J. Gayle Beck

Post-trauma anger is understudied in individuals who have experienced interpersonal trauma, although related work documents a curvilinear association between anger and symptoms of post-traumatic stress disorder. The current study aimed to explore whether the association between negative post-trauma cognitions about the self and about the world with anger (expressed inward and expressed outward) increased with greater elapsed time since trauma. The sample included 119 women who experienced intimate partner violence (IPV). Moderation analyses were conducted separately for each type of negative cognition and each form of anger expression. Results indicated that elapsed time since IPV exposure moderated the association between negative cognitions and anger expressed inward, such that as more time passed since the IPV ended, negative cognitions about the self and world were significantly positively associated with anger expression inward. This association was not significant at lower elapsed times since IPV. Elapsed time did not moderate the association between both forms of negative cognitions and anger expressed outward. The findings of the study highlight the importance of understanding different types of anger expression in survivors of interpersonal trauma and their association with other post-trauma psychological processes, such as negative post-trauma cognitions.

This article describes the work of a task force, commissioned by the American Psychological Association’s Society of Clinical Psychology (SCP), to define “psychological treatment.” We discuss SCP’s rationale for needing such a definition, including the potential for non-psychological interventions to be considered under the current model of empirically supported treatments. The task force, in collaboration with the membership of SCP, proposes the following definition: Psychological treatment is an intervention consisting of specific actions between a person or persons and a mental health professional or designee, with the intent of engaging cognitive, emotional, behavioral, or interpersonal processes, in the service of modifying health or functional outcomes, and whose core assumptions about its procedures and mechanisms of change are founded in psychological science and consistent with scientific understanding. We outline our thinking around this definition and discuss alternatives that were rejected. The definition proposed here is largely consistent with the clinical practice guidelines of the American Psychological Association, though we note that at least one of those guidelines goes well beyond interventions that could reasonably be called psychological treatments. Potential uses and misuses of this definition are outlined, and we suggest additional areas for exploration and clarification.

Objective: This study examined the contributions of shame and posttraumatic stress disorder (PTSD) symptoms to two dimensions of social problem‐solving.Method: A sample of 426 women who were seeking mental health assistance following experiences of intimate partner violence completed self‐report and clinician measures. Separate path analyses were conducted for problem orientation and problem‐solving styles.Results: In the model examining problem orientation, higher levels of shame were significantly associated with lower levels of positive problem orientation (f² = 0.32) and higher levels of negative problem orientation (f² = 0.92), with large effects noted. PTSD symptoms were significantly, positively associated with negative problem orientation (f² = 0.3, large effect). When examining problem‐solving styles, shame showed a significant negative association with rational style (f² = 0.08, small effect) and significant positive associations with impulsive style (f² = 0.45, large effect) and avoidant style (f² = 0.48, large effect). PTSD symptoms did not return significant associations with any of the three problem‐solving styles.Conclusion: Results indicate that shame holds notable associations with both dimensions of social problem‐solving, relative to PTSD symptoms, and are discussed in light of current models of post‐trauma functioning. Implications for clinical care and early intervention efforts are highlighted.

Objective. The current study examined associations of symptoms of posttraumatic stress disorder [PTSD], depression, and generalized anxiety disorder [GAD] with alcohol consumption and drinking to cope in a sample of 310 nurses during the first six months of the COVID-19 pandemic.Method. Using a cross-sectional design, nurses completed online surveys.Results. Over 50% of the sample reported alcohol misuse and 12.2% reported drinking to cope. Further, 38.7% reported elevated symptoms of PTSD, 29.7% moderate-to-high symptoms of depression, and 56.8% elevated symptoms of GAD symptoms. Hierarchical regression analyses were conducted to examine how mental health symptoms were associated with alcohol outcomes, controlling for age, gender pronouns, education, and race. No significant predictors emerged for alcohol consumption. Significant associations of symptoms of PTSD and depression were found for drinking to cope, such that higher levels of mental health symptoms were associated with greater endorsement of drinking to cope.Conclusion. Results are discussed in light of increasing prevention and support services for nurses.

This study examined the association of three specific COVID‐19–related workplace stressors (percentage of nursing work with COVID‐positive [COVID+] patients, number of COVID‐19–related patient deaths witnessed, and living separately from family for safety) and their associations with posttraumatic stress symptoms (PTSS) and symptoms of major depressive disorder (MDD) and generalized anxiety disorder (GAD) among 391 nurses (93.6% White, 93.4% utilize she/her pronouns). Cross‐sectional data were collected via an online survey. Institutional betrayal (i.e., the perception that an institution failed to protect a member who depends on and trusts it) was examined as a moderator of these associations. Although institutional betrayal was not a significant moderator in the three individual models, it held small‐to‐medium–sized positive main effects with PTSS and symptoms of GAD and MDD in both the individual and combined models. In the individual models, the percentage of nursing work with COVID+ patients was significantly positively associated with all three mental health conditions, f² = .019–.195, whereas it only showed a significant effect with PTSS in the combined model, f² = .138. Living separately from family was significantly positively associated with PTSS and MDD symptoms in both the individual, f² = .037 and .015, respectively, and combined models, f² = .025 and .013, respectively. Number of patient deaths held a significant positive association with PTSS alone, f² = .022, in the individual model only. The findings are discussed in light of ways in which health care settings can better support and prioritize mental health among nursing staff.

Group therapy is a frequently used therapy format for posttraumatic stress disorder (PTSD). However, factors contributing to treatment completion remain understudied. The current study examined predictors of treatment completion, defined as having completed 10 out of 14 sessions within 16 weeks, in veterans with PTSD who engaged in a hybrid efficacy–effectiveness randomized controlled trial of group psychotherapy for PTSD. Veterans (N = 198) were randomly assigned to 14 sessions of either group cognitive behavioral treatment (GBCT; n = 98) or group present‐centered treatment (GPCT; n = 100). Four primary domains of predictors were examined, encompassing sociodemographic factors, the severity of PTSD and comorbid conditions, modifiable predictors, and treatment condition. Multilevel binomial logistic regression models following the Fournier analysis approach were used to examine significant predictors within domains, which were then included in a final model. Overall, 70.7% of participants completed treatment (GCBT = 61.6%, GPCT = 79.8%). Participants in the GPCT condition were 2.389 times, 95% CI [1.394, 4.092], more likely to complete treatment than those in the GCBT condition. Older age, a higher income and level of educational attainment, more lifetime and current mental health diagnoses, and higher use of positive reappraisal ER skills predicted treatment completion. Higher levels of depressive symptoms, cumulative trauma burden, and use of positive refocusing ER skills predicted treatment noncompletion. These findings are discussed in the context of current clinical and research practices for examining treatment noncompletion, with attention to the inclusion of translational predictors.

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