Publications by authors named "Ateka A Contractor"

112 Publications

Positive emotion dysregulation and posttraumatic stress disorder symptoms: Investigating the role of anxiety sensitivity.

J Anxiety Disord 2021 Sep 7;84:102475. Epub 2021 Sep 7.

Department of Psychology, University of Rhode Island, Kingston, RI, USA. Electronic address:

Objective: Posttraumatic stress disorder (PTSD) symptoms are prevalent and deleterious among individuals who have experienced a sexual assault. Although an emerging field of research has established a link between positive emotion dysregulation and PTSD symptoms, there is a limited understanding of mechanisms underlying this relation. Individuals who have experienced a sexual assault may begin to fear any arousal-related sensations via stimulus generalization, including that associated with positive emotions, which, in turn, may amplify PTSD symptoms. Thus, the current study examined the role of anxiety sensitivity in the association between positive emotion dysregulation and PTSD symptoms.

Methods: A sample of 500 community members reporting a history of sexual assault (M=34.54, 54.4% male, 79.0% white) completed measures of positive emotion dysregulation, anxiety sensitivity, and PTSD symptoms.

Results: Findings detected a significant indirect effect of anxiety sensitivity in the relation between positive emotion dysregulation and PTSD symptoms (β = 0.28, SE=0.03, 95% CI [0.22, 0.34]). Supplementary analyses revealed that effects held for subscales of anxiety sensitivity (i.e., cognitive, physical, social concerns) and PTSD symptom clusters (i.e., intrusions, avoidance, negative alternations in cognitions and mood, alternations in arousal and reactivity).

Conclusions: This study offers preliminary empirical support for the assertion that fear of arousal-related sensations associated with positive emotions may partially explain the link between positive emotion dysregulation and PTSD symptoms among those who have experienced a sexual assault. Information from this study could advance future research and treatment.
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http://dx.doi.org/10.1016/j.janxdis.2021.102475DOI Listing
September 2021

Examining indirect effects of emotion dysregulation between PTSD symptom clusters and reckless/self-destructive behaviors.

Psychol Trauma 2021 Sep 9. Epub 2021 Sep 9.

Department of Psychology.

Objectives: Emotion dysregulation theoretically and empirically explains the link between posttraumatic stress disorder (PTSD) and posttrauma reckless and self-destructive behaviors (RSDBs).

Method: The current study uniquely examined the role of emotion dysregulation in the association between the four heterogeneous PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]) and an overall measure of posttrauma RSDBs. Trauma-exposed participants ( = 411) completed self-report measures assessing PTSD symptoms (PTSD Checklist for -5), emotion dysregulation (Difficulties in Emotion Regulation Scale-16), and engagement in RSDBs (Posttrauma Risky Behaviors Questionnaire).

Results: Direct and indirect effects were examined using PROCESS Model 4. The bias-corrected bootstrap revealed a significant indirect effect of emotion dysregulation in posttrauma RSDBs' relation with PTSD's intrusions ( = -.13, = .04, 95% CI [-.23, -.06]), avoidance ( =.15, =.07, 95% CI [.04, .33]), NACM ( =.17, =.05, 95% CI [.09, .27]), and AAR ( =.14, =.05, 95% CI [.05, .27]).

Conclusions: Emotion dysregulation explained associations between the severity of each PTSD symptom cluster and overall posttrauma RSDBs. PTSD treatments targeting emotion dysregulation may help to reduce posttrauma RSDBs for trauma-exposed individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0001118DOI Listing
September 2021

Processing of Positive Memories Technique (PPMT) for Posttraumatic Stress Disorder: A Primer.

J Psychother Integr 2021 Jun 6;31(2):195-207. Epub 2020 Jul 6.

Department of Veteran Affairs, Providence VA Medical Center, Providence, RI, USA.

Despite substantial evidence linking posttraumatic stress disorder (PTSD) and positive memory processes, existing trauma research and clinical work focuses primarily on traumatic memories. In light of this limitation, Contractor and colleagues proposed a conceptual model linking PTSD to positive memories; this provided the backdrop to develop a manualized positive memory therapy protocol for trauma-exposed individuals (Processing of Positive Memories Technique; PPMT). In the current study, we first present justification for developing PPMT by outlining the role of positive memories in trauma theories, as well as empirical evidence and intervention research linking trauma/PTSD to positive memory processes. Next, we provide information on the preliminary PPMT protocol by outlining (1) theoretical foundations; (2) intervention strategies PPMT draws from; (3) objectives; and (4) a session-by-session description of goals, content, and homework assignments. Finally, we end by highlighting some (1) unique features and advantages of PPMT such as integrating well-supported experimental and cognitive psychology research into intervention research, bridging the gap between basic science and applied research, and being tailored to PTSD's unique symptomatology; and (2) directions for future research. The aim of this paper was to provide a primer on PPMT to facilitate its empirical examination and applicability in PTSD research and clinical work.
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http://dx.doi.org/10.1037/int0000239DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8412231PMC
June 2021

Posttraumatic stress disorder symptoms moderate the relation between childhood sexual abuse and disordered eating in a community sample.

Int J Eat Disord 2021 Aug 19. Epub 2021 Aug 19.

Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA.

Objective: Previous work has found clear associations between childhood sexual abuse (CSA) and disordered eating in adulthood. However, further research is needed to clarify factors that may influence this relationship. The current study advanced existing research by examining the moderating influence of posttraumatic stress disorder (PTSD) symptom severity in the association between CSA and disordered eating.

