Universität zu Köln

Spies, Jan Peter, Cwik, Jan Christopher ORCID: 0000-0002-2290-353X, Willmund, Gert Dieter, Knaevelsrud, Christine, Schumacher, Sarah, Niemeyer, Helen, Engel, Sinha, Kuester, Annika, Muschalla, Beate ORCID: 0000-0001-5285-6618, Koehler, Kai, Weiss, Deborah and Rau, Heinrich (2020). Associations Between Difficulties in Emotion Regulation and Post-Traumatic Stress Disorder in Deployed Service Members of the German Armed Forces. Front. Psychiatry, 11. LAUSANNE: FRONTIERS MEDIA SA. ISSN 1664-0640

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Abstract

Background Experiencing a traumatic event can lead to post-traumatic stress disorder (PTSD), but not every traumatized person develops PTSD. Several protective and risk factors have been identified in civilians and veterans to explain why some individuals develop PTSD and others do not. However, no research has confirmed the relationship between emotion regulation and PTSD in deployed German Armed Forces service members after a foreign assignment. Previous studies have identified some protective factors, such as social support, social acknowledgment, specific personal values, and posttraumatic growth, as well as risk factors, like moral injury and emotion regulation. Thus, the aim of the present study is to confirm the relationship between emotion regulation and PTSD and to test for factors that are associated with higher severity of PTSD symptoms in such a sample. Methods Apost-hocsecondary analysis was conducted on data collected in a randomized controlled trial. Participants (N= 72) were male active and former military service members that have returned from deployment and were recruited from the German Armed Forces. These participants were separated into two groups according to PTSD diagnosis based on the results of a structured diagnostic interview. Data from evaluation questionnaires administered upon entry into the study were subjected to a cross-sectional analysis. The measures included the severity of PTSD symptoms, clusters of PTSD symptoms, clinical measures, and several measures assessing PTSD-related constructs. Analyses included the Spearman rank correlation coefficient, X(2)tests for nominal data, Mann-Whitney U-tests for non-parametric data, and a mediation analysis. Results The results of the mediation analysis revealed that difficulties in emotion regulation were significantly associated with the severity of PTSD symptoms, which was mediated by social acknowledgment and experimental avoidance but not by moral injury. The analyses showed that the severity of PTSD symptoms and all clusters of PTSD symptoms were significantly associated with most of the measured constructs in expectable directions. Participants in the PTSD group showed significantly higher mean scores on questionnaires measuring constructs that have been associated with PTSD, like emotion regulation and moral injury. They also showed lower mean scores in questionnaires for social support and social acknowledgment as a victim or survivor than participants in the non-PTSD group. Conclusion The present results show that difficulties in emotion regulation are directly associated with the severity of PTSD symptoms in service members of the German Armed Forces. This association is mediated by social acknowledgment and experimental avoidance, but not by moral injury. Thus, future studies should investigate these potentially crucial factors for better understanding of the development and maintenance of PTSD in service members of the German Armed Forces after deployment to create possible treatment adaptions.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Spies, Jan Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Cwik, Jan Christopher UNSPECIFIED orcid.org/0000-0002-2290-353X UNSPECIFIED Willmund, Gert Dieter UNSPECIFIED UNSPECIFIED UNSPECIFIED Knaevelsrud, Christine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schumacher, Sarah UNSPECIFIED UNSPECIFIED UNSPECIFIED Niemeyer, Helen UNSPECIFIED UNSPECIFIED UNSPECIFIED Engel, Sinha UNSPECIFIED UNSPECIFIED UNSPECIFIED Kuester, Annika UNSPECIFIED UNSPECIFIED UNSPECIFIED Muschalla, Beate UNSPECIFIED orcid.org/0000-0001-5285-6618 UNSPECIFIED Koehler, Kai UNSPECIFIED UNSPECIFIED UNSPECIFIED Weiss, Deborah UNSPECIFIED UNSPECIFIED UNSPECIFIED Rau, Heinrich UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-319054
DOI:	10.3389/fpsyt.2020.576553
Journal or Publication Title:	Front. Psychiatry
Volume:	11
Date:	2020
Publisher:	FRONTIERS MEDIA SA
Place of Publication:	LAUSANNE
ISSN:	1664-0640
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language MENTAL-HEALTH PROBLEMS; SOCIAL SUPPORT; PSYCHOLOGICAL FLEXIBILITY; MORAL INJURY; PSYCHOMETRIC PROPERTIES; REGULATION STRATEGIES; GROWTH INVENTORY; VIETNAM VETERANS; SELF-COMPASSION; PERSONAL VALUES Multiple languages Psychiatry Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/31905