Nicole A. Short

The Momentary Posttraumatic Stress Disorder Checklist for DSM‐5 (PTSD; mPCL‐5) is a 10‐item ecological momentary assessment (EMA) version of the PTSD Checklist for DSM ‐5 designed to capture momentary PTSD symptoms. Prior work supports its reliability and validity but is limited by small samples, short EMA periods, and untested stability across time and participants. The present study examined within‐ and between‐person reliability, convergent and discriminant validity, factor structure, and measurement invariance across time and participants. The sample comprised 64 women who presented to emergency care after sexual assault ( M _age = 25.80 years, 54.7% White) who completed EMA surveys over 6 weeks. Total mPCL‐5 scores demonstrated good within‐person, ω = .88, and excellent between‐person, ω = .96, reliability. Moderate‐to‐strong correlations between mPCL‐5 total and subscale scores and negative affect, r s = .41–.88, p s < .001, evidenced convergent validity. Mostly nonsignificant positive affect associations suggested discriminant validity. Confirmatory factor analysis results supported a four‐factor structure as the best‐fitting model across levels, CFI = .94, TLI = .91, RMSEA = .072, although a one‐factor model was also appropriate for between‐person analyses. Measurement invariance analyses indicated stable loadings, B s = 0.41–0.55, and intercepts, B s = 1.51–2.18, across time and participants, with minimal between‐time variance (< .002). Findings support mPCL‐5 use in EMA research for monitoring short‐term PTSD symptom change, identifying high‐risk periods, and evaluating intervention responsiveness.

Background: Adverse posttraumatic neuropsychiatric sequelae are common after trauma. Early identification of individuals at risk for these outcomes could enable the deployment of preventive interventions to survivors at greatest risk. Smartphone keystroke biomarkers show promise in identifying individuals with neuropsychiatric symptoms; however, to our knowledge, no research has examined whether they can be used to identify symptoms in the aftermath of trauma. Objective: This study evaluates whether passively collected keystroke data from smartphone use in daily life could identify individuals with high symptom levels, as well as worsening or recovery of symptoms, after trauma exposure. Methods: Data from a diverse cohort of individuals presenting to 27 emergency departments after trauma were analyzed. Inclusion criteria were presenting to the emergency department within 72 hours of trauma, age 18-75, and the ability to speak and read English. Exclusion criteria were solid organ injury, significant hemorrhage, operative intervention, or likely admission for over 72 hours. Participants installed an app that passively collected keystroke data during use of any app on their smartphone, beginning in the emergency department. Participants also completed serial symptom assessments over 8 weeks after trauma exposure. Results: A total of 3445 patients met study criteria, provided informed consent, and completed assessments in the emergency department. Of these, 1072 (mean age 40, SD 13; 616/1072, 57.46%, women; 565/1072, 52.71% non–Hispanic Black) installed the app on their Android smartphone and completed the 8-week assessment and were therefore included in analyses. Keystroke biomarkers related to typing speed, identified using bivariate linear mixed models controlling for false discovery rates, were associated with elevated pain, reexperiencing, and mental fatigue (absolute values of rs=0.22-0.25, Ps=.02). Separate change-of-operation and scrolling keystroke biomarkers were associated with increased reexperiencing symptoms (r=0.18, P=.047) and mental fatigue (rs=0.18-0.19, Ps=.031-.047). Further, changes in specific keystroke biomarkers were associated with worsening or recovery of pain (rs=0.07-0.10, Ps=.02), somatic symptoms (rs=0.02, Ps=.02), mental fatigue (rs=0.02-0.04, Ps=.02), sleep disturbance (absolute rs=0.07-0.09, Ps=.02), reexperiencing (rs=0.02-0.04, Ps=.02), and hyperarousal (rs=0.02-0.04, Ps=.02). Conclusions: In general, slower typing and scrolling speeds were associated with higher symptom levels, with small to medium effect sizes. Keystroke data passively collected via smartphone use may help identify individuals with significant or changing posttraumatic symptoms. Future research should continue to explore these keystroke biomarkers and whether they can be leveraged to connect vulnerable trauma survivors to appropriate services. Overall, these results add to the literature, indicating that passively collected keystroke data may help identify individuals with neuropsychiatric symptoms or changes and are, to our knowledge, the first to test whether keystroke biomarkers are useful in the aftermath of trauma. This represents a critical period during which preventive interventions could be deployed to reduce the long-term burden of trauma-related sequelae.