Method: Data were collected from 463 individuals with a history of sexual assault or other unwanted sexual experience(s) (M  = 34.71, 54.9% women, 77.5% white) who were recruited from MTurk.

Results: Results indicated significant positive relations among CSA, PTSD symptom severity, and disordered eating. CSA was found to be associated with disordered eating at high, but not low, levels of PTSD symptom severity.

Discussion: This study highlights the importance of assessing disordered eating and PTSD symptoms in individuals who report a history of CSA. Clinicians aiming to reduce their patients' symptoms of disordered eating may benefit from considering the potential role of PTSD symptom severity as a barrier to achieving treatment gains.
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http://dx.doi.org/10.1002/eat.23593DOI Listing
August 2021

The differential relation of trauma types with negative and positive emotion dysregulation.

Anxiety Stress Coping 2021 Aug 9:1-15. Epub 2021 Aug 9.

Department of Psychology, University of Rhode Island, Kingston, RI, USA.

Research provides robust support for an association between traumatic exposure and emotion dysregulation. Less understood is the relation of emotion dysregulation stemming from positive emotions to traumatic exposure, or the extent to which negative and positive emotion dysregulation may be uniquely related to specific trauma types. The present study explored the associations between negative and positive emotion dysregulation and specific trauma types in a community sample of 433 adults ( age = 43.81, 68.4% women). Results highlighted three main findings: (1) negative and positive emotion dysregulation were significantly higher among individuals with vs. without exposure to six and nine specific trauma types, respectively; (2) negative and positive emotion dysregulation were significantly and positively related to total number of specific traumatic events; and (3) negative emotion dysregulation was significantly higher among individuals with Victimization Traumas in the overall sample as well as the no-PTSD and no-MDD subsamples, and positive emotion dysregulation was significantly lower among individuals with Accidental/Injury Traumas and Victimization Traumas in the PTSD subsample. Results underscore the relative and unique roles of negative and positive emotion dysregulation in trauma types; these findings may inform future research.
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http://dx.doi.org/10.1080/10615806.2021.1964072DOI Listing
August 2021

Psychometric Evaluation of the Posttrauma Risky Behaviors Questionnaire: Item Response Theory Analyses.

Assessment 2021 Jul 30:10731911211036760. Epub 2021 Jul 30.

University of Vermont, VT, USA.

The Posttrauma Risky Behaviors Questionnaire (PRBQ) assesses extent of engagement in posttrauma reckless and self-destructive behaviors (RSDBs). Given PRBQ's recent development with limited psychometric investigations, we used item response theory to examine (a) item analysis, (b) person fit, and (c) differential item functioning (DIF) across gender-based groups and two different samples. One sample included 464 participants reporting potentially traumatic experiences (Mechanical Turk [MTurk], recruited online), and the other sample included 171 trauma-exposed women reporting current intimate partner violence and substance use (recruited in-person). All PRBQ items contributed to the RSDB scale, and all PRBQ items and the PRBQ scale provided maximum information for high levels of the RSDB latent trait. Seven and 11 items were conceptualized as low information items in the MTurk and intimate partner violence samples, respectively. Eight MTurk participants' responses did not fit the overall pattern of responses as expected. Seven items were flagged for DIF between the two samples, and eight items were flagged for DIF between men and women in the MTurk sample. However, all effect sizes were <8%. Conclusively, results suggest good psychometric properties for the PRBQ and support its use to compare RSDBs across different samples and gender-based groups.
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http://dx.doi.org/10.1177/10731911211036760DOI Listing
July 2021

Exploring the moderating role of gender in the relation between emotional expressivity and posttraumatic stress disorder symptom severity among Black trauma-exposed college students at a historically Black university.

J Clin Psychol 2021 Jul 28. Epub 2021 Jul 28.

University of Rhode Island, Kingston, Rhode Island, USA.

Objectives: Posttraumatic stress disorder (PTSD) is characterized in part by negative alterations of cognition or mood, including alterations in emotional expressivity, or the extent to which one outwardly displays emotions. Yet, research in this area has relied on predominantly white samples and neglected to consider the potential role of gender, despite there being demonstrated gender differences in both PTSD symptom severity and emotional expressivity, separately. The goal of the current study was to fill a critical gap in the literature by examining the moderating role of gender in the relation between PTSD symptom severity and emotional expressivity in a sample of trauma-exposed Black adults.

Methods: Participants were 207 Black individuals enrolled in a historically Black university in the Southern United States (68.6% female; M  = 22.32 years).

Results: Findings provided support for the moderating role of gender in the association between PTSD symptom severity and emotional expressivity. Specifically, greater PTSD symptom severity was inversely related to emotional expressivity among trauma-exposed Black males and positively associated with emotional expressivity among trauma-exposed Black females.

Discussion: These results suggest the potential need for gender-specific assessment and treatment techniques for PTSD symptom severity among trauma-exposed Black college students.
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http://dx.doi.org/10.1002/jclp.23226DOI Listing
July 2021

Effects of bodily arousal on desire to drink alcohol among trauma-exposed college students.

Alcohol 2021 Jul 19;96:15-25. Epub 2021 Jul 19.

University of North Texas, Department of Psychology, 1155 Union Circle, Denton, TX, 76203, United States.

Introduction: Alcohol consumption on college campuses is a major public health concern. Extant literature has identified trauma exposure as a robust risk factor for problematic alcohol use in this at-risk population. However, the mechanisms underlying this association are less well-studied. Research indicates that bodily arousal is a fundamental feature of trauma exposure, and posits that internal stimuli (e.g., heart pounding) at the time of trauma may manifest into conditioned cues that can trigger posttraumatic responding and related symptomatology, including alcohol use. However, past work supporting these assertions has used paradigms purposefully designed to evoke memories of the trauma, making it difficult to ascertain whether the mechanism driving subsequent alcohol craving is the explicit memory cue or the associated bodily arousal.

