Both borderline personality disorder (BPD) and posttraumatic stress disorder (PTSD) are associated with emotion dysfunction and often co-occur. Emotional reactivity is also evident in some studies in BPD and PTSD. Despite the frequent co-occurrence of these diagnoses, only a few studies have examined the independent and joint effects of BPD and PTSD on emotional functioning. Some data suggest that co-occurring PTSD may drive discordance between domains of emotional reactivity in BPD, dampening physiological reactivity but increasing subjective reactivity. Low reliance on acceptance-based emotion regulation may also account for this divergence. The current study examined the independent and interactive effects of BPD and PTSD on emotional reactivity, regulation, and concordance across physiological and subjective measures. We also examined the role of acceptance in driving concordance across physiological and subjective measures. Participants (N = 195) underwent a diagnostic interview and completed a computerized task including neutral and negative emotion inductions. We examined subjective and physiological outcomes after both inductions. Linear regressions were used to examine relationships between diagnostic group and self-reported reactivity and regulation outcomes, as well the mediating role of acceptance on discordance. Multilevel models were used to examine the associations between diagnostic criteria and time on reactivity and regulation outcomes. We found that BPD and BPDxPTSD, but not PTSD, were significantly associated with greater difficulty regulating and accepting emotions. No significant differences in physiological reactivity and regulation were present across diagnostic groups, and acceptance was not found as a mediator between diagnostic groups and discordance indices. We discuss possible interpretations of our reactivity and regulation findings. Investigating BPD and PTSD’s association with reactivity and regulation, along with the role of emotional acceptance on these outcomes, will extend our understanding of diagnostic profiles and potentially pinpoint how acceptance can be utilized to influence emotional concordance.

Disrupted emotion processes are central features of posttraumatic stress disorder (PTSD) and major depressive disorder (MDD), which are linked to altered neural response patterns. However, inconsistent results have led to questions about the reliability of such findings. Heterogeneous clinical presentations across individuals with PTSD and MDD are likely to be associated with heterogeneous neurobehavioral changes which may differ depending on the emotion process studied. Similarly, neurobehavioral signatures of treatment response prediction may vary based on the task or context probed. In these studies, we examined how neuroimaging of emotion processes may shed light on mechanisms underlying symptom heterogeneity in PTSD (Study 1) and how similar neuroimaging signatures may be useful for predicting response to MDD treatment (Study 2). Results showed re-experiencing and hyperarousal symptoms had opponent effects on neural habituation to negative images, such that while increasing severity of hyperarousal symptoms was related to diminished habituation, increasing severity of re-experiencing symptoms was associated with enhanced habituation. Additionally, across MDD studies, two regions of the brain, the right anterior insula and the subgenual anterior cingulate cortex, exhibited pretreatment responses to negative emotional stimuli that were predictive of clinical response to treatment. Considered together, this work demonstrates the translational utility of neuroimaging of negative emotion processes to enhance our understanding of symptomatology and treatment prediction in PTSD and MDD. / Ph.D. / People who have posttraumatic stress disorder (PTSD) or depression often notice changes in the intensity and range of emotions they experience. These changes are thought to be related to differences in how the brain processes emotional information. Using neuroimaging to visualize changes that occur in the brains of individuals with PTSD or depression when they are experiencing negative emotions, we may gain a better understanding of how their symptoms are impacting them and how they may respond to different types of treatments. In these studies, I used brain imaging to measure responses to emotional images of people with and without PTSD. I found that certain PTSD symptoms affected the way people's brains responded over time to negative and neutral images. More several arousal symptoms were linked to less decreases of brain responses over time or less habituation. More severe symptoms of intrusive memories or distress when exposed to reminders of trauma were associated with greater decreases of brain responses to negative images. In a second study, I found that across studies of people with depression, two regions of the brain that are involved in emotion processing and stress responsivity, show pretreatment responses to negative emotional stimuli that are related to how they are likely to respond to treatment for depression. Overall, my research demonstrates how brain responses to negative emotions may be useful for understanding symptoms of mental health disorders and may help with predicting how individuals will respond to treatment.

Posttraumatic Stress Disorder (PTSD) has been demonstrated as the primary pathway through which morbidity and mortality is achieved post-trauma. However, less is known about protective factors to PTSD, depression, and self-reported health outcomes of adults following a traumatic event. Through examination of residential fire survivors, the current project evaluated the predictive validity of protective factors of PTSD as they relate to PTSD, depression, and somatic health outcomes. Additionally, the project collapsed the three outcomes variables into a unified health construct and evaluated protective factors ability to predict health. It was hypothesized the peritraumatic emotionality, social support, and resource loss would predict PTSD, depression, and somatic health. Additionally, it was predicted that peritraumatic emotionality, social support, and resource loss would predict a unified construct of health. Participants were assessed via self-report and semi-structured interviews approximately four months post-fire. Results of the current project demonstrated strong associations amongst peritraumatic emotionality and resource loss for many of the outcome variables. However, social support was not found to be a predictor of any of the outcomes variables. When evaluating the unified health construct, resource loss was found to significant predict a resilient group of trauma survivors four months post-fire. The present study suggests lower peritraumatic emotionality and lower sustained resource loss are significant protective factors for resiliency from trauma. / Ph. D.

