Physical injury survivors who experience post-traumatic stress disorder (PTSD) symptoms need tailored interventions targeting adaptation mechanism resources. During recovery, strengthening survivors' tenuous self-compassion and belief that they can overcome trauma (i.e., trauma coping self-efficacy) could facilitate adaptation and reduce risk for persistent PTSD symptoms. The present research considered the preliminary plausibility of a conceptual model reasoning that elevated self-compassion might decrease injury survivors' PTSD symptoms through increased trauma coping self-efficacy. Adult injury survivors, recruited mostly from a Level 1 trauma center, participated in a tailored brief-psychotherapy pilot intervention and completed measures of self-compassion, trauma coping self-efficacy, and PTSD symptom severity. Data fit with the conceptual model was evaluated based on mediation analysis at pretreatment (N = 29) and the degree to which pre-post-treatment improvements in the three focal variables intercorrelated (N = 11). Mediation analysis results were consistent with the putative conceptual model, indicating a negative indirect effect of self-compassion on PTSD symptoms via increased trauma coping self-efficacy. Correlation coefficients among pre-post treatment improvements in these three variables were also qualitatively consistent with the putative model. The present research highlights potential ways self-compassion and trauma coping self-efficacy could mitigate PTSD symptoms, and it provides concrete intervention approaches to leverage individual therapy strategies and group therapy dynamics during survivors' injury recovery to facilitate self-compassion, trauma coping self-efficacy, and adaptation. To address limitations of the present pilot research and further improve how injury survivors' needs get met, future studies should employ rigorous longitudinal intervention research designs.

Physical injury events can lead to significant distress, but early psychosocial intervention may promote coping and prevent the development of psychopathology. This study evaluates a pilot program built upon a partnership with a U.S. Level 1 trauma center to serve these purposes. It aimed to (a) identify demographic and clinical characteristics of patients who engaged in therapy as an indicator of who such a program can serve and (b) evaluate the program's feasibility by examining patients' reported mental health-related changes and feedback about the program. The program provided 4-6 weeks of flexible, trauma-informed, patient-tailored, cognitive behaviorally oriented psychotherapy that emphasized trauma psychoeducation, coping self-efficacy, and self-compassion to facilitate symptom reduction, psychological growth, and preparation for transitioning to longer term trauma-focused therapy when appropriate (i.e., stepped care). Of the 149 patients referred to the program, 38 engaged in therapy, and 16 completed pre- to postsurveys including open-ended items soliciting feedback about the program and validated quantitative measures. Patient feedback responses were subjected to thematic analyses related to facets of feasibility. Patients' feedback included suggestions and appreciation of the program's accessibility and flexibility as well as evidence supporting the program's feasibility, in terms of acceptability, demand, and limited-efficacy testing. Relatedly, substantial quantitative improvements in posttraumatic stress disorder symptoms, depressive symptoms, coping self-efficacy, self-compassion, and posttraumatic growth were observed. This work demonstrates the potential utility of brief stabilization therapy programs to meet postinjury psychosocial needs, and it highlights successes and challenges that may inform the development and implementation of future programs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

OBJECTIVE:Evaluating posttraumatic stress symptoms (PTSS) shortly after trauma offers a more precise understanding of interrelated variables. This study examined how cognitive control performance, assessed after a trauma recall trigger, moderates the relationship between coping self-efficacy (CSE) and PTSS over a 3-month period postmotor vehicle collision. METHOD:Motor vehicle collision survivors recruited from emergency departments were assessed 1 week (N = 180), 30 days (N = 104), and 90 days (N = 84) postcollision. Cued cognitive control was assessed at Time 2 using the Wisconsin Card Sorting Test (WCST) and was completed after listening to an audio transcription of the collision. PTSS and CSE self-report measures were administered at each time point. RESULTS:Mixed-effects modeling showed an interaction of CSE and WCST on PTSS, with relations dependent on time. At Time 1, higher CSE was associated with lower PTSS when WCST performance was high or average. At Time 2, higher CSE was related to lower PTSS across all levels of WCST performance. At Time 3, lower CSE was associated with higher PTSS, when WCST performance was low or average. CONCLUSIONS:Findings highlight self-evaluation processes, cognitive control in the presence of trauma recollection, and time as factors in posttrauma adaptation. Implications for intervention are offered. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

