Student veterans: A national survey exploring psychological symptoms and suicide risk.

The current study explored psychological symptoms, symptom severity, and suicide risk in a national sample (N = 628) of student veterans. We hypothesized that the rates, types, and severity of problems experienced by student veterans on campus would in many ways mirror those reported by active duty service members as well as the Operation Iraqi Freedom/Operation Enduring Freedom veteran population. Almost 35% of the sample experienced “severe anxiety,” 24% experienced “severe depression,” and almost 46% experienced significant symptoms of posttraumatic stress disorder. Of particular concern, there were significant numbers of participants thinking about suicide (46%), with 20% having a plan, 10.4% thinking about suicide “often or very often,” 7.7% making an attempt, and 3.8% believing that suicide is either “likely” or “very likely.” Implications of the findings are discussed, with a particular focus on college and university campuses. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The effects of forgiveness therapy on depression, anxiety, and posttraumatic stress for women after spousal emotional abuse.

Emotionally abused women experience negative psychological outcomes long after the abusive spousal relationship has ended. This study compares forgiveness therapy (FT) with an alternative treatment (AT; anger validation, assertiveness, interpersonal skill building) for emotionally abused women who had been permanently separated for 2 or more years (M = 5.00 years, SD = 2.61; n = 10 per group). Participants, who were matched, yoked, and randomized to treatment group, met individually with the intervener. Mean intervention time was 7.95 months (SD = 2.61). The relative efficacy of FT and AT was assessed at p     

Adolescent male rats exposed to social defeat exhibit altered anxiety behavior and limbic monoamines as adults.

Social stress in adolescence is correlated with emergence of psychopathologies during early adulthood. In this study, the authors investigated the impact of social defeat stress during mid-adolescence on adult male brain and behavior. Adolescent male Sprague–Dawley rats were exposed to repeated social defeat for 5 days while controls were placed in a novel empty cage. When exposed to defeat-associated cues as adults, previously defeated rats showed increased risk assessment and behavioral inhibition, demonstrating long-term memory for the defeat context. However, previously defeated rats exhibited increased locomotion in both elevated plus-maze and open field tests, suggesting heightened novelty-induced behavior. Adolescent defeat also affected adult monoamine levels in stress-responsive limbic regions, causing decreased medial prefrontal cortex dopamine, increased norepinephrine and serotonin in the ventral dentate gyrus, and decreased norepinephrine in the dorsal raphe. Our results suggest that adolescent social defeat produces both deficits in anxiety responses and altered monoaminergic function in adulthood. This model offers potential for identifying specific mechanisms induced by severe adolescent social stress that may contribute to increased adult male vulnerability to psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment in individuals with social anxiety disorder: The relationship among adult attachment styles, social anxiety, and depression.

Despite their apparent implications for social functioning, adult attachment styles have never been specifically explored among persons with social anxiety disorder. In the current study, a cluster analysis of the Revised Adult Attachment Scale (N. L. Collins, 1996) revealed that 118 patients with social anxiety (58.6% males and 41.4% females, mean age 32.43 yrs) were best represented by anxious and secure attachment style clusters. Members of the anxious attachment cluster exhibited more severe social anxiety and avoidance, greater depression, greater impairment, and lower life satisfaction than members of the secure attachment cluster. This pattern was replicated in a separate sample of 56 patients and compared with the pattern found in 36 control participants. Social anxiety mediated the association between attachment insecurity and depression. Findings are discussed in the context of their relevance to the etiology, maintenance, and cognitive-behavioral treatment of social anxiety disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The structure of distress following trauma: Posttraumatic stress disorder, major depressive disorder, and generalized anxiety disorder.

The current report used confirmatory factor analysis to examine the latent structures of both key features and associated symptoms of three disorders that commonly develop following a traumatic event: posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD). Participants were 228 motor-vehicle accident survivors who sought treatment for emotional difficulties. PTSD, MDD, and GAD were assessed with a combination of self-report and interview-based measures. The results of construct level analyses suggested that PTSD, MDD, and GAD are distinguishable but highly correlated disorders following a traumatic event. Symptom level analyses supported a model where the Reexperiencing, Avoidance, and Hypervigilance factors were subsumed under the PTSD construct. However, in this model the Dysphoria factor was a higher order construct correlated with the PTSD, MDD, and GAD factors, suggesting that the Dysphoria cluster may not be unique to PTSD. Diagnostic and theoretical implications of these results are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predictors of posttraumatic stress disorder following cancer.