Methods: The current study examined whether an implicit, trauma-relevant cue of bodily arousal (via voluntary hyperventilation) - independent of any explicit memory cue - would elicit increased desire to drink among 104 (M = 20.30; 61.5% female) trauma-exposed undergraduates.

Results: Results found no statistically significant difference in change in alcohol craving between the hyperventilation and control tasks. However, secondary analyses indicated that trauma type (i.e., interpersonal/non-interpersonal) may play an influential role in this relationship. More specifically, individuals reporting interpersonal trauma as their most traumatic event evidenced a significantly greater increase in desire to drink following hyperventilation compared to the non-interpersonal index trauma group.

Discussion: Generally, these findings suggest that bodily arousal may only serve as an implicit, trauma-relevant interoceptive cue that increases desire to drink within a specific subset of trauma-exposed college students (i.e., individuals indexing interpersonal trauma). Replication and extension are needed to further understand the influence of bodily arousal on subsequent alcohol use behavior, which will be critical to PTSD-alcohol use modeling and, ultimately, help in informing prevention- and treatment-oriented intervention efforts aimed at reducing problematic alcohol use on college campuses.
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http://dx.doi.org/10.1016/j.alcohol.2021.07.002DOI Listing
July 2021

Posttraumatic stress disorder symptom severity modulates avoidance of positive emotions among trauma-exposed military veterans in the community.

Psychol Trauma 2021 Jul 1. Epub 2021 Jul 1.

Department of Psychology.

Objective: Theoretical and empirical evidence links emotional avoidance to the development and maintenance of posttraumatic stress disorder (PTSD) symptoms. However, few studies have tested whether these findings extend to positive emotional avoidance. Addressing this important gap in the literature, the current study examined the moderating role of PTSD symptom severity in the relation between positive emotional intensity and positive emotional avoidance.

Method: Participants were 465 trauma-exposed veterans recruited from the community ( = 38.00, 71.6% male, 69.5% White).

Results: The interaction between positive emotional intensity and PTSD symptom severity on positive emotional avoidance was significant. Analysis of simple slopes revealed that positive emotional intensity was significantly positively associated with positive emotional avoidance when participants endorsed high, but not low, levels of PTSD symptom severity.

Conclusions: Veterans with more severe PTSD symptoms may utilize avoidance strategies in the context of intense positive emotions. These findings may suggest the potential need for addressing positive emotional avoidance in interventions to reduce PTSD symptom severity. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0001048DOI Listing
July 2021

Positive memory intervention techniques: a scoping review.

Memory 2021 07 10;29(6):793-810. Epub 2021 Jun 10.

Facultad de Psicología, Universidad Complutense de Madrid, Madrid, Spain.

The scoping review examines and summarises the available knowledge base on intervention techniques focused on positive memories. An iterative series of and searches was conducted up to April 2021 following PRISMA-ScR guidelines. Thirty-nine studies, spanning 12 intervention techniques, were selected and described including: (1) theoretical basis; (2) type of study, sample, and measures; (3) intervention protocol; and (4) results of empirical studies if applicable. Results indicated that most techniques have only been tested in one-two studies with modest sample sizes and, when follow-ups are conducted, they are typically short. Results indicate that working with positive memories has the greatest impact on improving positive affect and reducing depressive symptoms, and that these effects are often temporary. This review serves as a quick reference guide to help professionals' access to descriptions and information on empirical evidence of positive memory techniques, improving their therapeutic arsenal to enhance well-being and therapeutic outcomes in their patients.
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http://dx.doi.org/10.1080/09658211.2021.1937655DOI Listing
July 2021

Examining the Interaction Between Potentially Morally Injurious Events and Religiosity in Relation to Alcohol Misuse Among Military Veterans.

J Trauma Stress 2021 May 8. Epub 2021 May 8.

Department of Psychology, University of North Texas, Denton, Texas, USA.

Given the disproportionate rate of alcohol misuse among veterans and related outcomes as compared to the general population, the examination of predictors of alcohol misuse in this population is imperative. Potentially morally injurious events (PMIEs), defined as severe transgressions of a moral code, have been positively associated with alcohol misuse. Exposure to PMIEs may challenge one's religious beliefs, which may, in turn, influence the strength of the association between PMIEs and alcohol misuse among military veterans. The goal of the current study was to examine the potential moderating role of religiosity in the association between PMIEs and alcohol misuse (i.e., alcohol consumption, drinking behaviors, adverse reactions to drinking, and alcohol-related problems). Participants were 496 military veterans in the community (M = 37.80 years, SD = 11.42; 70.5% male). The results of moderation analyses indicated that overall religiosity, organizational religiosity, and intrinsic religiosity significantly moderated the association between PMIEs and alcohol misuse such that the positive relation between PMIEs and alcohol misuse was stronger at high versus low levels of religiosity, R s = .01. Our findings highlight the importance of considering the role of religiosity in relation to alcohol misuse as a moral injury outcome and the potential utility of tailoring treatments for military veterans who have experienced moral injury.
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http://dx.doi.org/10.1002/jts.22682DOI Listing
May 2021

Factors Related to Positive Memory Count Among Trauma-Exposed Individuals: A Scoping Review.

Trauma Violence Abuse 2021 May 7:15248380211013130. Epub 2021 May 7.