OBJECTIVE:The COVID-19 pandemic has been conceptualized as a potentially traumatic event, although heterogeneity in experience (e.g., isolation) and in type and severity of traumatic stress response (e.g., hygiene hypervigilance) query the applicability of the posttraumatic stress disorder (PTSD) diagnostic construct. Parallels may be drawn to chronic illness and continuous traumatic situations (CTS) literature, which suggests unique symptom presentations that may occur during cumulative, ongoing traumas. METHOD:Eighty-four adults completed the PTSD Checklist with appended questions evaluating pandemic index events, temporality of intrusive symptoms, self-appraised abnormality, and context dependence of symptoms. Using exploratory latent profile analysis, we modeled the latent structure of traumatic stress response to COVID-19 in order to evaluate possible nuanced patterns of symptoms differentiating PTSD from a transient ongoing trauma response. RESULTS:Two profiles broadly delineated by severity across all variables emerged, suggesting the framework of PTSD is apt when applied to COVID-19. However, secondary analyses revealed subtle signals supporting chronic illness and CTS frameworks. Specifically, some participants who met criteria for PTSD did not endorse index events meeting Criterion A, most endorsed intrusive symptoms related to a present or future threat (versus a past trauma), and 30% reported their symptoms to be context dependent. CONCLUSION:Results highlight a need for improved assessment and opportunities for treatment modification. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

People's negative societal perceptions, otherwise known as public stigma, serve as a barrier to help-seeking behavior for military service members and veterans with posttraumatic stress disorder (PTSD). Relatively little experimental research has been conducted to examine public perceptions of stigma regarding PTSD in male and female military service members. Participants (N = 252) were randomly assigned to 1 of 4 variations containing a manipulated photograph of either a man or a woman in military or civilian clothing accompanied by a vignette describing the person's PTSD symptoms and diagnosis. The dependent measure of stigmatizing attitudes toward PTSD was adapted from the Attribution Questionnaire (AQ-27). Confirmatory factor analysis supported the 9-factor measurement structure of the AQ-27 using the current data. A multivariate analysis of variance was performed on the 9 attribution subscales. The main effects for military status showed that participants perceived the person in military uniform to be more dangerous, fear-inducing, and needing to be segregated than the civilian. No main effect for gender was found on stigmatizing attitudes. No interaction effect of the manipulated military status and gender emerged. Main effects for the nonexperimental factor of PTSD contact revealed that participants who indicated knowing someone with PTSD endorsed fewer stigmatizing attitudes toward those with PTSD. These findings help to understand people's stigmatizing attitudes toward individuals with PTSD and serve to inform interventions aimed at combating stigma.

OBJECTIVE:This study explored risk and resilience factors of mental health functioning during the coronavirus disease (COVID-19) pandemic.METHODS:A sample of 467 adults (M age = 33.14, 63.6% female) reported on mental health (depression, anxiety, posttraumatic stress disorder [PTSD], and somatic symptoms), demands and impacts of COVID-19, resources (e.g., social support, health care access), demographics, and psychosocial resilience factors.RESULTS:Depression, anxiety, and PTSD rates were 44%, 36%, and 23%, respectively. Supervised machine learning models identified psychosocial factors as the primary significant predictors across outcomes. Greater trauma coping self-efficacy and forward-focused coping, but not trauma-focused coping, were associated with better mental health. When accounting for psychosocial resilience factors, few external resources and demographic variables emerged as significant predictors.CONCLUSION:With ongoing stressors and traumas, employing coping strategies that emphasize distraction over trauma processing may be warranted. Clinical and community outreach efforts should target trauma coping self-efficacy to bolster resilience during a pandemic.

