Lynsey Miron

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Lara Coffin

University of Aberdeen

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carlos percio volponi

Universidade Federal do Espirito Santo

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Wageningen University

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Papers by Lynsey Miron

Adapting Cognitive Processing Therapy for PTSD for People With Disabilities: A Case Study With a U.S. Veteran

Cognitive and Behavioral Practice

Patterns of conventional and complementary non-pharmacological health practice use by US military veterans: a cross-sectional latent class analysis

BMC Complementary and Alternative Medicine

Background: Non-pharmacological therapies and practices are commonly used for both health mainten... more Background: Non-pharmacological therapies and practices are commonly used for both health maintenance and management of chronic disease. Patterns and reasons for use of health practices may identify clinically meaningful subgroups of users. The objectives of this study were to identify classes of self-reported use of conventional and complementary non-pharmacological health practices using latent class analysis and estimate associations of participant characteristics with class membership. Methods: A mailed survey (October 2015 to September 2016) of Minnesota National Guard Veterans from a longitudinal cohort (n = 1850) assessed current pain, self-reported overall health, mental health, substance use, personality traits, and health practice use. We developed the Health Practices Inventory, a self-report instrument assessing use of 19 common conventional and complementary non-pharmacological health-related practices. Latent class analysis was used to identify subgroups of health practice users, based on responses to the HPI. Participants were assigned to their maximum-likelihood class, which was used as the outcome in multinomial logistic regression to examine associations of participant characteristics with latent class membership. Results: Half of the sample used non-pharmacological health practices. Six classes of users were identified. "Low use" (50%) had low rates of health practice use. "Exercise" (23%) had high exercise use. "Psychotherapy" (6%) had high use of psychotherapy and support groups. "Manual therapies" (12%) had high use of chiropractic, physical therapy, and massage. "Mindfulness" (5%) had high use of mindfulness and relaxation practice. "Multimodal" (4%) had high use of most practices. Use of manual therapies (chiropractic, acupuncture, physical therapy, massage) was associated with chronic pain and female sex. Characteristics that predict use patterns varied by class. Use of self-directed practices (e.g., aerobic exercise, yoga) was associated with the personality trait of absorption (openness to experience). Use of psychotherapy was associated with higher rates of psychological distress. Conclusions: These observed patterns of use of non-pharmacological health practices show that functionally similar practices are being used together and suggest a meaningful classification of health practices based on self-directed/active and practitioner-delivered. Notably, there is considerable overlap in users of complementary and conventional practices.

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Prospective associations between DSM–5 PTSD symptom clusters and suicidal ideation in treatment-seeking veterans

Psychological Services

Barriers to self-compassion for female survivors of childhood maltreatment: The roles of fear of self-compassion and psychological inflexibility

Child Abuse & Neglect

When Does Child Maltreatment Occur? Daily Variations in Child Maltreatment Among Families Served by the U.S. Air Force Family Advocacy Program

Military Behavioral Health, 2016

The Potential Indirect Effect of Childhood Abuse on Posttrauma Pathology Through Self-Compassion and Fear of Self-Compassion

Mindfulness, 2016

Prospective Associations between Emotion Dysregulation and Fear-Potentiated Startle: The Moderating Effect of Respiratory Sinus Arrhythmia

Frontiers in psychology, 2016

Emotion dysregulation has been implicated in the negative outcomes following trauma exposure. A p... more Emotion dysregulation has been implicated in the negative outcomes following trauma exposure. A proposed biomarker of emotion dysregulation, respiratory sinus arrhythmia (RSA), has demonstrated associations with trauma-related phenomena, such as the fear-potentiated startle (FPS) response. The current study aimed to examine the prospective association between emotion dysregulation and RSA and FPS several years following trauma exposure. Participants were 131 women exposed to a campus mass shooting on February 14, 2008. Pre-shooting emotion dysregulation was assessed in 2006-2008. Startle response, measured by orbicularis oculi electromyography (EMG), and RSA were gathered during an FPS paradigm conducted from 2012 to 2015. No significant associations among emotion dysregulation, RSA, and FPS emerged among the full sample. However, emotion dysregulation predicted FPS during both acquisition (r = 0.40, p < 0.05) and extinction (r = 0.57, p < 0.01) among individuals with high res...

