INTERNATIONAL JOURNAL OF STRESS MANAGEMENT

Differential effects of COVID-19 stressor types on mental health and moderating roles of coping strategies
Emrich M, Park CL, Russell BS and Fendrich M
Stress exposure often leads to poor mental health, but whether of stressors predict levels of mental health symptoms and whether coping differentially moderates these associations remain untested. This study examined whether COVID-19 stressor types (financial-, activity-, and infection-related) differentially predicted subsequent mental health (general distress, posttraumatic stress symptoms (PTSS), and positive states of mind) and whether different types of coping moderated these relationships. In April, 2020, questionnaires assessing the impact of COVID-19 on daily life were administered to an adult sample across the US ( = 1,546); 861 (55.7%) of whom completed questionnaires one month later. Nearly all stressor types independently predicted each aspect of mental health. Behavioral disengagement moderated links between both activity- and infection-related stressors and mental health. Seeking emotional social support moderated links between infection-related stressors and both general distress and positive states of mind as well as activity-related stressors and general distress. Positive reappraisal moderated links between financial-related stressors and positive states of mind. Acceptance coping predicted better mental health but was not a significant moderator. Stressor types and coping strategies are important determinants of effects of COVID-19 on mental health; our findings suggest possible screening and intervention implications and directions for future research.
Morally Injurious Events and Depression: Examining the Role of Rumination Among Combat-Deployed Military Veterans in the Community
Thomas ED, Weiss NH, Forkus SR and Contractor AA
While depression remains a common psychological disorder among combat military veterans, there is a need to investigate factors that relate to the development and maintenance of this disorder. Potentially morally injurious events (PMIEs), perceived transgressions against one's moral code, is associated with depression. This relationship may be influenced by level of engagement in brooding rumination. Therefore, the current study sought to examine the moderating role of rumination in the association between PMIEs and depression. Two hundred three participants were included in the study (77.7% male, 72.2% White), with a mean age of 35.08 years ( = 8.09). Findings indicated that the association between PMIEs and depression was stronger at higher levels of rumination, suggesting that military veterans who are exposed to PMIEs and engage in more repetitive thoughts centered around negative emotions are at a higher risk for experiencing more severe depression symptoms.
Clusters of Trauma Types as Measured by the Life Events Checklist for DSM-5
Contractor AA, Weiss NH, Natesan P and Elhai JD
Experiences of potentially traumatic events (PTE), commonly assessed with the Life Events Checklist for (LEC-5), can be both varied in pattern and type. An understanding of LEC-assessed PTE type clusters and their relation to psychopathology can enhance research feasibility (e.g., address low base rates for certain PTE types), research communication/comparisons via the use of common terminology, and nuanced trauma assessments/treatments. To this point, the current study examined (1) clusters of PTE types assessed by the LEC-5; and (2) differential relations of these PTE type clusters to mental health correlates (i.e., posttraumatic stress disorder [PTSD] severity, depression severity, emotion dysregulation, reckless and self-destructive behaviors [RSDBs]). A trauma-exposed community sample of 408 participants was recruited via Amazon's Mechanical Turk ( = 35.90 years; 56.50% female). Network analyses indicated three PTE type clusters: Accidental/Injury Traumas (LEC-5 items 1, 2, 3, 4, 12), Victimization Traumas (LEC-5 items 6, 8, 9), and Predominant Death Threat Traumas (LEC-5 items 5, 7, 10, 11, 13-16). Multiple regression analyses indicated that the Victimization Trauma Cluster significantly predicted PTSD severity (β = .23, <.001), depression severity (β = .20, =.001), and negative emotion dysregulation (β = .22, <.001); and the Predominant Death Threat Trauma Cluster significantly predicted engagement in RSDBs (β = 31, <.001) and positive emotion dysregulation (β = .26, <.001), accounting for the influence of other PTE Clusters. Results support three PTE type classifications assessed by the LEC-5, with important clinical and research implications.
