Jane A. Luterek

Emotion Dysregulation in Generalized Anxiety Disorder: A Comparison with Social Anxiety Disorder

From an emotion regulation framework, generalized anxiety disorder (GAD) can be conceptualized as a syndrome involving heightened intensity of subjective emotional experience, poor understanding of emotion, negative reactivity to emotional experience, and the use of maladaptive emotion management strategies (including over-reliance on cognitive control strategies such as worry). The current study sought to replicate previous findings of emotion dysregulation among individuals with GAD and delineate which aspects of emotion dysregulation are specific to GAD or common to GAD and another mental disorder (social anxiety disorder). Individuals with GAD reported greater emotion intensity and fear of the experience of depression than persons with social anxiety disorder and nonanxious control participants. Individuals with social anxiety disorder indicated being less expressive of positive emotions, paying less attention to their emotions, and having more difficulty describing their emotions than either persons with GAD or controls. Measures of emotion differentiated GAD, social anxiety disorder, and normal control groups with good accuracy in a discriminant function analysis. Findings are discussed in light of theoretical and treatment implications for both disorders.

posttraumatic stress and its relationship to physical health functioning in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA health care.

The relationship between posttraumatic stress and physical health functioning was examined in a sample of Iraq and Afghanistan War veterans seeking postdeployment VA care. Iraq and Afghanistan War veterans (N = 108) who presented for treatment to a specialty postdeployment care clinic completed self-report questionnaires that assessed symptoms of posttraumatic stress disorder (PTSD), chemical exposure, combat exposure, and physical health functioning. As predicted, PTSD symptom severity was significantly associated with poorer health functioning, even after accounting for demographic factors, combat and chemical exposure, and health risk behaviors. These results highlight the unique influence of PTSD on the physical health in treatment seeking Iraq and Afghanistan War veterans.

An Experimental Study of Emotional Responding in Women With Posttraumatic Stress Disorder Related to Interpersonal Violence

Although posttraumatic stress disorder (PTSD) is defined by the experience of intense negative emotions and emotional numbing (American Psychiatric Association, 1994), empirical study of emotional responding in PTSD has been limited. This study examined emotional responding among women with and without PTSD to positive and negative film stimuli across self-reported experience, facial expression, and written expression. Consistent with previous findings, no evidence for generalized numbing was found. In general, women with PTSD exhibited higher levels of negative activation and expressed more negative emotion words to both positive and negative film stimuli, whereas no group differences emerged in facial expressivity. Results are interpreted within the context of the current literature on emotional deficits associated with PTSD.

Drinking motives moderate daily relationships between PTSD symptoms and alcohol use

Posttraumatic stress disorder (PTSD) and alcohol dependence (AD) frequently co-occur, although results of both cross-sectional and longitudinal studies evaluating the nature of their relationship have been mixed. There has been varied support for competing models explaining how these conditions influence one another. To assess both the self-medication and mutual maintenance models, as well as examine the potential moderating role of drinking motives, the current study used Generalized Estimating Equations to evaluate daily associations for an average of 7.3 days between PTSD symptoms and alcohol use in a mixed-gender sample of individuals who met criteria for both PTSD and AD. Results generally supported a self-medication model with elevated PTSD symptoms predictive of greater alcohol use on that same day and on the following day. Contrary to a mutual maintenance model prediction, drinking did not predict next-day PTSD symptoms. Results also indicated that both coping and enhancement drinking motives were significant moderators of the PTSD and drinking relationships, suggesting that these relationships may be more or less salient depending on an individuals particular drinking motivations. For example, among those higher on coping drinking motives, a 1-unit increase in PTSD symptom severity was associated with a 35% increase in amount of alcohol consumed the same day, while among those low on coping drinking motives, a 1-unit PTSD increase was associated with only a 10% increase in alcohol consumption. We discuss implications of these findings for the larger literature on the associations between PTSD and alcohol use as well as for clinical interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Interpersonal Rejection Sensitivity in Childhood Sexual Abuse Survivors Mediator of Depressive Symptoms and Anger Suppression

This study investigated whether interpersonal rejection sensitivity serves a mediating role between childhood sexual abuse (CSA) and three long-term psychological correlates of CSA in adult female survivors: depressive symptoms, anger suppression, and attenuated emotional expression. Interpersonal rejection sensitivity has been shown to be a risk factor for the development of depression and is elevated in CSA survivors. Similarly, attenuated emotional expression, particularly anger, has been related to adjustment difficulties in CSA survivors. Participants in this study were 355 female undergraduates, 34 ofwhomreported a history of CSA. Results demonstrated that interpersonal rejection sensitivity mediates the relationship between CSA and later depressive symptoms. Interpersonal rejection sensitivity partially mediated the relationship between CSA and anger suppression; however, it did not mediate the relationship between CSA and attenuated emotional expression. These results are examined within the context of the current literature on adult CSA survivors and their implications are discussed.

The development and psychometric evaluation of the emotional reactivity and numbing scale.

Recent research has highlighted the role of hyperresponsivity and numbing of emotions in posttraumatic stress disorder. Preliminary research suggests that emotional numbing symptoms impact the development, maintenance, and treatment of posttraumatic stress disorder. However, research in this area has been hindered, in part, due to the absence of a psychometrically sound, conceptually based measure of emotional numbing. The present study examined the psychometric properties of the Emotional Reactivity and Numbing Scale in a sample of 92 trauma-exposed men and women veterans. Results provide preliminary support for the internal consistency, test-retest reliability, convergent, and discriminant validity of the measure. Implications for future research are discussed.

A controlled examination of two coping skills for daily alcohol use and PTSD symptom severity among dually diagnosed individuals

Investigations of targeted coping skills could help guide initial treatment decisions for individuals with co-occurring posttraumatic stress disorder (PTSD) and alcohol dependence (AD) who often endorse worse coping skills than those with AD but not PTSD. Although improvement in coping skills is associated with enhanced alcohol use outcomes, no study has evaluated the utility of teaching specific coping skills in the context of comorbid PTSD/AD. We compared the effects of teaching two coping skills (cognitive restructuring [CR] and experiential acceptance [EA]) or an attention control condition on drinking and PTSD symptoms among 78 men and women with comorbid PTSD/AD during a 5-week daily follow-up assessment. Both CR and EA skills were associated with decreased drinking compared to control, and that change in drinking over time did not significantly differ between those who received CR and EA. Individuals who received CR skills, however, consumed less alcohol on a given day than those who received EA skills. Neither CR nor EA was associated with a decrease in PTSD symptom severity. These results provide preliminary support for clinicians to prioritize CR and EA skills during initial treatment sessions when working with individuals with PTSD/AD, and offer ideas for continued investigation and intervention refinement.