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Childhood Sexual Abuse and Later Alcohol-Related Problems: Investigating the Roles of Revictimization, PTSD, and Drinking Motivations Among College Women

Journal of interpersonal violence, Jan 30, 2015

The current study sought to examine whether symptoms of posttraumatic stress disorder (PTSD), ado... more The current study sought to examine whether symptoms of posttraumatic stress disorder (PTSD), adolescent sexual assault (ASA), and drinking motivations (e.g., drinking to regulate emotional experiences) mediate the relationship between a history of childhood sexual abuse (CSA) and subsequent alcohol-related problems among college women. Participants were 579 female students at a Midwestern university. Participants were recruited as part of a larger longitudinal study that investigated risk and resiliency factors related to sexual revictimization. Using a serial mediation model, the current study found that the proposed constructs mediated the relationship between CSA and subsequent alcohol-related problems via two separate paths. In one path, CSA was associated with PTSD, which in turn predicted drinking to regulate emotional experiences, which then was related to alcohol-related problems in adulthood. In the second path, CSA was related to ASA, which in turn predicted drinking to r...

Impact of Mass Shootings on Individual Adjustment

Norris (2007) provided an excellent introduction to the literature on mass shootings. Our goal is... more Norris (2007) provided an excellent introduction to the literature on mass shootings. Our goal is to provide an update on this literature. Norris focused on individual, as well as broader community factors in examining responses to mass shootings. Our guide focuses solely on quantitative studies examining factors at the level of the individual that appear to be related to adjustment following a mass shooting. Our definition of a mass shooting involves an individual (with few exceptions, a male), acting alone and with generally personal rather than political motivation, entering a densely populated space and shooting as many people as possible. In addition, while not required in the definition, the shooter typically takes, his or her, own life. Our guide to the literature proceeds chronologically, with an emphasis on studies that use longitudinal data.

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Fight, flight, and freeze: Threat sensitivity and emotion dysregulation in survivors of chronic childhood maltreatment

Personality and Individual Differences, 2014

ABSTRACT Chronic childhood maltreatment (C-CM) is thought to result in permanent neurobiological ... more ABSTRACT Chronic childhood maltreatment (C-CM) is thought to result in permanent neurobiological alterations to the brain that manifest as a threat-sensitivity trait. However, extant research has yet to identify this trait in the context of existing personality theories. The current study utilized the fight–flight–freeze system (FFFS), a brain subsystem of the revised reinforcement sensitivity theory of personality, to identify the threat-sensitivity trait proposed to result from C-CM. Research suggests that C-CM is associated with both FFFS sensitivity and emotion dysregulation (ED), whereby increased threat-sensitivity is thought to contribute to greater ED. Accordingly, C-CM was expected to predict FFFS sensitivity, which was expected to mediate the relationship between C-CM and ED in an undergraduate sample (N = 471). Participants were separated into three maltreatment groups: C-CM, non-chronic CM (NC-CM), and no CM. Results indicated that individuals with a history of C-CM reported greater FFFS sensitivity and ED than those with a history of NC-CM or no CM. Analysis of the significance of the indirect effect of C-CM on ED via FFFS sensitivity indicated that FFFS sensitivity partially mediated this relationship. Specifically, individuals with C-CM, compared to no CM, reported greater FFFS sensitivity, which significantly accounted for a portion of their increased ED.

Interest in partner-involved services among veterans seeking mental health care from a VA PTSD clinic

Psychological Trauma: Theory, Research, Practice, and Policy, 2013

Associations between PTSD and difficulties in intimate relationships have prompted national calls... more Associations between PTSD and difficulties in intimate relationships have prompted national calls for partner-involvement in treatment for PTSD. However, research is limited evaluating patient preferences for the format of these services or predictors of these preferences. Such information is vital to shaping services so they are relevant to those most interested in them and to those with greatest need. To address these gaps, we surveyed 185 coupled veterans as they presented for mental health appointments at a VA PTSD treatment clinic. We assessed broad interest in greater partner-involvement, specific interest in couple therapy, and potential predictors of these interests, including family concerns, relationship satisfaction, PTSD symptom severity, and combat era. We found unique positive associations between interest in partner-involvement and both family concerns and relationship satisfaction, suggesting those most interested in partner-involvement are likely those experiencing the greatest family concerns and the most satisfied in their intimate relationships. Associations between interest and PTSD severity were nonsignificant. Interest in couple therapy was significantly greater among returning veterans than Vietnam/Korean War Veterans. However, these two groups did not vary significantly in their interest in greater partner-involvement more broadly. Discussion of findings considers the roles of both insight into PTSD-related family problems and relationship satisfaction in motivating interest in partner-involvement in care, the potential need to address motivation for partnerinvolvement among veterans in distressed relationships, and the importance of alternative methods of partner-involvement to full courses of couple therapy, particularly for Vietnam/Korean War era veterans.