BACKGROUND:Patients with PTSD often voice concern over their perceived change in cognitive functioning. However, these negative appraisals do not always align with objective neuropsychological performance, yet are strongly predictive of PTSD symptom severity and self-reported functional impairment.METHODS:The present study involves a secondary analysis examining the role of appraisals of a subsample of 81 adults with full or subthreshold PTSD on treatment outcomes in a randomized controlled trial investigating the effectiveness of a cognitive rehabilitation treatment, Strategic Memory and Reasoning Training (n = 38), compared to a psychoeducation control arm, the Brain Health Workshop (n = 43). Neither condition addressed PTSD symptoms, focusing instead on cognitive skills training and psychoeducation about the brain.RESULTS:Intent-to-treat models showed statistically significant improvements for both groups on composite scores of executive functioning and memory. Additionally, both groups experienced clinically significant reductions in PTSD symptoms (assessed via the Clinician-Administered PTSD Interview) and the SMART group showed fewer negative appraisals about cognitive functioning following training. Change in appraisals of cognitive functioning was associated with change in PTSD as well as change in quality of life, with no differential associations based on group status. In contrast, neurocognitive test score changes were not associated with change in symptoms or functional outcomes.LIMITATIONS:We did not collect data on other appraisals (e.g., self-efficacy), which could have further elucidated pathways of change.CONCLUSIONS:Our findings suggest that interventions that do not directly target PTSD symptoms can lead to PTSD symptom change via change in appraisals of functioning.

OBJECTIVEThe current study was conducted in a naturalistic treatment setting to examine whether and how perceptions about social engagement, trauma coping self-efficacy, and posttraumatic stress symptoms (PTS) influence one another across 6 months of psychotherapy for trauma survivors.METHODThe sample included 183 clients who reported exposure to traumatic events and significant PTS (PCL-5 ≥ 33). Participants (Mage  = 37.8, 53.6% female) completed surveys at intake, 3 months, and 6 months into treatment. A cross-lagged panel analysis was used to test the relationships among perceived social engagement, coping self-efficacy, and PTS across three assessment points.RESULTSPTS at 3-months was a mediator in the relationship between intake perceived social engagement and 6-month coping self-efficacy and between intake perceived social engagement and 6-month perceived social engagement.CONCLUSIONSPTS several months into treatment may serve as a mechanism between intake perceived social engagement and functional outcomes such as coping self-efficacy.

Although there is evidence of mild cognitive impairments for many individuals with mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD), little research evaluating the effectiveness of cognitive training interventions has been conducted. This randomized controlled trial examined the effectiveness of a 9-h group cognitive training targeting higher-order functions, Strategic Memory Advanced Reasoning Training (SMART), compared to a 9-h psychoeducational control group in improving neurocognitive functioning in adults with mTBI and PTSD. A sample of 124 adults with histories of mild TBI (n = 117) and/or current diagnoses of PTSD (n = 84) were randomized into SMART (n = 66) or Brain Health Workshop (BHW; n = 58) and assessed at three time points: baseline, following training, and 6 months later. Participants completed a battery of neurocognitive tests, including a test of gist reasoning (a function directly targeted by SMART) as well as tests of verbal, visual, and working memory and executive functioning, functions commonly found to be mildly impaired in mTBI and PTSD. The two groups were compared on trajectories of change over time using linear mixed-effects models with restricted maximum likelihood (LMM). Contrary to our hypothesis that SMART would result in superior improvements compared to BHW, both groups displayed statistically and clinically significant improvements on measures of memory, executive functioning, and gist reasoning. Over 60% of the sample showed clinically significant improvements, indicating that gains can be found through psychoeducation alone. A longer SMART protocol may be warranted for clinical samples in order to observe gains over the comparison group.