This study investigated the predictors of posttraumatic stress disorder (PTSD) following a diagnosis of cancer. Individuals who were recently diagnosed with 1st onset head and neck or lung malignancy (N = 82) were assessed within 1 month of diagnosis for acute stress disorder (ASD) and other psychological responses including depression; individuals were reassessed (N = 63) for PTSD 6 months following their cancer diagnosis. At the initial assessment ASD was diagnosed in 28% of participants, and 22% met criteria for PTSD at 6-months follow-up. Peritraumatic dissociative symptoms at the time of receiving one's cancer diagnosis was the sole predictor of PTSD severity at 6-months follow-up. Elevated dissociative symptoms and greater distress at the initial assessment were the best predictors of PTSD caseness at 6-months follow-up. This study provides evidence for identifying recently diagnosed cancer patients who may benefit from psychological assistance in order to prevent chronic psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress disorder and major depression in veterans with spinal cord injury.

Objective: To explore the relationship between posttraumatic stress disorder (PTSD) and major depressive disorder (MDD) in veterans with spinal cord injury and to compare those results with results found in veterans who had sustained other traumatic injuries. Method: To investigate the relationship between PTSD and MDD in persons with spinal cord injury, the authors examined whether individuals endorsed overlapping items on measures of both disorders, evaluated the contribution of overlapping items to comorbid diagnosis, and conducted an exploratory factor analysis. Results: The overlapping symptoms between the 2 disorders did not fully explain the high rate of comorbidity, although participants who endorsed a symptom common to MDD and PTSD on 1 measure were likely to endorse the corresponding item on another measure. In both samples, items loaded on separate PTSD and MDD factors. Conclusion: MDD and PTSD appear to represent independent reactions to trauma in those individuals who had experienced either a nonspinal cord injury or a spinal cord injury. This research also provides an initial investigation of some of the possible ways that MDD and PTSD are related by addressing psychometric issues inherent in their measurement. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A predictive screening index for posttraumatic stress disorder and depression following traumatic injury.

Posttraumatic stress disorder (PTSD) and major depressive episode (MDE) are frequent and disabling consequences of surviving severe injury. The majority of those who develop these problems are not identified or treated. The aim of this study was to develop and validate a screening instrument that identifies, during hospitalization, adults at high risk for developing PTSD and/or MDE. Hospitalized injury patients (n = 527) completed a pool of questions that represented 13 constructs of vulnerability. They were followed up at 12 months and assessed for PTSD and MDE. The resulting database was split into 2 subsamples. A principal-axis factor analysis and then a confirmatory factor analysis were conducted on the 1st subsample, resulting in a 5-factor solution. Two questions were selected from each factor, resulting in a 10-item scale. The final model was cross-validated with the 2nd subsample. Receiver-operating characteristic curves were then created. The resulting Posttraumatic Adjustment Scale had a sensitivity of .82 and a specificity of .84 when predicting PTSD and a sensitivity of .72 and a specificity of .75 in predicting posttraumatic MDE. This 10-item screening index represents a clinically useful instrument to identify trauma survivors at risk for the later development of PTSD and/or MDE. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

For suicidal young adults with comorbid depressive and anxiety disorders, probem-solving treatment may be better than treatment as usual.

Practicing psychologists face many complexities and challenges in caring for suicidal patients who have comorbid mood and anxiety disorders. Not only must suicidal crises be addressed, but co-occurring depressive and anxiety symptoms compete for attention as well and are associated with relatively poor clinical prognosis in usual treatments. The current study compared problem-solving treatment to treatment as usual among depression–anxiety comorbid versus noncomorbid clinically suicidal young adults. Suicidal patients with mood and anxiety disorders were randomized to the 2 treatments and followed over time. Comorbid suicidal patients, in particular, experienced notable symptom improvements from the problem-solving treatment. Features of the problem-solving treatment are described for use in clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Latent variable analysis of coping, anxiety/depression, and somatic symptoms in adolescents with chronic pain.

Reports of adolescents' coping with recurrent pain, symptoms of anxiety/depression, and somatic complaints were obtained from a sample of 164 adolescents with recurrent abdominal pain and their parents. Confirmatory factor analysis revealed that coping consisted of 3 nonorthogonal factors: Primary Control Engagement Coping (problem solving, emotional expression, and emotional regulation), Secondary Control Engagement Coping (positive thinking, cognitive restructuring, acceptance, and distraction), and Disengagement Coping (denial, avoidance, and wishful thinking). Structural equation modeling using latent variables revealed that secondary control engagement coping predicted lower levels of anxiety/depression symptoms and somatic complaints, and disengagement coping was related to higher levels of anxiety/depression and somatic complaints. Implications for understanding child and adolescent coping with pain are highlighted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differentiating anxiety and depression in older adults with generalized anxiety disorder.

