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Schizotypy is marked by negative symptoms including blunted affect, social isolation, and social anhedonia. Contemporary personality theory suggests that maladaptive shame regulation may disrupt interpersonal function across personality disorders. We hypothesized that "affect shame"-a conditioned response of shame evoked by openly expressing emotions would co-occur with interpersonal deficits in schizotypy. As hypothesized, affect shame was associated with interpersonal deficits (r = 0.17, p0.001), physical anhedonia (r = 0.13, p = 0.001), and social anhedonia (r = 0.17, p = 0.001). The observed findings were upheld in analyses controlling for demographic characteristics, depression symptom severity, and neuroticism and were maintained consistently across sensitivity analyses. Findings suggest that shame related to emotional expression is related to interpersonal deficits in schizotypy and have implications for our understanding of the etiology and treatment of this disorder.

The physiological impact on citizens of prolonged exposure to violence and conflict is a crucial, yet underexplored, issue within the political science and biology literature. We examined the effect of high levels of exposure to rocket and terrorist attacks on biological markers of immunity and inflammation in a sample of 92 Israelis. A stratified random sample of individuals was drawn from a pool of subjects in Israel who had previously been interviewed regarding their stress exposure and psychological distress during a period of active rocket and terrorist attacks. These individuals were reinterviewed and blood samples were collected to assess antibodies to cytomegalovirus (CMV antibodies) and C-reactive protein (CRP). Posttraumatic stress disorder (PTSD) was significantly related to CRP, β =.33, p =.034, with body mass index, depression, and exposure to terrorism included in the model. Depression scores were not significantly associated with CRP or CMV antibody levels. In contrast to the established convention that psychological distress is the sole outcome of terrorism exposure, these findings reveal that individuals exposed to terrorism experience higher levels of both PTSD/depression, and inflammation. This study has important ramifications for how policy makers and medical health professionals should formulate public health policies and medically treat individuals living in conflict zones. Language: en

We conducted a four-wave prospective study of Palestinian adults living in the West Bank, Gaza Strip, and East Jerusalem, interviewed between 2007 and 2009 at 6-month interval to explore transactional relationships between resource loss (i.e., intra and interpersonal resource loss) and psychological distress (i.e., posttraumatic stress disorder and depression symptoms). Initially, 1196 Palestinians completed the first wave interview and 752 of these participants completed all four interviews. A cross-lagged panel design was constructed to model the effects of trauma exposure on both resource loss and psychological distress and the subsequent reciprocal effects of resource loss and psychological distress across four time waves. Specifically, resource loss was modeled to predict distress, which in turn was expected to predict further resource loss. Structural equation modeling was used to test this design. We found that psychological distress significantly predicts resource loss across shorter, 6-month time waves, but that resource loss predicts distress across longer, 12-month intervals. These findings support the Conservation of Resources theory's corollary of loss spirals.

Cognitive behavioral therapies have positive effects on anger and aggression; however, individuals differ in their response to treatment. The authors previously found that dynamic factors, such as increases in readiness to change, are associated with enhanced outcomes for violence reduction training. This study investigated how less dynamic factors, specifically Cluster B personality traits, moderate the effects of violence reduction training. The authors used mixed modeling to fit growth curves to 14 weeks of anger strategies data and evaluated whether the presence of Cluster B traits affected pretreatment anger levels and rates of change. As expected, overall levels of negative anger strategies decreased across the 14-week treatment. Participants with antisocial, borderline, and histrionic personality features reported higher rates of negative anger strategies, whereas those with narcissistic personality features reported fewer negative anger strategies. Those with antisocial personality features improved at a rate similar to the overall trend of those without Cluster B traits. Those with borderline and histrionic features improved at an accelerated rate.

