Skip to main content
Top
Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment 4/2012

01-12-2012

A Prospective Investigation of Changes in Avoidant and Active Coping and Posttraumatic Stress Disorder Symptoms among Military Veteran

Auteurs: Matthew Tyler Boden, Marcel O. Bonn-Miller, Anka A. Vujanovic, Kent D. Drescher

Gepubliceerd in: Journal of Psychopathology and Behavioral Assessment | Uitgave 4/2012

Log in om toegang te krijgen
share
DELEN

Deel dit onderdeel of sectie (kopieer de link)

  • Optie A:
    Klik op de rechtermuisknop op de link en selecteer de optie “linkadres kopiëren”
  • Optie B:
    Deel de link per e-mail

Abstract

The present investigation utilized a prospective design to investigate associations between changes in self-reported avoidant and active coping occurring during residential treatment for posttraumatic stress disorder (PTSD) and PTSD symptom severity at treatment discharge. Participants were 636 military Veteran patients (91.4 % male; M age = 51.7 years) admitted to a Veterans Affairs (VA) residential rehabilitation program for PTSD, between 2000 and 2008. Results indicated that increases in avoidant coping and decreases in active coping from treatment intake to discharge were simultaneously and incrementally predictive of total PTSD symptom severity at treatment discharge, after accounting for PTSD symptom severity at treatment intake. These findings hold particular relevance for treatment-seeking populations with severe PTSD and researchers and clinicians attempting to understand and treat these populations.
Voetnoten
1
Significant gender differences were found for avoidant coping at intake (M Male  = 2.1, SD = 0.8, M Female  = 1.8, SD = 0.7; t(634) = −3.0, p < .01) and discharge (M Male  = 2.1, SD = 0.8, M Female  = 1.8, SD = 0.7; t(634) = −2.8, p < .01), active coping at discharge (M Male  = 2.7, SD = 0.8, M Female  = 2.9, SD = 0.7; t(634) = 2.1, p < .05), and PTSD severity at discharge (M Male  = 59.5, SD = 14.0, M Female  = 54.1, SD = 17.1; t(634) = −2.7, p < .01), but not in active coping at intake or PTSD severity at intake (all p’s > .08).
 
2
We formed a four-item version of the avoidant coping scale that didn’t include items assessing substance use, and found that all results reported below are similar in magnitude and significance when using this scale.
 
3
We note that results were similar for each PTSD symptom cluster (i.e., re-experiencing, avoidant/numbing, hyperarousal) when examined separately (all Δr 2  = .04, p’s < .01).
 
4
When removing shared variance with gender, age, length of treatment stay and trauma severity measured at treatment intake using the 7-item Combat Exposure Scale (Keane, et al., 1989), the addition of avoidant and active coping scores on Step 2 significantly and substantially improved the prediction of total PTSD symptom severity (Δr 2  = .04, p < .01), and both change in avoidant and active coping significantly predicted PTSD symptom severity.
 
5
Calculation of the RCI revealed that 36.3 % of participants (N = 231) experienced improvements in PTSD symptoms at rates greater than could be attributable to measurement error alone. These participants had significantly greater increases in active coping (t(634) = −4.5, p < .01) and significantly greater decreases avoidant coping (t(634) = 4.2, p < .01) compared to those who did not improve at rates greater than could be attributable to measurement error alone.
 