Department of Psychology, University of Rhode Island, Kingston, RI, USA.

To examine the existing knowledge base on trauma experiences and positive memories, we conducted a scoping review of trauma and post-trauma factors related to positive memory count. In July 2019, we searched PubMed, Medline, PsycINFO, Web of Science, Cumulative Index of Nursing and Allied Health Literature, Embase, and PTSDpubs for a combination of words related to "positive memories/experiences," "trauma/posttraumatic stress disorder (PTSD)," and "number/retrieval." Twenty-one articles met inclusion criteria (adult samples, original articles in English, peer-reviewed, included trauma-exposed group or variable of trauma exposure, trauma exposure examined with a trauma measure/methodology, assessed positive memory count, empirical experimental/non-experimental study designs). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, two authors reviewed abstracts, completed a secondary search, and independently extracted data. Our review indicated (1) that depression and PTSD were most researched; (2) no conclusive relationships of positive memory count with several psychopathology (depression, acute stress disorder, eating disorder, and anxiety), cognitive/affective, neurobiological, and demographic factors; (3) trends of potential relationships of positive memory count with PTSD and childhood interpersonal traumas (e.g., sexual and physical abuse); and (4) lower positive memory specificity as a potential counterpart to greater overgeneral positive memory bias. Given variations in sample characteristics and methodology as well as the limited longitudinal research, conclusions are tentative and worthy of further investigations.
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http://dx.doi.org/10.1177/15248380211013130DOI Listing
May 2021

Moderating effects of sleep difficulties on relations between posttraumatic stress disorder symptoms and positive memory count.

J Clin Psychol 2021 Sep 19;77(9):2057-2076. Epub 2021 Apr 19.

Department of Psychology, University of Arizona, Tucson, Arizona, USA.

Objectives: Posttraumatic stress disorder (PTSD) severity relates to positive memory retrieval difficulties. One variable potentially influencing this relation is sleep difficulties. We examined moderating effects of sleep difficulties (duration and quality) on relations between PTSD severity and count of specific positive memories covarying for age, gender, and depression.

Methods: Participants were an Amazon Mechanical Turk-recruited trauma-exposed community sample of 205 respondents (M  = 35.44; 61.40% women).

Results: Moderated regression analyses indicated significant interaction effects between sleep quality (b = 0.03; p = 0.036) and PTSD severity on specific positive memory count. Among individuals reporting better sleep quality, there were negative associations between PTSD severity and specific positive memory count (b = -0.04, SE = 0.02, p = 0.010). Similar results were obtained for PTSD's intrusion and arousal clusters.

Conclusion: Results support targeting sleep quality and PTSD severity to improve positive memory retrieval in PTSD and memory interventions, and the importance of considering sleep when examining links between PTSD and positive memory retrieval.
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http://dx.doi.org/10.1002/jclp.23142DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8405540PMC
September 2021

Critical considerations for the positive memory-posttraumatic stress disorder model.

Clin Psychol Psychother 2021 Apr 18. Epub 2021 Apr 18.

Department of Psychology, University of Rhode Island, Kingston, RI, USA.

Posttraumatic stress disorder (PTSD) includes changes in processes such as encoding and retrieval for both traumatic and positive memories. However, most work has predominantly focused on traumatic memories. Thus, Contractor and colleagues proposed a Positive Memory-PTSD model, which highlighted potential benefits associated with and mechanisms underlying positive memory retrieval/processing among individuals reporting PTSD symptoms. To enhance research on and clinical impacts of this model, the current review provides critical considerations for the Positive Memory-PTSD model. Drawing from emerging research and clinical observations, we (i) clarify that the model addresses specific versus overgeneral positive memories; (ii) underscore the importance of considering the heterogeneity in, and transitionary nature of, affect processes following positive memory retrieval; and (iii) highlight the rationale for considering trauma type/count and co-occurring conditions, as potential moderators of relations between positive memory processing and PTSD. Hereby, we provide an updated Positive Memory-PTSD model and implications for positive memory interventions drawing from this model.
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http://dx.doi.org/10.1002/cpp.2599DOI Listing
April 2021

Posttraumatic stress disorder in daily life among World Trade Center responders: Temporal symptom cascades.

J Psychiatr Res 2021 06 6;138:240-245. Epub 2021 Apr 6.

Department of Psychiatry, Stony Brook University, USA.

Background: Posttraumatic stress disorder (PTSD) symptoms are common in the immediate aftermath of a trauma, but it is their persistence over time that leads to a diagnosis. This pattern highlights the critical role of symptom maintenance to understanding and treating the disorder. Relatively few studies have explored whether PTSD symptoms may be interacting or triggering one another to worsen and maintain the disorder, a dynamic we refer to as "symptom cascades." Additionally, little work has tested in real-time how other maintenance factors, such as stress, contribute to such events in daily life.

Methods: The present study in a group (N = 202) of World Trade Center (WTC) responders oversampled for PTSD tested day-to-day temporal associations among PTSD symptom dimensions (i.e., intrusions, avoidance, numbing, and hyperarousal) and stress across one week.

Results: Longitudinal models found hyperarousal on a given day predicted increased PTSD symptoms the next day, with the effect sizes almost double compared to other symptom dimensions or daily stress. Intrusions, in contrast, showed little prospective predictive effects, but instead were most susceptible to the effects from other symptoms the day before. Avoidance and numbing showed weaker bidirectional effects.

Limitations: Findings are from a unique population and based on naturalistic observation.

