongly related to actual growth for individuals who reported less distress and more life satisfaction posttrauma. None of the 4 variables were significant moderators for the no-trauma group. Clinical and research implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cognitive processing and posttraumatic growth after stroke.

Objective: To examine whether posttraumatic growth (PTG) after stroke is associated with cognitive processing and psychological distress and whether time since stroke moderates relationships between these variables. Method: A sample of stroke survivors (N = 60) completed the Posttraumatic Growth Inventory, the Cognitive Processing of Trauma Scale and the Hospital Anxiety and Depression Scale. Results: PTG correlated positively with four indicators of cognitive processing (i.e., positive cognitive restructuring, downward comparison, resolution, and denial) and negatively with depression. Time since stroke moderated a number of these relationships. As length of time since stroke increased, the relationships between PTG and anxiety and depression became more negative and significant, and the relationships between PTG and downward comparisons and resolution became more positive and significant. Discussion: The findings indicate the possibility of PTG after stroke and suggest that cognitive processing is an important process for engendering such growth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological predictors of chronic posttraumatic stress disorder after motor vehicle accidents

A prospective longitudinal study assessed 967 consecutive patients who attended an emergency clinic shortly after a motor vehicle accident, again at 3 months, and at 1 year. The prevalence of posttraumatic stress disorder (PTSD) was 23.1% at 3 months and 16.5% at 1 year. Chronic PTSD was related to some objective measures of trauma severity, perceived threat, and dissociation during the accident, to female gender, to previous emotional problems, and to litigation. Maintaining psychological factors, that is, negative interpretation of intrusions, rumination, thought suppression, and anger cognitions, enhanced the accuracy of the prediction. Negative interpretation of intrusions, persistent medical problems, and rumination at 3 months were the most important predictors of PTSD symptoms at 1 year. Rumination, anger cognitions, injury severity, and prior emotional problems identified cases of delayed onset.     

The posttraumatic growth path: An emerging model for prevention and treatment of trauma-related behavioral health conditions.

The aim of this study is threefold. First, the current evidence-based treatments for posttraumatic stress disorder (PTSD) are reviewed. Treatments reviewed for efficacy include prolonged exposure therapy, cognitive processing therapy, and eye movement desensitization and reprocessing. Next, concepts identified as protective measures against chronic PTSD are explored, with particular emphasis on resiliency and posttraumatic growth (PTG). Third, based on the abovementioned systematic review, a new treatment model for trauma-related behavioral health conditions, the posttraumatic growth path (PTGP), is proposed. This research will demonstrate how this new model integrates a variety of therapeutic approaches and protective measures to treat and mitigate the development of chronic PTSD and other concomitant mental health concerns. Implications for practice are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Neural responses to masked fear faces: Sex differences and trauma exposure in posttraumatic stress disorder.

Although women have a greater propensity than men to develop posttraumatic stress disorder (PTSD) following trauma, sex differences in neural activations to threat have received little investigation. This study tested the prediction that trauma would heighten activity in automatic fear-processing networks to a greater extent in women than in men. Functional magnetic resonance imaging (fMRI) data were recorded in 23 participants with PTSD (13 women, 10 men), 21 trauma-exposed controls (9 women, 12 men), and 42 non-trauma-exposed controls (22 women, 20 men) while they viewed masked facial expressions of fear. Exposure to trauma was associated with enhanced brainstem activity to fear in women, regardless of the presence of PTSD, but in men, it was associated only with the development of PTSD. Men with PTSD displayed greater hippocampal activity to fear than did women. Both men and women with PTSD showed enhanced amygdala activity to fear relative to controls. The authors conclude that greater brainstem activation to threat stimuli may contribute to the greater prevalence of PTSD in women, and greater hippocampal activation in men may subserve an enhanced capacity for contextualizing fear-related stimuli. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neural correlates of age-related declines in the formation and realization of delayed intentions.

Neural correlates of age-related declines in prospective memory were studied by using event-related brain potentials (ERPs) in a task in which individuals formed and later realized simple intentions. The behavioral data revealed that prospective responding was less accurate and slower in older than in younger adults. The electrophysiological data revealed age-related differences in the amplitude of modulations of the ERPs associated with the encoding of intentions, the detection of cues, and disengagement from the ongoing activity. These findings support the hypothesis that age-related declines in prospective memory result from a reduction in the efficiency with which older adults encode intentions and detect cues. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A Replication Study of the Neural Correlates of Deception.

The authors attempted to replicate prior group brain correlates of deception (F. Kozel et al., in press) and improve on the consistency of individual results. Healthy, right-handed adults were instructed to tell the truth or to lie while being imaged in a 3T magnetic resonance imaging (MRI) scanner. Blood oxygen level-dependent functional MRI significance maps were generated for subjects giving a deceptive answer minus a truthful answer (lie minus true) and the reverse (true minus lie). The lie minus true group analysis (n = 10) revealed significant activation in 5 regions, consistent with a previous study (right orbitofrontal, inferior frontal, middle frontal cortex, cingulate gyrus, and left middle frontal), with no significant activation for true minus lie. Individual results of the lie minus true condition were variable. Results show that functional MRI is a reasonable tool with which to study deception. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessment and treatment of posttraumatic stress disorder after a motor vehicle collision: Empirical findings and clinical observations.

