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Notably, the Prevailed group scored above the Detached group on most measures, except for health-related quality of life and optimism, suggesting that high growth may be more beneficial than low symptoms when coping with trauma.<br /><br /> Findings suggest that coping after trauma is more complex than merely doing well or doing poorly in response to trauma. Promoting posttraumatic growth may help even highly symptomatic people achieve well-being after trauma. (PsycInfo Database Record (c) 2021 APA, all rights reserved).<br /><br />Findings suggest that coping after trauma is more complex than merely doing well or doing poorly in response to trauma. Promoting posttraumatic growth may help even highly symptomatic people achieve well-being after trauma. (PsycInfo Database Record (c) 2021 APA, all rights reserved).<br /><br /> Written Exposure Therapy (WET) for posttraumatic stress disorder (PTSD) has been shown to be efficacious in clinical trials; however, research is needed to determine WET's effectiveness in clinical practice settings. [https://www.selleckchem.com/products/crenolanib-cp-868596.html Crenolanib order] Additionally, research is needed to understand whether patient characteristics or treatment delivery format moderate outcomes.<br /><br /> Patient outcomes (<br /><br /> = 277) were assessed as part of a multisite training and implementation program in the Department of Veterans Affairs (VA). During treatment, patients completed self-report measures of PTSD, depression, and functional impairment. Patient characteristics (i.e., demographics, psychiatric comorbidity, trauma type) and treatment delivery format (i.e., telehealth vs. in-person) were assessed as treatment moderators.<br /><br /> Intent-to-treat analyses indicated that WET was effective in reducing PTSD symptoms (<br /><br /> = .84), depression symptoms (<br /><br /> = .47), and functional impairment (<br /><br /> = .36) during treatment. Approximately one quarter of patients dropped out of treatment prematurely. No moderators of PTSD treatment outcome were observed; however, telehealth delivery was associated with lower dropout.<br /><br /> WET was an effective approach across a range of patient characteristics in this sample of veterans with PTSD. WET was also effective whether delivered in-person or via telehealth. WET is a promising treatment option for veteran patients in VA clinical care settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).<br /><br />WET was an effective approach across a range of patient characteristics in this sample of veterans with PTSD. WET was also effective whether delivered in-person or via telehealth. WET is a promising treatment option for veteran patients in VA clinical care settings. (PsycInfo Database Record (c) 2021 APA, all rights reserved).<br /><br /> Women experience higher risk for PTSD following trauma compared with men. Fluctuations in ovarian hormones might contribute to this greater vulnerability, given that estradiol is associated with affect and stress reactivity. Our objective was to test the relations between menstrual cycle-related changes in estradiol, affect, stress reactivity, and trauma-related symptoms.<br /><br /> We assessed trauma-related symptoms in ethnically diverse naturally cycling women with a history of trauma during a clinical interview. Participants also completed a 10-day ecological momentary assessment (EMA) that included lower- and higher-estradiol phases. We tested associations between estradiol and PTSD symptoms and stress reactivity to a trauma reminder using Spearman correlation and Wilcoxon rank-sum tests. We tested the effect of menstrual cycle day on daily affect using multilevel modeling.<br /><br /> Estradiol was negatively associated with symptom severity (<br /><br /> = -.36), and participants in low- versus high-estradiol cycle phases at intiated with higher trauma-related symptoms. In addition, trauma-exposed women showed a discordant pattern of stress reactivity to a trauma reminder, higher daily symptoms, and greater affective lability in a low-estradiol phase. Given that our sample consisted of high-functioning trauma-exposed women, these results should be replicated in women with PTSD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).Among veterans in Veterans Health Administration (VHA) care, patients with mental health and substance use conditions experience elevated suicide rates. However, despite previously demonstrated high rates of suicidal behavior, little is known regarding suicide rates among veteran VHA users with personality disorders (PDs) as a whole, or by PD clusters (A Eccentric; B Dramatic; C Fearful; and PD-not otherwise specified). PD prevalence and suicide rates were assessed through 2017; overall and by clusters for 5,517,024 veterans alive as of 12/31/2013 and with more than 2 VHA encounters in 2012-2013. In all, 46,050 (.83%) had a PD diagnosis in 2012-2013. Suicide risk was examined using proportional hazards regressions adjusted for age, sex, veteran status, clustering within a geographic region, and other mental health diagnoses. Patients with PDs had greater suicide risk than those without (156.5 vs. 46.7 per 100,000 person-years). Individuals in Cluster B, which includes borderline and antisocial PDs, were at the highest risk (178.5 per 100,000 person-years), followed by PD-not otherwise specified and Cluster C (152.6 and 121.4 per 100,000 person-years, respectively). Rates of PDs in the VHA system were lower than those usually found in community samples. Veterans with a PD diagnosis had an increased risk of suicide, which was especially elevated for those with Cluster B diagnoses. Study findings document the importance of enhancing diagnosis and treatment for veterans with PDs and targeted suicide prevention services. (PsycInfo Database Record (c) 2021 APA, all