STUDY OBJECTIVES:Hypnotic medications can adversely affect behavior during unanticipated awakenings during the night. Animals treated with the hypocretin (Hcrt) receptor antagonist almorexant (ALM) have less acute cognitive impairment compared to the GABAA receptor modulator zolpidem (ZOL). This study aimed to determine whether ALM produces less acute cognitive impairment than ZOL in human subjects.METHODS:Healthy, young adult, unmedicated male and female subjects participated in a controlled trial of a single dose of ALM 100 mg (N = 48), ALM 200 mg (N = 53), ZOL 10 mg (N = 49), and placebo (PBO, N = 52).RESULTS:ZOL and both doses of ALM produced similar levels of subjective sleepiness and impaired the ability of subjects to remain awake in a dark, low-stimulus setting relative to PBO. For most cognitive measures, performance under ZOL was significantly worse than ALM or PBO. For tasks involving verbal memory or visual-motor coordination, ZOL impaired performance, whereas the two doses of ALM were no different than PBO. For tasks involving higher-order executive function, ZOL produced impairment in processing speed and inhibitory control, whereas the two doses of ALM were no different than PBO. Performance decrements for ALM were less than ZOL but greater than PBO for some reaction time measures.CONCLUSIONS:The data provide support for the hypothesis that Hcrt receptor antagonists produce less functional impairment than a benzodiazepine receptor agonist (BzRA). These observations are particularly relevant to patients treated with sedative-hypnotics who are at elevated risk for falls and other untoward events during the intended hours for sleep.

A constellation of psychosocial factors contributes to the complex trauma symptoms that survivors of torture may experience. We examined the roles of pretrauma, peritrauma, and postmigration factors as predictors of posttraumatic stress disorder, depression, and anxiety in a sample of 101 culturally heterogeneous torture survivors residing in the United States. Predictors included demographic variables (sex, education, marital status), peritrauma torture type variables generated by principal components analysis (PCA), and postmigration variables (employment status, legal immigration status, and family separation). Of the torture factors identified through PCA (torture inflicted on the self and torture inflicted on family members), torture inflicted on the self significantly predicted anxiety. Undocumented legal status and female sex were related to poorer psychological outcomes. Results highlight the importance of considering postmigration factors, specifically legal status, rather than elements of the torture experience itself, in the delivery of trauma-informed psychological interventions and policy development for survivors of torture.

OBJECTIVEThe Interpersonal Theory of Suicide (IPTS; Joiner, 2005. Why People Die by Suicide. Cambridge, MA: Harvard University Press) hypothesizes that repeated exposure to painful and provocative events (PPE) increases capability for suicide (CS), therefore facilitating the development of suicidal intent, and that impulsive individuals are more likely to experience these painful and provocative events, creating an indirect relationship between impulsivity and CS. Research to date largely supports this hypothesis but has not translated this theory to actual suicidal intent.METHODThe present study used data from the MacArthur Violence Risk Assessment Study to examine the relationship between PPE and intent, and the indirect relationship between impulsivity and intent among a sample of 245 recent suicide attempters, using the clinician-rated Suicide Intent Scale as an objective measure of intent.RESULTSResults supported the hypothesized direct relationship between PPE and intent, and the indirect relationship between impulsivity and intent through PPE. There was no direct relationship between impulsivity and intent, suggesting that the relationship between impulsivity and intent occurs entirely through exposure to PPE.CONCLUSIONSThese findings suggest that assessing exposure to painful and provocative events is critical in evaluating risk of suicide, and that impulsivity itself does not confer an increased risk of lethal or nearly lethal attempts.

