We conducted a systematic review of studies that have evaluated invariance of the construct of posttraumatic stress disorder (PTSD) to summarize their conclusions related to invariance/noninvariance and sources of noninvariance. In November 2017, we searched Pubmed, PSYCINFO, PILOTS Web of Science, CINAHL, Medline, and Psychological and Behavioral Science Collection for abstracts and articles with these inclusionary criteria: peer-reviewed, including DSM-IV or DSM-5 PTSD invariance as a main study aim, use of multigroup confirmatory factor analyses, and use of an independent PTSD instrument or module. In total, 45 articles out of 1,169 initially identified abstracts met inclusion criteria. Research assistants then followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to complete a secondary search and independently extract data. Results indicated that DSM-IV dysphoric arousal and DSM-5 hybrid model factors demonstrated the most stability; sources of instability were some intrusion (distress to trauma cues), dysphoria/numbing (traumatic amnesia, foreshortened future, emotional numbness, detachment), and arousal (hypervigilance) items. The PTSD Checklist and PTSD Reaction Index were most often used to assess PTSD in studies investigating its invariance; however, these measures demonstrated partial conceptual equivalence of PTSD across subgroups. Instead, clinician-administered measures demonstrated more conceptual equivalence across subgroups. Age, gender, cultural/linguistic factors, and sample diversity had the least moderating effect on PTSD's symptom structure. Our review demonstrates the need to examine invariance of the PTSD construct following recommended guidelines for each empirical and clinical trial study to draw meaningful multigroup comparative conclusions.Clinicians and researchers use diverse instruments to measure the psychological construct of posttraumatic stress disorder (PTSD). Scores obtained from these instruments are compared across subgroups, using statistical tests that depend on-yet assume-empirically established conceptual equivalence of the construct of PTSD. From a latent variable model perspective, participants with the same true PTSD factor (latent) score interpret and/or respond to PTSD-related items in a conceptually similar manner (i.e., same probability of observed scores), and PTSD items similarly capture the latent symptomology of PTSD across subgroups (Bauer, 2017;Dimitrov, 2010;
Positive memory characteristics relate to posttraumatic stress disorder (PTSD) severity. We utilized a network approach to examine relations between PTSD clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], alterations in arousal and reactivity [AAR]) and positive memory characteristics (count, valence, vividness, coherence, time perspective, sensory details). We identified differential relations between PTSD clusters and positive memory characteristics, and central/bridging symptoms. Participants were an Amazon Mechanical Turkrecruited sample of 206 participants (M age = 35.36; 61.20% females). We estimated a regularized Gaussian Graphic Model comprising four nodes representing the PTSD clusters and six nodes representing positive memory characteristics. Regarding cross-community relations, AAR (highest node strength) was negatively associated with positive memory count, valence, coherence, and access; avoidance was positively and negatively associated with positive memory vividness and count respectively. The NACM-AAR and intrusion-avoidance edges were significantly stronger than most edges. From the PTSD community, AAR and avoidance had the highest bridge strength and bridge expected influence respectively; from the positive memory community, coherence and vividness had the highest bridge strength and bridge expected influence respectively. Results indicate the potential pivotal role of AAR, avoidance, coherence, and vividness in the PTSDpositive memory relation, which renders them assessment/treatment targets pending further investigation.
To examine the existing knowledge base on trauma experiences and positive memories, we conducted a scoping review of trauma and post-trauma factors related to positive memory count. In July 2019, we searched PubMed, Medline, PsycINFO, Web of Science, Cumulative Index of Nursing and Allied Health Literature, Embase, and PTSDpubs for a combination of words related to “positive memories/experiences,” “trauma/posttraumatic stress disorder (PTSD),” and “number/retrieval.” Twenty-one articles met inclusion criteria (adult samples, original articles in English, peer-reviewed, included trauma-exposed group or variable of trauma exposure, trauma exposure examined with a trauma measure/methodology, assessed positive memory count, empirical experimental/non-experimental study designs). Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines, two authors reviewed abstracts, completed a secondary search, and independently extracted data. Our review indicated (1) that depression and PTSD were most researched; (2) no conclusive relationships of positive memory count with several psychopathology (depression, acute stress disorder, eating disorder, and anxiety), cognitive/affective, neurobiological, and demographic factors; (3) trends of potential relationships of positive memory count with PTSD and childhood interpersonal traumas (e.g., sexual and physical abuse); and (4) lower positive memory specificity as a potential counterpart to greater overgeneral positive memory bias. Given variations in sample characteristics and methodology as well as the limited longitudinal research, conclusions are tentative and worthy of further investigations.
Posttraumatic stress disorder (PTSD) symptoms commonly co-occur with reckless and self-destructive behaviors (RSDBs; e.g., substance use, aggression). To better understand comorbidity mechanisms between RSDBs and PTSD symptom clusters (best-fitting PTSD model), this study examined their latent-level relations. Methodologically, the current study used a cross-sectional approach administering self-report surveys (PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, measuring PTSD severity and the Posttrauma Risky Behaviors Questionnaire measuring RSDBs) to a convenience sample. The study description (45–60 min survey to develop a posttrauma reckless behaviors measure), compensation, and eligibility information was posted on Amazon’s Mechanical Turk platform. A sample of 417 trauma-exposed community participants averaging 35.92 years of age (56.60% female) was recruited. Confirmatory factor analyses revealed that the seven-factor PTSD hybrid model provided optimal fit to the data. Wald χ2 tests of parameter constraint results indicated the strongest relation of the RSDB factor with PTSD’s Externalizing Behaviors factor (r = .70) and weakest relation with PTSD’s Avoidance factor (r = .37); PTSD’s Anhedonia factor (r = .53) had a stronger relation to the RSDB factor compared with PTSD’s Anxious Arousal factor (r = .43). Results support the construct validity of the PTSD hybrid model factors in relation to RSDBs. Additionally, results indicate that PTSD’s Positive Affect factor may be strongly embedded in the PTSD–RSDB relation, supporting the emotion dysregulation viewpoint and trauma interventions addressing emotion dysregulation (including for positive emotions). Lastly, our study results provide additional psychometric support for the Posttrauma Risky Behaviors Questionnaire.
Posttraumatic stress disorder (PTSD) treatments primarily address traumatic memories, despite PTSD's association with both traumatic and positive memory difficulties. Addressing this gap, we explored the perspectives of trauma-exposed individuals with mental health treatment experience on therapeutically addressing positive memories. A treatment-seeking sample from a community mental health center (n 1 = 60) and a community sample from Amazon's Mechanical Turk (n 2 = 123) were queried on the acceptability, feasibility, and delivery/components of a pilot positive memory technique. Results indicated interest or willingness in therapeutically discussing positive memories; most endorsed benefits were improved mood, positive thoughts, and self-esteem. Few barriers were identified (e.g., lack of evidence) compared with feasibility factors (ease/usefulness, improved satisfaction/tolerability, and engagement in PTSD treatment). Preferred treatment components included identifying/discussing positive memories, eliciting associated positive affect, and writing about the positive memory as homework. Results provide formative support for the development and integration of a positive memory technique into PTSD treatments.
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