The pandemic affected daily life on an unprecedented global scale resulting in the need for adaptation and flexibility to cope with ongoing stress, uncertainty, and loss that may affect couple relationships. Understanding resource loss in the context of mass stress events is critical because resource loss has been defined as the primary agent of stress (Hobfoll, 1989). As such, it is important to understand what factors may have shaped the degree of resource loss incurred during the pandemic. Extant research implies that considering early life adversity may be useful to explore as it may be a form of resource loss and is linked to poorer mental health and relational outcomes in adulthood. Furthermore, the stress sensitization hypothesis posits that childhood adversity may prime individuals to have a lower threshold for later life stress. This study utilizes both the stress sensitization hypothesis and the conservation or resources theory as lenses for understanding how childhood adversity affects pandemic-related resource loss for couples. Given that myriad resource loss was a prominent feature of the pandemic, it will be useful to understand whether childhood adversity sets individuals and couples up to experience greater loss in the context of pandemic-related stressors. Additionally, few studies have addressed the influence of mass stressors in the context of couple relationships using data from both partners. This gap in the literature is problematic because the pandemic's unique constraints and stressors were shared and lived in relationships and mental health distress tends to be interrelated among partners. This study is thus designed to examine how family of origin stress (reported at the outset of pandemic related shutdowns in the US in April 2020) associated with posttraumatic stress (PTSS) 3 months later (July 2020) to, in turn, predict variation in resource losses reported 3 months later (October 2020) associated with the COVID-19 pandemic in 535 cisgender, heterosexual couples. Findings showed that individual's higher family of origin stress predicted higher levels of their own PTSS at wave 2, and higher PTSS at wave 2 predicted higher levels of couples' shared resource loss at wave 3. Additionally, family of origin stress associated with higher levels of couples' shared experience of loss via higher levels of their own PTSS.

Posttraumatic Stress Disorder (PTSD) is marked by avoidance, arousal, re-experiencing, and negative mood and cognition. To date, these symptoms are assessed using self-report measures (e.g., the PCL-5) and clinician administered assessments (e.g., the CAPS-5). While these are the present gold-standard assessments for PTSD, they still are prone to bias on behalf of both the administrator and the patient. Presently, there is evidence that individuals with PTSD perform differently than individuals without PTSD on certain cognitive tasks that measure attention bias and avoidance behaviors. As such, creating a battery of these tasks may be a viable route for objectively measuring PTSD. In an effort to provide preliminary evidence for such a battery, we used three cognitive assessments [the Emotional Stroop Task (EST), the Visual Search Task (VST), and the Approach Avoidance Task (AAT)] to assess cognitive performance in veterans with PTSD, and veterans and civilians without PTSD. We hypothesized that veterans with PTSD would perform worse than the other groups (as measured by reaction times and accuracy scores) following the presentation of combat-related stimuli compared to negative and positive stimuli. The results indicated that veterans with PTSD were generally slower across all conditions in the EST, had lower accuracy scores on the VST, and were slower in the combat condition compared to the other control groups in the AAT. This study provides preliminary support for the hypothesis that a battery of cognitive tasks may be an effective tool for objectively identifying PTSD. Furthermore, we discuss important methodological ways in which future studies could improve the sensitivity of these tasks.

Evidence has linked alterations of the endocannabinoid system with trauma exposure and posttraumatic stress disorder (PTSD). Childbirth-related PTSD symptoms (CB-PTSS) affect about every eighth woman and can negatively influence the entire family. While aetiological models of CB-PTSD include psychological risk factors such as maternal trauma history and negative subjective birth experience (SBE), they lack biological risk indicators. We investigated whether lifetime trauma and CB-PTSS were associated with long-term endocannabinoid concentrations during pregnancy. Further, we tested endocannabinoids as mediators between lifetime trauma and CB-PTSS and whether SBE moderated such mediational paths. Within the prospective cohort study DREAMHAIR, 263 expectant mothers completed trauma assessments and provided hair samples for quantification of long-term endocannabinoid levels (anandamide [AEA], 2-arachidonoylglycerol [1-AG/2-AG], and N-acyl-ethanolamides [NAE]) prior to their anticipated birth date. Two months postpartum, CB-PTSS and SBE were measured. Regression models controlling for relevant confounders showed no association between lifetime trauma and hair endocannabinoids during pregnancy, yet higher number of lifetime trauma events and lower hair AEA were significantly associated with CB-PTSS, with the latter finding not remaining significant when Bonferroni corrections due to multiple testing were applied. While hair AEA did not mediate the association between lifetime trauma and CB-PTSS, the effect of lower hair AEA on CB-PTSS was stronger upon negative SBE. Results suggest greater lifetime trauma and reduced maternal hair AEA during pregnancy may be associated with increased risk for CB-PTSS, particularly upon negative SBE. Findings confirm lifetime trauma as a CB-PTSS risk factor and add important preliminary insights on the role of endocannabinoid ligand alterations and SBE in CB-PTSS pathology.

