Understanding Social Factors in the Context of Trauma: Implications for Measurement and Intervention

Wagner, Anne Catherine; Monson, Candice M.; Hart, Tae L.

doi:10.1080/10926771.2016.1152341

Cited by 81 publications

(117 citation statements)

References 74 publications

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“…In growing recognition that PTSD may influence and be influenced by social support and family systems, research has begun to explore the effects that military-related PTSD may have on varied aspects of close relationship and family functioning (Vogt et al, 2016; Wagner et al, 2016). Understanding these associations is essential, as social and relationship functioning may have important implications for treatment and prevention of PTSD.…”

Section: Introductionmentioning

confidence: 99%

Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families

2017

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Posttraumatic stress disorder (PTSD) is strongly associated with exposure to war related trauma in military and veteran populations. In growing recognition that PTSD may influence and be influenced by social support and family systems, research has begun to explore the effects that war related trauma and the ensuing PTSD may have on varied aspects of close relationship and family functioning. Far less research, however, has examined the influence of war-related PTSD on parent-child functioning in this population. This paper provides a timely review of emergent literature to examine the impacts that PTSD may have on parenting behaviors and children’s outcomes with a focus on studies of military and veterans of international conflicts since post-9/11. The review sheds light on the pathways through which PTSD may impact parent-child relationships, and proposes the cognitive-behavioral interpersonal theory of PTSD as a theoretical formulation and extends this to parenting/children. The review identifies the strengths and limitations in the extant research and proposes directions for future research and methodological practice to better capture the complex interplay of PTSD and parenting in military and veteran families.

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Section: Introductionmentioning

confidence: 99%

Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families

2017

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“…The aim of the present study was to test the degree to which pretreatment social support moderated the association between CPT treatment duration and change in PTSD symptoms among rural veterans. Most prior research has explored the effect of emotional and tangible support in the context of PTSD (Wagner et al., 2016), and these two types of support are more plausibly linked to mechanisms that could increase PTSD symptom change than affectionate support, defined as expressions of love, or positive support, defined as the availability of others for fun social activities. Specifically, as described by Wagner and colleagues (2016), cognitive reappraisals of trauma are likely influenced by an individual's close relationships, and supportive responses by others may influence the cognitive processing of trauma.…”

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confidence: 99%

Social Support Moderates the Association Between Posttraumatic Stress Disorder Treatment Duration and Treatment Outcomes in Telemedicine‐Based Treatment Among Rural Veterans

Campbell

Erbes

Grubbs

et al. 2020

Journal of Traumatic Stress

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For patients participating in trauma‐focused psychotherapies for posttraumatic stress disorder (PTSD), such as cognitive processing therapy (CPT), pretreatment characteristics may moderate treatment effectiveness. For instance, preexisting supportive relationships may encourage skill utilization or provide contrasts to maladaptive cognitive biases highlighted in trauma‐focused treatments for PTSD. Such pretreatment characteristics are important to study in rural individuals, who may experience barriers to initiating and completing treatment. The aim of this study was to examine whether pretreatment social support, measured using the Medical Outcomes Study Social Support Survey, would moderate the association between CPT duration (i.e., number of sessions attended) and change in PTSD symptoms, using data from a pragmatic randomized controlled trial of a telemedicine‐based collaborative care intervention for rural veterans (N = 225). Social support moderated the association between CPT duration and PTSD symptom change, B = −0.016, SE = −.006; 95% CI [−0.028, −0.005], such that increased duration was associated with more PTSD symptom change only at average or higher levels of support. This effect was found for overall and emotional support but not tangible support. Additionally, on average, among participants who attended eight or more CPT sessions, only those at or above 1 standard deviation above the mean social support score demonstrated a reliable change in PTSD symptoms. The results indicate that the link between CPT treatment duration and treatment outcomes may be stronger for veterans with higher levels of pretreatment social support.

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“…We necessarily used only two items assessing social connectedness that were pre-selected for program evaluation purposes. These two items map on to two distinct aspects of social connectedness but it is not clear how closely linked they are to the higher-order construct of social connectedness (Holt-Lunstad, 2018), nor to perceived positive and negative perceived social support, which have distinct effects across the trauma recovery course (Wagner et al, 2016). Namely, promoting positive social factors after trauma could mitigate trauma's negative effects (social causation) and not stress social support networks (social erosion/selection).…”

Section: Discussionmentioning

confidence: 99%

“…Posttraumatic stress disorder (PTSD), a mental health condition that can develop following exposure to trauma, is highly prevalent among military veterans (Fulton et al, 2015;Marmar et al, 2015). PTSD has been increasingly recognized as a disorder that develops, and may be mitigated, in the context of social connections (Bryant, 2016;Wagner, Monson, & Hart, 2016). PTSD is robustly correlated with poor social support (Brewin, Andrews, & Valentine, 2000;Ozer, Best, Lipsey, & Weiss, 2003;Steenkamp et al, 2017), with this association generalizing across veterans with heterogeneous demographic characteristics (Sripada, Lamp, Defever, Venners, & Rauch, 2016) and across sources of support (Wilcox, 2010).…”

Section: Contactmentioning

confidence: 99%

Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination

Sippel

Watkins

Pietrzak

et al. 2019

European Journal of Psychotraumatology

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Elucidating whether PTSD symptoms predict poorer social connectedness over time (i.e. social erosion) and/or that poor social connectedness contributes to maintenance of PTSD (i.e. social causation) has implications for PTSD treatment and relapse prevention. Most extant research has been cross-sectional and examined overall PTSD symptoms. Evidence of longitudinal associations among heterogeneous PTSD symptom clusters and social connectedness could provide insight into more nuanced targets for intervention. Using data from 1,491 U.S. military veterans in residential treatment for PTSD at 35 Department of Veterans Affairs facilities, we evaluated a two-wave cross-lagged panel model including a five-factor model of PTSD and two aspects of social connectedness. PTSD, quality of connectedness (i.e. degree of distress related to interpersonal conflict), and structural social support (i.e. number of days of contact with supportive loved ones) in the past 30 days were assessed at baseline and 4 months after discharge. The largest effect was greater severity of PTSD dysphoric arousal symptoms (i.e. irritability/anger, poor concentration, and sleep problems) at baseline predicting more conflict-related distress at follow-up (β = 0.43). Post-hoc symptom-level analyses indicated that irritability/anger drove this association. In addition, conflict-related distress predicted greater PTSD symptom severity across all five clusters (β’s = 0.10 to 0.14, p ’s < 0.01). More days of contact predicted lower severity of avoidance and numbing symptoms (β’s = −.05 and −.07, p ’s < 0.01), along with individual symptoms within these clusters, plus flashbacks. Results support both social erosion and social causation models. Engaging loved ones in veterans’ treatment and targeting dysphoric arousal symptoms, particularly anger and irritability, may improve long-term PTSD and relationship outcomes, respectively.

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Understanding Social Factors in the Context of Trauma: Implications for Measurement and Intervention

Cited by 81 publications

References 74 publications

Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families

Parenting with PTSD: A Review of Research on the Influence of PTSD on Parent-Child Functioning in Military and Veteran Families

Social Support Moderates the Association Between Posttraumatic Stress Disorder Treatment Duration and Treatment Outcomes in Telemedicine‐Based Treatment Among Rural Veterans

Heterogeneity of posttraumatic stress symptomatology and social connectedness in treatment-seeking military veterans: a longitudinal examination

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