Background: Anxiety sensitivity (AS), defined as the fear of anxious arousal, is a promising therapeutic target for reducing posttraumatic stress disorder (PTSD) symptom development after trauma exposure. Initial research suggests that smartphone-based AS interventions may be acceptable to sexual assault survivors at risk for PTSD symptoms and effective for symptom reduction, but only small one-arm proof-of-concept studies have been conducted. Objective: The goal of this study was to extend prior proof-of-concept work by conducting a pilot randomized controlled trial. The aims were to evaluate intervention efficacy, AS and PTSD symptom change, the acceptability and credibility of a control intervention, and the feasibility of a larger randomized controlled trial. Methods: A total of 60 women with high AS presenting for emergency care after sexual assault were recruited and randomized to either the AS intervention or a control condition, and they were followed up with for over 6 months via remote self-report questionnaires. Results: The findings indicated that the study population is at risk and in need of intervention: 88.8% (40/45) and 80.6% (29/36) of women sexual assault survivors in the sample met the criteria for probable PTSD at 7 weeks and 6 months post assault, respectively. Most (16/27, 59.3%) individuals receiving the AS intervention who completed it rated it as acceptable (eg, 18/21, 85.7% reported that the treatment was helpful). Early within-group reductions were not statistically significant, but by month 6, statistically significant reductions in AS and PTSD symptoms were observed in both conditions. Recruitment and retention data supported the feasibility of the study design, although some suggestions were noted for future research (eg, improving intervention and ecological momentary assessment compliance). Conclusions: This pilot study replicated the proof of concept and acceptability of a novel smartphone-based intervention targeting AS delivered to women sexual assault survivors presenting to emergency care. Intervention completion was in line with or better than traditional therapy but remained a challenge. Our selected control condition demonstrated a larger effect than expected, and we were unable to track its initiation or completion, causing difficulty in drawing conclusions. Overall, the results highlight the need for additional research.

Coping-oriented cannabis use is a robust predictor of hazardous cannabis use. Anxiety sensitivity (AS), the fear of anxiety-related sensations, may be a risk factor for coping-oriented cannabis use, however, findings are mixed in prior literature. The current study aimed to clarify inconsistent research by incorporating the role of positive cannabis expectancies, such as belief that cannabis use results in relaxation or positive social outcomes, in the association between AS, its subfactors, and coping-oriented cannabis use. Undergraduates (n = 232) reporting past-six-month cannabis use completed cross-sectional online self-report measures. Four moderation models were tested with PROCESS macro for SPSS. The interaction of AS and positive cannabis expectancies was significant, such that AS and coping-oriented cannabis use was stronger at high versus low levels of positive cannabis expectancies. Similar patterns emerged for AS cognitive and social, but not physical, concerns. Individuals with elevated AS, particularly cognitive and social concerns, may be at risk for increased coping-oriented cannabis use when they also have higher positive expectancies. Considering how other variables, including positive cannabis expectancies, affect associations between AS and coping motives may help to explain previous discrepant findings on associations between AS and cannabis use. Future work should replicate methods among other, diverse populations and consider alternative measures of cannabis expectancies. Pending future research, AS may be important to assess and target among individuals who use cannabis and endorse positive cannabis expectancies.