According to anxiety buffer disruption theory, traumatic experiences can disrupt one’s ability to manage anxiety. There are several studies finding that after reminders of death, individuals high in trauma symptoms respond atypically – that is, whereas most individuals respond to reminders of death with increased self-esteem striving, traumatized individuals do not. Prior research has found that a certain level of cognitive resources are integral to the process of managing death-related thoughts; because traumatized individuals often report cognitive deficits, it may be that atypical responses to reminders of death stem from trauma-related cognitive impairments. Ninety-three participants were recruited via the psychology department at the University of Colorado Colorado Springs. Participants were administered a working memory task and randomly assigned to one of two conditions: a mortality salience prime, or a neutral prime. Though it was hypothesized that working memory performance and PTSD symptoms would moderate the effect of MS on death-thought accessibility and judgment of moral transgressions, the results did not provide support these hypotheses. Possible explanations and future directions are discussed.

OBJECTIVE:Trauma researchers have recently begun using Amazon's Mechanical Turk (MTurk) as a data collection platform that is both time- and cost-efficient. Research is needed to determine the utility, generalizability, and validity of MTurk as a recruitment source for trauma-exposed samples.METHOD:Data were collected from 266 trauma-exposed MTurk participants on several clinical and psychological constructs relevant to trauma research. The mean scores, prevalence rates, and correlation strengths of the MTurk sample were compared to those reported in previously published studies of undergraduate, community, and treatment-seeking samples.RESULTS:Findings indicated that prevalence rates of posttraumatic stress disorder (PTSD) and depression were not significantly different from comparison samples, but prevalence rates of generalized anxiety were significantly higher than that of a community sample. The MTurk sample showed significantly lower mean scores of PTSD, depression, and generalized anxiety symptoms than all comparison samples. Correlations were examined to determine whether established relationships between common trauma-related constructs were correlated for MTurk participants as they were in other samples. Correlations between PTSD symptom severity, posttraumatic cognitions (PTCs), and trauma coping self-efficacy (CSE-T) in the MTurk sample were not significantly different from the correlations observed in all comparison samples. Finally, MTurk participants who met criteria for probable PTSD scored significantly higher on measures of depression, generalized anxiety, and PTCs, and lower on CSE-T, than those without probable PTSD.CONCLUSIONS:Future trauma researchers utilizing MTurk should consider potential similarities and differences between MTurk samples and community, clinical, and undergraduate samples when interpreting the generalizability of findings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

OBJECTIVE:Posttraumatic stress disorder (PTSD) is associated with somatic and cognitive changes, which may be magnified when accompanied by persistent pain. The mechanisms of somatic sensation processing may extend to cognitive symptoms, revealing a potential generalization of impairment across cognitive and somatic domains in PTSD. We hypothesized that somatic burden would mediate relationships between PTSD, pain, and perceived cognitive impairment.METHODS:Two samples-360 trauma-exposed college students and 268 mechanical Turk users-completed self-report measures.RESULTS:Both samples revealed similar findings. There was a significant indirect effect of PTSD and pain on perceived cognitive problems through somatic burden. There remained a direct effect of PTSD symptoms. These findings indicate that in trauma-exposed samples with pain, somatic burden rather than pain severity accounts for perceived cognitive problems.CONCLUSION:High somatic burden may reflect an underlying appraisal about somatic cues, which extend in part to interpretation of cognitive cues.

