Samantha L. Anders

Perceived past, present, and future control and adjustment to stressful life events

Perceived control is a central construct in psychology and is key to understanding individual differences in poststress outcomes (Frazier, Berman, & Steward, 2001). The goals of the current studies (using 4 samples of undergraduate students, total N = 1,421) were to examine the relations between different aspects of perceived control and poststress outcomes and to differentiate perceived control over specific events from related constructs (i.e., general control beliefs, coping strategies). To accomplish these goals, we first developed a new measure of perceived past, present, and future control over stressful life events. The data supported the content validity, factor structure, internal consistency and test-retest reliability, and convergent and discriminant validity of the new measure. Consistent with the temporal model of control (Frazier et al., 2001), these 3 forms of control had very different relations with adjustment. Present control was consistently related to lower distress levels in cross-sectional, longitudinal, and prospective analyses. Present control also predicted outcomes beyond the effects of general control beliefs and coping strategies. Past and future control had nonsignificant or positive relations with distress, although future control was associated with better outcomes (i.e., course grades) when the stressor was controllable. Thus, our measure can be used to assess the relations between perceived past, present, and future control and outcomes across a range of stressors. Because the relations between these 3 forms of control and outcomes differ markedly, measures that combine these aspects of control hinder the understanding of the important role of perceived control in adjustment to stress.

Beyond Criterion A1: The Effects of Relational and Non-Relational Traumatic Events

Trauma research has historically focused on Criterion A1 traumas, neglecting many other negative interpersonal events that have been shown to lead to posttraumatic stress disorder (PTSD; S. L. Anders, P. A. Frazier, & S. Frankfurt, 2011). Trauma research has also focused primarily on PTSD and neglected other important outcomes, such as relationship functioning. This study aimed to assess a broader range of events, including many Criterion A1 interpersonal events; assess the cumulative impact of event exposure; and examine the relation between event exposure and a broad range of outcomes, including relationship functioning. A sample of 181 undergraduate students completed measures assessing exposure to a broad range of events, their worst lifetime event, and current psychological (e.g., psychological distress) and relationship (e.g., partner trust) functioning. Results suggested that non-Criterion A1 relational events were very common in our sample. The number of lifetime relational events experienced, whether Criterion A1 or non-Criterion A1, was strongly and consistently associated with all outcomes. The number of lifetime Criterion A1 non-relational events experienced was significantly associated with current PTSD symptoms but was not associated with other mental health and relationship outcomes. No differences were found between Criterion A1 relational, non-Criterion A1 relational, and Criterion A1 non-relational worst events on any of the mental health or relationship measures. Implications for further research and interventions are discussed.

A randomized controlled pilot study of CBT-I Coach: Feasibility, acceptability, and potential impact of a mobile phone application for patients in cognitive behavioral therapy for insomnia

There has been growing interest in utilizing mobile phone applications (apps) to enhance traditional psychotherapy. Previous research has suggested that apps may facilitate patients’ completion of cognitive behavioral therapy for insomnia (CBT-I) tasks and potentially increase adherence. This randomized clinical trial pilot study (n = 18) sought to examine the feasibility, acceptability, and potential impact on adherence and sleep outcomes related to CBT-I Coach use. All participants were engaged in CBT-I, with one group receiving the app as a supplement and one non-app group. We found that patients consistently used the app as intended, particularly the sleep diary and reminder functions. They reported that it was highly acceptable to use. Importantly, the app did not compromise or undermine benefits of cognitive behavioral therapy for insomnia and patients in both groups had significantly improved sleep outcomes following treatment.

Further Development of the Temporal Model of Control.

The temporal model of control (Frazier, Berman, & Steward, 2001) posits that different temporal aspects of control (i.e., past, present, and future) have markedly different relations with adjustment and need to be clearly distinguished from each other. The Perceived Control over Stressful Events Scale (PCOSES; Frazier, Keenan, et al., 2011) was recently developed to assess these different aspects of control and to advance understanding of the role of perceived control in adjustment to stressful life events. The goals of the 2 studies presented here were to expand the temporal model of control by developing a new subscale of the PCOSES and to gather additional evidence regarding the temporal model. In Study 1, we developed a new future likelihood subscale and found evidence for the internal consistency, test-retest reliability, and construct validity of its scores in a sample of undergraduate students (N = 201). In Study 2, we confirmed the 4-factor structure of the PCOSES with the new future likelihood subscale using confirmatory factor analysis in another sample of undergraduates (N = 1,084). Study 2 also provided additional evidence, consistent with the temporal model, that the PCOSES subscales were differentially related to distress and other forms of adjustment (e.g., physical health) and that present control and future likelihood were associated with less event-related distress after controlling for 4 known correlates of distress (e.g., social support). Implications for counseling psychology research and practice are discussed.

Social resources mediate the relations between attachment dimensions and distress following potentially traumatic events.

