These results provide support for the multidimensionality of the construct of posttraumatic dissociation and contribute to the understanding of the dissociative subtype of PTSD among adolescents. (PsycINFO Database Record

This study compared the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) diagnostic 3-factor structure of posttraumatic stress disorder (PTSD) symptoms with leading 4-factor models and the newly proposed 5-factor dysphoric arousal model in a sample of 1,363 juvenile-justice-involved adolescents (990 boys, 373 girls). Structural equation modeling suggested that the 5-factor dysphoric arousal model fit significantly better than each of the other models. The model fit better for girls than for boys, and girls evidenced stronger factor loadings for items on all but the Anxious Arousal factor. The factors of the 5-factor model were then tested as mediators of the association between interpersonal and noninterpersonal trauma and mental health problems. Interpersonal trauma was associated with PTSD symptoms for boys and girls, whereas noninterpersonal trauma exposure was only associated with PTSD symptoms for boys, despite equal levels of exposure across genders, suggesting that girls may be more sensitive to the effects of interpersonal, but not noninterpersonal, trauma. Patterns in mediation were moderated by gender, as girls' data showed stronger paths leading to depression/anxiety, somatic complaints, and suicidal ideation through PTSD symptoms, whereas for boys, paths were stronger leading to anger/irritability symptoms. Mediation results suggested differential patterns of influence for dysphoric versus anxious arousal and also indicate the importance of numbing for delinquent youth. These results add to the evidence base supporting the 5-factor dysphoric arousal model in establishing developmentally sensitive criteria for the diagnosis of PTSD among traumatized youth.

This study examined the mediating role of the six Difficulties with Emotion Regulation Scale (DERS) subscales in the relation between adverse childhood experiences (ACEs) and adult psychological distress in a clinical sample of adults receiving psychological treatment at a community-based mental health clinic. In the first part of the study, we found (a) a direct association between childhood adversity and adult psychological distress and (b) the DERS total score mediated this relation. In addition, the DERS subscales differentially mediated this relation. Specifically, the Nonacceptance of Emotional Responses, Impulse Control Difficulties, and Lack of Access to Emotion Regulation Strategies significantly affected psychological distress in adulthood. In the second part of the study, the moderating role of the level of exposure to ACEs in the abovementioned relation was analyzed. For individuals with low ACE scores, the relation between ACEs and adult psychological distress was mediated by four of the six DERS subscales (Nonacceptance of Emotional Responses, Difficulty Engaging in Goal-Directed Behavior, Impulse Control Difficulties, and Limited Access to Emotion Regulation Strategies). For individuals with high ACE scores, none of the DERS subscales significantly moderated the relation between ACEs and psychological distress. These findings suggest that how each dimension of emotional regulation contributes to distress among a marginalized urban population is a function of the level of trauma exposure. These data offer an important guidepost for clarifying impeding regulatory difficulties to target for future intervention work.

Increasing attention has been drawn to the symptom of emotional numbing in the phenomenology of posttraumatic stress disorder (PTSD), particularly regarding its implications for maladaptive outcomes in adolescence such as delinquent behavior. One change in the definition of emotional numbing according to the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) was the limitation to the numbing of positive emotions. Previous research with youth, however, has implicated general numbing or numbing of negative emotions in PTSD, whereas numbing of positive emotions may overlap with other disorders, particularly depression. Consequently, the goal of this study was to investigate whether numbing of positive emotions was associated with PTSD symptoms above and beyond numbing of negative emotions, general emotional numbing, or depressive symptoms among at-risk adolescents. In a sample of 221 detained youth (mean age = 15.98 years, SD = 1.25; 50.7% ethnic minority), results of hierarchical multiple regressions indicated that only general emotional numbing and numbing of anger accounted for significant variance in PTSD symptoms (total R(2) = .37). In contrast, numbing of sadness and positive emotions were statistical correlates of depressive symptoms (total R(2) = .24). Further tests using Hayes' Process macro showed that general numbing, 95% CI [.02, .45], and numbing of anger, 95% CI [.01, .42], demonstrated indirect effects on the association between trauma exposure and PTSD symptoms.

Extensive literature demonstrates associations between occupational stress and adverse health outcomes. This review addresses occupational stress's effects on specific physiological biomarkers among teachers, a workforce with high occupational stress, and the potential for broad social impacts when stress compromises teacher health. A systematic PRISMA search identified 38 papers evaluating occupational stress and biomarkers in teachers (early childhood education (ECE) and K-12). Findings indicate that occupational stress (burnout, perceived acute stress, job strain, effortreward imbalance) negatively relates to teacher health. Most endocrine studies (n = 20 of 29) found negative associations between higher chronic stress (burnout) and blunted hypothalamic-pituitary-adrenal axis (HPA) responses, and/or positive associations between acute stress (e.g., job strain) and increased HPA response. Cardiovascular (CV) studies (n = 10) showed inconsistent relations between stress and CV measures. Immunologic studies (n = 6) found that chronic work stress was associated with increased pro-inflammatory and less effective anti-inflammatory activity. We provide recommendations for future research topics and policy implications.