Conclusions: Results are consistent with the idea of symptom cascades, they underscore hyperarousal's strong role in forecasting short-term increases in PTSD (even more than stress per se) and they raise the prospect of highly specific ecological momentary interventions to potentially disrupt PTSD maintenance in daily life.
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http://dx.doi.org/10.1016/j.jpsychires.2021.04.002DOI Listing
June 2021

Examination of the Structural Relations Between Posttraumatic Stress Disorder Symptoms and Reckless/Self-Destructive Behaviors.

Int J Stress Manag 2020 Feb 15;27(1):35-44. Epub 2019 Apr 15.

Department of Clinical Health Psychology, University of Manitoba, MB, CANADA.

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http://dx.doi.org/10.1037/str0000133DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7993008PMC
February 2020

What goes around comes around: Nightmares and daily stress are bidirectionally associated in nurses.

Stress Health 2021 Mar 21. Epub 2021 Mar 21.

Department of Psychology, University of Arizona, Tucson, Arizona, USA.

Nurses may experience frequent nightmares due to stressful work environments. Nightmares may also exacerbate stress among nurses, although this has yet to be tested empirically. We examined daily bidirectional associations between stress severity and nightmares, and moderation by post-traumatic stress disorder (PTSD) symptoms. 392 nurses (92% female; 78% White) completed 14 days of sleep diaries to assess previous-day stress severity and nightmare occurrence and severity. PTSD symptoms were assessed at baseline. Multilevel models were used to examine bidirectional, within-person associations between daily stress and nightmares, and cross-level moderation by baseline PTSD symptoms. 47.2% of nurses reported at least one nightmare across the two weeks. Days with greater stress were associated with higher odds of experiencing a nightmare (OR = 1.22, p = 0.001), as well as greater nightmare severity (b = 0.09, p = 0.033). Nightmare occurrence was associated with greater next-day stress severity (b = 0.15, p < 0.001). Daily stress and nightmare associations were similar for those with and without PTSD symptoms. Nightmares and stress may occur in a bidirectional fashion. Nurses face intense occupational demands and frequent exposure to potentially traumatic events. Studies should explore whether targeting nightmares and stress may improve nurses' health and well-being.
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http://dx.doi.org/10.1002/smi.3048DOI Listing
March 2021

A pilot study examining roles of cognitions and affect between positive memory processing and posttraumatic stress disorder symptom severity.

Psychol Trauma 2021 Mar 18. Epub 2021 Mar 18.

Stress, Trauma, & Related Conditions (STARC) Research Lab.

Posttraumatic stress disorder (PTSD) symptoms may impact cognitive processes underlying encoding and retrieval of positive memories. Contractor and colleagues thus proposed a Positive Memory-PTSD model outlining hypothesized pathways (e.g., improved cognitions and affect) linking active processing of positive memories and PTSD symptoms. In the current study, we empirically explored direct and indirect pathways of the Positive Memory-PTSD model including relations between presence/types of processing memory methodology, posttrauma maladaptive cognitions, positive/negative affect, and PTSD symptom severity. We randomly assigned 65 students reporting trauma histories to time-matched narrating (identifying and sharing details of elicited positive memories), writing (identifying and writing details of elicited positive memories), or control conditions. Participants completed self-report measures (T0) and repeated their assigned task condition and self-report measures 6-8 days later (T1). Half-longitudinal models demonstrated direct associations of (1) being in the narrating versus other conditions with decreases in posttrauma maladaptive cognitions and negative affect, and increases in positive affect; and (2) increases in posttrauma maladaptive cognitions and negative affect with greater PTSD symptom severity. Although, when controlling for posttrauma maladaptive cognitions and negative/positive affect, being in the narrating versus other conditions was associated with decreases in PTSD symptom severity, these constructs did not explain examined relations. Results suggest beneficial impacts of narrating positive memories on PTSD symptom severity (accounting for cognitions/affect) and improved cognitions/affect, and a need to examine moderating variables (e.g., emotion regulation) in the Positive Memory-PTSD model. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000625DOI Listing
March 2021

A pilot study examining roles of cognitions and affect between positive memory processing and posttraumatic stress disorder symptom severity.

Psychol Trauma 2021 Mar 18. Epub 2021 Mar 18.

Stress, Trauma, & Related Conditions (STARC) Research Lab.

Posttraumatic stress disorder (PTSD) symptoms may impact cognitive processes underlying encoding and retrieval of positive memories. Contractor and colleagues thus proposed a Positive Memory-PTSD model outlining hypothesized pathways (e.g., improved cognitions and affect) linking active processing of positive memories and PTSD symptoms. In the current study, we empirically explored direct and indirect pathways of the Positive Memory-PTSD model including relations between presence/types of processing memory methodology, posttrauma maladaptive cognitions, positive/negative affect, and PTSD symptom severity. We randomly assigned 65 students reporting trauma histories to time-matched narrating (identifying and sharing details of elicited positive memories), writing (identifying and writing details of elicited positive memories), or control conditions. Participants completed self-report measures (T0) and repeated their assigned task condition and self-report measures 6-8 days later (T1). Half-longitudinal models demonstrated direct associations of (1) being in the narrating versus other conditions with decreases in posttrauma maladaptive cognitions and negative affect, and increases in positive affect; and (2) increases in posttrauma maladaptive cognitions and negative affect with greater PTSD symptom severity. Although, when controlling for posttrauma maladaptive cognitions and negative/positive affect, being in the narrating versus other conditions was associated with decreases in PTSD symptom severity, these constructs did not explain examined relations. Results suggest beneficial impacts of narrating positive memories on PTSD symptom severity (accounting for cognitions/affect) and improved cognitions/affect, and a need to examine moderating variables (e.g., emotion regulation) in the Positive Memory-PTSD model. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000625DOI Listing
March 2021

The role of positive emotion dysregulation in the relationship between childhood abuse and PTSD in a community sample of veterans.