No description available.

In my thesis, I postulated the target to map the methods and procedures applied by the CR Police, Regional Police Headquarters of the South-Bohemian Region within the primary, secondary as well as tertiary prevention of posttraumatic reactions and disorder. A partial target of the thesis is finding out the rate of the satisfaction with availability of intervention care for policemen and employees of the Regional Police Headquarters of the South-Bohemian Region, finding out the rate of the awareness, usability and satisfaction with the care of the posttraumatic intervention team in the South-Bohemian Region, awareness of the service Help Line in crisis and its usability. Moreover I postulated the goal to map the interest in the possible internet helpline in the scope of IZS with elaboration of SWOD analysis. Everybody, also policemen may suffer from stress reaction. Also they can have the psychical and physical signs of an acute stress reaction. They perform the most of service acts, interventions in a routine way, however, besides this, also situations occur, differing from the normal life experience and policemen get in this way very often into the stress situations, which can arouse deep mental turbulences. The impact of feelings on the mental state in case of extreme experiences is a normal human reaction in a not normal situation. At present, each policeman has the possibility to ask for help a team of specially trained experts, the team of posttraumatic intervention care. In the team, not only psychologists are working, but also experienced policemen, experts of the branch of the Ministry of Interior and the priests prepared to help with their experience, erudition and knowledge acquired by a special training. Since 2001 the impacted person may call the anonymous Crisis Help Line, which is a supporting part of the posttraumatic intervention care for the policemen, firemen, employees of the branch of the Ministry of Interior and their family members. The crisis help line is also at disposal to the public in case of extraordinary events and crisis situations. For this reason, this thesis treats the methods of posttraumatic intervention care, awareness, usability, satisfaction and trust in these branch offices of the CR Police.

Inledning: Behovet av traumabehandling till flyktingar har ökat. Psykoterapeuten blir vittne till berättelser som handlar om lidande, rädsla och smärta. Syftet med denna studie är att undersöka hur psykoterapeuter upplever sitt arbete med behandling av krigs- och tortyrskadade flyktingar. Frågeställningar: 1. Hur upplever psykoterapeuter arbetet med krigs- och tortyrskadade flyktingar? 2. Använder sig psykoterapeuter av bemästringsstrategier för att hantera sina upplevelser i arbetet med krigs- och tortyrskadade flyktingar? Om så är fallet, vilka? Metod: Kvalitativ metod med fenomenologisk, deskriptiv ansats valdes. Fem psykoterapeuter som arbetar med krigs- och tortyrskadade flyktingar intervjuades. Resultat: Studiens resultat har en manifest del och en latent del. ”Att pendla mellan vanmakt och skapande förändring” är ett tema som representerar det underliggande, latenta budskapet, d.v.s. det som sägs ”mellan raderna” och representerar den röda tråd som finns i samtliga intervjuer. Det manifesta resultatet visar att terapeuterna upplever sitt arbete som ett privilegium och som betungande. Terapeuterna använder medvetna bemästringsstrategier för att hantera känslomässig stress. Diskussion: Terapeuternas beskrivning av sitt arbete med krigs- och tortyrskadade stämmer väl överens med tidigare forskning. Terapeuternas upplevelse av sitt arbete kan förstås genom begreppen motöverföring, projektiv identifikation, vikarierande traumatisering, sekundär traumatisk stress och posttraumatic growth. / Introduction: The need for trauma treatment for refugees has increased. The psychotherapist testifies to stories that concern suffering, fear and pain. The purpose of this study is to investigate how psychotherapists experience their work in dealing with war and torture injured refugees. Research questions: How do psychotherapists experience the work of war and torture injured refugees? Are psychotherapists using coping strategies to handle their experiences in the work of war and torture-injured refugees? If so, which? Method: Qualitative method with phenomenological, descriptive approach was chosen. Five psychotherapists working with war and torture injured refugees were interviewed. Results: ”Oscillating between powerlessness and creative change" is a theme that represents the underlying latent message, what is said "between the lines" and represents the red thread found in all the interviews. The manifest results show that the therapists experience their work as a privilege and as burdensome. The therapists use conscious coping strategies to deal with emotional stress. Discussion: The therapists' description of their work on war and torture injured is in line with previous research. Therapists' experience of their work can be understood by the concepts of transference, projective identification, vicarious traumatization, secondary traumatic stress and posttraumatic growth.

No description available.