Individuals who experience a serious motor vehicle accident (MVA) are at increased risk for psychological problems, particularly posttraumatic stress disorder (PTSD). In this article, we review the literature on PTSD among MVA survivors, with particular attention to available instruments to screen for and assess symptomatology of the disorder. Approaches to the treatment of PTSD in this population are reviewed, separated into interventions designed to prevent PTSD in unselected samples, treatment targeting individuals with acute stress disorder that is designed to prevent subsequent development of PTSD, and therapy for individuals with chronic PTSD. Treatment process issues are discussed in an effort to integrate empirical findings with clinical observations. The empirical literature suggests several approaches to treatment that have good potential outcomes, although continued work is needed to identify factors that predict treatment response as well as augment individual-based treatment formats. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of posttraumatic distress 1 year after exposure to community violence: The importance of acute symptom severity.

In this longitudinal study of 333 primarily male, Hispanic survivors of community violence, the authors investigated the effects of 4 categories of risk factors on posttraumatic stress disorder (PTSD) symptom severity: demographic characteristics, pretraumatic psychological factors, characteristics of the trauma, and reactions to the trauma. Replicating past research, exemplars from all 4 categories predicted PTSD symptom severity at 12-month follow-up. Acute symptom severity, measured approximately 5 days posttrauma, accounted for the largest proportion of variance among all the predictors included. No other predictors remained significant after 5-day distress was included in the model. These findings suggest that the effects of several purported risk factors for chronic posttraumatic distress may already be reflected in acute distress following trauma exposure. These results bear on current conceptions of the fundamental nature of PTSD and suggest that initial distress during the immediate aftermath of the trauma may be an important target for intervention. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cannabis use among military veterans after residential treatment for posttraumatic stress disorder.

The present investigation prospectively evaluated whether treatment changes in PTSD symptom severity, among military Veterans in residential PTSD treatment, were related to cannabis use 4 months after discharge from residential rehabilitation. The sample was comprised of 432 male military Veteran patients (Mage = 51.06 years, SD = 4.17), who had a primary diagnosis of PTSD and were admitted to a VA residential rehabilitation program for PTSD. Results demonstrated that lower levels of change in PCL-M scores between treatment intake and discharge were significantly predictive of greater frequency of cannabis use at 4-month follow-up (p     

Disasters and youth: A meta-analytic examination of posttraumatic stress.

Objective: Meta-analyze the literature on posttraumatic stress (PTS) symptoms in youths post-disaster. Method: Meta-analytic synthesis of the literature (k = 96 studies; Ntotal = 74,154) summarizing the magnitude of associations between disasters and youth PTS, and key factors associated with variations in the magnitude of these associations. We included peer-reviewed studies published prior to 1/1/2009 that quantitatively examined youth PTS (≤18 years at event) after a distinct and identifiable disaster. Results: Despite variability across studies, disasters had a significant effect on youth PTS (small-to-medium magnitude; rpooled = .19, SEr = .03; d = 0.4). Female gender (rpooled = .14), higher death toll (disasters of death toll ≤25: rpooled = .09; vs. disasters with ≥1,000 deaths: rpooled = .22), child proximity (rpooled = .33), personal loss (rpooled = .16), perceived threat (rpooled = .34), and distress (rpooled = .38) at time of event were each associated with increased PTS. Studies conducted within 1 year post-disaster, studies that used established measures, and studies that relied on child-report data identified a significant effect. Conclusion: Youths are vulnerable to appreciable PTS after disaster, with pre-existing child characteristics, aspects of the disaster experience, and study methodology each associated with variations in the effect magnitude. Findings underscore the importance of measurement considerations in post-disaster research. Areas in need of research include the long-term impact of disasters, disaster-related media exposure, prior trauma and psychopathology, social support, ethnicity/race, prejudice, parental psychopathology, and the effects of disasters in developing regions of the world. Policy and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pathways to posttraumatic growth: The contributions of forgiveness and importance of religion and spirituality.

Posttraumatic growth may follow the experience of being significantly hurt by another person. This study examines the roles of forgiveness and the importance of religion and spirituality in posttraumatic growth after a significant interpersonal transgression among a diverse sample of 146 adults. Results demonstrated that transgression severity was negatively related to forgiveness: the more distressing the event, the more revenge and avoidance were endorsed in response to the offender. Regression analyses revealed that benevolence toward the offender predicted growth in the area of relating to others. The positive relationship between forgiveness and posttraumatic growth was mediated by importance of religion and spirituality; however, the relationship between unforgiveness and lack of growth was not similarly mediated. Results suggest that religious and spiritual variables influence how individuals respond to significant interpersonal transgressions through positive processes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Examining the neural correlates of choice behavior in a gambling task using steady state topography.

