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Background: Attention-deficit/hyperactivity disorder (ADHD) and posttraumatic stress disorder (PTSD) are associated, but it is unclear if this is a causal relationship or confounding. We used genetic analyses and sibling comparisons to clarify the direction of this relationship. Methods: Linkage disequilibrium score regression and 2-sample Mendelian randomization were used to test for genetic correlation (r g) and bidirectional causal effects using European ancestry genome-wide association studies of ADHD (20,183 cases and 35,191 controls) and 6 PTSD definitions (up to 320,369 individuals). Several additional variables were included in the analysis to verify the independence of the ADHD-PTSD relationship. In a population-based sibling comparison (N = 2,082,118 individuals), Cox regression models were fitted to account for time at risk, a range of sociodemographic factors, and unmeasured familial confounders (via sibling comparisons). Results: ADHD and PTSD had consistent r g (r g range, 0.43–0.52; p < .001). ADHD genetic liability was causally linked with increased risk for PTSD (β = 0.367; 95% CI, 0.186–0.552; p = 7.68 × 10 −5). This result was not affected by heterogeneity, horizontal pleiotropy (Mendelian randomization Egger intercept = 4.34 × 10 −4, p = .961), or other phenotypes and was consistent across PTSD datasets. However, we found no consistent associations between PTSD genetic liability and ADHD risk. Individuals diagnosed with ADHD were at a higher risk for developing PTSD than their undiagnosed sibling (hazard ratio = 2.37; 95% CI, 1.98–3.53). Conclusions: Our findings add novel evidence supporting the need for early and effective treatment of ADHD, as patients with this diagnosis are at significantly higher risk to develop PTSD later in life.

OBJECTIVE This study investigated preshooting emotion dysregulation and posttraumatic cognitions as predictors of mental health service utilization ([MHU]; i.e., therapy/medication) among undergraduate women following a campus mass shooting, controlling for time, age, and postshooting posttraumatic stress (PTS) and depressive symptoms. METHOD Undergraduate women (N = 483, Mage = 19.23, SD = 2.39) were engaged in a study when a mass shooting occurred on Northern Illinois University's campus. A separate, longitudinal study was then implemented to monitor postshooting adjustment among these same women. The present study examined predictors of MHU using data from the preshooting assessment and the following postshooting timepoints: 9 months (T1; n = 416); 14 months (T2; n = 416); 20 months (T3; n = 417); 26 months (T4; n = 405); and 33 months (T5; n = 397). RESULTS Multilevel models showed preshooting emotion dysregulation and postshooting PTS and depressive symptoms positively predicted increased likelihood of MHU while controlling for covariates. Posttraumatic cognitions initially predicted increased therapy utilization, but this relationship became nonsignificant after accounting for preshooting emotion dysregulation. Preshooting emotion dysregulation also weakened the positive relationship between depressive symptoms and therapy utilization and strengthened the positive relationship between age and therapy utilization. CONCLUSIONS Preshooting emotion dysregulation and postshooting mental health symptoms were the most robust predictors of increased MHU following a mass shooting. Findings suggest women exposed to a mass shooting engage in treatment when needed, but preexisting emotion dysregulation may serve as a barrier for those who go on to develop depression. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

OBJECTIVE Research suggests that the overuse of maladaptive emotion regulation strategies, such as avoidance, represents a vulnerability following trauma exposure. Conversely, self-compassion, which impacts emotion regulation through the acceptance of negative emotions, may be an adaptive strategy for managing posttraumatic stress (PTS). METHOD An experimental design was used to examine whether a single-session of self-compassion training improved self-compassion and decreased difficulties in emotion regulation, compared to muscle relaxation training, for trauma-exposed undergraduates. RESULTS Findings replicated previous research among these three constructs (PTS, self-compassion, and difficulties with emotion regulation), with relationships found in the expected directions. However, there was not conclusive evidence to suggest that participating in a brief self-compassion intervention was more effective for reducing difficulties with emotion regulation than participating in a muscle relaxation training intervention. CONCLUSIONS Results supported inverse associations between self-compassion and posttraumatic stress, as well as self-compassion and difficulties with emotion regulation. Future research is needed to investigate how self-compassion skills training can be best utilized to produce clinically significant and long-lasting changes in emotion regulation. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Objective: Existing literature suggests strong positive associations between posttraumatic stress disorder (PTSD) symptoms and emotion regulation difficulties; however, many of these findings are the result of monomethodological approaches (e.g., self-report questionnaires) versus multimethodological approaches. The current study utilized both self-report questionnaires and an emotion regulation choice paradigm (see Sheppes, Scheibe, Suri, & Gross, 2011) to assess various facets of emotion dysregulation in a sample of trauma-exposed undergraduate students with varying levels of self-reported PTSD symptoms (measured by the PTSD Checklist, fifth edition). Method: Data were collected from 83 students who underwent a laboratory paradigm, followed by completion of numerous self-report measures of emotion regulation (e.g., the Difficulties in Emotion Regulation Scale, the Acceptance and Action Questionnaire-II, and the Emotion Regulation Questionnaire). Results: Students with probable PTSD (n = 25) exhibited greater emotion dysregulation on self-report measures compared with students with nonprobable PTSD (n = 58; ηp² ranged from .06 to .42). Additionally, results from the emotion regulation choice paradigm suggested that students with probable PTSD were more likely to exhibit regulatory inflexibility compared with students with nonprobable PTSD (ηp² = .05). In other words, students with probable PTSD were less likely to use reappraisal (vs. distraction) to help regulate their emotions in response to low-intensity negative stimuli compared with students with nonprobable PTSD. Conclusions: Students with probable PTSD report greater perceived emotion regulation difficulties on self-report questionnaires as well as greater behavioral regulatory inflexibility during a laboratory paradigm. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Obsessive-compulsive disorder (OCD) and posttraumatic stress disorder (PTSD) are heterogeneous disorders that share common underlying factors, etiology, and symptoms. A small body of literature suggests common OCD symptom presentations may exist for this comorbid group, yet common comorbid PTSD symptom presentations remain unknown. The current study examined common symptom presentations in individuals with probable comorbid OCD + PTSD compared with those with a sole presentation of probable OCD or PTSD, controlling for overlapping symptoms, using a sample of 133 undergraduates. Individuals who exceeded cutoffs for probable OCD + PTSD endorse more severe OCD symptoms overall but report similar levels of PTSD symptoms compared with the respective diagnostic groups. Logistic regressions found that symptom domains present similarly overall in a comorbid presentation compared with the respective diagnostic groups, yet some OCD symptom domains were significantly more severe in the comorbid group compared with individuals with probable PTSD. Explanations for the unique contributions of symptoms are discussed, and clinical recommendations for addressing these domains are provided.

