PTSD Symptom Severity and Emotion Regulation Strategy Use During Trauma Cue Exposure Among Patients With Substance Use Disorders: Associations With Negative Affect, Craving, and Cortisol Reactivity

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

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Psychological Security in At-Risk Youth: Attachment, Emotion Regulation, and PTSD Symptom Severity

International Journal on Child Maltreatment Research Policy and Practice ◽

10.1007/s42448-019-00015-8 ◽

2019 ◽

Vol 2 (1-2) ◽

pp. 17-36

Author(s):

Sue D. Hobbs ◽

◽

Daniel Bederian-Gardner ◽

Christin M. Ogle ◽

Gail S. Goodman ◽

...

Keyword(s):

At Risk ◽

Emotion Regulation ◽

Symptom Severity ◽

Ptsd Symptom ◽

At Risk Youth ◽

Ptsd Symptom Severity

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Supplemental Material for Betrayal vs. Nonbetrayal Trauma: Examining the Different Effects of Social Support and Emotion Regulation on PTSD Symptom Severity

Psychological Trauma Theory Research Practice and Policy ◽

10.1037/tra0000983.supp ◽

2020 ◽

Keyword(s):

Social Support ◽

Emotion Regulation ◽

Symptom Severity ◽

Ptsd Symptom ◽

Ptsd Symptom Severity

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Associations between posttraumatic stress disorder and substance use: a longitudinal investigation of individuals recently exposed to trauma

10.32920/ryerson.14644506 ◽

2021 ◽

Author(s):

Sonya G. Wanklyn

Keyword(s):

Posttraumatic Stress Disorder ◽

Substance Use ◽

Alcohol Use ◽

Posttraumatic Stress ◽

Symptom Severity ◽

Stress Disorder ◽

Ptsd Symptom ◽

Traumatic Event ◽

Ptsd Symptoms ◽

Ptsd Symptom Severity

Posttraumatic stress disorder (PTSD) and substance use disorder (SUD) commonly cooccur following trauma, and their co-occurrence is associated with substantial costs; however, our understanding of the timing and sequencing of these posttrauma mental health conditions is limited. This study examined the trajectories of PTSD symptom severity and substance use among individuals recently exposed to a traumatic event, with a focus on the potential moderating roles of PTSD and SUD diagnoses at the final assessment. Additionally, in attempt to better understand the functional relationship between PTSD symptoms and substance use posttrauma, this study compared models reflecting the theories of self-medication, susceptibility, and mutual maintenance. Participants included 137 individuals who had experienced a traumatic event within 6 months prior to study enrollment. Participants completed four assessments over an approximate 1-year period that included clinician-administered measures for DSM-5 PTSD symptoms and SUD diagnosis and self-report measures of alcohol and drug use. Change over time in PTSD symptoms and substance use by diagnostic status were investigated using growth curve models. Temporal sequencing between PTSD symptom severity and substance use was investigated with bivariate latent difference score structural equation modeling. In line with the conceptualization of PTSD as a disorder of impeded recovery, having a diagnosis of PTSD at the final assessment moderated the trajectory of PTSD symptom severity such that symptom severity declined only among those without PTSD. In contrast, the influence of SUD appeared to be negligible. Both PTSD and SUD diagnoses were associated with initial drug use frequency. However, the relationship between alcohol use and diagnostic status did not reach statistical significance. Regarding temporal relationships between PTSD symptoms and substance use, significant and negative PTSD to change in substance use cross-lagged paths were found across most of the models, while only one significant substance use to change in PTSD severity crosslagged path emerged in the PTSD intrusion with alcohol use model. These results add to a growing body of research suggesting trauma-focused intervention is viable for individuals with PTSD/SUD. Further, examination of potential mediators and moderators of the relation between PTSD and SUD is recommended as a critical focus for future research.