Examination of the Structural Relations Between Posttraumatic Stress Disorder Symptoms and Reckless/Self-Destructive Behaviors
Contractor AA, Weiss NH, Dolan M and Mota N
Assessment of PTSD's E2 Criterion: Development, Pilot Testing, and Validation of the Posttrauma Risky Behaviors Questionnaire
Contractor AA, Weiss NH, Kearns NT, Caldas SV and Dixon-Gordon K
Trauma Sensitive Yoga as a complementary treatment for posttraumatic stress disorder: A Qualitative Descriptive analysis
West J, Liang B and Spinazzola J
Research on Posttraumatic Stress Disorder and chronic childhood abuse has revealed that traditional trauma treatments often fail to fully address the complicated symptom presentation, including the somatic complaints, loss of awareness of one's emotional and physical being in the present moment, and overall lack of integration between the self and the body. The mindfulness-based intervention of hatha yoga shows promise as a complementary treatment, and focuses on personal growth in addition to symptom reduction. This qualitative study explored the experiences of thirty-one adult women with PTSD related to chronic childhood trauma who participated in a 10-week Trauma Sensitive Yoga class, specifically examining perceived changes in symptoms and personal growth. Five themes were identified that reflect participants' feelings of Gratitude and compassion, Relatedness, Acceptance, Centeredness, and Empowerment. Results and implications for research and clinical work are presented.
Stress and Binge Drinking: A Daily Process Examination of Stressor Pile-up and Socioeconomic Status in Affect Regulation
Grzywacz JG and Almeida DM
The goal of this study was to enhance understanding of the interconnections between stress, negative mood, and alcohol use. To achieve this goal, daily diary data collected over eight consecutive nights from a nationally representative adult cohort were used to identify if: 1) both daily stress and stress pile-up were associated with increased risk of binge drinking, 2) negative affect mediated associations between stressor variables and binge drinking, and 3) associations among stress, negative affect and binge drinking were moderated by educational attainment as an indicator of socioeconomic status. Results from hierarchical linear models indicated that the odds of binge drinking was higher on days that individuals experienced more severe stressors in contrast to no stress days. Further, the odds of binge drinking also increased as stressors piled-up over consecutive days. There was no evidence indicating that negative affect mediated the effect of stressor exposure on binge drinking. Associations between stressor exposure (both daily stress and stress pile-up) and binge drinking were moderated by educational attainment. The findings of this study are consistent with previous daily process studies examining the association between stress and alcohol. However, the pattern of results from this study suggest that affect regulation researchers need to handle "stress" in a multidimensional way and better situate stressors and individuals stress responses within their social context.
Long-Term Patterns and Predictors of Successful Stressor Resolution in Later Life
Brennan PL, Schutte KK and Moos RH
At 1 year, 4 years, and 10 years after baseline, late-middle-aged adults reported whether they had successfully resolved their most important stressor of the past year. Compared to individuals who never resolved focal stressors over the 10-year interval, those who always did consistently showed less negative stressor appraisal, less reliance on avoidance coping, and less use of exploratory relative to directed coping responses, independent of type and severity of focal stressor. Less use of exploratory relative to directed coping and having more social resources, fewer health problems, and fewer depressive symptoms at baseline predicted more stressor resolution over the next 10 years. These predictors are promising foci for prospective efforts to optimize ways in which aging adults manage late-life stressors.
The Impact of Social Support on the Relationship between Trauma History and PTSD Symptoms in Motor Vehicle Accident Victims
Gabert-Quillen CA, Irish LA, Sledjeski E, Fallon W, Spoonster E and Delahanty DL
The present study examined how different types of social support differentially moderated the relationship between trauma history characteristics and the development of posttraumatic stress disorder symptoms (PTSS) following a motor vehicle accident (MVA). Two hundred thirty-five MVA victims self-reported levels of social support and trauma history, and were evaluated for PTSS 6- and 12-months post-MVA. Results indicated that after controlling for gender, injury severity and income, number of prior trauma types and subjective responses to prior traumatization predicted subsequent PTSS (ps < .05). Appraisal social support was a significant moderator of the total number of types of trauma (appraisal: 6-months β = -.16, p < .05; 12-months β = -.17, p < .05) and subjective physical injury during the prior trauma (appraisal: 6-months β = -.14, p < .05; 12-months β = -.19, p < .05) in predicting PTSS. Results underscore the importance of examining both trauma history and social support as multi-dimensional constructs and suggest merit to addressing social support in trauma victims with a prior trauma history.