rights reserved).Borderline personality disorder (BPD) manifests in adolescents, serving as a forerunner for later dysfunctionality and life constraints. BPD is characterized by multiple difficulties in understanding the self and others, and it has been implied that intrapsychic processes of reasoning might be the primary driver of these disturbances. In this study, we examined the role of narrative identity, the dynamic and evolving story people construct about their personal pasts, presents, and futures, as a potentially important but largely overlooked aspect of temporal reasoning within the intrapsychic system of adolescents with BPD features. A total of 174 American inpatient adolescents (Mage = 15.12 years, SD = 1.52) completed self-report measures of BPD upon hospital admission. Adolescents' narrative identity (i.e., themes/future wishes of agency and communion), mentalizing, and emotion dysregulation were assessed. Results showed that narrative identity (i.e., thwarted themes of agency and communion) was associated with lower mentalizing and higher emotional dysregulation capacities, supporting narrative identity's relation to other relevant aspects of intrapsychic processes of reasoning in BPD. Regression analyses showed that both higher levels of emotion dysregulation and more thwarted narrative themes of agency (but not mentalizing) were significantly associated with BPD features. Intriguingly, narrative identity (i.e., thwarted themes of agency) showed incremental validity in accounting for features of BPD, over and above emotion dysregulation. It is concluded that disturbances related to narrative identity might be a prominent component of the intrapsychic reasoning system in BPD and should be included in future work on the topic. (PsycInfo Database Record (c) 2021 APA, all rights reserved).The purpose of this article is to reveal whether traits can predict the core processes constituting borderline personality disorder (BPD). A large sample, including many with BPD, completed personality questionnaires and reported trigger and symptom experiences 5 times per day for 2 weeks. Multilevel modeling revealed first that symptoms were strongly contingent upon concurrent triggers and that BPD's association to symptoms was largely due to this contingency. Second, personality traits predicted all components of this process trigger experiences, symptom intensity, and the contingency of the symptoms on triggers. However, normal personality traits only partially accounted for the heightened experience of triggers, elevated symptoms, and magnified reactivity to triggers among those with BPD. Thus, normal personality traits are capable of explaining the dynamic processes characteristic of clinical disorders, meaning that normal traits can elucidate even complex dynamic clinical processes. However, traits appear to only partially contain the active ingredients responsible for the core process in BPD. Aspects of the disorder other than traits may account for the heightened trigger experience, elevated symptom intensity, and magnified reactivity to triggers in those with BPD. (PsycInfo Database Record (c) 2021 APA, all rights reserved).This article discusses the Diabetes Prevention Program (DPP). DPP was an extremely successful clinical trial that demonstrated the efficacy of lifestyle intervention in the prevention of type 2 diabetes in those at increased risk. Many have asked how this study came to be. The author presents a historical perspective on the DPP trial, stressing both the many years of research that preceded and permitted this successful study and its impact on both clinical approaches and subsequent research directions. The author discusses the tension that seems to exist between two important types of research-conducting systematic research aimed at optimizing an intervention to ensure that it will successfully change the targeted behavior versus moving more rapidly to clinical trials testing the health benefits derived from changing the targeted behavior. Today studies that propose to conduct programmatic research related to intervention optimization are criticized for not also testing if these interventions produce clinically important health outcomes. It is not cost-effective to seek answers to questions about health outcomes before developing and demonstrating the efficacy of the intervention on changing the behavioral targets. There are many examples of large clinical trials examining the effect of changing a behavior on an important health outcome that have failed to achieve significant differences in health outcomes because the intervention was not successful in changing the behavior relative to the control condition. (PsycInfo Database Record (c) 2021 APA, all rights reserved).In dual-task experiments, overlapping response characteristics of two subsequently performed tasks may not only affect performance in Task 2 but also in Task 1. This phenomenon is often explained through activated Task 2 response information influencing Task 1 response selection, which then possibly propagates again into Task 2. So far, however, only little is known about (a) the time course of this Task 2 response activation and (b) possible transmission/propagation mechanisms. The present study addressed both issues by testing 10 plausible drift-diffusion models with 5 data sets from dual-task experiments. To this end, we first examined if the temporal course of the response activation is linearly increasing or pulse like. The pulse-like model turned out to be superior, but the corresponding dynamics of the response activation often described a monotonically increasing function that reached its peak late during Task 1 processing. By extending the pulse-like model with an additional diffusion process, we then examined whether and how the Task 2 response information could affect subsequent Task 2 response selection.