Literatuur
go back to reference Alvarez, J., McLean, C., Harris, A., Rosen, C. S., Ruzek, J., & Kimerling, R. (2011). The comparative effectiveness of cognitive processing therapy for male veterans treated in a VHA posttraumatic stress disorder residential rehabilitation program. Journal of Consulting and Clinical Psychology, 79, 590–599. doi:10.1037/a0024466.PubMedCrossRef Alvarez, J., McLean, C., Harris, A., Rosen, C. S., Ruzek, J., & Kimerling, R. (2011). The comparative effectiveness of cognitive processing therapy for male veterans treated in a VHA posttraumatic stress disorder residential rehabilitation program. Journal of Consulting and Clinical Psychology, 79, 590–599. doi:10.​1037/​a0024466.PubMedCrossRef
go back to reference Amir, M., Kaplan, Z., Efroni, R., Levine, Y., & Kotler, M. (1997). Coping styles in post-traumatic stress disorder (PTSD) patients. Personality and Individual Differences, 23, 399–405. doi:10.1016/S0191-8869(97)00066-4. Amir, M., Kaplan, Z., Efroni, R., Levine, Y., & Kotler, M. (1997). Coping styles in post-traumatic stress disorder (PTSD) patients. Personality and Individual Differences, 23, 399–405. doi:10.​1016/​S0191-8869(97)00066-4.
go back to reference American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author. American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text revision). Washington, DC: Author.
go back to reference Blake, D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90. doi:10.1002/jts.2490080106.PubMedCrossRef Blake, D., Weathers, F. W., Nagy, L. M., Kaloupek, D. G., Gusman, F. D., Charney, D. S., & Keane, T. M. (1995). The development of a clinician-administered PTSD scale. Journal of Traumatic Stress, 8, 75–90. doi:10.​1002/​jts.​2490080106.PubMedCrossRef
go back to reference Cardena, E., Dennis, J. M., Winkel, M., & Skitka, L. J. (2005). A snapshot of terror: Acute posttraumatic responses to the September 11 attack. Journal of Trauma & Dissociation, 6, 69–84. doi:10.1300/J229v06n02_07.CrossRef Cardena, E., Dennis, J. M., Winkel, M., & Skitka, L. J. (2005). A snapshot of terror: Acute posttraumatic responses to the September 11 attack. Journal of Trauma & Dissociation, 6, 69–84. doi:10.​1300/​J229v06n02_​07.CrossRef
go back to reference Feeny, N. C., & Foa, E. B. (2005). Cognitive vulnerability to PTSD. In L. B. Alloy & J. H. Riskind (Eds.), Cognitive vulnerability to emotional disorders (pp. 285–301). Mahweh, NJ, US: Lawrence Erlbaum Associates Publishers. Feeny, N. C., & Foa, E. B. (2005). Cognitive vulnerability to PTSD. In L. B. Alloy & J. H. Riskind (Eds.), Cognitive vulnerability to emotional disorders (pp. 285–301). Mahweh, NJ, US: Lawrence Erlbaum Associates Publishers.
go back to reference First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders-Non-Patient Edition. New York: New York State Psychiatric Institute. First, M. B., Spitzer, R. L., Gibbon, M., & Williams, J. B. W. (1995). Structured Clinical Interview for DSM-IV Axis I Disorders-Non-Patient Edition. New York: New York State Psychiatric Institute.
go back to reference Hepp, U., Moergeli, H., Buchi, S., Wittmann, L., & Schnyder, U. (2005). Coping with serious accidental injury: A one-year follow-up study. Psychotherapy and Psychosomatics, 74, 379–386. doi:10.1159/000087786.PubMedCrossRef Hepp, U., Moergeli, H., Buchi, S., Wittmann, L., & Schnyder, U. (2005). Coping with serious accidental injury: A one-year follow-up study. Psychotherapy and Psychosomatics, 74, 379–386. doi:10.​1159/​000087786.PubMedCrossRef
go back to reference Institute of Medicine. (2007). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington, DC: National Academy of Sciences. Institute of Medicine. (2007). Treatment of posttraumatic stress disorder: An assessment of the evidence. Washington, DC: National Academy of Sciences.
go back to reference Jacobsen, P. B., Sadler, I. J., Booth-Jones, M., Soety, E., Weitzner, M. A., & Fields, K. K. (2002). Predictors of posttraumatic stress disorder symptomatology following bone marrow transplantation for cancer. Journal of Consulting and Clinical Psychology, 71, 235–240. doi:10.1037/0022-006X.70.1.235.CrossRef Jacobsen, P. B., Sadler, I. J., Booth-Jones, M., Soety, E., Weitzner, M. A., & Fields, K. K. (2002). Predictors of posttraumatic stress disorder symptomatology following bone marrow transplantation for cancer. Journal of Consulting and Clinical Psychology, 71, 235–240. doi:10.​1037/​0022-006X.​70.​1.​235.CrossRef
