Studies have established a link between contextual factors, such as neighborhood and community environments, and psychopathology. Although these factors have been shown to affect the expression of symptoms of depression and other disorders, little evidence exists of a link between contextual factors and posttraumatic stress disorder (PTSD). The current study tested the relationships among perceived neighborhood disorder (a measure of self-reported perceptions of the physical environment), community cohesion (a measure of perceived social ties), and self-reported PTSD symptoms while controlling for previous trauma exposure in a low-income, urban, African American population. Regression analyses indicated that both neighborhood disorder and community cohesion are related to PTSD symptoms after controlling for trauma exposure. Community cohesion, however, was found to be a partial mediator of the relationship between neighborhood disorder and PTSD symptoms.

This randomized controlled trial assessed the efficacy of a five‐session version of Skills Training in Affective and Interpersonal Regulation (STAIR) among veterans obtaining treatment in primary care. Veterans who screened positive for either posttraumatic stress disorder (PTSD) or depression (N = 26) were enrolled and randomized into either five‐session STAIR or treatment as usual (TAU). Assessments of PTSD symptoms (PTSD Checklist for DSM‐5; PCL‐5), depression (Beck Depression Inventory–II; BDI‐II), emotion regulation (Difficulties in Emotion Regulation Scale; DERS), and social engagement difficulties (World Health Organization Disability Assessment 2.0; WHODAS‐2) were assessed at pretreatment, posttreatment, and 3‐month follow‐up assessments. Participants assigned to the five‐session STAIR condition reported significant improvements on all measures, whereas those assigned to TAU showed no change. Group × Treatment interactions were significant for all outcomes, and effect sizes for the interactions ranged from moderate to large, Hedge's gs = 0.81 for the PCL‐5, 1.15 for the BDI‐II, 0.75 for the DERS, and 0.81 for the WHODAS‐2. The results indicate that five‐session STAIR, a brief, skills‐focused treatment, may be effective in reducing a range of symptoms and in improving social functioning among veterans treated in primary care settings.

Attachment insecurity is determined early in life, is a risk factor for psychopathology, and can be measured on two separate continuous dimensions: attachment anxiety and attachment avoidance. Therapeutic changes toward more secure attachment correlate with reduction in psychiatric symptoms. Psilocybin-assisted psychotherapy has demonstrated promise in the treatment of psychopathology, such as treatment-resistant depression and substance use disorders. We hypothesized that psilocybin-assisted psychotherapy would reduce attachment anxiety and attachment avoidance, thus increasing attachment security. We also hypothesized that baseline measures of attachment insecurity, which can reflect a diminished capacity for trust and exploration, would inform the quality of the psilocybin session. Participants were male long-term AIDS survivors with moderate-severe demoralization (n = 18). Using the Experiences in Close Relationships scale, we measured attachment insecurity at baseline as well as immediately, and 3 months, after completion of a brief group therapy course, which included a single midtreatment open-label psilocybin session conducted individually. Clinically important aspects of the psilocybin session were assessed using the revised Mystical Experience Questionnaire and the Challenging Experience Questionnaire the day following psilocybin administration. Self-reported ratings of attachment anxiety decreased significantly from baseline to 3-months post-intervention, t(16) = −2.2; p = 0.045; d rm = 0.45; 95% CI 0.01, 0.87. Attachment avoidance did not change significantly. Baseline attachment anxiety was strongly correlated with psilocybin-occasioned mystical-type experiences, r(15) = 0.53, p = 0.029, and baseline attachment avoidance was strongly correlated with psilocybin-related challenging experiences, r(16) = 0.62, p = 0.006. These findings have important implications for the general treatment of psychopathology as well as optimizing psilocybin-assisted psychotherapy as a broadly applicable treatment modality.

Research has linked multiple risk and resiliency factors to developing posttraumatic stress disorder (PTSD). One potentially important construct for understanding connections between trauma and PTSD is attachment. Although relationships between attachment and risk for PTSD have been described theoretically, limited research has addressed these relationships empirically. Furthermore, aspects of object relations overlap with attachment and PTSD, but have not been adequately incorporated in empirical research. One proposed pathway between attachment and PTSD involves the mediating role of object relations, particularly views of self and others. Present data were from a larger study investigating environmental and genetic risk factors for PTSD in an impoverished, primarily African American sample seeking care at a public urban hospital. Correlations indicated that adult attachment (with the exception of dismissing) and object relations relate to childhood traumas, (|r|s = .19-.29), adult traumas (|r|s = .14-.20), and self-reported PTSD symptoms (|r|s = .20-.36). Analyses also found support for mediational roles of object relations in relationships between attachment and PTSD symptoms (Model R(2) range = .136-.160). These data have theoretical, clinical, and research implications for understanding how particular aspects of attachment, specifically its effects on object relations, may protect against or predispose one to develop PTSD.