Objective Alcohol expectancy theory, which examines beliefs about the effects of alcohol on the consumer, is especially relevant for understanding the role of alcohol use in posttraumatic stress disorder (PTSD). Previous research on the relationship between alcohol expectancies and PTSD suggests that greater endorsement of positive alcohol expectancies is positively associated with alcohol use, problem drinking, and increased PTSD symptomatology. The purpose of the current study was to investigate relationships among positive and negative PTSD alcohol expectancies, PTSD symptom clusters, and alcohol use in a sample of undergraduates. Additionally, a 4-factor structure of PTSD alcohol expectancies, based on the supported 4-domain model of PTSD, was examined. Method Participants included 336 undergraduates at a large Midwestern university who completed measures of trauma exposure, PTSD symptomatology, PTSD alcohol expectancies, and alcohol use. Results Moderation analysis found positive alcohol expectancies influenced the relationship between posttraumatic stress (PTS) and alcohol use. Additionally, each of 4 proposed symptom clusters of PTSD alcohol expectancies moderated the association between corresponding PTSD symptom clusters and alcohol use. No support for the utility of negative alcohol expectancies was found. Conclusions The current study provides support for a PTSD symptom domain-specific approach for measuring alcohol expectancies. Though limited in generalizability, this research also provides evidence for positive PTSD alcohol expectancies as an important moderator in the relationship between symptoms of PTS and alcohol, suggesting that perceptions of alcohol's effect on PTSD symptoms confer risk for problematic drinking. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Funding Information: This work was supported by the National Institute of Mental Health / U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, IL, MBS, KJRe, and KCK], National Institutes of Health (Grant No. 5U01MH109539 to the Psychiatric Genomics Consortium ), and Brain & Behavior Research Foundation (Young Investigator Grant [to KWC]). Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience . Statistical analyses were carried out on the LISA/Genetic Cluster Computer ( https://userinfo.surfsara.nl/systems/lisa ) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). This work would have not been possible without the financial support provided by Cohen Veterans Bioscience, the Stanley Center for Psychiatric Genetics at the Broad Institute, and One Mind. Funding Information: MBS has in the past 3 years received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and has stock options in Oxeia Biopharmaceuticals and Epivario. In the past 3 years, NPD has held a part-time paid position at Cohen Veterans Bioscience, has been a consultant for Sunovion Pharmaceuticals, and is on the scientific advisory board for Sentio Solutions for unrelated work. In the past 3 years, KJRe has been a consultant for Datastat, Inc., RallyPoint Networks, Inc., Sage Pharmaceuticals, and Takeda. JLM-K has received funding and a speaking fee from COMPASS Pathways. MU has been a consultant for System Analytic. HRK is a member of the Dicerna scientific advisory board and a member of the American Society of Clinical Psychopharmacology Alcohol Clinical Trials Initiative, which during the past 3 years was supported by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Dicerna, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka. HRK and JG are named as inventors on Patent Cooperative Treaty patent application number 15/878,640, entitled “Genotype-guided dosing of opioid agonists,” filed January 24, 2018. RP and JG are paid for their editorial work on the journal Complex Psychiatry. OAA is a consultant to HealthLytix. All other authors report no biomedical financial interests or potential conflicts of interest. Funding Information: This work was supported by the National Institute of Mental Health/ U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, IL, MBS, KJRe, and KCK], National Institutes of Health (Grant No. 5U01MH109539 to the Psychiatric Genomics Consortium), and Brain & Behavior Research Foundation (Young Investigator Grant [to KWC]). Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience. Statistical analyses were carried out on the LISA/Genetic Cluster Computer (https://userinfo.surfsara.nl/systems/lisa) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). This work would have not been possible without the financial support provided by Cohen Veterans Bioscience, the Stanley Center for Psychiatric Genetics at the Broad Institute, and One Mind. This material has been reviewed by the Walter Reed Army Institute of Research. There is no objection to its presentation and/or publication. The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting true views of the U.S. Department of the Army or the Department of Defense. We thank the investigators who comprise the PGC-PTSD working group and especially the more than 206,000 research participants worldwide who shared their life experiences and biological samples with PGC-PTSD investigators. We thank Mark Zervas for his critical input. Full acknowledgments are in Supplement 1. MBS has in the past 3 years received consulting income from Actelion, Acadia Pharmaceuticals, Aptinyx, Bionomics, BioXcel Therapeutics, Clexio, EmpowerPharm, GW Pharmaceuticals, Janssen, Jazz Pharmaceuticals, and Roche/Genentech and has stock options in Oxeia Biopharmaceuticals and Epivario. In the past 3 years, NPD has held a part-time paid position at Cohen Veterans Bioscience, has been a consultant for Sunovion Pharmaceuticals, and is on the scientific advisory board for Sentio Solutions for unrelated work. In the past 3 years, KJRe has been a consultant for Datastat, Inc. RallyPoint Networks, Inc. Sage Pharmaceuticals, and Takeda. JLM-K has received funding and a speaking fee from COMPASS Pathways. MU has been a consultant for System Analytic. HRK is a member of the Dicerna scientific advisory board and a member of the American Society of Clinical Psychopharmacology Alcohol Clinical Trials Initiative, which during the past 3 years was supported by Alkermes, Amygdala Neurosciences, Arbor Pharmaceuticals, Dicerna, Ethypharm, Indivior, Lundbeck, Mitsubishi, and Otsuka. HRK and JG are named as inventors on Patent Cooperative Treaty patent application number 15/878,640, entitled ?Genotype-guided dosing of opioid agonists,? filed January 24, 2018. RP and JG are paid for their editorial work on the journal Complex Psychiatry. OAA is a consultant to HealthLytix. All other authors report no biomedical financial interests or potential conflicts of interest. Publisher Copyright: © 2021 Society of Biological Psychiatry Background: Posttraumatic stress disorder (PTSD) is heritable and a potential consequence of exposure to traumatic stress. Evidence suggests that a quantitative approach to PTSD phenotype measurement and incorporation of lifetime trauma exposure (LTE) information could enhance the discovery power of PTSD genome-wide association studies (GWASs). Methods: A GWAS on PTSD symptoms was performed in 51 cohorts followed by a fixed-effects meta-analysis (N = 182,199 European ancestry participants). A GWAS of LTE burden was performed in the UK Biobank cohort (N = 132,988). Genetic correlations were evaluated with linkage disequilibrium score regression. Multivariate analysis was performed using Multi-Trait Analysis of GWAS. Functional mapping and annotation of leading loci was performed with FUMA. Replication was evaluated using the Million Veteran Program GWAS of PTSD total symptoms. Results: GWASs of PTSD symptoms and LTE burden identified 5 and 6 independent genome-wide significant loci, respectively. There was a 72% genetic correlation between PTSD and LTE. PTSD and LTE showed largely similar patterns of genetic correlation with other traits, albeit with some distinctions. Adjusting PTSD for LTE reduced PTSD heritability by 31%. Multivariate analysis of PTSD and LTE increased the effective sample size of the PTSD GWAS by 20% and identified 4 additional loci. Four of these 9 PTSD loci were independently replicated in the Million Veteran Program. Conclusions: Through using a quantitative trait measure of PTSD, we identified novel risk loci not previously identified using prior case-control analyses. PTSD and LTE have a high genetic overlap that can be leveraged to increase discovery power through multivariate methods. publishersversion published