Disruptions in sleep have long been part of our diagnostic criteria for a variety of psychological disorders. However, only recently have researchers begun to examine the complex interactions between sleep and specific pathology. Sleep is an energetic resource (Zohar, Tzischinsky, Epstein, & Lavie, 2005) that is thought to have enabled our evolutionary ancestors to preserve energy, avoid nighttime predation, maximize learning from ontogenic contingencies, and ultimately survive and reproduce (Rechtstaffen, 1998). Deprivation of this energetic resource results in an array of detrimental biopsychosocial consequences (Orzel-Gryglewska, 2010). At the biochemical level, sleep disruption alters the normal sleep-induced surge of ATP needed for biosynthesis in the brain (Dworak, McCarley, Kim, Kalinchuck & Basheer, 2010) and triggers patterns of altered immune activation (Orzel-Gryglewska, 2010). At the psychological level, persons deprived of sleep report increased pain and discomfort (Lentz, Landis, Rothermel & Shaver, 1999), evidence mood dysregulation (Walker & van Der Helm, 2009) and exhibit neurocognitive impairments in attention and memory (Durmer & Dinges, 2005). Therefore, disruptions in sleep lead to considerable biological and psychological dysfunction. Sleep disruption is a significant challenge to individuals suffering from posttraumatic stress disorder (PTSD), a disorder marked by exposure to trauma and subsequent re-experiencing of the traumatic event, heightened arousal, and avoidance of trauma-related stimuli (American Psychiatric Association, 2000; Lamarche and De Koninck, 2007). This is reflected in the diagnostic criteria such that nightmares are included as a symptom of reexperiencing and insomnia is reflected in the hyperarousal cluster. Additionally, a high prevalence of sleep problems are reported among persons exposed to an array of traumatic experiences including sexual abuse (Steine et al., 2011), motor vehicle accidents (Kobayashi et al., 2008), political violence (Palmieri, Chipman, Canetti, Johnson & Hobfoll, 2010), and war (Peterson, Goodie, Satterfield & Brim, 2008). Given the high prevalence of these sleep problems among traumatized populations, some have argued that sleep disturbance is a core feature of PTSD (Spoormaker & Montgomery, 2008; Ross, Ball, Sullivan & Caroff, 1989). Sleep problems tend to evoke and exacerbate general discomfort and dysphoria (Lentz, Landis, Rothermel & Shaver, 1999; Walker & Van de Helm, 2009), suggesting that negative emotionality in PTSD and other psychological disorders is amplified in the absence of sleep. Individuals with PTSD also report greater fear and anxiety about sleeping due to trauma related nightmares, exhibit conditioned avoidance of sleep and sleep related stimuli, and report higher levels of substance use which interfere with sleep (Lamarche and De Koninck, 2007). In addition to behavioral manifestations of sleep problems, individuals with PTSD demonstrate differences in their sleep architecture (Kobayahsi, Boarts, Delahanty, 2007) which may interfere with normal processes of fear extinction such that habituation to feared stimuli is not retained in memory (Mellman, Pigeon, Nowell & Nolan, 2007; Spoormaker et al., 2010). What is less clear is the critical question of causality, whether sleep disruption is exacerbating PTSD symptoms or vice versa. Despite clinical and epidemiological evidence linking sleep problems to PTSD, only a few longitudinal studies have evaluated the relationship between sleep problems and PTSD over time (Babson & Feldner, 2010; Kobayashi et al., 2008; Mellman, Bustamente, Fins, Pigeon & Nolan, 2002; Steine et al., 2011; Wright et al., 2011). In a small study of patients admitted to the hospital for traumatic injuries related to motor vehicle accidents, industrial accidents, and gunshots, fragmented REM sleep predicted PTSD six weeks later (Mellman et al., 2002). Conversely, a study of motor vehicle accident survivors found that PTSD and nightmares were shown to predict later sleep problems (Kobayashi et al., 2008). In a two-wave study of U.S. veterans, initial insomnia was significantly associated with increased PTSD and depression eight months later, but PTSD and depression were not associated with later insomnia (Wright et al. 2011). Thus, the literature remains mixed whether sleep problems lead to later psychological problems or whether psychological problems lead to later sleep difficulties. We attempt to help answer this question in the current study. In the current study, the longitudinal relationships between sleep and PTSD, depression, and intrapersonal resource loss were investigated in a large national random sample of adults living in the Palestinian Authority during 2008. Since the start of the Al Aqsa Intifada, or Second Intifada, in September 2000, to the time of the current study, thousands of Palestinians have been killed in acts of political violence (B'Tselem, 2012). The Israeli-Palestinian conflict occurring during 2008 was greatest during Israel's “Operation Hot Winter” in the early months of that year. Although a truce between Israel and the Palestinian Authority was reached on June 19, 2008 and lasted until December, it is estimated that 455 Palestinians were killed by Israeli forces in the period from January 1 through December 26, 2008 (B'Tselem, 2008). There was also active violence between Palestinian factions during this time. Previous studies demonstrated that ongoing political violence in this region is a source of significant posttraumatic stress and resource loss (Canetti, Galea, Hall, Johnson, Palmieri, & Hobfoll, 2010; Gelkopf, Berger, Bleich, & Silver, 2012; Heath, Hall, Russ, Canetti, & Hobfoll, 2012; Hobfoll, Hall, & Canetti, 2012; Hobfoll, Mancini, Hall, Canetti & Bonanno, 2012). Prior cross-sectional work conducted in neighboring Israel indicated that political violence is a source of markedly high levels of sleep disturbance and psychological distress (Palmieri et al., 2010). The current study extends this work by examining the relationship between sleep problems, each of the PTSD symptom clusters, depression, and intrapersonal resource loss using a more powerful prospective design. Based on the literature that sleep serves multiple core survival functions, sleep problems were conceptualized as a loss of an energetic resource (Zohar et al., 2005) which broadly impairs the ability to cope with ongoing adversity and trauma (Hobfoll & Lilly, 1993; Hobfoll, 2002). That is, if individuals’ sleep patterns are markedly disrupted, they are expected to have less energy to deal with problems and cope; this in turn may contribute to the loss of intrapersonal resources such as feelings of self-efficacy. As such, the first hypothesis was that sleep problems would have a broad impact on psychological distress, predicting increased symptoms of re-experiencing, avoidance, and hyperarousal, depression, and intrapersonal resource loss. It is also possible that sleep problems may worsen as a function of earlier PTSD. For instance, individuals may become increasingly anxious and agitated as PTSD transitions to a chronic phase. As emotion regulation resources erode, individuals may struggle to manage symptoms, become increasingly hyperaroused, and evince greater sleep problems. As such, the second hypothesis was that psychological distress would predict later sleep problems. Thus, a reciprocal process in which sleep problems predict greater distress, and greater distress predicts later sleep problems was anticipated. An initial cross-panel model included overall PTSD and sleep problems, nightmares, and depression. A second cross-panel model included PTSD symptom clusters, depression, intrapersonal resource loss, sleep problems, and nightmares.