Objective The Fort Campbell Cohort study was designed to assess predeployment biological and behavioral markers and build predictive models to identify risk and resilience for posttraumatic stress disorder (PTSD) following deployment. This article addresses neurocognitive functioning variables as potential prospective predictors. Method In a sample of 403 soldiers, we examined whether PTSD symptom severity (using the PTSD Checklist) as well as posttraumatic stress trajectories could be prospectively predicted by measures of executive functioning (using two web-based tasks from WebNeuro) assessed predeployment. Results Controlling for age, gender, education, prior number of deployments, childhood trauma exposure, and PTSD symptom severity at Phase 1, linear regression models revealed that predeployment sustained attention and inhibitory control performance were significantly associated with postdeployment PTSD symptom severity. We also identified two posttraumatic stress trajectories utilizing latent growth mixture models. The resilient group consisted of 90.9% of the soldiers who exhibited stable low levels of PTSD symptoms from pre- to postdeployment. The increasing group consisted of 9.1% of the soldiers, who exhibited an increase in PTSD symptoms following deployment, crossing a threshold for diagnosis based on PTSD Checklist scores. Logistic regression models predicting trajectory revealed a similar pattern of findings as the linear regression models, in which predeployment sustained attention (95% CI of odds ratio: 1.0109, 1.0558) and inhibitory control (95% CI: 1.0011, 1.0074) performance were significantly associated with postdeployment PTSD trajectory. Conclusions These findings have clinical implications for understanding the pathogenesis of PTSD and building preventative programs for military personnel. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Objective: Posttraumatic stress disorder (PTSD) is associated with mild neurocognitive deficits, yet clients often complain of cognitive problems that exceed what their objective performance demonstrates. In addition, PTSD is associated with negative appraisals about the self, traumatic event, and one's ability to cope. This study examined posttraumatic cognitions as a moderator, and trauma coping self-efficacy as a mediator, of the relationship between PTSD symptoms and self-report of cognitive problems. Method: A sample of 268 trauma-exposed adults completed the PTSD Checklist for DSM-5, the Posttraumatic Cognitions Inventory, the Trauma Coping Self-Efficacy Scale, the Cognitive Self-Report Questionnaire, and the Quality of Life Scale. Results: Negative self-appraisals was a significant moderator in the relationship between PTSD symptoms and perception of cognitive problems (beta = -.252, p = .001). In participants with high levels of negative posttraumatic cognitions, perception of cognitive problems was high regardless of PTSD symptom level. In a mediator analysis, there was a significant indirect effect of trauma coping self-efficacy (b = .125, 95% CI [. 088,.172]). Finally, there was evidence of moderated mediation, such that trauma coping self-efficacy was a mediator only when posttraumatic cognitions were low or average. Conclusions: Results indicate that posttraumatic appraisals and coping self-efficacy play significant roles in perception of cognitive problems following trauma. Clinically, in patients for which there is a perception of cognitive impairment that is not borne out in neuropsychological testing, cognitive-behavioral therapy focused on altering negative self-perceptions and appraisals may be beneficial.

Trauma exposure is associated with various parenting difficulties, but few studies have examined relationships between trauma, posttraumatic stress disorder (PTSD), and parenting stress. Parenting stress is an important facet of parenting and mediates the relationship between parental trauma exposure and negative child outcomes (Owen, Thompson, & Kaslow, 2006). We examined trauma type (child maltreatment, intimate partner violence, community violence, and non-interpersonal traumas) and PTSD symptoms as predictors of parenting stress in a sample of 52 trauma-exposed mothers. Community violence exposure and PTSD symptom severity accounted for significant variance in parenting stress. Further analyses revealed that emotional numbing was the only PTSD symptom cluster accounting for variance in parenting stress scores. Results highlight the importance of addressing community violence exposure and emotion regulation difficulties with trauma-exposed mothers.

OBJECTIVES:Maternal posttraumatic stress disorder (PTSD) is a risk factor for negative child adjustment, but it is unclear whether this association is direct (e.g., a mother's PTSD symptoms are observed, learned, and internalized by children which results in behavioral and emotional problems) or indirect, through parent-child relationship difficulties or parenting stress. We hypothesized that parenting stress and maternal emotional availability would exhibit indirect effects on relationships between maternal PTSD and children's functioning.METHOD:Participants were 52 trauma-exposed mothers and their children (aged 7-12 years). Mothers completed measures of PTSD and parenting stress and reported on their children's functioning. Emotional availability was assessed through observer-rated mother-child interactions.RESULTS:Emotional availability was not related to PTSD or child outcomes. Parenting stress had a substantial indirect effect on the relationships between maternal PTSD and child emotion regulation, internalizing, and externalizing behaviors.CONCLUSIONS:Results highlight the need to target parenting stress in interventions with trauma-exposed families.