Funding Information: This work was supported by the National Institute of Mental Health/U.S. Army Medical Research and Development Command (Grant No. R01MH106595 [to CMN, MBS, KJRe, and KCK]), and National Institutes of Health (Grant No. 5U01MH109539 [to the Psychiatric Genomics Consortium] and Grant No. U19 MH069056 [to BWD])). Financial support for the PTSD PGC was provided by the Cohen Veterans Bioscience, Stanley Center for Psychiatric Research at the Broad Institute, and One Mind. Genotyping of samples was provided in part through the Stanley Center for Psychiatric Genetics at the Broad Institute supported by Cohen Veterans Bioscience Statistical analyses were carried out on the LISA/Genetic Cluster Computer ( https://userinfo.surfsara.nl/systems/lisa ) hosted by SURFsara. This research has been conducted using the UK Biobank resource (Application No. 41209). Posttraumatic stress disorder (PTSD) is a heritable (h2 = 24–71%) psychiatric illness. Copy number variation (CNV) is a form of rare genetic variation that has been implicated in the etiology of psychiatric disorders, but no large-scale investigation of CNV in PTSD has been performed. We present an association study of CNV burden and PTSD symptoms in a sample of 114,383 participants (13,036 cases and 101,347 controls) of European ancestry. CNVs were called using two calling algorithms and intersected to a consensus set. Quality control was performed to remove strong outlier samples. CNVs were examined for association with PTSD within each cohort using linear or logistic regression analysis adjusted for population structure and CNV quality metrics, then inverse variance weighted meta-analyzed across cohorts. We examined the genome-wide total span of CNVs, enrichment of CNVs within specified gene-sets, and CNVs overlapping individual genes and implicated neurodevelopmental regions. The total distance covered by deletions crossing over known neurodevelopmental CNV regions was significant (beta = 0.029, SE = 0.005, P = 6.3 × 10−8). The genome-wide neurodevelopmental CNV burden identified explains 0.034% of the variation in PTSD symptoms. The 15q11.2 BP1-BP2 microdeletion region was significantly associated with PTSD (beta = 0.0206, SE = 0.0056, P = 0.0002). No individual significant genes interrupted by CNV were identified. 22 gene pathways related to the function of the nervous system and brain were significant in pathway analysis (FDR q < 0.05), but these associations were not significant once NDD regions were removed. A larger sample size, better detection methods, and annotated resources of CNV are needed to explore this relationship further. publishersversion published

Women are at notable risk for negative reactions from others following sexual victimization which serve to intensify negative post-traumatic outcomes. The current study tested the effectiveness of cognitive bias modification-appraisal (CBM-App) training targeting post-traumatic cognitions theorized to be impacted by positive and negative social support with 45 female undergraduates, grouped by experiencing overall positive or negative post-assault support. Whereas all participants experienced improvements in post-traumatic cognitions at 1-week follow-up, a crossover effect for intrusion symptoms was found; CBM-App training reduced intrusions in participants with negative support experiences yet increased intrusions in participants with positive support experiences. While findings highlight the need for careful selection of post-trauma interventions, the study is the first to integrate findings from CBM-App, sexual assault, and social support literature. Socially relevant post-traumatic cognitions appear to be malleable and may be an important focus of treatment for survivors who experienced negative post-assault support.

Defensive attribution posits that victim blame results from one’s underlying perception of vulnerability. The resulting blame is believed to reduce perceived similarity to the victim and vulnerability to victimization, though extant research has neglected to examine its effectiveness in men and women. The current study employed multigroup analysis structural equation modeling with 618 male and female undergraduates exposed to fictional police reports of a reported rape. The theory was partially supported; among women, defensive attribution of blame effectively reduced perceived vulnerability to sexual victimization, whereas among men, blame had no effect on perceived similarity or vulnerability. Recommendations for interventions to target perceived vulnerability are discussed.

Childhood abuse is a serious and prevalent public health concern, both in the United States and around the world. The association between child abuse and adverse outcomes in adulthood is well-established, with those experiencing abuse more likely to be diagnosed with mental health disorders, including posttraumatic stress disorder (PTSD), into adulthood. One way to conceptualize the relationship between trauma and adverse mental health outcomes in adulthood is through resource loss. Previous research indicates that individuals who have experienced childhood abuse may not adequately develop resources, such as tangible (e.g., money) and intangible (e.g., emotional) support systems, with the loss of these resources associated with decreased ability to cope with distress. The current study investigated the relationship between resource loss and symptoms of posttraumatic stress longitudinally in a sample of women who had experienced both childhood abuse and a mass-shooting event. Results demonstrated that experiencing childhood physical abuse and sexual abuse predicted symptoms of posttraumatic stress after controlling for exposure to the mass-shooting event. Additionally, symptoms of posttraumatic stress and resource loss predicted each other at two time points after the shooting. Findings demonstrate the bidirectional nature of the relationship between posttraumatic stress and resource loss, as well as highlight how effects of childhood abuse can be long-standing and negatively impact psychosocial functioning in women throughout adulthood.

