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Loneliness, Depressive Symptomatology, and Suicide Ideation in Adolescence: Cross-Sectional and Longitudinal Analyses

The paper presents the first known longitudinal study of the relationship between loneliness, depressive symptoms, and suicide ideation in adolescence, in a stratified sample of high school students (Time 1 N = 1009; 57 % female; Time 2 N = 541; 60 % female). Cross-lagged structural equation modeling indicated that depressive symptoms led to more loneliness across time, whereas loneliness did not predict higher levels of depressive symptoms across time. Loneliness was found to be a correlate of depressive symptoms at the cross-sectional level, independent of gender, other demographic factors, multiple psychosocial variables, and social desirability. Loneliness did not predict suicide ideation over time or at the cross-sectional level, when controlling for depressive symptoms. Gender did not predict loneliness, depressive symptoms or suicide ideation across time. Future longitudinal studies of the relationship between loneliness, depressive symptoms, and suicide ideation in adolescence should use more extensive designs.

The Crisis Support Scale: Psychometric qualities and further validation.

The objective of the present study was to provide a further validation of the Crisis Support Scale, which is a short scale for measuring social support after a crisis has occurred. The data from eleven trauma studies of 4213 subjects were used to investigate the psychometric properties of the scale and the differences that emerge due to age, gender, and type of trauma. The scale appears to be very robust. Some aspects of crisis support seem to decrease as time goes by while others increase. Women survivors report less support than men both right after the trauma and later on. The younger survivors tend to report the least support in the acute phase although this picture is reversed later on. The various types of trauma have different item profiles, which supports the concurrent validity of the scale.

The structure of PTSD symptoms: A test of alternative models using confirmatory factor analysis

OBJECTIVES This study aimed to examine the structure of self-reported post-traumatic stress disorder (PTSD) symptoms. DESIGN Based on previous factor analytic findings and the DSM-IV formulation, six confirmatory factor models were specified and estimated that reflected different symptom clusters. METHODS The analyses were based on responses from 1116 participants who had suffered whiplash injuries and screened for full or subclinical PTSD using the Harvard Trauma Questionnaire. RESULTS A correlated four-factor model with re-experiencing, avoidance, dysphoria and arousal factors fitted the data very well. Correlations with criteria measures showed that these factors were associated with other trauma related variables in a theoretically predictable way and showed evidence of unique predictive utility. CONCLUSIONS These results concur with previous research findings using different trauma populations but do not reflect the current DSM-IV symptom groupings.

Attachment styles, traumatic events, and PTSD: a cross-sectional investigation of adult attachment and trauma.

The aim of the present study was to examine the association between post-traumatic stress disorder (PTSD) and adult attachment in a young adult population. A sample of 328 Danish students (mean age 29.2 years) from four different schools of intermediate education level were studied by the Harvard Trauma Questionnaire (HTQ), the Revised Adult Attachment Scale (RAAS), the Trauma Symptom Checklist (TSC), the Crisis Support Scale (CSS), the Coping Style Questionnaire (CSQ), and the World Assumption Scale (WAS). Attachment styles were associated with number of PTSD symptoms, negative affectivity, somatization, emotional coping, attributions, and social support. The distribution of attachment styles in relation to PTSD symptoms could be conceived as uni-dimensional.

Psychosocial treatment of posttraumatic stress disorder in adult refugees: A systematic review of prospective treatment outcome studies and a critique

BACKGROUND Refugees with posttraumatic stress disorder (PTSD) often present with complicated traumatic symptoms, prolonged and repeated exposure to traumatic events, acculturation, and social problems. A consensus about suitability of psychosocial treatments for refugees does not exist. Never the less there is a need to review the state of knowledge about effective treatments for traumatized refugees, to help guide the practitioners in their choice of treatment methods. METHODS A systematic review of treatment outcome studies was carried out. RESULTS Twenty-five studies were reviewed. The majority were treatment studies of different forms of cognitive-behavioral therapy (CBT). The rest were reports of outcomes of alternative treatments and a small group of studies of multidisciplinary treatments. LIMITATIONS The amount of grey literature not covered by the review could not be estimated precisely. Included studies are methodologically diverse and consist of different refugee populations. This makes a broad interpretation of the treatment results only tentative. CONCLUSIONS Very large effect sizes were obtained in some of the CBT studies, indicating a broad suitability of CBT in the treatment of core symptoms of PTSD in adult refugees. Empirical evidence also points to the possibility that the maladaptive traumatic reactions in refugees can take shape of more complex reactions than those strictly specified in the diagnostic category of PTSD. Effectiveness of CBT treatments has as yet not been tested on the whole range of symptoms in these complex cases. There are few studies of treatments alternative to CBT and they are less methodologically rigorous than the CBT studies.