To examine affect and cognition in differentiating anxiety and depression, 83 older participants with generalized anxiety disorder completed the Cognitive Checklist (CCL) and the Positive and Negative Affect Schedule (PANAS). A 3-factor solution was found for the PANAS: positive affect (PA), anxiety and anger (Negative Affect 1 [NA-1]), and guilt and shame (Negative Affect 2 [NA-2]). A 2-factor structure was noted for the CCL. Correlations with anxiety and depression measures suggested that the CCL Depression (CCL-D) subscale showed stronger correlations with depression, whereas the CCL Anxiety subscale did not uniquely correlate with anxiety. The NA-1 subscale correlated positively with measures of depression and anxiety, whereas the PA subscale showed negative correlations. Hierarchical regression suggested that the CCL-D subscale was a significant predictor of self-reported depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Predisaster trait anxiety and negative affect predict posttraumatic stress in youths after Hurricane Katrina.

On the basis of theory and previous research, it was hypothesized that predisaster child trait anxiety would predict disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms, even after controlling for the number of hurricane exposure events. Results support this hypothesis and further indicate that predisaster negative affect predicted disaster-related posttraumatic stress symptoms and generalized anxiety disorder symptoms. Also, Katrina-related posttraumatic stress disorder symptoms were predicted by the number of hurricane exposure events and sex (being female). Predisaster generalized anxiety disorder symptoms predicted postdisaster generalized anxiety disorder symptoms, and predisaster trait anxiety predicted postdisaster depressive symptoms. Findings are discussed in terms of their relevance for developing interventions to mitigate the impact of disasters in youths. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies.

The authors report a meta-analysis of high-quality studies published from 1990-1998 on the efficacy of manualized psychotherapies for depression, panic disorder, and generalized anxiety disorder (GAD) that bear on the clinical utility and external validity of empirically supported therapies. The results suggest that a substantial proportion of patients with panic improve and remain improved; that treatments for depression and GAD produce impressive short-term effects; that most patients in treatment for depression and GAD do not improve and remain improved at clinically meaningful follow-up intervals; and that screening procedures used in many studies raise questions about generalizability, particularly in light of a systematic relation across studies between exclusion rates and outcome. The data suggest the importance of reporting, in both clinical trials and meta-analyses, a range of outcome indices that provide a more comprehensive, multidimensional portrait of treatment effects and their generalizability. These include exclusion rates, percent improved, percent recovered, percent who remained improved or recovered at follow-up, percent seeking additional treatment at follow-up, and data on both completer and intent-to-treat samples. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Acculturative stress, depression, and anxiety in migrant farmwork college students of Mexican heritage.

Migrant status (migrant, nonmigrant) and sex (female, male) differences were examined in a sample of 168 college students of Mexican heritage on measures of college stress, acculturative stress, depression, anxiety, and academic achievement. Migrant farmwork students reported higher levels of acculturative stress than nonmigrants, and men reported higher levels of acculturative stress than women. When language preference was held constant, there were no differences in depression and anxiety. However, migrant students reported higher levels of depression and anxiety than nonmigrants when language preference was not held constant. The overall sample reported high levels of depression: 55% versus the expected 20% of the general population shown in other research. Depression and anxiety were highly correlated, and women reported a higher grade point average than male students. Implications include the importance of integrating cultural factors in stress research with this population and accounting for acculturative stress, depression, and anxiety in clinical treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A prospective study of risk and resilience factors associated with posttraumatic stress symptoms and depression symptoms among Jews and Arabs exposed to repeated acts of terrorism in Israel.

In the first prospective study, to our knowledge, of the impact of ongoing terrorism and political violence, we analyzed nationally representative data from 560 Jews and 182 Arabs in Israel over a 6-month period. Based on Conservation of Resources (COR) theory (Hobfoll, 1989, 1998), we predicted that exposure to terrorism and political violence would result in psychosocial and economic resource loss and resource lack, which in turn, would be primary predictors of increases in symptoms of posttraumatic stress (PTS) and depression. We also predicted that trauma exposure and PTS symptoms, in particular, would be related to ethnocentrism and support for political violence. Furthermore, based on theory and prior research, we predicted that posttraumatic growth (PTG) would be related to a worsening of symptoms of distress and that distress would be related to increased ethnocentrism and support for extreme political violence for their “cause.” Women, older individuals, and Arabs (compared with Jews) were more likely to have continued psychological distress over time. In addition, using simultaneous equation modeling, we found good fit for a structural model that partially supported our hypotheses. Psychosocial resource loss, PTG, and social support had direct and indirect effects on psychological distress. Political attitudes tended to harden over time but were not prospectively related to PTS or depressive symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of recovery from trauma: The use of intraindividual analysis.