Compared to the depth of research examining the impact of sexual assault disclosure and related responses from others, little is known about the content shared during disclosures. Categorizing survivors as disclosers or nondisclosers disregards the nuanced and complex nature of disclosure. To address this gap, the current studies examined the reliability and preliminary results of the Sexual Assault Inventory of Disclosure (SAID), an inventory of content shared during disclosures and the context in which it was shared. The SAID proved reliable and preliminary findings suggest that perceptions of disclosures as positive or negative are predicted by differences in content and context, above and beyond disclosure recipients' response. The current study also explored gender differences in disclosure. Additional findings, implications, and suggestions for future studies using the SAID are discussed.

Background: A robust relationship has been established between childhood maltreatment and risky substance use. Posttraumatic stress symptoms and callous-unemotional (CU) traits, both of which can b...

Researchers have called for examinations of associations between distinct facets of distress tolerance and specific forms of psychopathology. We examined associations between five facets of distress tolerance (intolerance of uncertainty, ambiguity, frustration, negative emotion, and physical discomfort) and health anxiety using a large community sample of adults. Structural equation modeling was used to examine associations. Intolerance of uncertainty, negative emotion, and physical discomfort were the only facets of distress tolerance that shared unique associations with health anxiety after accounting for the overlap among the facets of distress tolerance. Intolerance of physical discomfort shared an especially strong unique association with health anxiety. These results highlight facets of distress tolerance that are particularly relevant to health anxiety. Conceptual and therapeutic implications are discussed.

Objective The current study sought to investigate whether experiential avoidance (EA) mediates the effect of shame on posttraumatic symptoms (PTS) in a population of trauma-exposed individuals. Given demonstrated gender differences in posttraumatic stress disorder (PTSD), the current cross-sectional study also sought to examine whether gender moderates this mediational proposed effect. EA has been shown to mediate shame and depression symptoms, suggesting that the unwillingness to feel and/or the attempt to control shame may be an important factor in later psychopathological symptoms. Furthermore, EA appears to influence PTS over time. Method Trauma-exposed undergraduates (n = 326, 68.8% male, Mage = 19.35, SD = 2.30) at a large Midwestern university completed measures of shame, EA, and PTS. Results EA was found to fully mediate the relationship between shame and PTS. The role of gender was mixed as it moderated the relationship between EA and PTS such that the effect of EA is stronger for men than women; however, when analyzed with more robust methods, the effect of gender was no longer significant. A competing, flipped mediational model was run to further assess the direction of hypothesized relationships, but shame was not a significant mediator of EA and PTSD symptoms. Conclusions Results provide further evidence for the centrality of EA in maintaining PTS and suggest targeting EA rather than shame in treatment as an avenue for intervention. Future research is needed to investigate gender differences in engagement in EA. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Background Deficits in safety signal learning are well-established in fear-related disorders (e.g., PTSD, phobias). The current study used a fear conditioning paradigm to test associations among eye blink startle and event-related brain potential (ERP) latency measures of safety signal learning, as well as the role of cardiac vagal control (a measure of top-down inhibition necessary for safety learning). Methods Participants were 49 trauma-exposed women ages 17 to 28 years. Eyeblink startle response and ERP amplitudes/latencies were derived for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus. ERPs included the P100 and late positive potential (LPP), which index early visual processing and sustained emotional encoding, respectively. Cardiac vagal control was assessed with resting heart rate variability (HRV). Results P100 and LPP latencies for the CS- (safety signal stimulus) were significantly negatively associated with startle to the CS-, but not the CS + . LPP CS- latencies were significantly negatively associated with PTSD Intrusion scores, and this relationship was moderated by vagal control, such that the effect was only present among those with low HRV. Conclusions ERP-based markers of safety signal learning were associated with startle response to the CS- (but not CS+) and PTSD symptoms, indicating that these markers may have relevance for fear-related disorders. Cardiac vagal control indexed by HRV is a moderating factor in these associations and may be relevant to safety signal learning.

Individual reactions following trauma exposure vary, with up to one-third of survivors developing posttraumatic stress disorder (PTSD; Kessler, Chiu, Demler, & Walters, 2005 ). Individuals exposed to trauma have high rates of co-occurring psychiatric disorders, with alcohol abuse among the most common comorbid conditions ( Kessler et al., 2005 ). One factor that may influence this relationship is alcohol expectancies ( Hruska & Delahanty, 2012 ), where individuals who believe that using alcohol will help reduce negative affect (i.e., positive alcohol expectancies) may be more likely to use and misuse alcohol. Low distress tolerance has also been implicated as a vulnerability for the development PTSD and alcohol use disorders, particularly as it relates to a desire to reduce negative affect. In the current study, the relationship between posttraumatic stress and alcohol use was proposed to be influenced by positive PTSD alcohol expectancies, whereas distress tolerance was hypothesized to be a moderator. Results demonstrated that positive PTSD alcohol expectancies partially mediated the relationship between posttraumatic stress and alcohol use. Post-hoc analyses found a conditional indirect effect for symptoms of negative alterations in cognitions and mood when distress tolerance was high. These results underscore the importance of advancing knowledge on how individual differences impact posttrauma processes.

Mindfulness is considered a multifaceted construct consisting of non-judging, non-reactivity, describing, observing, and acting with awareness. Mindfulness has received increased attention for its use in the treatment of psychological disorders, including posttraumatic stress disorder (PTSD), though little is known about how mindfulness facets relate to PTSD symptom clusters. The current study performed a path analysis to examine these relationships while controlling for emotion dysregulation in a sample of 298 college undergraduates with endorsed trauma histories. Hypotheses about the specific proposed relationships were partially supported. Above and beyond emotion dysregulation, non-judging was negatively related to the re-experiencing and negative alternations in cognitions and mood symptom clusters and was marginally related to hyperarousal. Additionally, acting with awareness was negatively related to hyperarousal, whereas non-reactivity was unexpectedly positively associated with hyperarousal. Overall, findings suggest the mindfulness facet most relevant to PTSD may be non-judging of inner experience.