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When and How to Regulate: Everyday Emotion-Regulation Strategy Use and Stressor Intensity

Affective Science ◽

10.1007/s42761-021-00087-1 ◽

2021 ◽

Author(s):

Elisabeth S. Blanke ◽

Jennifer A. Bellingtier ◽

Michaela Riediger ◽

Annette Brose

Keyword(s):

Emotion Regulation ◽

Negative Affect ◽

Daily Life ◽

Contextual Factors ◽

Experience Sampling ◽

Contextual Factor ◽

Strategy Use ◽

Emotional Stimuli ◽

Emotion Regulation Strategy

AbstractContextual factors shape emotion regulation (ER). The intensity of emotional stimuli may be such a contextual factor that influences the selection and moderates the effectiveness of ER strategies in reducing negative affect (NA). Prior research has shown that, on average, when emotional stimuli were more intense, distraction was selected over reappraisal (and vice versa). This pattern was previously shown to be adaptive as the preferred strategies were more efficient in the respective contexts. Here, we investigated whether stressor intensity predicted strategy use and effectiveness in similar ways in daily life. We examined five ER strategies (reappraisal, reflection, acceptance, distraction, and rumination) in relation to the intensity of everyday stressors, using two waves of experience-sampling data (N = 156). In accordance with our hypotheses, reappraisal, reflection, and acceptance were used less, and rumination was used more, when stressors were more intense. Moreover, results suggested that distraction was more effective, and rumination more detrimental the higher the stressor intensity. Against our hypotheses, distraction did not covary with stressor intensity, and there was no evidence that reappraisal, reflection, and acceptance were more effective at lower levels of stressor intensity. Instead, when examined individually, reflection and reappraisal (like distraction) were more effective at higher levels of stressor intensity. In sum, stressor intensity predicted ER selection and moderated strategy effectiveness, but the results also point to a more complex ER strategy use in daily life than in the laboratory.

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454. Neural Indices of Cognitive Emotion Regulation and Course of PTSD Symptom Severity in OEF/OIF/OND Veterans

Biological Psychiatry ◽

10.1016/j.biopsych.2017.02.938 ◽

2017 ◽

Vol 81 (10) ◽

pp. S185

Author(s):

Jacklynn Fitzgerald ◽

Julia DiGangi ◽

Autumn Kujawa ◽

Darrin Aase ◽

Justin Greenstein ◽

...

Keyword(s):

Emotion Regulation ◽

Symptom Severity ◽

Ptsd Symptom ◽

Cognitive Emotion Regulation ◽

Ptsd Symptom Severity

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Emotion Regulation Difficulties in Trauma Survivors: The Role of Trauma Type and PTSD Symptom Severity

Behavior Therapy ◽

10.1016/j.beth.2010.04.004 ◽

2010 ◽

Vol 41 (4) ◽

pp. 587-598 ◽

Cited By ~ 280

Author(s):

Thomas Ehring ◽

Dorothea Quack

Keyword(s):

Emotion Regulation ◽

Symptom Severity ◽

Ptsd Symptom ◽

Trauma Survivors ◽

Ptsd Symptom Severity ◽

Trauma Type

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Thwarted Belongingness and PTSD Symptom Severity among Firefighters: The Role of Emotion Regulation Difficulties

Behavior Modification ◽

10.1177/01454455211002105 ◽

2021 ◽

pp. 014544552110021

Author(s):

Samuel J. Leonard ◽

Anka A. Vujanovic

Keyword(s):

Emotion Regulation ◽

Indirect Effect ◽

Symptom Severity ◽

Ptsd Symptom ◽

Thwarted Belongingness ◽

Online Questionnaire ◽

Ptsd Symptom Severity ◽

Bidirectional Associations ◽

Empirical Implications

The present investigation examined the associations among thwarted belongingness (TB), emotion regulation difficulties (ERD), and posttraumatic stress disorder (PTSD) symptom severity among firefighters. First, the associations of TB and ERD with PTSD symptom severity were evaluated. Second, the indirect effect of TB on PTSD symptom severity through ERD was examined. The sample included 246 trauma-exposed firefighters ( M age = 40.21, SD = 9.93, 93.1% male) who completed an online questionnaire battery. Results demonstrate significant, positive associations among TB, ERD, and PTSD symptom severity; and an indirect effect of TB on PTSD symptom severity through heightened ERD (β = 0.17; CI [0.08, 0.29]). Alternate indirect effect models were also significant, underscoring the potentially bidirectional associations of these variables. These findings suggest that there is merit in investigating the role of interpersonal factors and ERD among firefighter populations to better understand PTSD symptomatology. Clinical and empirical implications are discussed.

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