Insecure adult attachment dimensions are consistently related to poorer posttrauma adjustment, but these relations have rarely been examined prospectively or across a wide range of potentially traumatic events. In addition, the factors mediating these relations are not yet fully understood. Therefore, the first aim of this study was to assess whether anxious and avoidant attachment dimensions assessed preevent would predict changes in adjustment (e.g., distress) following a broad range of potentially traumatic events. The second aim was to determine whether postevent social resources mediated the relations between attachment dimensions and postevent adjustment. Undergraduate students (N = 1,084) completed preevent measures of attachment dimensions and psychological distress at Time 1 (T1); 73% (n = 789) completed a follow-up survey 2 months later assessing exposure to potentially traumatic events and social resources (Time 2; T2). Those who reported experiencing a potentially traumatic event between T1 and T2 and who completed a final follow-up survey assessing distress 2 months after T2 (Time 3) constituted the sample for the present analyses (n = 174). Individuals with more attachment avoidance and anxiety had greater increases in posttraumatic stress disorder symptoms and general psychological distress. These relations were mediated by social resources (i.e., positive and negative support, social withdrawal) at T2 such that anxious and avoidant attachment dimensions were associated with having fewer social resources following a potentially traumatic event, which in turn was associated with reporting more distress. Implications for research and practice with individuals exposed to potentially traumatic events are discussed.

The Number of Cysteine Residues per Mole in Apolipoprotein E Is Associated With the Severity of PTSD Re-Experiencing Symptoms.

Apolipoprotien E (ApoE) is involved in critical neural functions and is associated with various neuropsychiatric disorders. ApoE exists in three isoforms that differ in the number of cysteine residues per mole (CysR/mole). This study evaluated associations between this informative ordinal biochemical scale (CysR/mole) and symptom severity in veterans with posttraumatic stress disorder (PTSD) or subthreshold PTSD. Results demonstrated a significant negative relationship between the CysR/mole and severity of PTSD re-experiencing symptoms, adjusted for trauma. The findings suggest a genetic influence on PTSD symptomatology and dovetail with recent advances regarding the molecular mechanisms underlying the differential effects of ApoE in the brain.

DSM-5 personality traits discriminate between posttraumatic stress disorder and control groups

The relevance of personality traits to the study of psychopathology has long been recognized, particularly in terms of understanding patterns of comorbidity. In fact, a multidimensional personality trait model reflecting five higher-order personality dimensions—negative affect, detachment, antagonism, disinhibition, and psychoticism—is included in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and represented in the Personality Inventory for DSM-5 (PID-5). However, evaluation of these dimensions and underlying personality facets within clinical samples has been limited. In the present study, we utilized the PID-5 to evaluate the personality profile elevation and composition of 150 control veterans and 35 veterans diagnosed with posttraumatic stress disorder (PTSD). Results indicated that veterans with PTSD endorsed significantly more personality pathology than control veterans, with scores on detachment and psychoticism domains most clearly discriminating between the two groups. When personality domain scores were considered as parts of each subject’s personality profile, a slightly different picture emerged. Specifically, the PTSD composition was primarily characterized by detachment and negative affect, followed by disinhibition, psychoticism, and antagonism in that order of relative importance. The profile of the control group was significantly different, mostly accounted for differences in antagonism and psychoticism. Using these complementary analytic strategies, the findings demonstrate the relevance of personality pathology to PTSD, highlight internalizing features of PTSD, and pave the way for future research aimed at evaluating the role of shared maladaptive personality traits in underlying the comorbidity of PTSD and related disorders.

Evaluating the dimensionality of PTSD in a sample of OIF/OEF veterans.

Both categorical and dimensional models of mental disorders, including posttraumatic stress disorder (PTSD), are useful for diagnostic and heuristic purposes; however, few empirical studies have compared categorical and dimensional models of PTSD side-by-side or compared these models to a hybrid (dimensional and categorical) model. In the present study, the dimensionality of PTSD was examined by fitting latent profile analytic, confirmatory factor analytic, and factor mixture models in 271 Operation Iraqi Freedom/Operation Enduring Freedom veterans 6 months after return from deployment. Latent profile analysis was used to identify subgroups of individuals with similar PTSD symptom profiles and predictors of subgroup membership, confirmatory factor analysis was used to identify the underlying continuous structure of PTSD in this sample, and factor mixture modeling was used to test whether a hybrid categorical and continuous model of PTSD best fit our sample. A factor mixture model consisting of a 4-factor dysphoria model of PTSD with 2 classes characterized by low and moderate symptom severity was the best-fitting model. Dissociation and deployment concerns emerged as significant predictors of membership in the moderate symptoms class. Implications for PTSD diagnostic conceptualization and treatment planning are discussed.

Mediators of the relation between sexual victimization and distress: Comparison to bereavement.

Objective: The purposes of this research were (a) to examine relationship quality and neuroticism as mediators of the relation between past sexual victimization and current distress in 2 samples of college students and (b) to examine the specificity of the mediated effects by assessing whether these variables also mediated the relation between the most common potentially traumatic event in both samples (past bereavement) and current distress. This study improved on prior research by using longitudinal data, assessing multiple mediators, assessing specificity of mediated effects, and replicating results across 2 samples. Method: Participants in both studies were undergraduate students in psychology courses (Ns = 1,528 and 1,084, respectively). In both studies, sexual victimization, bereavement and the 2 mediators (relationship quality and neuroticism) were assessed at baseline, and distress was assessed at baseline and 2 months later using standard measures. Results: Structural equation modeling was used to assess the indirect (mediated) effects of sexual victimization and bereavement on later distress through relationship quality and neuroticism, controlling for baseline distress. In Study 1, the indirect effects of sexual victimization on distress through relationship quality and neuroticism were both significant. In Study 2, only the indirect effects through neuroticism were significant. None of the indirect effects were significant for bereavement, suggesting that the mediators were specific to sexual victimization. Conclusions: Neuroticism was a consistent mediator of the relation between lifetime sexual victimization and current distress, suggesting that it may be an important target of intervention for those with a history of sexual victimization.