Institutional betrayal reflects the failings of a trusted institution to prevent or respond appropriately to negative experiences. Following sexual assault, survivors who encounter institutional betrayal may experience greater distress and poorer functioning. The current study sought to assess the construct validity of the Institutional Betrayal Questionnaire, Version 2 (IBQ.2) and evaluate its factor structure. Survivors of sexual assault ( N = 426) were recruited via Amazon Mechanical Turk and completed various questionnaires related to mental health, disclosure and assault characteristics, world beliefs, and rape myth adherence. The IBQ.2 demonstrated convergent validity with disclosure to formal support providers, assault severity, turning against reactions, and beliefs about self-control, and evidenced discriminant validity with disclosure timing, rape myth adherence, and beliefs about randomness and controllability of outcomes. Notably, the IBQ.2 was unrelated to measures of distress, including symptoms of stress, depression, anxiety, and posttraumatic stress disorder, providing mixed evidence for the IBQ.2’s construct validity. Confirmatory factor analyses failed to replicate the single-factor model of institutional betrayal found in a previous study, and, instead, suggested a two-factor structure of the IBQ.2 that delineates between the promotion of and response to sexual victimization. Post hoc analyses revealed that only one of the two factors (Response to Sexual Victimization) evidenced convergent and discriminant validity largely consistent with the single-factor model. The novelty of these relationships and factor structure of the IBQ.2 found in the current study warrants replication in future research.

Institutional betrayal occurs when, following sexual victimization, institutions create hostile environments which normalize sexual violence, make it difficult to report the experience, mishandle the complaint, attempt to cover up the experience, or retaliate against survivors. These responses are not uncommon and have been linked to adverse survivor outcomes such as dissociation, anxiety, sexual dysfunction, poorer physical health, and depression, yet little is known about which survivors are most at risk for experiencing institutional betrayal. Using a sample of 404 sexual assault survivors recruited from Amazon Mechanical Turk, the current study employed logistic regression to identify risk factors for institutional betrayal. The findings indicate that institutional betrayal is more likely to be reported by survivors who identify as heterosexual, were older at the time of the assault, and endorse more severe PTSD symptoms yet, unexpectedly, less severe distress severity. Gender, race, assault characteristics, and disclosure tendencies did not significantly predict institutional betrayal risk. Although some relationships may be bidirectional, the results suggest that survivors already at risk for some negative post-assault outcomes may be particularly at risk for institutional betrayal.

Childhood maltreatment has well-documented relationships with emotional dysregulation. Emotional dysregulation confers heightened risk for psychopathology and therefore represents an important ther...

To examine the relative risk of the multiple forms of violence against women as well as the incidence and co-occurrence rates of self-reported childhood sexual assault (CSA), childhood physical ass...

Recognizing that alcohol might affect subsequent processing of trauma-related information, this study examined whether high dose alcohol consumption (HDAC) following a campus mass shooting affected the relation between shooting exposure and post-traumatic stress symptoms (PTSS).Female participants (N = 691) recorded levels of physical exposure to the shooting event, alcohol use, and PTSS 1 month following the shooting event and 8 months later.No evidence was found to suggest that pre-shooting HDAC moderated the relationship between trauma exposure and PTSS 1 month following the shooting. HDAC in the month following the shooting predicted less resolution of PTSS 8 months later. Specifically, at higher (but not lower) levels of HDAC, shooting exposure was associated with less reduction in PTSS from 1 to 8 months post-trauma. Several alternate explanations were ruled out.Less reduction in PTSS seems to occur at high levels of both shooting exposure and HDAC. Theoretical implications and directions for future research are discussed.

Self-defense training is consistently linked to psychological benefits for survivors of sexual trauma, yet little is known about how training may uniquely benefit survivors compared with their nonsurvivor peers enrolled in the same course. Path analysis was used to examine how history of sexual trauma impacts pre- and post-training scores on three domains of self-efficacy using a national sample of Rape Aggression Defense (RAD) participants. All participants reported significant increases in self-efficacy domains, and sexual trauma history significantly predicted pre-training interpersonal self-efficacy and post-training self-defense self-efficacy, suggesting that self-defense training confers benefits for survivors above and beyond benefits for other participants.

Although theory suggests that a bias for attending to threat information (ABT) may be a biobehavioral process underlying the transdiagnostic vulnerability factor of emotion dysregulation, there is a paucity of empirical evidence showing direct associations between emotion dysregulation and ABT. The purpose of the present study was to examine the relation between ABT and emotion dysregulation. Participants (N = 200) completed a battery of self-report questionnaires and a modified dot-probe task with both neutral and threat stimuli and four stimulus presentation durations. Task response times were used to examine traditionally calculated ABT scores, as well as attention bias variability (ABV). As predicted, those with greater emotion dysregulation exhibited greater ABV. Importantly, emotion dysregulation was not associated with response time variability on trials for which only neutral stimuli were presented, thus increasing confidence that emotion dysregulation-related ABV is specific to the presence of threat stimuli and not merely a function of general variability in response times. Results suggest that those with greater emotion dysregulation exhibit attentional dyscontrol in the presence of perceived threat that is characterized by dynamic shifts between vigilance and avoidance.

This chapter introduces and defines the construct of experiential avoidance (EA) and how EA can be distinguished from other related constructs (e.g., emotion regulation). Relational frame theory is described and discussed within the context of the development of EA. The relationship between EA and posttraumatic stress disorder (PTSD) is presented through the review of the extant literature within the context of several proposed theoretical models. Mechanisms by which the relationship between EA and PTSD develops and is maintained are proposed and discussed. The malleability of EA is presented through the summation of the limited treatment research that discussed changes in EA and PTSD. Limitations, clinical implications, and future directions for the literature on EA and PTSD are offered and discussed.

Despite increases in campus shootings, there is limited research on treatment utilization after these tragic events. The present study prospectively examined the prevalence and predictors of treatment use among college women following a campus shooting. Predictors included age, race/ethnicity, education level, severity of exposure to shooting, and post-shooting sequelae (i.e., social support, posttraumatic stress disorder [PTSD] severity, depression severity). Present data were obtained from 516 women on campus at the time of the shooting. They completed electronic and online surveys across three time points – pre-shooting (T1), 1-month post-shooting (T2), and 6-months post-shooting (T3). As expected, few participants (14.4%) sought any treatment. Of note, 77.5% of participants endorsed at least one risk factor for PTSD. Prevalence rates of probable PTSD significantly decreased from 51.8% of the full sample at T2 to 12.9% at T3. Results showed that a significantly higher proportion of participants with probable PTSD at T3 sought treatment than those participants at minimal to no risk for PTSD. Psychotherapy was sought at higher rates than medication or combined treatment across risk groups. No reliable predictors of treatment use were observed for at-risk participants or those with probable PTSD. Research and clinical suggestions for optimizing post-disaster recovery and improving treatment utilization among students following campus shootings are discussed.