Patterns of recovery from sexual and nonsexual assault were examined. Two studies containing data from female victims of these assaults were analyzed. In Study 1, victims (N?=?101) underwent 12 weekly assessments with measures of posttraumatic stress disorder (PTSD), depression, and state anxiety. In Study 2, victims (N?=?108) underwent monthly assessments on the same measures. The authors examined the effects of type of trauma and time of peak reaction on long-term recovery using intraindividual analysis of change. In both studies, initial and peak reactions of rape victims were more severe than were those of nonsexual assault victims on all measures of psychopathology. Victims with delayed peak reaction exhibited more severe pathology at the final assessment than did victims with early peak reaction. Results of Study 2 indicated a slower recovery rate from sexual than nonsexual assault; in Study 1 a similar pattern of recovery emerged. The advantages of an individual-focused, longitudinal approach to recovery from a trauma are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

All PTSD symptoms are highly associated with general distress: Ramifications for the dysphoria symptom cluster.

This study used longitudinal data collected from two trauma-exposed samples, survivors of community violence (N = 294) and wildfire evacuees (N = 234), to examine a key claim underlying a proposed reformulation of the symptom structure of posttraumatic stress disorder (PTSD). This theory, which we term the PTSD–dysphoria model, posits that 8 of 17 symptoms of PTSD reflect dysphoria or general psychological distress and might be deemphasized to improve the utility of the PTSD construct (Simms, Watson, & Doebbeling, 2002). For each sample, we analyzed PTSD symptoms and measures of general distress administered at 2 time points. A consistent pattern of findings was observed across assessments for each sample: All 17 PTSD symptoms were highly associated with measures of general distress. Moreover, we found no evidence that dysphoria symptoms were more highly correlated than PTSD-specific symptoms with general distress. Results call into question both the conceptual basis and the clinical utility of differentiating between symptoms that appear to be relatively specific to PTSD and those that seem more broadly characteristic of general psychological distress. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of The prevention of anxiety and depression: Theory, research and practice.

Reviews the book, The prevention of anxiety and depression: Theory, research and practice edited by David J. A. Dozois and Keith S. Dobson (2004). Dozois and Dobson have compiled an impressive volume whose chapters identify and then address the highly complex issues relevant to prevention of anxiety and depression, ending with an excellent summary and synthesis of the body of work covered in the text. The book features contributions by leading researchers in the area, the level of scholarship is consistently high, and the writing is clear and accessible. The essential message of this book is that the development of prevention interventions is a) necessary and b) foreseeable, if not in the immediate future. The book illustrates the charted territories of research on factors associated with the development of anxiety and depression, with successful treatment and with maintenance of treatment gains, but it also appropriately identifies large uncharted territories, such as our lack of understanding of comorbidity and of the development of specific disorders. At the same time, the book offers detailed guidelines for measuring and evaluating the success of prevention interventions. It thus provides an excellent road map for future work on prevention of anxiety and depression. This book is a very valuable contribution to knowledge and will be essential reading for researchers and clinicians interested in prevention and in anxiety and depression. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reduced autobiographical memory specificity predicts depression and posttraumatic stress disorder after recent trauma.

In this prospective longitudinal study, the authors examined the relationship between reduced specificity in autobiographical memory retrieval and the development of depression, posttraumatic stress disorder (PTSD), and specific phobia after injury in an assault. Assault survivors (N = 203) completed the Autobiographical Memory Test (J. M. G. Williams & K. Broadbent, 1986) at 2 weeks after the trauma as well as structured clinical interviews at 2 weeks and 6 months. Participants with acute stress disorder or major depression at 2 weeks, but not those with phobia, retrieved fewer specific autobiographical memories than those without the respective disorder. Reduced memory specificity at 2 weeks also predicted subsequent PTSD and major depression at 6 months over and above what could be predicted from initial diagnoses and symptom severity. Moderator analyses showed that low memory specificity predicted later depression in participants with prior episodes of major depression but not in those without prior depression. Mediation analyses suggested that rumination partly mediated and perceived permanent change fully mediated the effects of low memory specificity on posttrauma psychopathology at follow-up. (PsycINFO Database Record (c) 2010 APA, all rights reserved)