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College students demonstrate high rates of depression and anxiety, particularly among students with self-reported history of trauma exposure. Neuroticism, a personality trait characterized by emotional instability and negative affect, is consistently associated with internalizing symptoms; however, our understanding of malleable risk characteristics that help to clarify these associations between neuroticism and internalizing symptoms is limited. The current study investigated whether anxiety sensitivity (AS) and/or distress tolerance (DT) would predict changes in internalizing symptoms (depression and anxiety), beyond the effects of neuroticism, in a high-risk sample of college students. Participants were 316 college students (75.9% women) with self-reported history of interpersonal trauma exposure who participated in a university-wide longitudinal study of emotional health. Participants completed assessments of personality, AS, DT, depression, and anxiety over three time points spanning an average of 26 months. Results of structural equation modeling demonstrated that higher AS predicted increases in depression and anxiety, and lower DT predicted increases in depression and anxiety (controlling for neuroticism). Neuroticism did not predict changes in depression or anxiety. These findings contribute to our understanding of the role of AS and DT in the development of depression and anxiety in trauma-exposed college students.

Exposure to trauma (particularly interpersonal trauma), post-traumatic stress disorder (PTSD) symptoms, and low distress tolerance (DT; the ability to tolerate negative internal states), are all related to risk for alcohol use disorders (AUD). The aim of this study was to examine the main and interactive effects of PTSD symptom severity and DT in relation to current (past 30-day) alcohol consumption and binge drinking among emerging adult men and women with a history of sexual/physical assault. Participants were 572 undergraduate students (66% women) with a history of physical/sexual assault endorsing past month alcohol use. Participants completed the Distress Tolerance Scale (DTS), the PTSD Checklist for DSM-V (PCL-5), and an abbreviated Timeline Followback Questionnaire (TLFB), which assessed past 30-day total alcohol consumption (i.e., total number of drinks) and binge drinking frequency (i.e., 5+ drinks [4+ for women]). Negative binomial regression analyses revealed that male sex, higher trauma load (i.e., total number of trauma categories endorsed), and higher PTSD symptom severity were associated with both higher number of total drinks and higher frequency of binge drinking episodes. However, DT was not associated with either alcohol outcome when PTSD symptom severity was entered in the models. The interaction of PTSD symptom severity and DT was not significantly associated with total alcohol consumption or binge drinking. These results highlight the importance of investigating the unique contributions of PTSD symptoms and DT (as well as other transdiagnostic cognitive-affective constructs) in the onset and maintenance of AUD.

Posttraumatic stress disorder (PTSD) symptoms are associated with significant emotion dysregulation, which in turn marks risk for greater symptom-related difficulties and psychiatric comorbidity. Individuals with PTSD symptoms who are high in anxiety sensitivity (AS; fear of anxiety and related sensations) may have particular difficulty managing negative affect, as they tend to perceive their trauma-related symptoms to be more threatening. The present study investigated the main and interactive effects of PTSD symptoms (PTSD Checklist for DSM-5) and AS (Anxiety Sensitivity Index-3) on emotion dysregulation (Difficulties in Emotion Regulation Scale-16) in a sample of 836 trauma-exposed firefighters (94.6% men; Mage = 38.5 years, SD = 8.5). Results of hierarchical linear regression models indicated that the main effects of PTSD symptom severity (β = .353, p

PURPOSE: Posttraumatic stress disorder (PTSD) often co-occurs with panic disorder (PD), with some etiological models positing a causal role of panic reactivity in PTSD onset; however, data addressing the temporal ordering of these conditions are lacking. The aim of this study was to examine the bi-directional associations between PD and PTSD in a nationally representative, epidemiologic sample of trauma-exposed adults. METHODS: Participants were community-dwelling adults (62.6% women; M(age)=48.9, SD=16.3) with lifetime DSM-IV PTSD Criterion A trauma exposure drawn from the 2001/2 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) and re-interviewed in 2004/5 (N=12,467). Cox discrete-time proportional hazards models with time-varying covariates were used to investigate the bi-directional associations between lifetime PD and PTSD, accounting for demographic characteristics, trauma load, and lifetime history of major depression, generalized anxiety disorder, and social anxiety disorder. RESULTS: PD was significantly associated with subsequent onset of PTSD (HR=1.210, 95%CI=1.207-1.214, p

Although several investigations—on primarily adult samples—demonstrate a potential role of emotion dysregulation in the etiology and maintenance of posttraumatic stress disorder (PTSD), investigations into the mechanisms that may underlie these associations in general and among adolescents in particular are lacking. The present study examined associations among emotional clarity (i.e., the extent to which individuals are confused about the specific emotions they are experiencing), (Gratz, Journal of Psychopathology Behavioral Assessment 26(1):41–54, 2004) anxiety sensitivity, and DSM-IV PTSD symptom cluster severity (i.e., re-experiencing, avoidance, and hyperarousal symptoms) in a diverse sample of trauma-exposed inpatient adolescents. It was hypothesized that anxiety sensitivity would underlie association between emotional clarity and PTSD symptoms. Participants (N = 50; 52.0% female; M age = 15.1 years, SD = 0.51; 44% White) completed measures of emotion dysregulation, anxiety sensitivity, and PTSD. Lower emotional clarity was significantly associated with greater total PTSD symptoms, as well as re-experiencing, avoidance, and arousal symptoms. Additionally, there were indirect effects for lack of emotional clarity via anxiety sensitivity in relation to total PTSD symptoms [B = 0.17, SE = 0.08, BC 95% CI (0.04, 0.35)], re-experiencing symptoms [B = 0.15, SE = 0.08, BC 95% CI (0.03, 0.36)], avoidance symptoms [B = 0.12, SE = 0.07, BC 95% CI (0.02, 0.29)], and hyperarousal symptoms [B = 0.17, SE = 0.08, BC 95% CI (0.04, 0.36)]. Reversed models were violated, supporting the direction of hypothesized effects. Difficulties recognizing and accurately understanding emotions may increase risk for PTSD symptoms among trauma-exposed youth. Furthermore, anxiety sensitivity may be a promising intervention target among youth at risk for PTSD, especially among those demonstrating poorer emotional clarity.