Child Abuse Negl 2021 04 6;114:104979. Epub 2021 Feb 6.

University of Rhode Island, United States. Electronic address:

Background: The co-occurrence of childhood abuse and posttraumatic stress disorder (PTSD) among United States military veterans is highly prevalent and clinically significant. Emotion dysregulation is one factor that has been found to underlie the association between childhood abuse and PTSD, yet past research has focused exclusively on dysregulation stemming from negative emotions.

Objective: The current study extends existing research by clarifying the role of positive emotion dysregulation in the relation between childhood abuse and PTSD in a community sample of military veterans.

Participants And Setting: Participants were 465 trauma-exposed military veterans in the community (M = 38.00, 71.6 % women, 69.5 % White).

Method: Using structural equation modeling, we tested the indirect association of childhood abuse to PTSD symptom severity through positive emotion dysregulation.

Results: The hypothesized model showed adequate model fit, χ (32, n = 465) = 176.22, p < .001, CFI = .97, RMSEA = .10, 90 % CI [.08, .11], SRMR = .04. Results showed that childhood abuse was indirectly associated with PTSD symptom severity through positive emotion dysregulation.

Conclusions: This finding highlights the potential utility of targeting positive emotion dysregulation in the detection and treatment of PTSD symptoms in veterans who experienced childhood abuse.
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http://dx.doi.org/10.1016/j.chiabu.2021.104979DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7983031PMC
April 2021

Effect of trauma-related stress after alcohol consumption on perceived likelihood of negative consequences and willingness to drive.

Addict Behav 2021 06 18;117:106836. Epub 2021 Jan 18.

Brown University, School of Public Health, Center for Alcohol and Addiction Studies, 121 S. Main St., Providence, RI 02912, USA. Electronic address:

Background: Alcohol-related motor vehicle crashes are a major preventable cause of death in the United States. One potential factor that may modulate the influence of alcohol on driving-related cognitions and decision-making is trauma-related stress. Indeed, in addition to compelling research indicating that both acute trauma-related stress and acute alcohol consumption may independently affect driving-related risky decision-making, there is reason to believe that the combination of these antecedents may have an exacerbating effect.

Methods: The current study evaluated the influence of induction of acute trauma-related stress (via script-driven imagery) after alcohol consumption (0.06% Breath Alcohol Concentration [BrAC]) on driving-related cognitions - perceived likelihood of negative consequences and willingness to drive - among 25 trauma-exposed (currently symptomatic) adult drinkers from the community (M = 24.08; 36.0% female).

Results: Participants who were acutely exposed to trauma-related stress after alcohol consumption evidenced lower perceived likelihood of being pulled over by a police officer (ηp2 = 0.38, large effect size) and lower perceived likelihood of getting in an accident (ηp2 = 0.17, medium-to-large effect size) relative to participants exposed to a neutral cue; conversely, participants exposed to trauma-related stress after alcohol consumption evidenced greater willingness to drive (d = 1.16, large effect size) than participants exposed to a neutral cue.

Conclusions: Generally, findings suggest that individuals with a trauma history that are acutely exposed to trauma-related stressors (e.g., reminders of their traumatic experience) may be particularly vulnerable to poorer driving-related decision-making after alcohol consumption. Results provide a meaningful target for the development of intoxicated driving prevention and intervention efforts geared specifically for individuals with trauma history.
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http://dx.doi.org/10.1016/j.addbeh.2021.106836DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956021PMC
June 2021

A psychometric investigation on the diagnostic utility of the posttrauma risky behaviors questionnaire.

Psychiatry Res 2021 02 21;296:113667. Epub 2020 Dec 21.

Department of Psychology, University of North Texas, Denton, TX, USA.

The Posttrauma Risky Behaviors Questionnaire (PRBQ) is a screening measure for posttrauma reckless and self-destructive behaviors (RSDBs). We examined (1) PRBQ's predictive relations with clinical (vs. not) endorsements of distinct RSDBs, and (2) PRBQ's optimal cutoff score yielding the most appropriate balance of sensitivity and specificity statistics. The sample included 354 adult trauma-exposed community participants (M=35.76 years; 57.90% female). Logistic regression analyses indicated that the PRBQ significantly differentiated individuals endorsing (vs. not) clinical levels of alcohol/drug misuse, disordered eating, problematic gambling, and compulsive buying. Receiver operating characteristic (ROC) curve analyses indicated that the 14-item PRBQ total score had moderate accuracy in differentiating individuals endorsing clinical vs. non-clinical levels of drug misuse, disordered eating, problematic gambling, compulsive buying, and engagement in RSDBs (PTSD's E2 Criterion); and low accuracy for alcohol misuse. ROC curve analyses indicated 3.5-6.5 as the optimal range of PRBQ cutoff scores. Thus, the PRBQ has good ability to discriminate participants endorsing (vs. not) clinical levels of alcohol/drug misuse, disordered eating, problematic gambling, and compulsive buying (lowest accuracy in identifying participants with clinical levels of alcohol misuse), and a minimum cutoff score between 3.5 and 6.5 may suggest using additional diagnostic assessments and clinical interventions.
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http://dx.doi.org/10.1016/j.psychres.2020.113667DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855932PMC
February 2021

Alcohol to down-regulate negative and positive emotions: Extending our understanding of the functional role of alcohol in relation to posttraumatic stress disorder.