The present study investigated the behavioral and neuropsychological characteristics of decision-making behavior during a gambling task as well as how these characteristics may relate to the Somatic Marker Hypothesis and the Frequency of Gain model. The applicability to intertemporal choice was also discussed. Patterns of card selection during a computerized interpretation of the Iowa Gambling Task were assessed for 10 men and 10 women. Steady State Topography was employed to assess cortical processing throughout this task. Results supported the hypothesis that patterns of card selection were in line with both theories. As hypothesized, these 2 patterns of card selection were also associated with distinct patterns of cortical activity, suggesting that intertemporal choice may involve the recruitment of right dorsolateral prefrontal cortex for somatic labeling, left fusiform gyrus for object representations, and the left dorsolateral prefrontal cortex for an analysis of the associated frequency of gain or loss. It is suggested that processes contributing to intertemporal choice may include inhibition of negatively valenced options, guiding decisions away from those options, as well as computations favoring frequently rewarded options. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Peritraumatic dissociation and experiential avoidance as prospective predictors of posttraumatic stress symptoms.

Peritraumatic dissociation (PD) and experiential avoidance (EA) have been implicated in the etiology of posttraumatic stress symptomatology (PTSS); however, the function of these two factors in the onset and maintenance of PTSS following a potentially traumatic event is unclear. The temporal relationships between EA, PD, and the four clusters of PTSS proposed by the Simms/Watson dysphoria model (Simms, Watson, & Doebbeling, 2002) were examined in a three-wave prospective investigation of 532 undergraduate women participating in an ongoing longitudinal study at the time of a campus shooting. Path analyses indicated that preshooting EA predicted greater PD, intrusions, and dysphoria symptoms approximately one month postshooting. PD was associated with increased symptomatology across all four clusters 1-month postshooting, while 1-month postshooting EA was associated with higher dysphoria and hyperarousal symptoms eight months postshooting. PD had a significant indirect effect on all four PTSS clusters eight months postshooting via 1-month postshooting symptom reports. The results suggest that both EA and PD show unique influences as risk factors for PTSS following a potentially traumatic event. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Well-being and posttraumatic growth in unrelated donor marrow transplant survivors: A nine-year longitudinal study.

Objective: To study posttraumatic growth and psychological and physical well-being among 25 cancer survivors (12 men, 13 women) 9 years after receiving a hematopoietic stem cell transplant from an unrelated donor. Measures: Participants completed measures of well-being (e.g., depression, physical function) and posttraumatic growth at the 9-year follow-up. Prior to treatment, optimism, social support, and well-being had been assessed. Results: Findings reveal high levels of physical and psychological well-being. Survivors reported posttraumatic growth in several domains, including increased personal strengths and enhanced interpersonal relationships. Higher levels of growth were significantly related to gender and age: Women reported more total posttraumatic growth, and older survivors reported more enhanced spirituality, one domain of growth. Posttraumatic growth and well-being after treatment were predicted by 2 psychosocial variables assessed prior to treatment: dispositional optimism and social support. Implications: Although long-term survivors report ongoing physical limitations, they also experience well-being in both physical and psychological domains. Posttraumatic growth is an area of well-being deserving of additional research and clinical attention. In particular, there may be reason to assist survivors to articulate growth as part of ongoing care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A model of meaning-making coping and growth in combat veterans.

More than 1.6 million military men and women have deployed to fight the global war on terror. Although studies have suggested that approximately one third of these service men and women return with a mental health condition or a brain injury, a gap remains in our understanding about how these individuals cope with and grow from their experiences. In this article, we review the existing body of research related to growth and recovery from trauma and then propose an empirically informed and contextually sensitive model to guide future research with combat veterans. We draw from research focused on resilience, posttraumatic growth, and decline (negative or pathological) change trajectories, and we propose that meaning-making coping is a core mechanism of the posttraumatic growth process for combat veterans. Implications for practitioners and the next steps for future research are presented. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Predicting posttraumatic growth in breast cancer survivors.

Wide variability exists with respect to how breast cancer survivors respond to common psychological and psychosocial challenges of their disease, ranging from posttraumatic stress disorder to posttraumatic growth. This cross-sectional study examined contextual, disease-related, and intraindividual predictors of posttraumatic growth in 224 randomly selected breast cancer survivors. A series of hierarchical regression analyses found that age at diagnosis, marital status, employment, education, perceived intensity of disease, and active coping accounted for 34%, 35%, and 28% of the variance in growth in relationships with others, new possibilities, and appreciation for life. These findings suggest that a more comprehensive model of growth will be helpful in understanding the various factors that play a role in breast cancer survivors' perception of psychological and psychosocial growth. (PsycINFO Database Record (c) 2010 APA, all rights reserved)