Childhood maltreatment is highly prevalent and serves as a risk factor for mental and physical disorders. Self-reported childhood maltreatment appears heritable, but the specific genetic influences on this phenotype are largely unknown. The aims of this study were to 1) identify genetic variation associated with reported childhood maltreatment, 2) calculate the relevant SNP-based heritability estimates, and 3) quantify the genetic overlap of reported childhood maltreatment with mental and physical health-related phenotypes. Genome-wide association analysis for childhood maltreatment was undertaken, using a discovery sample from the UK Biobank (UKBB) (n=124,000) and a replication sample from the Psychiatric Genomics Consortium–posttraumatic stress disorder working group (PGC-PTSD) (n=26,290). Heritability estimations for childhood maltreatment and genetic correlations with mental/physical health traits were calculated using linkage disequilibrium score regression (LDSR). Two genome-wide significant loci associated with childhood maltreatment, located on chromosomes 3p13 (rs142346759, beta=0.015, p=4.35×10−8,FOXP1) and 7q31.1 (rs10262462, beta=-0.016, p=3.24×10−8,FOXP2), were identified in the discovery dataset but were not replicated in the PGC-PTSD sample. SNP-based heritability for childhood maltreatment was estimated to be ∼6%. Childhood maltreatment was most significantly genetically correlated with depressive symptoms (rg=0.70, p=4.65×10−40). This is the first large-scale genetic study to identify specific variants associated with self-reported childhood maltreatment.FOXPgenes could influence traits such as depression and thereby be relevant to childhood maltreatment. Alternatively, these variants may be associated with a greater likelihood of reporting maltreatment. A clearer understanding of the genetic relationships of childhood maltreatment, including particular abuse subtypes, with various psychiatric disorders, may ultimately be useful in in developing targeted treatment and prevention strategies.

Objective Emerging research shows that event centrality, or the degree to which trauma is perceived as integral to one's worldviews and personal identity, has a substantial impact on trauma recovery. Given that high centrality fosters both distress and growth, additional research on potential moderators that could better distinguish the course of adjustment is needed. This study examined whether differences in psychological flexibility (or the ability to persist in a behavior despite urges to do otherwise) impacted posttraumatic stress symptoms (PTS) and perceived posttraumatic growth (PTG) as event centrality increased. Method One-hundred and 25 college students (52% female) with a history of trauma exposure were recruited from a large Midwestern university. Participants completed an electronic survey for course credit. Results There was a significant interaction between event centrality and psychological flexibility on PTS severity (B = 2.10, p = .003). A simple slopes analysis revealed that low psychological flexibility was associated with greater PTS severity as event centrality increased. Although event centrality and psychological flexibility independently predicted perceived PTG, no interaction effect was observed (B = -4.68, p = .080). Conclusion This suggests that while differences in psychological flexibility may influence PTS severity following highly centralized traumatic experiences it has a more complicated relationship with perceived PTG that requires further investigation. Clinical implications are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

We examined five dimensions of distress tolerance (i.e. uncertainty, ambiguity, frustration, negative emotion, physical discomfort) as prospective predictors of perceived stress. Undergraduate students (N = 135) completed self-report questionnaires over the course of two assessment sessions (T1 and T2). Results of a linear regression in which the five dimensions of distress tolerance and covariates (i.e. T1 perceived stress, duration between T1 and T2) served as predictor variables and T2 perceived stress served as the outcome variable showed that intolerance of uncertainty was the only dimension of distress tolerance to predict T2 perceived stress. To better understand this prospective association, we conducted a post hoc analysis simultaneously regressing two subdimensions of intolerance of uncertainty on T2 perceived stress. The subdimension representing beliefs that "uncertainty has negative behavioral and self-referent implications" significantly predicted T2 perceived stress, while the subdimension indicating that "uncertainty is unfair and spoils everything" did not. Results support a growing body of research suggesting intolerance of uncertainty as a risk factor for a wide variety of maladaptive psychological outcomes. Clinical implications will be discussed.

Emotion regulation has been implicated as a risk and maintaining factor for posttraumatic stress disorder (PTSD). Three aspects of emotion regulation have demonstrated the strongest relations with PTSD symptoms: experiential avoidance, rumination, and thought suppression. Given that emotion regulation has demonstrated differential relations with DSM-IV PTSD symptom clusters, the current study sought to examine these relations with the DSM-5 symptom clusters of PTSD. Participants were recruited via Amazon's Mechanical Turk (N = 403). All participants endorsed trauma exposure. Measures included the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire-II (AAQ-II), the negative affect scale of the Positive and Negative Affect Schedule (PANAS-NA; included as a control variable), the Ruminative Responses Scale (RRS), and the White Bear Suppression Inventory (WBSI). A path analysis model in Mplus indicated that the AAQ-II demonstrated large effects with all four PTSD symptom clusters. Of those relations, the largest was observed for the AAQ-II and the Negative Alterations in Cognition and Mood cluster of PTSD. Results suggest that individual variation in PTSD symptoms may have implications for the salience of particular emotion regulation strategies.

Although many women do not report sexual victimization as motivation for seeking self-defense training, differences in self-efficacy suggest that self-efficacy deficits may influence survivors' desire to seek training. Lower self-efficacy, thought to negatively influence perceived confidence in one's ability to engage in everyday activities, may relate to avoidance of mundane activities and cause exacerbation of post-traumatic stress symptoms (PTSS). The current study examined a three-way interaction modeling the relationships between history of rape, activities self-efficacy, activities avoidance, and PTSS in a diverse sample of 233 women enrolled in self-defense training. Results suggest that survivors who avoid everyday activities experience increased PTSS, but this effect is mitigated by perceived self-efficacy to engage in these activities. Activities self-efficacy may promote resilience in rape survivors regardless of whether they actually engage in such activities. Training that targets self-efficacy, rather than actual engagement in activities, may be sufficient to reduce PTSS in rape survivors.

