Lucy J. Allbaugh

The role of repetitive thought in determining posttraumatic growth and distress following interpersonal trauma

Background and Objectives: Repetitive thought (RT) strategies have been linked to a range of negative outcomes following traumatic interpersonal events but are proposed to serve an adaptive function under particular circumstances. This study examined outcomes following RT within a transdiagnostic framework, and explored the potentially adaptive nature of trait-like and event-related RT. Design: The centrality of a traumatic event to ones identity was explored as a context under which the adaptive nature of RT might change. Young adults with interpersonal violence experiences (N = 163) reported use of trait-like and event-related RT, centrality of the event, depressive, anxious, and posttraumatic stress symptoms (PTSS), posttraumatic depreciation and posttraumatic growth. Methods: Hierarchical multiple regression analyses were used to examine main and moderating effects of four types of RT and event centrality on outcome variables. Results: Centrality positively predicted depressive symptoms and PTSS, depreciation, and growth. Brooding RT positively predicted all negative outcomes. Reflecting RT positively predicted anxious symptoms and PTSS and depreciation. Only deliberate RT positively predicted growth. Centrality did not moderate any examined relationships. Conclusions: Findings highlight the importance of addressing specific types of RT in interventions with survivors and of considering centrality as a robust contributor to outcomes following interpersonal violence.

Vitamin D levels and perinatal depressive symptoms in women at risk: a secondary analysis of the mothers, omega-3, and mental health study

BackgroundVitamin D insufficiency may be associated with depressive symptoms in non-pregnant adults. We performed this study to evaluate whether low maternal vitamin D levels are associated with depressive symptoms in pregnancy.MethodsThis study was a secondary analysis of a randomized trial designed to assess whether prenatal omega-3 fatty acid supplementation would prevent depressive symptoms. Pregnant women from Michigan who were at risk for depression based on Edinburgh Postnatal Depression Scale Score or history of depression were enrolled. Participants completed the Beck Depression Inventory (BDI) and Mini International Neuropsychiatric Interview at 12–20 weeks, 26–28 weeks, 34–36 weeks, and 6–8 weeks postpartum. Vitamin D levels were measured at 12–20 weeks (N = 117) and 34–36 weeks (N = 112). Complete datasets were available on 105 subjects. Using regression analyses, we evaluated the relationship between vitamin D levels with BDI scores as well as with MINI diagnoses of major depressive disorder and generalized anxiety disorder. Our primary outcome measure was the association of maternal vitamin D levels with BDI scores during early and late pregnancy and postpartum.ResultsWe found that vitamin D levels at 12–20 weeks were inversely associated with BDI scores both at 12—20 and at 34–36 weeks’ gestation (P < 0.05, both). For every one unit increase in vitamin D in early pregnancy, the average decrease in the mean BDI score was .14 units. Vitamin D levels were not associated with diagnoses of major depressive disorder or generalized anxiety disorder.ConclusionsIn women at risk for depression, early pregnancy low vitamin D levels are associated with higher depressive symptom scores in early and late pregnancy. Future investigations should study whether vitamin D supplementation in early pregnancy may prevent perinatal depressive symptoms.Trial registrationhttps://clinicaltrials.gov/ Registration Number: NCT00711971

Development of a screening and recruitment registry to facilitate perinatal depression research in obstetrics settings in the USA

To create a multi‐site registry to enable future large‐scale studies of perinatal depression among women attending obstetrics clinics in the USA.

Child Abuse—Suicide Resilience Link in African American Women: Interpersonal Psychological Mediators

ABSTRACT The interpersonal-psychological theory of suicidal behavior (IPTS) is an exemplary model for understanding the desire for suicidal behavior. As such, it is important to explore its applicability in ethnoracial minority groups at increasing risk for suicidal behavior, such as low-income, African American women. Guided by the IPTS, the current study used 5 parallel mediation models to examine if there are links between individual types of childhood abuse (physical, sexual, emotional) and suicide resilience, and between cumulative abuse (higher levels of abuse inclusive of all three types, more types of severe levels of abuse) and suicide resilience, and whether the three components of the model (thwarted belongingness, perceived burdensomeness, acquired capability for suicide) mediate these associations. In a sample of low-income, African American women (n = 179), higher levels of each of the 3 types of childhood abuse and cumulative abuse correlated with lower levels of suicide resilience. Parallel mediation analyses using bootstrapping techniques revealed that increased acquired capability for suicide mediated all 5 associations and perceived burdensomeness mediated 3 of the links (emotional abuse, cumulative abuse, and cumulative abuse–severe with suicide resilience). Attention is paid to the clinical implications of the findings in terms of attending to the acquired capability for suicide and suicide resilience in the assessment and treatment of low-income, suicidal, African American women.

Relational wellbeing following traumatic interpersonal events and challenges to core beliefs.