Pain is common after sexual assault and may be influenced by posttraumatic stress disorder (PTSD) symptoms. However, little research has tested these associations in the early aftermath of sexual assault. The current study used ecological momentary assessment collected in the context of a randomized clinical trial to test temporal associations between PTSD symptoms and usual pain and highest pain severity, as well as pain variability. Hypotheses were tested among 64 women sexual assault survivors presenting for emergency care who were followed over 6 weeks with 4×/day ecological momentary assessment assessments. Dynamic structural equation modeling analyses indicated that within-person elevations in PTSD symptoms prospectively predicted highest pain severity, while highest pain severity, usual pain severity, and pain interference prospectively predicted PTSD. Heterogeneous variable models revealed that elevated between-persons PTSD was associated with increased variability in all pain outcomes. Findings add to the body of research suggesting that PTSD symptoms may influence the development of persistent pain after sexual assault but add specificity to these models by indicating that PTSD symptoms may uniquely drive spikes in pain and pain variability. Simultaneously, highest pain severity and pain interference may drive PTSD symptoms in the early aftermath of sexual assault. Future research should test whether early interventions after sexual assault could interrupt the vicious cycle of PTSD symptoms and pain. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Trauma‐exposed individuals with posttraumatic stress disorder (PTSD) symptoms are at risk for problematic cannabis use. However, modifiable risk factors associated with cannabis use in this population are less clear. Posttraumatic cognitions (PTC; negative cognitions about the self, self‐blame, and negative cognitions about the world) have recently been investigated as potential motivators for substance use, particularly to cope with distress, but extant research is limited. The current study tested whether PTC are associated with increased coping‐oriented cannabis cravings using an experimental design (i.e., trauma script‐driven imagery). Method: Trauma‐exposed cannabis users ( N = 56; 58.9% female; M _age = 20.69 years; White: 73.2%, Black: 21.4%) self‐reported PTC and cannabis use frequency and were assessed for PTSD diagnosis. State cravings to use cannabis to cope with negative emotions were assessed before and after trauma script‐driven imagery. Results: After covarying for cannabis use frequency and PTSD diagnosis, elevated PTC were significantly associated with increased state cravings to use cannabis to cope with negative emotions (β = .19, t (46) = 2.32, p = .025, sr ² = .02). Of PTC subscales, only higher negative cognitions about the self were significantly associated with increased state cannabis cravings (β = .19, t (46) = 2.34, p = .024, sr ² = .03), while self‐blame and negative cognitions about the world were not. Conclusion: Elevated PTC, particularly about the self, may enhance cannabis cravings in response to trauma cues. Future research may include investigating associations between PTC and cannabis use in naturalistic environments outside of the laboratory setting.

BACKGROUND Adverse posttraumatic neuropsychiatric sequelae are common after trauma. Early identification of individuals at risk for these outcomes could enable the deployment of preventive interventions to survivors at greatest risk. Smartphone keystroke biomarkers show promise in identifying individuals with neuropsychiatric symptoms; however, to our knowledge, no research has examined whether they can be used to identify symptoms in the aftermath of trauma. OBJECTIVE This study evaluates whether passively collected keystroke data from smartphone use in daily life could identify individuals with high symptom levels, as well as worsening or recovery of symptoms, after trauma exposure. METHODS Data from a diverse cohort of individuals presenting to 27 emergency departments after trauma were analyzed. Inclusion criteria were presenting to the emergency department within 72 hours of trauma, age 18-75, and the ability to speak and read English. Exclusion criteria were solid organ injury, significant hemorrhage, operative intervention, or likely admission for over 72 hours. Participants installed an app that passively collected keystroke data during use of any app on their smartphone, beginning in the emergency department. Participants also completed serial symptom assessments over 8 weeks after trauma exposure. RESULTS A total of 3445 patients met study criteria, provided informed consent, and completed assessments in the emergency department. Of these, 1072 (mean age 40, SD 13; 616/1072, 57.46%, women; 565/1072, 52.71% non–Hispanic Black) installed the app on their Android smartphone and completed the 8-week assessment and were therefore included in analyses. Keystroke biomarkers related to typing speed, identified using bivariate linear mixed models controlling for false discovery rates, were associated with elevated pain, reexperiencing, and mental fatigue (absolute values of rs=0.22-0.25, Ps=.02). Separate change-of-operation and scrolling keystroke biomarkers were associated with increased reexperiencing symptoms (r=0.18, P=.047) and mental fatigue (rs=0.18-0.19, Ps=.031-.047). Further, changes in specific keystroke biomarkers were associated with worsening or recovery of pain (rs=0.07-0.10, Ps=.02), somatic symptoms (rs=0.02, Ps=.02), mental fatigue (rs=0.02-0.04, Ps=.02), sleep disturbance (absolute rs=0.07-0.09, Ps=.02), reexperiencing (rs=0.02-0.04, Ps=.02), and hyperarousal (rs=0.02-0.04, Ps=.02). CONCLUSIONS In general, slower typing and scrolling speeds were associated with higher symptom levels, with small to medium effect sizes. Keystroke data passively collected via smartphone use may help identify individuals with significant or changing posttraumatic symptoms. Future research should continue to explore these keystroke biomarkers and whether they can be leveraged to connect vulnerable trauma survivors to appropriate services. Overall, these results add to the literature, indicating that passively collected keystroke data may help identify individuals with neuropsychiatric symptoms or changes and are, to our knowledge, the first to test whether keystroke biomarkers are useful in the aftermath of trauma. This represents a critical period during which preventive interventions could be deployed to reduce the long-term burden of trauma-related sequelae.