Post-traumatic stress disorder (PTSD) is a common and debilitating disorder. The risk of PTSD following trauma is heritable, but robust common variants have yet to be identified by genome-wide association studies (GWAS). We have collected a multi-ethnic cohort including over 30,000 PTSD cases and 170,000 controls. We first demonstrate significant genetic correlations across 60 PTSD cohorts to evaluate the comparability of these phenotypically heterogeneous studies. In this largest GWAS meta-analysis of PTSD to date we identify a total of 6 genome-wide significant loci, 4 in European and 2 in African-ancestry analyses. Follow-up analyses incorporated local ancestry and sex-specific effects, and functional studies. Along with other novel genes, a non-coding RNA (ncRNA) and a Parkinson’s Disease gene,PARK2, were associated with PTSD. Consistent with previous reports, SNP-based heritability estimates for PTSD range between 10-20%. Despite a significant shared liability between PTSD and major depressive disorder, we show evidence that some of our loci may be specific to PTSD. These results demonstrate the role of genetic variation contributing to the biology of differential risk for PTSD and the necessity of expanding GWAS beyond European ancestry.

A growing evidence base suggests that increasing self-compassion is a valuable therapeutic target and may protect against the development and maintenance of posttrauma pathology. More recently, clinicians and researchers have noted that particular individuals respond to self-compassion with strong fear and resistance, a phenomenon known as fear of self-compassion. Yet to be examined is if survivors of childhood abuse exhibit fear of self-compassion and whether it relates to psychological functioning. The present model examined pathways from childhood physical and sexual abuse to symptoms of posttraumatic stress disorder (PTSD) and depression through self-compassion and fear of self-compassion using a college sample (N = 377). A main effect of childhood abuse type on fear of self-compassion scores was observed, while self-compassion scores did not significantly differ by abuse type. Path analyses using bootstrapping revealed a significant indirect effect of childhood sexual abuse on symptoms of depression and PTSD via fear of self-compassion, but not self-compassion. Findings suggest that fear of self-compassion may be uniquely related to trauma pathology for survivors of childhood sexual abuse, highlighting the potential value of addressing fear of self-compassion directly in posttraumatic intervention.

Research suggests that racial and ethnic minorities are more likely to attrit from longitudinal trauma studies than non-Hispanic Whites. Yet, little is known about how the loss of minority participants influences longitudinal findings as well as internal and external validity of study findings. Thus, the present study examined the effects of race/ethnicity on attrition in a longitudinal trauma study of women (minority = 223, non-Hispanic White or majority = 459) exposed to a campus shooting. Survival analyses were used to compare the attrition rates of minority participants to majority participants and assess the extent to which race/ethnicity, among other variables, predicted attrition. Minority participants were more likely to attrit than majority participants, hazard ratio (HR) = 0.69, 95% CI [0.48, 0.99], even after adjusting for study variables. A main effect was also found for age, HR = 1.06, 95% CI [1.01, 1.12]. Race/ethnicity did not interact with other study variables to influence attrition. The findings underscored the importance of assessing the effects of attrition on longitudinal findings and external validity.

OBJECTIVE: Research suggests that 4-factor models of posttraumatic stress disorder (PTSD) may be improved upon by the addition of novel factors, such as Dysphoric Arousal, Externalizing Behaviors, and Anhedonia. However, a novel 7-factor hybrid model has demonstrated superior fit in veteran and undergraduate samples. The current study sought to replicate this finding in a trauma-exposed community sample and examined relations with positive (PA) and negative affect (NA). METHOD: Participants included 403 adults (Mage = 37.75) recruited through Amazon's MTurk. PTSD was measured using the PTSD Checklist-5 (PCL-5). Confirmatory factor analyses were conducted in Mplus. RESULTS: The 7-factor hybrid model demonstrated good fit: CFI =.96, TLI =.95, RMSEA =.06 (90% CI [.05,.07]), SRMR =.03. This model was superior to the 5- and 6-factor models. All factors demonstrated significant relations with PA and NA, the largest of which were the Externalizing Behaviors (with NA) and Anhedonia (with PA) factors. CONCLUSION: Results provide support for the 7-factor hybrid model of PTSD using the PCL-5 in a community sample. FINDINGS replicate previous research suggesting that PTSD is highly related to NA, which has been purported as an underlying dimension of PTSD. It is recommended that future research use clinical measures to further examine the hybrid model. (PsycINFO Database Record (c) 2016 APA, all rights reserved) Language: en

Through its frequent use, a pattern has emerged showing psychometric limitations of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004). This 3-part study sought to (a) determine whether these limitations are due to a method effect by rewording all reverse-coded items in a straightforward manner and submitting them to exploratory factor analysis (EFA), and (b) examine the tenability of an adaptation of the original measure. EFA results from Study 1 (N = 743) supported retention of 29 modified items across 5 factors. Consistent with the original theoretical underpinnings of the DERS, Awareness and Clarity items loaded on the same factor. In Study 2 (N = 738), confirmatory factor analysis (CFA) was used to examine the factor structure of the pool of items identified in Study 1. All of the modified subscales clustered strongly with one another and evidenced large loadings on a higher-order emotion regulation construct. These results were replicated in Study 3 (N = 918). Results from Study 3 also provided support for the reliability and validity of scores on the modified version of the DERS (i.e., internal consistency, convergent and criterion-related validity). These findings provide psychometric support for a modified version of the DERS.

Objective Critiques of self-report indices of emotion regulation suggest that its measurement is in need of more critical investigation. The current study examined the factor structure of emotion regulation as informed by Gross' (1998a) Process Model: Situation Selection, Attentional Deployment, Cognitive Change, and Response Modulation. Method A sample of 553 participants was recruited using Amazon's Mechanical Turk (Mage = 37.12, SD = 13.66; n = 352 female). Confirmatory factor analysis with maximum likelihood estimation was performed in Mplus. Results A four-factor model of emotion regulation demonstrated poor fit. An alternative five-factor model fit the data well: CFI = .94, TLI = .93, RMSEA = .07. Conclusion Emotion regulation may be better conceptualized as a combination of specific strategy use and a broader construct, called “emotional distancing” (a trait-like disposition towards emotions). Further research is required to determine if the observed five-factor model can be replicated in more diverse samples.