Quantitative measures of psychological resilience related to discrete stressors, such as interpersonal (IP) trauma, are lacking. The current study examined whether a novel, quantitative measure of resilience was related to decreased risk for a broad range of lifetime DSM-IV axis I disorders in an epidemiologic sample. Resilience was defined as the residual resulting from the difference between the individual’s predicted and observed PTSD symptom count, based on their cumulative exposure to IP traumatic events. Participants were 6288 adults (59.5% women; M age = 46.9, SD = 14.5) from the National Epidemiologic Study on Alcohol and Related Conditions endorsing at least one lifetime IP traumatic event. Logistic regressions were conducted to examine the relationship between resilience and axis I diagnoses, covarying for age, sex, education level, social support, and recent stressful life events. Greater resilience scores were associated with decreased likelihood of major depression (OR = .64, p

Personality factors, such as neuroticism, are important for understanding motives for cannabis use; however, few studies have examined the role of neuroticism in the context of other personality factors, or possible mechanisms accounting for an association between neuroticism and motives for use. The present study examined concurrent associations between personality traits (i.e., conscientiousness, extraversion, agreeableness, and neuroticism) and cannabis use motives, and the role of anxiety sensitivity (AS) in the association between neuroticism and coping cannabis use motives. Seventy young adults endorsing past-month cannabis use (58.6 % female, M age = 20.91) completed self-report measures. Linear regressions were conducted to examine the concurrent associations between personality factors and cannabis use motives. Higher levels of neuroticism, but no other personality traits, were significantly associated with greater coping (β = 45, p

Exposure to natural disasters has been associated with increased risk for various forms of psychopathology. Evidence indicates that socioeconomic status (SES) may be important for understanding post-disaster psychiatric distress; however, studies of SES-relevant factors in non-Western, disaster-exposed samples are lacking. The primary aim of the current study was to examine the role of pre-typhoon SES-relevant factors in relation to post-typhoon psychiatric symptoms among Vietnamese individuals exposed to Typhoon Xangsane.In 2006, Typhoon Xangsane disrupted a mental health needs assessment in Vietnam in which the Self Reporting Questionnaire-20 (SRQ-20), and the Demographic and Health Surveys Wealth Index, a measure of SES created for use in low-income countries, were administered pre-typhoon. The SRQ-20 was re-administered post-typhoon.Results of a linear mixed model indicated that the covariates of older age, female sex, and higher levels of pre-typhoon psychiatric symptoms were associated with higher levels of post-typhoon psychiatric symptoms. Analysis of SES indicators revealed that owning fewer consumer goods, having lower quality of household services, and having attained less education were associated with higher levels of post-typhoon symptoms, above and beyond the covariates, whereas quality of the household build, employment status, and insurance status were not related to post-typhoon psychiatric symptoms.Even after controlling for demographic characteristics and pre-typhoon psychiatric symptoms, certain SES factors uniquely predicted post-typhoon psychiatric distress. These SES characteristics may be useful for identifying individuals in developing countries who are in need of early intervention following disaster exposure.

There is a significant need for advanced understanding of treatment of co-occurring posttraumatic stress disorder (PTSD) and substance use disorders (SUD). Approximately half of individuals seeking SUD treatment meet criteria for current PTSD, and individuals with co-occurring PTSD-SUD tend to have poorer treatment outcomes compared with those without such comorbidity. However, there is not sufficient empirical evidence to determine a best course of treatment for these individuals. This paper provides a review of the literature relevant to the treatment of co-occurring PTSD-SUD. To date, treatment studies have focused primarily on non-exposure-based psychosocial treatments, exposure-based psychosocial treatments, and medication trials. The most promising outcome data thus far are for psychosocial treatments that incorporate an exposure therapy component; however, further research is needed, particularly as related to how best to implement these approaches in real-world treatment settings.

The present investigation examined the main and interactive effects of a nonclinical panic attack history and two different measures of distress tolerance (DT)—perceived (self-report) and behavioral (breath-holding duration)—in relation to the global and lower-order factors of anxiety sensitivity (AS). Results indicated that lower levels of perceived DT were significantly related to greater levels of global as well as all lower-order AS factors (physical, cognitive, and social concerns); however, lower levels of behavioral DT were not significantly related to the global or lower-order AS factors at the main effect level. The interaction between a nonclinical panic attack history and perceived DT was only significantly related to the AS-cognitive factor. Moreover, the interaction between a nonclinical panic attack history and behavioral DT was only significantly related to the AS-physical factor. The present findings suggest that DT may be an important factor to target among panic-vulnerable populations.