Inês Jongenelen

The Strongest Correlates of PTSD for Firefighters: Number, Recency, Frequency, or Perceived Threat of Traumatic Events?

Firefighters experience a wide range of traumatic events while on duty and are at risk to develop psychopathology and posttraumatic stress disorder (PTSD). According to cognitive models, the persons interpretation of the traumatic event is responsible for the development of PTSD rather than the traumatic event itself. This cross-sectional study aimed to explore the contribution of perceived threat to explain PTSD symptoms in Portuguese firefighters, after adjusting for potential confounding factors. A sample of 397 firefighters completed self-report measures of exposure to traumatic events, psychopathology, and PTSD. Perceived threat explained unique variance in PTSD symptoms, R(2) = .40, ΔR(2) = .02, F(10, 367) = 24.55, p < .001, Cohens f(2) =.03, after adjusting for psychopathology, number, recency, and frequency of the events, and other potential confounding variables. The association between psychopathology and PTSD was also moderated by perceived threat, R(2) = .43, ΔR(2) = .03, F(11, 366) = 25.33, p < .001, Cohens f(2) =.05. Firefighters may benefit from interventions that focus on perceived threat to prevent PTSD symptoms.

Cortisol awakening response among women exposed to intimate partner violence.

The studies of the effects of intimate partner violence (IPV) on the cortisol awakening response (CAR) are scarce and contradictory. While some of the studies suggested that female victims of IPV showed high CAR, other studies found low CAR. Mixed results may be related to differences in sample characteristics as well as other potential covariates associated with the cortisol, as femalés history of abuse, chronicity, severity and type of IPV, psychological distress, posttraumatic stress disorder, and social support. The study examined individual differences in CAR among 149 female victims of severe IPV reported to authorities, including 76 (51%) living in shelter and 73 (49%) living with the abusive partners. Results revealed several individual differences in CAR that may contribute to understanding the mixed results found in literature, including women with cortisol that decreased between the baseline and 30min later, women with no increase of cortisol, and women whose cortisol increased above baseline. Additionally, women without CAR experienced more chronic and severe violence, more psychological distress and PTSD symptoms. However, hierarchical multiple regression indicated that chronic severe violence was the only independent variable that significantly explained 13% of the variance in CAR, even after including all covariates in the model, and adjusting for sociodemographic variables. In conclusion, this study suggests that the HPA axis dysregulation is influenced by chronic severe violence among women victims of IPV.

Psychological Distress and Posttraumatic Stress Symptoms: The Role of Maternal Satisfaction, Parenting Stress, and Social Support Among Mothers and Children Exposed to Intimate Partner Violence

Studies of the effects of intimate partner violence (IPV) on parenting have usually not examined the role of the maternal perceptions, either its stress or maternal satisfaction, on the mothers’ and children’s mental health functioning. The present study aimed to assess whether maternal satisfaction, parenting stress, and social support are significantly associated with women’s psychological functioning. The study also assessed whether maternal perceptions of the role of parenting were significantly associated with children’s emotional well-being and social behavior. The sample included 160 mothers, 79 (49.4%) who were living with the aggressors and 81 (50.6%) in shelters, and their children (n = 61). The findings suggested that high levels of maternal satisfaction and perception of social support were significantly negatively associated with women’s posttraumatic stress disorder (PTSD) symptoms and psychological distress, whereas parenting stress was significantly positively associated with these outcomes. Maternal satisfaction was the only parenting variable that predicted both maternal mental health and children’s emotional and behavioral problems, suggesting that it is a protective factor for both mothers and children. This study suggests that increasing maternal satisfaction with parenting and reducing parenting stress might promote better adjustment for both women and children victims of IPV.

Mães adolescentes: adaptação aos múltiplos papéis e a importância da vinculação

Becoming a mother during adolescence implies huge rearrangements in terms of individual developmental pathway. Using a sample of 38 adolescent mothers from the north region of Portugal, this study aims at examining the importance of adolescent mothers’ attachment organizations, assessed during pregnancy, in the adjustment to role changes imposed by motherhood. Following an ecological perspective on adolescent motherhood, sociodemographic and social support measures were also considered. Our results show that most adolescent mothers exhibit a lower level of adjustment towards the new configuration of roles. A statistically significant association between adolescent mothers’ attachment and quality of adjustment was found.Tornar-se mae na adolescencia obriga a profundos realinhamentos na trajetoria desenvolvimental individual. Partindo de uma amostra de trinta e oito maes adolescentes do Norte de Portugal, pretendeu-se com este estudo explorar o impacto da qualidade da organizacao de vinculacao das adolescentes, avaliada durante a gravidez, na adaptacao as mudancas de papeis decorrentes da maternidade. Seguindo uma perspetiva ecologica, foram igualmente contempladas medidas sociodemograficas e de suporte social. Os resultados revelam que a maioria das adolescentes evidencia um nivel inferior de adaptacao a nova configuracao de papeis, verificando-se uma associacao significativa entre o nivel de adaptacao conseguido e a qualidade da organizacao de vinculacao da adolescente.