Attentional control may be used by trauma survivors to temporarily disengage and shift attention from threat salient information, allowing individuals to remain in, and habituate to, trauma-relevant contexts rather than using less adaptive regulatory strategies. Thus, greater attentional control abilities may be one factor that differentiates those who recover from trauma exposure from those who do not. In the present study, we examined attentional control as a prospective predictor of posttraumatic (PTS) symptoms over the course of two assessment sessions (T1 and T2). Consistent with the hypothesis that attentional control can be used to alleviate trauma-related distress, we predicted that an inverse relation between T1 attentional control and T2 PTS symptoms would be significantly stronger among participants who had experienced a traumatic event between time points (24% of the total sample: N = 85). Pre-T1 trauma history and T1 PTS symptoms served as covariates in regression analysis. Results revealed that T1 attentional control only predicted T2 PTS symptoms for participants who had experienced a traumatic event between time points. Thus, attentional control may be a protective factor against the development of PTS symptomatology in the aftermath of a traumatic event.

The current study sought to examine whether symptoms of posttraumatic stress disorder (PTSD), adolescent sexual assault (ASA), and drinking motivations (e.g., drinking to regulate emotional experiences) mediate the relationship between a history of childhood sexual abuse (CSA) and subsequent alcohol-related problems among college women. Participants were 579 female students at a Midwestern university. Participants were recruited as part of a larger longitudinal study that investigated risk and resiliency factors related to sexual revictimization. Using a serial mediation model, the current study found that the proposed constructs mediated the relationship between CSA and subsequent alcohol-related problems via two separate paths. In one path, CSA was associated with PTSD, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. In the second path, CSA was related to ASA, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. These results suggest that individuals with a history of CSA are more likely to experience both revictimization in adolescence and PTSD symptoms in adulthood, which may lead to alcohol-related problems via drinking to regulate emotional experiences. These findings suggest the importance of incorporating skills training in adaptive emotion regulation strategies into treatment for individuals with a history of CSA and ASA.

This study examined relations among experiential avoidance, state dissociation during writing, cognitive-emotional processing, and posttraumatic stress in the context of an expressive writing task among 58 undergraduate females who were students at a large midwestern university that had recently experienced a mass shooting. Experiential avoidance significantly predicted reported suppression during the writing task. Additionally, posttraumatic stress symptoms (PTSS) at the time of the writing task were significantly associated with state dissociation, suppression, and the use of positive emotion words during the writing. Finally, at the zero-order level, prospective PTSS were associated with state dissociation and suppression during the earlier writing task. However, in a full regression model, only experiential avoidance and PTSS at the time of the writing task significantly predicted prospective PTSS. Supplemental analyses suggest processes may operate differently across levels of exposure. Findings from the present study provide further support for the role of experiential avoidance, state dissociation during writing, and cognitive-emotional processing in predicting PTSS. Additionally, experiential avoidance may play an important role in how individuals use cognitive-emotional processing to narrate a traumatic event.

Fear-potentiated startle (FPS) paradigms provide insight into fear learning mechanisms that contribute to impairment among individuals with posttraumatic stress symptoms (PTSS). Electrophysiology also has provided insight into these mechanisms through the examination of event-related potentials (ERPs) such as the P100 and LPP. It remains unclear, however, whether the P100 and LPP may be related to fear learning processes within the FPS paradigm. To this end, we tested differences in ERP amplitudes for conditioned stimuli associated (CS+) and not associated (CS-) with an aversive unconditioned stimulus (US) during fear acquisition. Participants included 54 female undergraduate students (mean age = 20.26). The FPS response was measured via electromyography of the orbicularis oculi muscle. EEG data were collected during the FPS paradigm. While the difference between CS+ and CS- P100 amplitude was not significant, LPP amplitudes were significantly enhanced following the CS+ relative to CS-. Furthermore, the LPP difference wave (CS+ minus CS-) was associated with FPS scores for the CS- during the later portion of fear acquisition. These findings suggest that conditioned stimuli may have altered emotional encoding (LPP) during the FPS paradigm. Thus, the LPP may be a promising neurophysiological marker that is related to fear learning processes.

Experiencing repeated trauma can have increasingly detrimental effects on psychosocial functioning after subsequent stressors. These effects may be intensified for victims of interpersonal traumas given that these events are often associated with heightened risk for adverse outcomes. To better understand this relationship, the present study prospectively examined the effect of pre-shooting trauma exposure (i.e., interpersonal vs. non-interpersonal trauma) on psychological functioning (i.e., posttraumatic stress symptoms, depression) following a mass campus shooting. Based on previous research, it was expected that negative appraisals and social support would mediate this relationship. A sample of 515 college women reporting prior trauma exposure was assessed at four time points following the shooting (i.e., pre-shooting, 1-month, 6-months, and 12-months post-shooting). Bootstrap analyses with bias-corrected confidence intervals were conducted. Contrary to expectation, pre-shooting trauma exposure was unrelated to 12-month post-shooting outcomes and neither negative appraisals nor social support at 6-months post-shooting emerged as mediators. Interestingly, a history of non-interpersonal trauma was associated with greater post-shooting family and friend support than a history of interpersonal trauma. Ad hoc analyses showed that pre-shooting symptom severity and level of exposure to the shooting had indirect effects on post-shooting outcomes via post-shooting negative appraisals. These findings support that cumulative trauma, regardless of type, may not have an additive effect unless individuals develop clinically significant symptoms following previous trauma. Trauma severity also appears to play a meaningful role.

Victims of sexual violence are frequently blamed by friends, family, or legal personnel in the aftermath of an attack, with men attributing greater blame on average than women. Victims’ experiences of being blamed may generate a vicious cycle in which they are more likely to be blamed in the future. Moreover, just world beliefs (JWB) have been studied extensively as an underlying cognitive mechanism that predicts greater blame. Studies examining the influence of social support on blame have yet to examine the unique role of JWB on these attributions. The current study examined blame attribution of a fictional rape victim who received either positive, negative, or neutral support from friends and family in a sample of 383 undergraduate men and women. Individually, social support and JWB were both significant predictors of blame, and women were more influenced by social support than men; specifically, gender was a more salient predictor of blame toward the positively supported victim, suggesting that positive support received by friends and family may evoke a domino effect of support from other women. Conditional effects revealed that JWB were most influential on blame when responding to the positively supported victim. Implications and suggestions for future research are discussed.