Addict Behav 2021 04 13;115:106777. Epub 2020 Dec 13.

Department of Psychology, University of North Texas, Denton, TX, USA.

Introduction: Functional models of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) underscore the role of internally-driven negative reinforcement. However, with the focus of these models being on negative emotions broadly, there is limited understanding of the effect of alcohol use to down-regulate specific forms of negative emotions or positive emotions generally. Among populations characterized by PTSD, there is growing evidence that positive emotions may elicit aversive reactions and thus be intentionally reduced, including via alcohol use.

Objective: The current study examined the associations among PTSD symptom severity, alcohol use to down-regulate both negative (i.e., despondency and anger) and positive emotions, and alcohol misuse.

Method: Data were collected from 320 trauma-exposed, substance-using individuals in the community (M age = 35.78, 46.9% women).

Results: Individuals with greater PTSD symptom severity reported significantly higher alcohol use to down-regulate despondency, anger, and positive emotions, which, in turn, were linked to greater alcohol misuse.

Conclusions: Alcohol use may serve to down-regulate both negative (i.e., despondency and anger) and positive emotions, and these functions may help to explain the association of PTSD symptom severity to alcohol misuse. PTSD-AUD models may benefit from specifying a negatively reinforcing function of alcohol use in the context of positive emotions.
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http://dx.doi.org/10.1016/j.addbeh.2020.106777DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7855539PMC
April 2021

Bayesian Time-Series Models in Single Case Experimental Designs: A Tutorial for Trauma Researchers.

J Trauma Stress 2020 12 17;33(6):1144-1153. Epub 2020 Nov 17.

Department of Psychology, University of North Texas, Denton, Texas, USA.

Single-case experimental designs (SCEDs) involve obtaining repeated measures from one or a few participants before, during, and, sometimes, after treatment implementation. Because they are cost-, time-, and resource-efficient and can provide robust causal evidence for more large-scale research, SCEDs are gaining popularity in trauma treatment research. However, sophisticated techniques to analyze SCED data remain underutilized. Herein, we discuss the utility of SCED data for trauma research, provide recommendations for addressing challenges specific to SCED approaches, and introduce a tutorial for two Bayesian models-the Bayesian interrupted time-series (BITS) model and the Bayesian unknown change-point (BUCP) model-that can be used to analyze the typically small sample, autocorrelated, SCED data. Software codes are provided for the ease of guiding readers in estimating these models. Analyses of a dataset from a published article as well as a trauma-specific simulated dataset are used to illustrate the models and demonstrate the interpretation of the results. We further discuss the implications of using such small-sample data-analytic techniques for SCEDs specific to trauma research.
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http://dx.doi.org/10.1002/jts.22614DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246830PMC
December 2020

Bayesian Time-Series Models in Single Case Experimental Designs: A Tutorial for Trauma Researchers.

J Trauma Stress 2020 12 17;33(6):1144-1153. Epub 2020 Nov 17.

Department of Psychology, University of North Texas, Denton, Texas, USA.

Single-case experimental designs (SCEDs) involve obtaining repeated measures from one or a few participants before, during, and, sometimes, after treatment implementation. Because they are cost-, time-, and resource-efficient and can provide robust causal evidence for more large-scale research, SCEDs are gaining popularity in trauma treatment research. However, sophisticated techniques to analyze SCED data remain underutilized. Herein, we discuss the utility of SCED data for trauma research, provide recommendations for addressing challenges specific to SCED approaches, and introduce a tutorial for two Bayesian models-the Bayesian interrupted time-series (BITS) model and the Bayesian unknown change-point (BUCP) model-that can be used to analyze the typically small sample, autocorrelated, SCED data. Software codes are provided for the ease of guiding readers in estimating these models. Analyses of a dataset from a published article as well as a trauma-specific simulated dataset are used to illustrate the models and demonstrate the interpretation of the results. We further discuss the implications of using such small-sample data-analytic techniques for SCEDs specific to trauma research.
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http://dx.doi.org/10.1002/jts.22614DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8246830PMC
December 2020

Ethnic-racial identity and posttraumatic stress disorder: The role of emotional avoidance among trauma-exposed community individuals.

Psychol Trauma 2021 Jan 8;13(1):35-43. Epub 2020 Oct 8.

Department of Psychology.

Objective: There are ethnic-racial differences in the prevalence of posttraumatic stress disorder (PTSD). However, the factors underlying these differences are not well studied or understood. The goal of this study was to explore the relation of strength of ethnic-racial identity to PTSD. Specifically, we examined whether strength of ethnic-racial identity was indirectly related to PTSD symptom severity through positive and negative emotional avoidance.

Method: Participants were 401 trauma-exposed community individuals ( = 43.86 years; 70.1% female; 23.4% Asian, 23.7% Black, 25.1% Hispanic, 25.4% White).

Results: Within the overall sample of ethnic-racial minorities, the indirect effect of strength of ethnic-racial identity on PTSD symptom severity through the pathways of both positive and negative emotional avoidance was significant. However, these findings were not replicated within each of the specific racial-ethnic subsamples. Specifically, while strength of ethnic-racial identity was indirectly associated with PTSD symptom severity through both positive and negative emotional avoidance in the Black subsample, this indirect effect was only significant through the pathway of positive emotional avoidance in the Hispanic subsample, and was nonsignificant in the Asian and White subsamples.

Conclusions: Results underscore ethnic-racial differences in the way in which strength of ethnic-racial identity impacts PTSD. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000974DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8443085PMC
January 2021

Military sexual trauma and alcohol misuse among military veterans: The roles of negative and positive emotion dysregulation.