go back to reference Marshall, G. N., Miles, J. N. V., & Stewart, S. H. (2010). Anxiety sensitivity and PTSD symptom severity are reciprocally related: Evidence from a longitudinal study of physical trauma survivors. Journal of Abnormal Psychology, 119, 143–150. doi:10.1037/a0018009.PubMedCrossRef Marshall, G. N., Miles, J. N. V., & Stewart, S. H. (2010). Anxiety sensitivity and PTSD symptom severity are reciprocally related: Evidence from a longitudinal study of physical trauma survivors. Journal of Abnormal Psychology, 119, 143–150. doi:10.​1037/​a0018009.PubMedCrossRef
go back to reference Russell, D. W. (2002). In search of underlying dimensions: The use (and abuse) of factor analysis in Personality and Social Psychology Bulletin. Personality and Social Psychology Bulletin, 28, 1629–1646. doi:10.1177/014616702237645.CrossRef Russell, D. W. (2002). In search of underlying dimensions: The use (and abuse) of factor analysis in Personality and Social Psychology Bulletin. Personality and Social Psychology Bulletin, 28, 1629–1646. doi:10.​1177/​014616702237645.CrossRef
go back to reference Schnider, K. R., Elhai, J. D., & Gray, M. J. (2007). Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss. Journal of Counseling Psychology, 54, 344–350. doi:10.1037/0022-0167.54.3.344.CrossRef Schnider, K. R., Elhai, J. D., & Gray, M. J. (2007). Coping style use predicts posttraumatic stress and complicated grief symptom severity among college students reporting a traumatic loss. Journal of Counseling Psychology, 54, 344–350. doi:10.​1037/​0022-0167.​54.​3.​344.CrossRef
go back to reference SPSS. (2009). PASW® Statistics 18 Core System User’s Guide. Chicago, IL: Author. SPSS. (2009). PASW® Statistics 18 Core System User’s Guide. Chicago, IL: Author.
go back to reference Vujanovic, A. A., Bernstein, A., & Litz, B. T. (2011). Traumatic stress. In M. J. Zvolensky, A. Bernstein, & A. A. Vujanovic (Eds.), Distress tolerance: Theory, research, and clinical applications (pp. 126–148). New York: Guilford Press. Vujanovic, A. A., Bernstein, A., & Litz, B. T. (2011). Traumatic stress. In M. J. Zvolensky, A. Bernstein, & A. A. Vujanovic (Eds.), Distress tolerance: Theory, research, and clinical applications (pp. 126–148). New York: Guilford Press.
go back to reference Vujanovic, A. A., Niles, B., Pietrefasa, A., Schmertz, S., & Potter, C. M. (2011). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Professional Psychology: Research and Practice, 42, 24–31. doi:10.1037/a0022272.CrossRef Vujanovic, A. A., Niles, B., Pietrefasa, A., Schmertz, S., & Potter, C. M. (2011). Mindfulness in the treatment of posttraumatic stress disorder among military veterans. Professional Psychology: Research and Practice, 42, 24–31. doi:10.​1037/​a0022272.CrossRef
go back to reference Weathers, F., Litz, B., Herman, D., Huska, J., & Keane, T. (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility. San Antonio, TX: Paper presented at the Annual Convention of the International Society for Traumatic Stress Studies. Weathers, F., Litz, B., Herman, D., Huska, J., & Keane, T. (1993). The PTSD checklist (PCL): Reliability, validity, and diagnostic utility. San Antonio, TX: Paper presented at the Annual Convention of the International Society for Traumatic Stress Studies.
go back to reference Widows, M. R., Jacobsen, P. B., & Fields, K. K. (2000). Relation of psychological vulnerability factors to posttraumatic stress disorder symptomatology in bone marrow transplant recipients. Psychosomatic Medicine, 62, 873–882. doi:0033-3174/00/6206-0873.PubMed Widows, M. R., Jacobsen, P. B., & Fields, K. K. (2000). Relation of psychological vulnerability factors to posttraumatic stress disorder symptomatology in bone marrow transplant recipients. Psychosomatic Medicine, 62, 873–882. doi:0033-3174/​00/​6206-0873.PubMed
Metagegevens
Titel
A Prospective Investigation of Changes in Avoidant and Active Coping and Posttraumatic Stress Disorder Symptoms among Military Veteran
Auteurs
Matthew Tyler Boden
Marcel O. Bonn-Miller
Anka A. Vujanovic
Kent D. Drescher
Publicatiedatum
01-12-2012
Uitgeverij
Springer US
Gepubliceerd in
Journal of Psychopathology and Behavioral Assessment / Uitgave 4/2012
Print ISSN: 0882-2689
Elektronisch ISSN: 1573-3505
DOI
https://doi.org/10.1007/s10862-012-9293-6

Andere artikelen Uitgave 4/2012

Journal of Psychopathology and Behavioral Assessment 4/2012 Naar de uitgave