Objective: Prior research has found that the degree to which a traumatic event challenges core beliefs is associated with adjustment problems; however, how such experiences impact relational wellbeing has received little attention. The current study examined whether negative posttraumatic cognitions mediated the relation between examination of core beliefs and relational wellbeing in young adults following experiences of interpersonal trauma. Method: A moderated parallel mediation model investigated the relation between core beliefs and relational wellbeing through negative cognitions about the self, the world and others, self-blame, and depressive symptoms, following interpersonal violence (IPV; n = 168) and violent loss (VL; n = 102), with ego-resilience moderating the paths from examination of core beliefs to each mediator and relational wellbeing. Results: For individuals with IPV experiences, greater examination of core beliefs was associated with increased depressive symptoms and negative cognitions about the self and about the world and others, each of which was associated with decreased relational wellbeing. For those reporting VL and lower ego-resilience, only negative cognitions about the self emerged as a mediator. Self-blame did not emerge as a mediator whereas ego-resilience emerged as both promotive and protective. Conclusions: Results suggest distinct pathways to relational difficulties following IPV and VL. Following IPV, it was not the process of examining core beliefs that impacted relational functioning, but rather the conclusions drawn about the self, others, and the world. Findings suggest that targeting specific posttraumatic cognitions may enhance relational functioning and possible interventions for addressing such cognitions and fostering ego-resilience are presented.

Suicidal ideation and hopelessness in PTSD: spiritual well-being mediates outcomes over time

ABSTRACT Background There is an increased interest in understanding the mechanisms through which post-traumatic stress disorder (PTSD) relates with hopelessness and suicidal ideation. Spiritual well-being could help explain the link between PTSD and both hopelessness and suicidal ideation in African Americans. However, no study has examined the mediational role of existential and religious well-being among these variables. Objectives To examine if initial levels of existential and religious well-being mediated the relation between levels of PTSD symptoms and prospective levels of hopelessness and suicidal ideation in a sample of African American females. Design The study used a longitudinal design with a 10-week time interval. Methods The sample comprised of 113 disadvantaged African American women survivors of a recent suicide attempt recruited from a southern hospital. Self-report measures of PTSD symptoms, hopelessness, suicidal ideation, and spiritual well-being were administered to examine the variables of interest. Bootstrapping techniques were used to test the mediational models. Results Existential, but not religious well-being, mediated the relationship between levels of PTSD symptoms severity and both levels of hopelessness and suicidal ideation over time. Conclusions Existential well-being appears to play a promising protective role against the negative effects of PTSD on both hopelessness and suicidal ideation.

An exploratory study of domains of parenting concern among mothers who are childhood sexual abuse survivors.

This study conducted an exploratory factor analysis and initial validation of Ruscio’s (2001) parenting attitudes questionnaire, which assessed parenting concerns among child sexual abuse survivors. Child sexual abuse survivor mothers (N = 60) reported on their abuse experiences and completed the parenting attitudes questionnaire, the Center for Epidemiologic Studies Depression Scale, and subscales of the Parenting Stress Index and the Parent–Child Relationship Inventory. Three primary factors emerged: (a) concerns regarding the child’s sexuality and safety, (b) boundary disturbances within the child–survivor relationship, and (c) lack of energy for parenting due to recovery issues. Concerns about safety and sexuality and lack of energy for parenting were robust predictors of parenting outcomes. Assessment of such concerns may facilitate discussion of the balance between recovery work and parenting challenges.

Relational factors critical in the link between childhood emotional abuse and suicidal ideation.

Understanding the pathways leading to suicidal behavior is critical for the development and implementation of effective assessment efforts and suicide prevention programs in public health care systems. Childhood trauma, such as emotional abuse, is one robust risk factor, but only recently have efforts been made to determine mediators of the link between childhood emotional abuse and suicidal ideation. Given that adult survivors of childhood emotional abuse often have attachment difficulties and problems securing positive social support, these interpersonal factors may serve such a mediating role. Using bootstrapping techniques, this investigation tested attachment security and social-support-seeking behaviors as serial mediators of the association between childhood emotional abuse and suicidal ideation in a sample of 150 low-income African American female childhood emotional abuse survivors receiving services in a public health system. Support seeking from family members and friends were tested separately. Results revealed the presence of serial mediation, as predicted. Specifically, increased childhood emotional abuse was associated with decreased attachment security, which, in turn, was related to decreased social support seeking from family members and from friends. These 3 factors combined in sequence subsequently were associated with increased suicidal ideation. Results illuminate the importance of attending to attachment security and social-support-seeking behaviors when designing and implementing assessment and suicide prevention programs for African American women who are survivors of childhood emotional abuse seeking services in public health care systems. Suggestions for universal, selective, and targeted prevention efforts for this population are discussed.

Trainees with Competence Problems in the Professionalism Domain

Increasingly, professionalism has been recognized as a core competency for health service professionals and is the domain in which vexing competence problems are observed in trainees. We begin by describing manifestations of problems of professionalism in accord with the values that fall within the rubric of this multifaceted construct. We provide an approach for evaluating problems of professionalism and discuss intervention for trainees with mild, moderate, or severe problems in this domain. We propose implications for training focused on enhancing the culture of programs; bolstering the education, guidance, and mentoring provided related to professionalism; and encouraging best practices for addressing trainees with problems of professionalism. We conclude by sharing ideas about defining professionalism, identifying problems of professionalism, strengthening our approach to assessing professionalism and intervening when problems are evident, developing strategies for preventing professionalism problems, and ensuring that psychologists take seriously their responsibility to address professionalism concerns with colleagues.