Typologies of intimate partner violence-maternal parenting and children’s externalizing problems: The moderating effect of the exposure to other forms of family violence

Typologies of IPV and parenting practices in mothers who experienced police-reported IPV remain surprisingly unexplored, in addition to how those typologies are linked with childrens externalizing problems. Using data from 162 Portuguese mother-child dyads with a police or child protection services referral of IPV, this study aimed to: (a) identify IPV-parenting typologies; (b) test the associations between typologies and childrens externalizing problems, and (c) examine the moderating effect of childrens exposure to other forms of family violence in those associations. Using a person-centered approach, two IPV-parenting typologies were found: a spillover typology, with high levels of physical, psychological, and sexual violence and high levels of harsh and inconsistent parenting practices; and a compartmentalized typology, with high levels of physical, psychological, and sexual violence and lower ineffective parenting practices. Results also showed that externalizing symptoms (reported by mothers and teachers) were significantly lower in children of mothers in the compartmentalized typology compared to those in the spillover typology. Childrens direct exposure to other forms of family violence moderated this association. Findings suggested that children with a high exposure to other forms of family violence showed the highest levels of externalizing problems when their mothers were classified into the spillover typology, and they exhibited the lowest levels of externalizing problems when their mothers were classified in the compartmentalized typology.

Efficacy indicators of four methods in outpatient addiction treatment

In Portugal, as far as we know, there are no recent studies that evaluated the comparative efficacy of therapeutic modalities in addiction problems by reference to a holistic and psychosocial model of effectiveness. Objectives Using a sample of Portuguese patients in outpatient treatment for drug and alcohol abuse, this study aimed to examine if a combined treatment modality (group therapy with individual intervention) had greater overall efficacy when compared to other three types of treatment without group therapy. Methods This is a correlational and cross-sectional study using a convenience sample of patients (N = 254) from an outpatient treatment in the Intervention Service on Addictive Behaviors and Substance Dependence. At the time of data collection, the patients were attending four types of treatment, such as receiving intervention based on individual psychological counseling (n = 66); receiving individual psychiatric counseling (n = 68); receiving both individual psychological and psychiatric counseling (n = 102); and receiving not only individual counseling (i.e., psychology or psychiatry), but also attending group therapy (n = 18). Results Using MANOVA and Wilks’s multivariate test criterion, there was a significant effect of treatment modality on the global efficacy, Λ = 0.88, F(9, 603) = 3.75, p < 0.0001. Examination of mean estimates indicated that patients in a combined therapeutic modality revealed more treatment involvement compared to patients in other therapeutic modalities without group therapy. Discussion The results obtained in this study highlight the importance of integrating interventions in a collaborative way. A combined therapeutic modality, adding group therapy, was associated with positive effects, such as more levels of peer support and involvement in treatment, and increasing the individual’s probability to remain abstinent

Cognitive-affective depression and somatic symptoms clusters are differentially associated with maternal parenting and coparenting

BACKGROUND Both depressive and somatic symptoms are significant predictors of parenting and coparenting problems. However, despite clear evidence of their co-occurrence, no study to date has examined the association between depressive-somatic symptoms clusters and parenting and coparenting. The current research sought to identify and cross-validate clusters of cognitive-affective depressive symptoms and nonspecific somatic symptoms, as well as to test whether clusters would differ on parenting and coparenting problems across three independent samples of mothers. METHOD Participants in Studies 1 and 3 consisted of 409 and 652 community mothers, respectively. Participants in Study 2 consisted of 162 mothers exposed to intimate partner violence. All participants prospectively completed self-report measures of depressive and nonspecific somatic symptoms and parenting (Studies 1 and 2) or coparenting (Study 3). RESULTS Across studies, three depression-somatic symptoms clusters were identified: no symptoms, high depression and low nonspecific somatic symptoms, and high depression and nonspecific somatic symptoms. The high depression-somatic symptoms cluster was associated with the highest levels of child physical maltreatment risk (Study 1) and overt-conflict coparenting (Study 3). No differences in perceived maternal competence (Study 2) and cooperative and undermining coparenting (Study 3) were found between the high depression and low somatic symptoms cluster and the high depression-somatic symptoms cluster. CONCLUSIONS The results provide novel evidence for the strong associations between clusters of depression and nonspecific somatic symptoms and specific parenting and coparenting problems. Cluster stability across three independent samples suggest that they may be generalizable. The results inform preventive approaches and evidence-based psychotherapeutic treatments.

When social support is not enough: Trauma and PTSD symptoms in a risk-sample of adolescents

Social support can mitigate the severity of posttraumatic stress disorder (PTSD) in children and adults following traumatic events. However, little is known about the role of social support in high-risk samples of adolescents from the community. The present study examined the relationship between social support and PTSD symptoms in adolescents exposed to traumatic events and childhood adversity, after adjusting for the effects of potential covariates, including sociodemographic factors, previous childhood adversity, level of exposure, comorbid anxiety, depression symptoms, and substance abuse, and coping strategies. METHOD The participants of the study were 183 adolescents, mean age of 16 years old (M=15.71, SD=1.31), ranged between 13 and 17 years old, 89 (48.6%) males and 94 (51.4%) females. RESULTS The results revealed that 26.2% of the sample met the criteria for probable PTSD. Our statistical model explained 64% of the variance in PTSD symptoms, but social support was not significant after adjusting for covariates. This study found that social support was not enough to reduce PTSD symptoms in adolescents exposed to trauma and adversity. Programs focused only on improving social support may not be effective in reducing mental health symptoms for adolescents, particularly when there has been severe and/or multiple forms of childhood adversity.