Psychol Trauma 2020 Oct;12(7):716-724

Department of Psychology.

Introduction: Alcohol misuse is a significant clinical concern among military and veteran populations, particularly among individuals who have experienced military sexual trauma (MST). Emotion dysregulation may be an important factor influencing alcohol misuse among individuals with a history of MST.

Objective: The current study thus examined the role of negative and positive emotion dysregulation in the association between MST type and alcohol misuse among military veterans.

Method: Data were collected from a community sample of 515 veterans ( = 37.48, 71.3% male, 70.5% White).

Results: Mediation analyses indicated that negative and positive emotion dysregulation (separately) explained the relation between military sexual assault and alcohol misuse, but not military sexual harassment.

Conclusions: Findings emphasize the clinical relevance of addressing negative and positive emotion dysregulation in relation to alcohol misuse among veterans with a history of sexual assault MST. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000604DOI Listing
October 2020

Coping strategy utilization among posttraumatic stress disorder symptom severity and substance use co-occurrence typologies: A latent class analysis.

Psychol Trauma 2020 Sep 7. Epub 2020 Sep 7.

Department of Psychology, University of North Texas.

Objective: There is a lack of research on primary prevention of posttraumatic stress disorder (PTSD) symptoms and substance use among trauma-exposed populations. To guide the development of more effective prevention efforts, the current study sought to identify underlying coping mechanisms that impact PTSD-substance use co-occurrence.

Method: A person-centered analytic approach (latent class analysis) examined PTSD-substance use co-occurrence typologies (classes) and identified theoretically adaptive (e.g., active coping) and maladaptive (e.g., denial) coping strategies that differentiated between classes among a sample of 1,270 trauma-exposed participants (Mage = 20.71, 73.5% female, 45.7% White).

Results: Latent class analysis identified five distinct typologies, reflective of extant epidemiological and etiological work. Generally, behavioral disengagement and self-blame coping increased the likelihood of being in more severe PTSD-illicit substance use (e.g., cocaine) comorbidity classes. Positive reframing and planning differentiated between low and moderate illicit substance typologies with moderate PTSD severity. Venting, acceptance, and self-distraction differentiated between asymptomatic and moderate PTSD severity typologies with low illicit substance use.

Conclusions: Findings identify general coping strategies associated with increased likelihood of being in more severe comorbidity typologies, as well as several unique coping strategies associated with risk of transitioning between low/moderate PTSD and illicit substance use classes. Relevant interventions (e.g., trauma psychoeducation, guilt-reduction therapy, psychological first aid) that may be targets for future prevention-oriented work are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000964DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7936986PMC
September 2020

Posttraumatic stress disorder and deliberate self-harm among military veterans: Indirect effects through negative and positive emotion dysregulation.

Psychol Trauma 2020 Oct 3;12(7):707-715. Epub 2020 Sep 3.

Department of Psychology.

Objective: Military veterans with posttraumatic stress disorder (PTSD) exhibit heightened rates of deliberate self-harm, yet few studies have explored underlying mechanisms. Addressing this critical gap in the literature, the present study examined the roles of negative and positive emotion dysregulation in the relation between PTSD severity and deliberate self-harm.

Method: Data were collected from 465 trauma-exposed military veterans in the community ( = 38.00, 71.4% male, 69.5% White) who responded to an online survey.

Results: Findings indicated that PTSD severity was indirectly related to deliberate self-harm through overall positive (but not negative) emotion dysregulation. Secondary analyses indicated an underlying role of the negative emotion dysregulation domains of difficulties controlling impulsive behaviors when experiencing negative emotions and lack of emotional clarity and the positive emotion dysregulation domains of nonacceptance of positive emotions, difficulties engaging in goal-directed behavior when experiencing positive emotions, and difficulties controlling impulsive behaviors when experiencing positive emotions in the association between PTSD severity and deliberate self-harm.

Conclusions: This study offers preliminary evidence for specific domains of negative and positive emotion dysregulation as possible pathways linking PTSD severity and deliberate self-harm. Findings highlight new avenues for research and treatment focused on the effects of emotion dysregulation on deliberate self-harm among trauma-exposed military veterans. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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http://dx.doi.org/10.1037/tra0000962DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8449933PMC
October 2020

Moderating effects of dysregulation and fear of positive emotions on the relationship between posttraumatic stress disorder symptoms and positive memory count.

J Clin Psychol 2021 03 26;77(3):701-721. Epub 2020 Aug 26.

Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA.

Objectives: We examined moderating effects of positive emotion dysregulation and fear of positive emotions in the relation between posttraumatic stress disorder (PTSD) severity and positive memory count.

Method: Participants were 205 trauma-exposed community individuals (M  = 35.44; 61.50% female).

Results: Moderation analyses indicated interaction effects of PTSD severity with nonacceptance of positive emotions (b = -0.01, p = .002) and difficulties with goal-directed behaviors when experiencing positive emotions (b = -0.01, p = .006) on positive memory count.

Conclusions: Greater PTSD severity was associated with more specific positive memories when individuals reported less nonacceptance of positive emotions and fewer difficulties engaging in goal-directed behaviors in the context of positive emotions. Greater PTSD severity was associated with fewer specific positive memories when individuals reported greater nonacceptance of positive emotions and greater difficulties engaging in goal-directed behaviors in the context of positive emotions. Results support addressing positive emotion dysregulation in memory-focused interventions for PTSD.
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http://dx.doi.org/10.1002/jclp.23046DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7878328PMC
March 2021
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