The combined effect of gender and age on post traumatic stress disorder: do men and women show differences in the lifespan distribution of the disorder?

BackgroundThe aim of the study was to examine the combined effect of gender and age on post traumatic stress disorder (PTSD) in order to describe a possible gender difference in the lifespan distribution of PTSD.MethodsData were collected from previous Danish and Nordic studies of PTSD or trauma. The final sample was composed of 6,548 participants, 2,768 (42.3%) men and 3,780 (57.7%) women. PTSD was measured based on the Harvard Trauma Questionnaire, part IV (HTQ-IV).ResultsMen and women differed in lifespan distribution of PTSD. The highest prevalence of PTSD was seen in the early 40s for men and in the early 50s for women, while the lowest prevalence for both genders was in the early 70s. Women had an overall twofold higher PTSD prevalence than men. However, at some ages the female to male ratio was nearly 3:1. The highest female to male ratio was found for the 21 to 25 year-olds.ConclusionsThe lifespan gender differences indicate the importance of including reproductive factors and social responsibilities in the understanding of the development of PTSD.

Assessing a Five Factor Model of PTSD: Is Dysphoric Arousal a Unique PTSD Construct Showing Differential Relationships with Anxiety and Depression?

Posttraumatic stress disorders (PTSD) latent structure has been widely debated. To date, two four-factor models (Numbing and Dysphoria) have received the majority of factor analytic support. Recently, Elhai et al. (2011) proposed and supported a revised (five-factor) Dysphoric Arousal model. Data were gathered from two separate samples; War veterans and Primary Care medical patients. The three models were compared and the resultant factors of the Dysphoric Arousal model were validated against external constructs of depression and anxiety. The Dysphoric Arousal model provided significantly better fit than the Numbing and Dysphoria models across both samples. When differentiating between factors, the current results support the idea that Dysphoric Arousal can be differentiated from Anxious Arousal but not from Emotional Numbing when correlated with depression. In conclusion, the Dysphoria model may be a more parsimonious representation of PTSDs latent structure in these trauma populations despite superior fit of the Dysphoric Arousal model.

Evidence of symptom profiles consistent with posttraumatic stress disorder and complex posttraumatic stress disorder in different trauma samples

Background The International Classification of Diseases, 11th version (ICD-11), proposes two related stress and trauma-related disorders, posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A diagnosis of CPTSD requires that in addition to the PTSD symptoms, an individual must also endorse symptoms in three major domains: (1) affective dysregulation, (2) negative self-concepts, and (3) interpersonal problems. This study aimed to determine if the naturally occurring distribution of symptoms in three groups of traumatised individuals (bereavement, sexual victimisation, and physical assault) were consistent with the ICD-11, PTSD, and CPTSD specification. The study also investigated whether these groups differed on a range of other psychological problems. Methods and Results Participants completed self-report measures of each symptom group and latent class analyses consistently found that a three class solution was best. The classes were “PTSD only,” “CPTSD,” and “low PTSD/CPTSD.” These classes differed significantly on measures of depression, anxiety, dissociation, sleep disturbances, somatisation, interpersonal sensitivity, and aggression. The “CPTSD” class in the three samples scored highest on all the variables, with the “PTSD only” class scoring lower and the “low PTSD/CPTSD” class the lowest. Conclusion This study provides evidence to support the diagnostic structure of CPTSD and indicted that CPTSD is associated with a broad range of other psychological problems.

Effectiveness of psychological debriefing

Objective: To identify literature concerning the effectiveness of psychological debriefing (PD) and analyse results according to different criteria of success and different uses of the intervention format.

World Assumptions and Combat-Related Posttraumatic Stress Disorder

The authors examined the association between (a) personal world assumptions and (b) combat stress reactions (CSRs), posttraumatic stress disorder (PTSD), and PTSDs course among three groups of Israeli veterans: 109 veterans who suffered from CSR on the battlefield, 98 decorated veterans, and 189 control participants. Participants completed standardized questionnaires that measured PTSD and world assumption. Both CSR and chronic PTSD were associated with lower levels of self-worth and beliefs about the benevolence of people. In addition, the authors found a linear association between self-worth perceptions and levels of mental status. The authors examined the results of the study considering the extraordinary characteristics and meaning of war.