Cardiovascular risk as a moderator of associations among anxiety sensitivity, distress tolerance, PTSD and depression symptoms among trauma-exposed firefighters

Ranney, Rachel M.; Bing-Canar, Hanaan; Paltell, Katherine C.; Tran, Jana K.; Berenz, Erin C.; Vujanovic, Anka A.

doi:10.1016/j.jpsychores.2020.110269

Cited by 11 publications

(8 citation statements)

References 63 publications

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“…Thus, it is suggested that greater DT can serve as a potentially protective factor for the development of PTSS for both veterans and parents. Our results are in line with other studies showing high DT as a protective factor for PTSS following traumatic events (e.g., R. C. Brown et al, 2018; Ranney et al, 2020). Moreover, increase in DT following treatment was associated with less severe PTSD (Banducci et al, 2017).…”

Section: Discussionsupporting

confidence: 93%

Distress tolerance, family cohesion and adaptability, and posttraumatic stress symptoms among combat veterans and their parents

Zerach

Gordon-Shalev

2023

Family Relations

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ObjectiveThe aversive impact of combat‐related posttraumatic stress disorder (PTSD) on family members has been examined mainly among veterans' partners as well as veterans' offspring.BackgroundOnly a few studies have examined secondary PTSD symptoms (PTSS) in veterans' parents, and the conditions in which distress tolerance (DT) contributes to veterans' PTSS and parents' secondary PTSS (SPTSS) remain unexplored. In the present study, we aimed to use a dyadic approach to explore the association between veterans' and parents' DT and their PTSS and that of their parents, as well as to examine the moderating role of family cohesion and adaptability in these associations.MethodA volunteer sample of 102 dyads of Israeli combat veterans and their parents responded to online validated self‐report questionnaires in a cross‐sectional study. Analysis included actor–partner interdependence modeling (APIM) and moderation analyses.ResultsVeterans' PTSS was positively correlated with parents' SPTSS. Moreover, two actor effects were revealed wherein veterans' DT contributed to their own PTSS, and parents' DT negatively predicted their own SPTSS. Moreover, veterans' DT negatively predicted their parents' SPTSS (partner effect). Importantly, analysis of moderation revealed that under average and high levels of parental perception of family cohesion, higher levels of DT were tied to lower PTSS among veterans.ConclusionExposure to a traumatized veteran offspring might entail SPTSS among parents. Veterans' high DT is associated with lower PTSS, and their parents' perception of the family as cohesive might augment this association.ImplicationsThe findings highlight the importance of acknowledging distress of indirectly exposed parents of combat veterans. Strengthening military families' cohesion might be important for veterans coping with posttraumatic stress.

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Section: Discussionsupporting

confidence: 93%

Distress tolerance, family cohesion and adaptability, and posttraumatic stress symptoms among combat veterans and their parents

Zerach

Gordon-Shalev

2023

Family Relations

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“…Our second main finding refers to the associations between veterans’ and parents’ distress tolerance and their own posttraumatic stress symptoms and secondary posttraumatic stress symptoms, respectively. Although high DT is known to be a resiliency factor for PTSS following traumatic events (e.g., Ranney et al, 2020), our results extend this body of knowledge with a dyadic approach to this often-neglected population (parents of veterans) (Banducci et al, 2017). Thus, we suggest that high DT, either as a pre-trauma resource or as an increased posttrauma capability may buffer the tendency to avoid internal or external reminders of the traumatic event(s) (Vujanovic et al, 2011).…”

Section: Resultssupporting

confidence: 65%

“…DT has been treated as a transdiagnostic, cognitive-affective factor associated with development and maintenance of varied psychiatric disorders such as depression, anxiety, substance abuse, and personality disorders (e.g., Vujanovic & Zegel, 2020). DT has recently gained increased attention in the traumatic stress literature due to its relevance for understanding and treatment of PTSD (Ranney et al, 2020). For example, recent meta-analysis results show negative associations between DT and PTSD symptoms, such that lower DT was associated with higher PTSS, particularly following a high number of traumatic events (e.g., Akbari et al, 2021).…”

Section: Introductionmentioning

confidence: 99%

Associations between distress tolerance and posttraumatic stress symptoms among combat veterans and their parents: The mediating role of parents’ accommodation