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Fear of self-compassion and psychological inflexibility interact to predict PTSD symptom severity

Journal of Contextual Behavioral Science, 2014

ABSTRACT Evidence suggests that increasing self-compassion is a worthwhile therapeutic target and... more ABSTRACT Evidence suggests that increasing self-compassion is a worthwhile therapeutic target and may be adaptive in the context of trauma recovery. Recently, researchers have noted that particular individuals respond to self-compassion with fear and resistance, a phenomenon known as fear of self-compassion. We argue that fear of self-compassion may increase post-trauma suffering, particularly for individuals who routinely attempt to control difficult private experiences. The present study investigated relations among fear of self-compassion, psychological inflexibility, and posttraumatic stress symptoms (PTSS) in a sample of trauma-exposed undergraduates (N=201). Hierarchical regression analyses revealed a significant interaction between fear of self-compassion and psychological inflexibility (B=1.22, p&lt;.05), controlling for negative affect. Follow-up simple effects indicated that psychological inflexibility moderated the relationship between fear of self-compassion and PTSS, such that there was a significant positive association between fear of self-compassion and PTSS among participants with higher psychological inflexibility (B=3.81, p&lt;.01), but not for those with lower psychological inflexibility. The prospect of fear of self-compassion as a contextual-behavioral treatment target is discussed.

Differential Predictors of Transient Stress Versus Posttraumatic Stress Disorder: Evaluating Risk Following Targeted Mass Violence

Behavior Therapy, 2014

Schools have become a common incident site for targeted mass violence, including mass shootings. ... more Schools have become a common incident site for targeted mass violence, including mass shootings. Although exposure to mass violence can result in significant distress, most individuals are able to fully recover over time, while a minority develop more pervasive pathology, such as PTSD. The present study investigated how several pre- and posttrauma factors predict posttraumatic stress symptoms (PTSS) in both the acute and distal aftermath of a campus mass shooting using a sample with known levels of pretrauma functioning (N=573). Although the largest proportion of participants evidenced resilience following exposure to the event (46.1%), many reported high rates of PTSS shortly after the shooting (42.1%) and a smaller proportion (11.9%) met criteria for probable PTSD both in the acute and more distal aftermath of the event. While several preshooting factors predicted heightened PTSS after the shooting, prior trauma exposure was the only preshooting variable shown to significantly differentiate between those who experienced transient versus prolonged distress. Among postshooting predictors, individuals reporting greater emotion dysregulation and peritraumatic dissociative experiences were over four times more likely to have elevated PTSS 8months postshooting compared with those reporting less dysregulation and dissociative experiences. Individuals with less exposure to the shooting, fewer prior traumatic experiences, and greater satisfaction with social support were more likely to recover from acute distress. Overall, results suggest that, while pretrauma factors may differentiate between those who are resilient in the aftermath of a mass shooting and those who experience heightened distress, several event-level and posttrauma coping factors help distinguish between those who eventually recover and those whose PTSD symptoms persist over time.

Relations Among Self-Compassion, PTSD Symptoms, and Psychological Health in a Trauma-Exposed Sample

Mindfulness, 2014

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Effectiveness of Brief Mindfulness Techniques in Reducing Symptoms of Anxiety and Stress

Mindfulness, 2013

ABSTRACT Mindfulness-based skills training has been increasingly incorporated into psychotherapeu... more ABSTRACT Mindfulness-based skills training has been increasingly incorporated into psychotherapeutic treatment for a variety of presenting complaints, most notably anxiety- and stress-related disorders. While there has been considerable literature documenting efficacy of full mindfulness-based treatment regimen (e.g., Mindfulness-Based Stress Reduction [MBSR]), fewer studies have examined the influence of incorporating distinct elements of these treatments in psychotherapy practice. The present study examined the efficacy of two brief elements of an empirically supported mindfulness-based protocol (MBSR), hatha yoga and body scan, in the reduction of anxiety and stress symptoms. