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Post-Traumatic Stress Disorders: HELP
Articles by Chérie Armour
Based on 76 articles published since 2010
(Why 76 articles?)
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Between 2010 and 2020, C. Armour wrote the following 76 articles about Stress Disorders, Post-Traumatic.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4
1 Editorial PTSD symptomics: network analyses in the field of psychotraumatology. 2017

Armour, Cherie / Fried, Eiko I / Olff, Miranda. ·Psychology Research Institute, Ulster University, Coleraine, Northern Ireland. · Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. · Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. · Department of Psychiatry, Arq Psychotrauma Expert Group, Diemen, The Netherlands. ·Eur J Psychotraumatol · Pubmed #29250305.

ABSTRACT: Recent years have seen increasing attention on posttraumatic stress disorder (PTSD) research. While research has largely focused on the dichotomy between patients diagnosed with mental disorders and healthy controls - in other words, investigations at the level of diagnoses - recent work has focused on psychopathology symptoms. Symptomics research in the area of PTSD has been scarce so far, although several studies have focused on investigating the network structures of PTSD symptoms. The present special issue of EJPT adds to the literature by curating additional PTSD network studies, each looking at a different aspect of PTSD. We hope that this special issue encourages researchers to conceptualize and model PTSD data from a network perspective, which arguably has the potential to inform and improve the efficacy of therapeutic interventions.

2 Review Posttraumatic stress disorder and positive memories: Clinical considerations. 2018

Contractor, Ateka A / Brown, Lily A / Caldas, Stephanie V / Banducci, Anne N / Taylor, Daniel J / Armour, Cherie / Shea, M Tracie. ·Department of Psychology, University of North Texas, Denton, TX, USA. Electronic address: ateka.contractor@unt.edu. · Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA. · Department of Psychology, University of North Texas, Denton, TX, USA. · VA Boston Healthcare System, Boston, MA, USA. · Institute of Mental Health Sciences, School of Psychology, Ulster University, Northern Ireland, UK. · Providence Veterans Affairs Medical Center, Providence, USA; Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, USA. ·J Anxiety Disord · Pubmed #30025253.

ABSTRACT: Encoding and retrieval difficulties, and avoidance of both traumatic and positive memories, are associated with posttraumatic stress disorder (PTSD) symptoms. However, most PTSD research and clinical work has solely examined the role of traumatic memories in the maintenance/resolution of PTSD symptoms. This review provides a comprehensive discussion of the literature on positive memories and PTSD. First, we review theories and evidence on the relations between trauma, PTSD, and memory processes (particularly positive memories). Next, we propose a conceptual model that integrates evidence from experimental and positive/memory-based intervention research and highlights hypothesized mechanisms underlying the potential effectiveness of targeting positive memories in PTSD interventions. Specifically, we discuss how targeting positive memories could (1) increase positive affect and reduce negative affect, (2) correct negative cognitions, (3) increase specificity of retrieving autobiographical memories, and (4) be effectively integrated/sequenced with and enhance the effects of trauma-focused interventions. Lastly, we suggest clinical research avenues for investigating the relations between positive memories and PTSD, to possibly alter the current PTSD intervention paradigm focused only on traumatic memories. Overall, our proposed model drawing from experimental and intervention research, and outlining potential effects of targeting positive memories to reduce PTSD severity, needs further empirical investigation.

3 Review Evidence of the dissociative PTSD subtype: A systematic literature review of latent class and profile analytic studies of PTSD. 2017

Hansen, Maj / Ross, Jana / Armour, Cherie. ·Department of Psychology, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark. Electronic address: mhansen@health.sdu.dk. · Psychology Research Institute, Psychotraumatology, Mental Health & Suicidal Behavior Research Group, Ulster University, Cromore Road, Coleraine BT52 1SA, Northern Ireland. ·J Affect Disord · Pubmed #28192736.

ABSTRACT: BACKGROUND: The dissociative PTSD (D-PTSD) subtype was first introduced into the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in 2013. Prior to this, studies using latent profile analysis (LPA) or latent class analysis (LCA), began to provide support for the D-PTSD construct and associated risk factors. This research is important, because dissociative symptoms in the context of PTSD may potentially interfere with treatment course or outcome. The aims of the present study were twofold: to systematically review the LCA and LPA studies investigating support for the D-PTSD construct; and to review the associated research on the risk factors or covariates of D-PTSD in the identified studies. METHOD: Six databases (PubMed, Web of Science, Scopus, PILOTS, PsychInfo, and Embase) were systematically searched for relevant papers. RESULTS: Eleven studies were included in the present review. The majority of the studies were supportive of the D-PTSD subtype; primarily characterized by depersonalization and derealization. Several covariates of the D-PTSD subtype have been investigated with mixed results. LIMITATIONS: Many limitations relate to the state of the current literature, including a small number of studies, the use of self-report measurements of PTSD, and heterogeneity across the samples in investigated covariates. CONCLUSION: The results were overall supportive of the D-PTSD construct. Future research on D-PTSD and associated risk factors is needed to shed light on the possibilities of facilitating preventive actions, screening, and implications on treatment effects.

4 Review A systematic literature review of PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders: DSM-IV to DSM-5. 2016

Armour, Cherie / Műllerová, Jana / Elhai, Jon D. ·School of Psychology, Ulster University, Coleraine, Northern Ireland, UK. Electronic address: armour.cherie@gmail.com. · School of Psychology, Ulster University, Coleraine, Northern Ireland, UK. · Department of Psychology, University of Toledo, Toledo, OH, USA; Department of Psychiatry, University of Toledo, Toledo, OH, USA. ·Clin Psychol Rev · Pubmed #26761151.

ABSTRACT: The factor structure of posttraumatic stress disorder (PTSD) has been widely researched, but consensus regarding the exact number and nature of factors is yet to be reached. The aim of the current study was to systematically review the extant literature on PTSD's latent structure in the Diagnostic and Statistical Manual of Mental Disorders (DSM) in order to identify the best-fitting model. One hundred and twelve research papers published after 1994 using confirmatory factor analysis and DSM-based measures of PTSD were included in the review. In the DSM-IV literature, four-factor models received substantial support, but the five-factor Dysphoric arousal model demonstrated the best fit, regardless of gender, measurement instrument or trauma type. The recently proposed DSM-5 PTSD model was found to be a good representation of PTSD's latent structure, but studies analysing the six- and seven-factor models suggest that the DSM-5 PTSD factor structure may need further alterations.

5 Review Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review. 2014

Lagdon, Susan / Armour, Cherie / Stringer, Maurice. ·School of Psychology, University of Ulster, Coleraine, Northern Ireland, UK. ·Eur J Psychotraumatol · Pubmed #25279103.

ABSTRACT: BACKGROUND: Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence. OBJECTIVE: To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes. METHOD: A systematic review of 11 electronic databases (2004-2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective. RESULTS: Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways. CONCLUSIONS: Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue.

6 Article Relation between PTSD symptom clusters and positive memory characteristics: A network perspective. 2020

Contractor, Ateka A / Greene, Talya / Dolan, Megan / Weiss, Nicole H / Armour, Cherie. ·Department of Psychology, University of North Texas, Denton, TX, USA. Electronic address: ateka.contractor@unt.edu. · Department of Community Mental Health, University of Haifa, Israel. · Department of Psychology, University of North Texas, Denton, TX, USA. · Department of Psychology, University of Rhode Island, Kingston, RI, USA. · School of Psychology, Queens University Belfast, Northern Ireland, UK. ·J Anxiety Disord · Pubmed #31751918.

ABSTRACT: 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, accessibility, 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 Turk-recruited sample of 206 individuals (M

7 Article A decennial review of psychotraumatology: what did we learn and where are we going? 2019

Olff, Miranda / Amstadter, Ananda / Armour, Cherie / Birkeland, Marianne S / Bui, Eric / Cloitre, Marylene / Ehlers, Anke / Ford, Julian D / Greene, Talya / Hansen, Maj / Lanius, Ruth / Roberts, Neil / Rosner, Rita / Thoresen, Siri. ·Department of Psychiatry, Amsterdam University Medical Centers (location AMC), University of Amsterdam, Amsterdam Neuroscience, Amsterdam, The Netherlands. · ARQ National Psychotrauma Centre, Diemen, The Netherlands. · Departemnts of Psychiatry, Psychology, & Human and Molecular Genetics, Virginia Commonwealth University, Richmond, USA. · School of Psychology, Queens University Belfast, Belfast, Northern Ireland, UK. · Section for implementation and treatment research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo Norway. · Department of Psychiatry, Massachusetts General Hospital & Harvard Medical School, Boston, MA, USA. · National Center for PTSD Dissemination and Training Division, Palo Alto, CA, USA. · Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA. · Department of Experimental Psychology, University of Oxford, Oxford, UK. · Department of Psychiatry, University of Connecticut Health Center, Farmington, USA. · Department of Community Mental Health, University of Haifa, Haifa, Israel. · Department of Psychology, Odense, Denmark. · Posttraumatic Stress Disorder (PTSD) Research Unit, Western University of Canada, London, ON, Canada. · Psychology and Psychological Therapies Directorate, Cardiff & Vale University Health Board, Cardiff, UK. · Division of Psychological Medicine & Clinical Neurosciences, Cardiff University, Cardiff, UK. · Department of Clinical and Biological Psychology, KU Eichstaett-Ingolstadt, Eichstaett, Germany. · Section for trauma, catastrophes and forced migration - children and youth, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway. ·Eur J Psychotraumatol · Pubmed #31897268.

ABSTRACT: On 6 December 2019 we start the 10th year of the

8 Article A latent profile analysis of PTSD symptoms among UK treatment seeking veterans. 2019

Murphy, D / Ross, J / Busuttil, W / Greenberg, N / Armour, C. ·Research Department, Combat Stress, Leatherhead, UK. · King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK. · Psychology Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland. ·Eur J Psychotraumatol · Pubmed #30719235.

ABSTRACT:

9 Article Comorbidity Patterns of Psychiatric Conditions in Canadian Armed Forces Personnel. 2019

Richardson, J Don / Thompson, Amanda / King, Lisa / Ketcheson, Felicia / Shnaider, Philippe / Armour, Cherie / St Cyr, Kate / Sareen, Jitender / Elhai, Jon D / Zamorski, Mark A. ·1 Department of Psychiatry, Western University, London, Ontario. · 2 Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario. · 3 Parkwood Institute Operational Stress Injury Clinic, London, Ontario. · 4 MacDonald/Franklin OSI Research Centre, London, Ontario. · 5 Canadian Forces Health Services Group, Ottawa, Ontario. · 6 Anxiety Treatment and Research Centre, St. Joseph's Healthcare Hamilton, Hamilton, Ontario. · 7 Ulster University, Coleraine, Co. Londonderry, UK. · 8 Departments of Psychiatry, Psychology, and Community Health Sciences, University of Manitoba, Winnipeg. · 9 Deer Lodge Centre Operational Stress Injury Clinic, Winnipeg, Manitoba. · 10 Departments of Psychology and Psychiatry, University of Toledo, Toledo, OH, USA. · 11 Department of Family Medicine, University of Ottawa, Ottawa, Ontario. ·Can J Psychiatry · Pubmed #30599762.

ABSTRACT: OBJECTIVE: Posttraumatic stress disorder (PTSD) is often accompanied by other mental health conditions, including major depressive disorder (MDD), substance misuse disorders, and anxiety disorders. The objective of the current study is to delineate classes of comorbidity and investigate predictors of comorbidity classes amongst a sample of Canadian Armed Forces (CAF) Regular Force personnel. METHODS: Latent class analyses (LCAs) were applied to cross-sectional data obtained between April and August 2013 from a nationally representative random sample of 6700 CAF Regular Force personnel who deployed to the mission in Afghanistan. RESULTS: MDD was the most common diagnosis (8.0%), followed by PTSD (5.3%) and generalized anxiety disorder (4.7%). Of those with a mental health condition, LCA revealed 3 classes of comorbidity: a highly comorbid class (8.3%), a depressed-only class (4.6%), and an alcohol use-only class (3.1%). Multinomial logit regression showed that women (adjusted relative risk ratio [ARRR] = 2.77; 95% CI, 2.13 to 3.60; CONCLUSIONS: Results provide further evidence to support screening for and treatment of comorbid mental health conditions. The role of sex, childhood abuse, and combat deployment in determining class membership may also prove valuable for clinicians treating military-related mental health conditions.

10 Article Assessing the existence of dissociative PTSD in sub-acute patients of whiplash. 2019

Hansen, Maj / Hyland, Philip / Armour, Cherie / Andersen, Tonny E. ·a ThRIVE, Department of Psychology , University of Southern Denmark , Odense , Denmark. · b School of Business , National College of Ireland , Dublin , Ireland. · c Psychology Research Institute, School of Psychology , Ulster University , Coleraine , Ireland. ·J Trauma Dissociation · Pubmed #29547063.

ABSTRACT: Numerous studies investigating dissociative posttraumatic stress disorder (D-PTSD) have emerged. However, there is a lack of studies investigating D-PTSD following a wider range of traumatic exposure. Thus, the present study investigates D-PTSD using latent class analysis (LCA) in sub-acute patients of whiplash and associated risk factors. The results of LCA showed a three-class solution primarily distributed according to posttraumatic stress disorder (PTSD) symptom severity and thus no indication of D-PTSD. Dissociative symptoms, psychological distress (i.e. anxiety/depression), and pain severity significantly predicted PTSD severity. Combined, the results support the component model of dissociation and PTSD, while still stressing the importance of dissociative symptoms when planning treatment for PTSD.

11 Article Examination of the latent structure of DSM-5 posttraumatic stress disorder symptoms in Slovakia. 2018

Ross, Jana / Kaliská, Lada / Halama, Peter / Lajčiaková, Petra / Armour, Cherie. ·Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK. Electronic address: j.ross@ulster.ac.uk. · Department of Psychology, Faculty of Education, Matej Bel University, Banská Bystrica, Slovakia. · Department of Psychology, Faculty of Arts, Trnava University in Trnava, Trnava, Slovakia. · Department of Psychology, Faculty of Arts and Letters, Catholic University in Ružomberok, Slovakia. · Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK. Electronic address: c.armour1@ulster.ac.uk. ·Psychiatry Res · Pubmed #29940453.

ABSTRACT: The latent structure of posttraumatic stress disorder (PTSD) has been widely discussed, with the majority of studies in this area being conducted in the US. The current study aimed to extend this area of research by comparing seven existing PTSD factor models in a sample of 754 trauma-exposed university students from Slovakia, where similar research has not been conducted yet. The sample was predominantly female (83.69%), with a mean age of 22.68 years. The comparison of competing models revealed that the Anhedonia model, consisting of six inter-correlated factors of reexperiencing, avoidance, negative affect, anhedonia, dysphoric arousal and anxious arousal, provided the best fit. Several factors of the Anhedonia model also showed differential relationships with the external variables of anxiety and depression. The study contributes to the limited literature on the latent structure of PTSD in Eastern Europe.

12 Article A network analysis of DSM-5 posttraumatic stress disorder and functional impairment in UK treatment-seeking veterans. 2018

Ross, Jana / Murphy, Dominic / Armour, Cherie. ·Psychology Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland, UK. Electronic address: j.ross@ulster.ac.uk. · Research Department, Combat Stress, Leatherhead, UK; King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK. Electronic address: dominic.murphy@combatstress.org.uk. · Psychology Research Institute, Faculty of Life & Health Sciences, Ulster University, Coleraine, Northern Ireland, UK. Electronic address: c.armour1@ulster.ac.uk. ·J Anxiety Disord · Pubmed #29886306.

ABSTRACT: Network analysis is a relatively new methodology for studying psychological disorders. It focuses on the associations between individual symptoms which are hypothesized to mutually interact with each other. The current study represents the first network analysis conducted with treatment-seeking military veterans in UK. The study aimed to examine the network structure of posttraumatic stress disorder (PTSD) symptoms and four domains of functional impairment by identifying the most central (i.e., important) symptoms of PTSD and by identifying those symptoms of PTSD that are related to functional impairment. Participants were 331 military veterans with probable PTSD. In the first step, a network of PTSD symptoms based on the PTSD Checklist for DSM-5 was estimated. In the second step, functional impairment items were added to the network. The most central symptoms of PTSD were recurrent thoughts, nightmares, negative emotional state, detachment and exaggerated startle response. Functional impairment was related to a number of different PTSD symptoms. Impairments in close relationships were associated primarily with the negative alterations in cognitions and mood symptoms and impairments in home management were associated primarily with the reexperiencing symptoms. The results are discussed in relation to previous PTSD network studies and include implications for clinical practice.

13 Article Replicability and Generalizability of Posttraumatic Stress Disorder (PTSD) Networks: A Cross-Cultural Multisite Study of PTSD Symptoms in Four Trauma Patient Samples. 2018

Fried, Eiko I / Eidhof, Marloes B / Palic, Sabina / Costantini, Giulio / Huisman-van Dijk, Hilde M / Bockting, Claudi L H / Engelhard, Iris / Armour, Cherie / Nielsen, Anni B S / Karstoft, Karen-Inge. ·Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. · Arq Psychotrauma Expert Group Diemen/Oegstgeest, The Netherlands. · Competence Center for Transcultural Psychiatry, Mental Health Center Ballerup, Copenhagen, Denmark. · Department of Psychology, University of Milan-Bicocca, Milan, Italy. · Altrecht Academic Anxiety Centre, Utrecht, The Netherlands. · Department of Clinical Psychology, Utrecht University, The Netherlands. · Psychology Research Institute, Ulster University, Coleraine Campus, Northern Ireland. · Research and Knowledge Center, The Danish Veteran Center, Ringsted, Denmark. · The Research Unit and Section of General Practice, Institute of Public Health, University of Copenhagen, Denmark. ·Clin Psychol Sci · Pubmed #29881651.

ABSTRACT: The growing literature conceptualizing mental disorders like posttraumatic stress disorder (PTSD) as networks of interacting symptoms faces three key challenges. Prior studies predominantly used (a) small samples with low power for precise estimation, (b) nonclinical samples, and (c) single samples. This renders network structures in clinical data, and the extent to which networks replicate across data sets, unknown. To overcome these limitations, the present cross-cultural multisite study estimated regularized partial correlation networks of 16 PTSD symptoms across four data sets of traumatized patients receiving treatment for PTSD (total

14 Article Examination of the heterogeneity in PTSD and impulsivity facets: A latent profile analysis. 2018

Contractor, Ateka A / Caldas, Stephanie / Weiss, Nicole H / Armour, Cherie. ·Department of Psychology, University of North Texas, Denton, TX, USA. · Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. · Psychology Research Institute, Ulster University, Coleraine, Northern Ireland. ·Pers Individ Dif · Pubmed #29628542.

ABSTRACT: The experience of traumatizing events and resulting posttraumatic stress disorder (PTSD) symptomology relates to a range of impulsive behaviors. While both PTSD and impulsivity are heterogeneous and multidimensional constructs, no research has used person-centered approaches to examine subgroups of individuals based on these response endorsements. Hence, our study examined PTSD-impulsivity typologies and their construct validity in two samples: university students (

15 Article PTSD's factor structure and measurement invariance across subgroups with differing count of trauma types. 2018

Contractor, Ateka A / Caldas, Stephanie V / Dolan, Megan / Lagdon, Susan / Armour, Chérie. ·Department of Psychology, University of North Texas, 369 Terrill Hall, Denton, TX 76201, USA. Electronic address: ateka.c@gmail.com. · Department of Psychology, University of North Texas, 369 Terrill Hall, Denton, TX 76201, USA. · School of Nursing & Midwifery, Queens University Belfast, UK. · Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK. ·Psychiatry Res · Pubmed #29627700.

ABSTRACT: To investigate the effect of the count of traumatizing event (TE) types on post-trauma mental health, several studies have compared posttraumatic stress disorder (PTSD) severity between individuals experiencing one versus multiple TE types. However, the validity of these studies depends on the establishment of measurement invariance of the construct(s) of interest. The current study examined the stability of the most optimal PTSD Model symptom cluster constructs (assessed by the PTSD Checklist for DSM-5 [PCL-5]) across subgroups experiencing one versus multiple TE types. The sample included university students (n = 556) endorsing at least one TE (Stressful Life Events Screening Questionnaire). Using data from the entire sample, results suggest that the PCL-5-assessed Hybrid Model provided a significantly better fit compared to other models. Results also indicated invariance of factor loadings (metric), and intercepts (scalar) for the PCL-5-assessed Hybrid Model factors across subgroups endorsing one (n = 191) versus multiple TE types (n = 365). Our findings thus support the stability, applicability, and meaningful comparison of the PCL-assessed Hybrid Model factor structure (including subscale severity scores) across subgroups experiencing one versus multiple TE types.

16 Article Empirically derived lifespan polytraumatization typologies: A systematic review. 2018

Contractor, Ateka A / Caldas, Stephanie / Fletcher, Shelley / Shea, M Tracie / Armour, Cherie. ·Department of Psychology, University of North Texas, Denton, TX, USA. · Psychology Research Institute, Coleraine Campus, Ulster University, Northern Ireland. · Department of Veteran Affairs, Providence VA Medical Center, Providence, RI, USA. · Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, USA. ·J Clin Psychol · Pubmed #29363746.

ABSTRACT: CONTEXT: Polytraumatization classes based on trauma endorsement patterns relate to distinct clinical outcomes. Person-centered approaches robustly evaluate the nature, and construct validity of polytraumatization classes. OBJECTIVE: Our review examined evidence for the nature and construct validity of lifespan polytraumatization typologies. DATA SOURCES: In September 2016, we searched Pubmed, PSYCINFO, PSYC ARTICLES, Academic Search Complete, PILPTS, Web of Science, CINAHL, Medline, PsycEXTRA, and PBSC. Search terms included "latent profile," "latent class," "latent analysis," "person-centered," "polytrauma," "polyvictimization," "traumatization," "lifetime," "cooccurring," "complex," "typology," "multidimensional," "sequential," "multiple," "subtype," "(re)victimization," "cumulative," "maltreatment," "abuse," and "stressor." Inclusionary criteria included: peer-reviewed; latent class/latent profile analyses (LCA/LPA) of lifespan polytrauma classes; adult samples of size greater than 200; only trauma types as LCA/LPA indicators; mental health correlates of typologies; and individual-level trauma assessment. Of 1,397 articles, nine met inclusion criteria. DATA EXTRACTION: Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, research assistants completed a secondary reference search, and independently extracted data with standardized coding forms. RESULTS: Three-class (n = 5) or four-class (n = 4) solutions were found. Seven studies found a class characterized by higher trauma endorsement (high-trauma). All studies found a class characterized by lower trauma endorsement (low-trauma), and predominance of specific traumas (specific-trauma; e.g., childhood maltreatment). High-trauma versus low-trauma classes and specific-trauma versus low-trauma classes differed on mental health correlates. CONCLUSION: Evidence supports the prevalence of a high-trauma class experiencing poorer mental health, and the detrimental impact of aggregated interpersonal and other traumas. We highlight the clinical importance of addressing polytraumatization classes, and comprehensively assessing the impact of all traumas.

17 Article Evaluating the stability of DSM-5 PTSD symptom network structure in a national sample of U.S. military veterans. 2018

von Stockert, Sophia H H / Fried, Eiko I / Armour, Cherie / Pietrzak, Robert H. ·Faculty of Psychology and Neuroscience, Maastricht University, The Netherlands; Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. · Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. · Psychology Research Institute, Ulster University, Coleraine Campus, Northern Ireland, UK; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. · United States Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. Electronic address: robert.pietrzak@yale.edu. ·J Affect Disord · Pubmed #29306694.

ABSTRACT: BACKGROUND: Previous studies have used network models to investigate how PTSD symptoms associate with each other. However, analyses examining the degree to which these networks are stable over time, which are critical to identifying symptoms that may contribute to the chronicity of this disorder, are scarce. In the current study, we evaluated the temporal stability of DSM-5 PTSD symptom networks over a three-year period in a nationally representative sample of trauma-exposed U.S. military veterans. METHODS: Data were analyzed from 611 trauma-exposed U.S. military veterans who participated in the National Health and Resilience in Veterans Study (NHRVS). We estimated regularized partial correlation networks of DSM-5 PTSD symptoms at baseline (Time 1) and at three-year follow-up (Time 2), and examined their temporal stability. RESULTS: Evaluation of the network structure of PTSD symptoms at Time 1 and Time 2 using a formal network comparison indicated that the Time 1 network did not differ significantly from the Time 2 network with regard to network structure (p = 0.12) or global strength (sum of all absolute associations, i.e. connectivity; p = 0.25). Centrality estimates of both networks (r = 0.86) and adjacency matrices (r = 0.69) were highly correlated. In both networks, avoidance, intrusive, and negative cognition and mood symptoms were among the more central nodes. LIMITATIONS: This study is limited by the use of a self-report instrument to assess PTSD symptoms and recruitment of a relatively homogeneous sample of predominantly older, Caucasian veterans. CONCLUSION: Results of this study demonstrate the three-year stability of DSM-5 PTSD symptom network structure in a nationally representative sample of trauma-exposed U.S. military veterans. They further suggest that trauma-related avoidance, intrusive, and dysphoric symptoms may contribute to the chronicity of PTSD symptoms in this population.

18 Article Assessing the structure and meaningfulness of the dissociative subtype of PTSD. 2018

Ross, Jana / Baník, Gabriel / Dědová, Mária / Mikulášková, Gabriela / Armour, Cherie. ·Psychology Research Institute, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK. · Faculty of Arts, Institute of Psychology, University of Prešov, Prešov, Slovakia. · Faculty of Arts, School of Psychology, Trnava University in Trnava, Trnava, Slovakia. · Psychology Research Institute, Ulster University, Coleraine, BT52 1SA, Northern Ireland, UK. c.armour1@ulster.ac.uk. ·Soc Psychiatry Psychiatr Epidemiol · Pubmed #29043375.

ABSTRACT: PURPOSE: Studies conducted in the USA, Canada and Denmark have supported the existence of the dissociative PTSD subtype, characterized primarily by symptoms of depersonalization and derealization. The current study aimed to examine the dissociative PTSD subtype in an Eastern European, predominantly female (83.16%) sample, using an extended set of dissociative symptoms. METHODS: A latent profile analysis was applied to the PTSD and dissociation data from 689 trauma-exposed university students from Slovakia. RESULTS: Four latent profiles of varying PTSD and dissociation symptomatology were uncovered. They were named non-symptomatic, moderate PTSD, high PTSD and dissociative PTSD. The dissociative PTSD profile showed elevations on depersonalization and derealization, but also the alternative dissociative indicators of gaps in awareness and memory, sensory misperceptions and cognitive and behavioural re-experiencing. The core PTSD symptoms of 'memory impairment' and 'reckless or self-destructive behaviour' were also significantly elevated in the dissociative PTSD profile. Moreover, anxiety and anger predicted membership in the dissociative PTSD profile. CONCLUSION: The results provide support for the proposal that the dissociative PTSD subtype can be characterized by a variety of dissociative symptoms.

19 Article Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans. 2017

Murphy, Dominic / Ross, Jana / Ashwick, Rachel / Armour, Cherie / Busuttil, Walter. ·Research Department, Combat Stress, Leatherhead, UK. · King's Centre for Military Health Research, Department of Psychological Medicine, King's College London, London, UK. · Faculty of Life & Health Sciences, Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK. ·Eur J Psychotraumatol · Pubmed #29435200.

ABSTRACT:

20 Article Predictors of PTSD Treatment Response Trajectories in a Sample of Childhood Sexual Abuse Survivors: The Roles of Social Support, Coping, and PTSD Symptom Clusters. 2017

Fletcher, Shelley / Elklit, Ask / Shevlin, Mark / Armour, Cherie. ·1 Ulster University, Northern Ireland, UK. · 2 University of Southern Denmark, Odense, Denmark. ·J Interpers Violence · Pubmed #29294985.

ABSTRACT: This study aimed to (a) identify posttraumatic stress disorder (PTSD) trajectories in a sample of Danish treatment-seeking childhood sexual abuse (CSA) survivors and (b) examine the roles of social support, coping style, and individual PTSD symptom clusters (avoidance, reexperiencing, and hyperarousal) as predictors of the identified trajectories. We utilized a convenience sample of 439 CSA survivors attending personalized psychotherapy treatment in Denmark. Four assessments were conducted on a six monthly basis over a period of 18 months. We used latent class growth analysis (LCGA) to test solutions with one to six classes. Following this, a logistic regression was conducted to examine predictors of the identified trajectories. Results revealed four distinct trajectories which were labeled high PTSD gradual response, high PTSD treatment resistant, moderate PTSD rapid response, and moderate PTSD gradual response. Emotional and detached coping and more severe pretreatment avoidance and reexperiencing symptoms were associated with more severe and treatment resistant PTSD. High social support and a longer length of time since the abuse were associated with less severe PTSD which improved over time. The findings suggested that treatment response of PTSD in CSA survivors is characterized by distinct patterns with varying levels and rates of PTSD symptom improvement. Results revealed that social support is protective and that emotional and detached coping and high pretreatment levels of avoidance and reexperiencing symptoms are risk factors in relation to PTSD severity and course. These factors could potentially identify patients who are at risk of not responding to treatment. Furthermore, these factors could be specifically addressed to increase positive outcomes for treatment-seeking CSA survivors.

21 Article Does size really matter? A multisite study assessing the latent structure of the proposed ICD-11 and DSM-5 diagnostic criteria for PTSD. 2017

Hansen, Maj / Hyland, Philip / Karstoft, Karen-Inge / Vaegter, Henrik B / Bramsen, Rikke H / Nielsen, Anni B S / Armour, Cherie / Andersen, Søren B / Høybye, Mette Terp / Larsen, Simone Kongshøj / Andersen, Tonny E. ·ThRIVE, Department of Psychology, University of Southern Denmark, Odense M, Denmark. · School of Business, National College of Ireland, IFSC, Dublin 1, Ireland. · Centre for Global Health, Trinity College Dublin, Dublin 2, Ireland. · Research and Knowledge Centre, The Danish Veteran Center, Ringsted, Denmark. · Pain Research Group, Pain Center South, Odense University Hospital, Odense C, Denmark. · Psychology Research Institute, Ulster University, Coleraine, Northern Ireland. · Interdisciplinary Research Unit, Elective Surgery Center, Silkeborg Regional Hospital, Silkeborg, Denmark. · Multidisciplinary Pain Center, Department of Anaesthesia and Intensive Care Medicine, Aalborg University Hospital, Aalborg, Denmark. ·Eur J Psychotraumatol · Pubmed #29201287.

ABSTRACT:

22 Article The 7-factor hybrid model of DSM-5 PTSD symptoms and alcohol consumption and consequences in a national sample of trauma-exposed veterans. 2017

Claycomb Erwin, Meredith / Charak, Ruby / Durham, Tory A / Armour, Cherie / Lv, Xin / Southwick, Steven M / Elhai, Jon D / Pietrzak, Robert H. ·Department of Psychology, University of Toledo, Toledo, OH, United States. · Department of Psychological Science, University of Texas-Rio Grande Valley, Edinburg, TX, United States. · Psychology Research Institute, Ulster University, Northern Ireland, UK. · U.S. Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, VA Connecticut Healthcare System, West Haven, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States. · Department of Psychology, University of Toledo, Toledo, OH, United States; Department of Psychiatry, University of Toledo, Toledo, OH, United States. Electronic address: contact@jon-elhai.com. ·J Anxiety Disord · Pubmed #28843574.

ABSTRACT: The purpose of the present study was to investigate associations between the 7-factor hybrid model of DSM-5 posttraumatic stress disorder (PTSD) symptoms, which includes intrusions, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal symptoms, and alcohol consumption and consequences. A nationally representative sample of 916 trauma-exposed U.S. military veterans were administered the Trauma History Screen, PTSD Checklist-5, and Alcohol Use Disorders Identification Test. Confirmatory factor analyses were conducted to determine associations between the 7-factor hybrid model of PTSD symptoms, and alcohol consumption and consequences. Results revealed that lifetime dysphoric arousal (r=0.31), negative affect (r=0.30), and anhedonia (r=0.29) symptom clusters were most strongly associated with past-year alcohol consequences. No significant associations were observed for alcohol consumption. While the cross-sectional study design does not allow one to ascertain causative associations between PTSD factors and alcohol consumption and consequences, results generally align with the self-medication hypothesis, as PTSD factors reflecting internalizing were most strongly related to alcohol-related consequences. These results underscore the importance of assessing for alcohol use problems in veterans who score highly on PTSD symptoms reflecting internalizing symptomatology.

23 Article PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology. 2017

Contractor, Ateka A / Weiss, Nicole H / Dranger, Paula / Ruggero, Camilo / Armour, Cherie. ·Department of Psychology, University of North Texas, Denton, TX, USA. Electronic address: ateka.c@gmail.com. · Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA. · Counseling Services, Valparaiso University, Valparaiso, IN, USA; Choices Counseling Services, Valparaiso, IN. · Department of Psychology, University of North Texas, Denton, TX, USA. · Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK. ·Psychiatry Res · Pubmed #28285248.

ABSTRACT: A new symptom criterion of reckless and self-destructive behaviors (E2) was recently added to posttraumatic stress disorder's (PTSD) diagnostic criteria in DSM-5, which is unsurprising given the well-established relation between PTSD and risky behaviors. Researchers have questioned the significance and incremental validity of this symptom criterion within PTSD's symptomatology. Unprecedented to our knowledge, we aim to compare trauma-exposed groups differing on their endorsement status of the risky behavior symptom on several psychopathology constructs (PTSD, depression, distress tolerance, rumination, anger). The sample included 123 trauma-exposed participants seeking mental health treatment (M age=35.70; 68.30% female) who completed self-report questionnaires assessing PTSD symptoms, depression, rumination, distress tolerance, and anger. Results of independent samples t-tests indicated that participants who endorsed the E2 criterion at a clinically significant level reported significantly greater PTSD subscale severity; depression severity; rumination facets of repetitive thoughts, counterfactual thinking, and problem-focused thinking; and anger reactions; and significantly less absorption and regulation (distress tolerance facets) compared to participants who did not endorse the E2 criterion at a clinically significant level. Results indicate the utility of the E2 criterion in identifying trauma-exposed individual with greater posttraumatic distress, and emphasize the importance of targeting such behaviors in treatment.

24 Article Heterogeneity in patterns of DSM-5 posttraumatic stress disorder and depression symptoms: Latent profile analyses. 2017

Contractor, Ateka A / Roley-Roberts, Michelle E / Lagdon, Susan / Armour, Cherie. ·Department of Psychology, University of North Texas, Denton, USA. Electronic address: ateka.c@gmail.com. · Department of Psychiatry and Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, USA. · School of Nursing & Midwifery, Queens University, Belfast, Northern Ireland, UK. · Psychology Research Institute, Ulster University, Coleraine, Northern Ireland, UK. ·J Affect Disord · Pubmed #28142081.

ABSTRACT: BACKGROUND: Posttraumatic stress disorder (PTSD) and depression co-occur frequently following the experience of potentially traumatizing events (PTE; Morina et al., 2013). A person-centered approach to discern heterogeneous patterns of such co-occurring symptoms is recommended (Galatzer-Levy and Bryant, 2013). We assessed heterogeneity in PTSD and depression symptomatology; and subsequently assessed relations between class membership with psychopathology constructs (alcohol use, distress tolerance, dissociative experiences). METHODS: The sample consisted of 268 university students who had experienced a PTE and susequently endorsed clinical levels of PTSD or depression severity. Latent profile analyses (LPA) was used to identify the best-fitting class solution accouring to recommended fit indices (Nylund et al., 2007a); and the effects of covariates was analyzed using a 3-step approach (Vermunt, 2010). RESULTS: Results of the LPA indicated an optimal 3-class solutions: high severity (Class 2), lower PTSD-higher depression (Class 1), and higher PTSD-lower depression (Class 3). Covariates of distress tolerance, and different kinds of dissociative experiences differentiated the latent classes. LIMITATIONS: Use of self-report measure could lead to response biases; and the specific nature of the sample limits generalizability of results. CONCLUSION: We found evidence for a depressive subtype of PTSD differentiated from other classes in terms of lower distress tolerance and greater dissociative experiences. Thus, transdiagnostic treatment protocols may be most beneficial for these latent class members. Further, the distinctiveness of PTSD and depression at comparatively lower levels of PTSD severity was supported (mainly in terms of distress tolerance abilities); hence supporting the current classification system placement of these disorders.

25 Article A network analysis of DSM-5 posttraumatic stress disorder symptoms and correlates in U.S. military veterans. 2017

Armour, Cherie / Fried, Eiko I / Deserno, Marie K / Tsai, Jack / Pietrzak, Robert H. ·Psychology Research Institute, Coleraine Campus, University of Ulster, Coleraine, Northern Ireland, BT52 1SA, UK. Electronic address: armour.cherie@gmail.com. · Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium. · Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands. · Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; United States Department of Veterans Affairs, New England Mental Illness Research, Education, and Clinical Center, West Haven, CT, USA. · Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; United States Department of Veterans Affairs, National Center for Posttraumatic Stress Disorder, Clinical Neurosciences Division, West Haven, CT, USA. ·J Anxiety Disord · Pubmed #27936411.

ABSTRACT: OBJECTIVE: Recent developments in psychometrics enable the application of network models to analyze psychological disorders, such as PTSD. Instead of understanding symptoms as indicators of an underlying common cause, this approach suggests symptoms co-occur in syndromes due to causal interactions. The current study has two goals: (1) examine the network structure among the 20 DSM-5 PTSD symptoms, and (2) incorporate clinically relevant variables to the network to investigate whether PTSD symptoms exhibit differential relationships with suicidal ideation, depression, anxiety, physical functioning/quality of life (QoL), mental functioning/QoL, age, and sex. METHOD: We utilized a nationally representative U.S. military veteran's sample; and analyzed the data from a subsample of 221 veterans who reported clinically significant DSM-5 PTSD symptoms. Networks were estimated using state-of-the-art regularized partial correlation models. Data and code are published along with the paper. RESULTS: The 20-item DSM-5 PTSD network revealed that symptoms were positively connected within the network. Especially strong connections emerged between nightmares and flashbacks; blame of self or others and negative trauma-related emotions, detachment and restricted affect; and hypervigilance and exaggerated startle response. The most central symptoms were negative trauma-related emotions, flashbacks, detachment, and physiological cue reactivity. Incorporation of clinically relevant covariates into the network revealed paths between self-destructive behavior and suicidal ideation; concentration difficulties and anxiety, depression, and mental QoL; and depression and restricted affect. CONCLUSION: These results demonstrate the utility of a network approach in modeling the structure of DSM-5 PTSD symptoms, and suggest differential associations between specific DSM-5 PTSD symptoms and clinical outcomes in trauma survivors. Implications of these results for informing the assessment and treatment of this disorder, are discussed.

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