Zerach

Gordon-Shalev

2022

Journal of Social and Personal Relationships

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Objective: Combat-related posttraumatic stress disorder (PTSD) might negatively impact the mental health of veterans’ family members. Nevertheless, nearly no research has examined secondary PTSD symptoms (PTSS) in veterans’ parents, and still to be explored are the mechanisms by which distress tolerance (DT) contributes to veterans’ PTSS and parents’ secondary PTSS (SPTSS). In the present study, we aimed to use a dyadic approach to explore the association between veterans’ and parents’ DT and their PTSS/SPTSS, as well as to examine the mediating role of parents’ accommodation of veterans’ behaviors in these associations. Method: A volunteer sample of 102 dyads of Israeli combat veterans and their parents responded to online validated self-report questionnaires in a cross-sectional study. Analysis included actor–partner interdependence modeling (APIM) and mediation analyses. Results: Veterans’ PTSS was positively correlated with parents’ SPTSS. Moreover, veterans’ DT and parents’ DT negatively predicted their own PTSS and SPTSS, respectively. Furthermore, veterans’ DT negatively predicted their parents’ SPTSS. Importantly, parents’ accommodation mediated the links between veterans’ DT and both veterans’ PTSS and parents’ SPTSS, as well as between parents’ DT and veterans’ PTSS with parents’ SPTSS. Conclusion: Parents of combat veterans might be indirectly traumatized by their offspring’s military experiences and suffer from secondary PTSS. Among both veterans and parents, low DT is associated with higher levels of parents’ accommodation, which in turn is related to more posttraumatic symptoms.

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“…Among risk factors against PTSD among firefighters, there are maladaptative coping styles [ 11 – 15 ], alienation, feelings of insecurity and lack of personal control [ 16 ], high neuroticism, and fear of dying on duty [ 17 ], anxiety sensitivity [ 18 , 19 ], negative emotionality [ 20 ], burnout [ 21 , 22 ], length of service and lower rank [ 10 , 14 , 23 – 25 ], previous high exposure to traumatic events and previous psychopathology [ 11 , 26 – 29 ], elevated startle response [ 30 ], increased tendency to catastrophize [ 31 ], high hostility and low self-efficacy [ 3 ], negative self-appraisals [ 14 , 32 ], occupational stress, lack of social support and shift work [ 10 , 33 – 35 ], external locus of control in the workplace, low education and low resilience [ 24 , 36 ], and high social introversion and masculinity [ 37 ]. These risk factors seem to fall into three broad categories—intrapersonal [ 11 – 22 , 27 – 31 , 36 ], workplace-related [ 10 , 11 , 14 , 23 – 26 ] and social [ 10 , 16 , 33 – 35 ].…”

Section: Introductionmentioning

confidence: 99%

The impact of the traditional male role norms on the posttraumatic stress disorder among Polish male firefighters

Jakubowski

Sitko-Dominik

2021

PLoS ONE

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Background The aim of this study was to explore potential associations between compliance with the traditional male role norms and posttraumatic stress disorder (PTSD) symptoms. Methods The study was conducted on 135 male Polish firefighters. The study used the Impact Event Scale-Revised, the Relations/Social Support Scale and the Male Role Norms Scale. Results The study revealed that the firefighters that suffered from probable PTSD (over 34% of all the respondents) seemed to comply with the male role norms more strictly than those without PTSD. The reverse was found to be true for the perceived social support. Social status norms and toughness norms understood as expectations that men should achieve high status by means of successful career, etc., and be tough and resilient at all costs to be perceived as “manly” were found to be positively associated with the development of PTSD, while in the case of perceived social support, a negative association was confirmed. The results might yield important clinical implications—traditional male role norms pertaining to toughness and social status might be associated with the increase in chances of developing PTSD after the exposure to potentially traumatic events. Conclusions Firefighting as a stereotypically masculine occupation may be associated with the reinforcement of stereotypically masculine behaviors, which in turn is associated with a decreased ability to cope with potentially traumatic stimuli and favoring maladaptive behaviors. The results might suggest that addressing the beliefs about masculinity during psychological intervention in the case of PTSD might be beneficial especially among such masculinized groups as firefighters. The main limitations of the study are: participation of those more eager to participate and reveal personal information; the recall and report bias; the relatively small sample size; sociodemographic data omissions; the study group almost exclusively consisting of firefighters from large urban centers.

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Cardiovascular risk as a moderator of associations among anxiety sensitivity, distress tolerance, PTSD and depression symptoms among trauma-exposed firefighters

Cited by 11 publications

References 63 publications

Distress tolerance, family cohesion and adaptability, and posttraumatic stress symptoms among combat veterans and their parents

Distress tolerance, family cohesion and adaptability, and posttraumatic stress symptoms among combat veterans and their parents

Associations between distress tolerance and posttraumatic stress symptoms among combat veterans and their parents: The mediating role of parents’ accommodation

The impact of the traditional male role norms on the posttraumatic stress disorder among Polish male firefighters

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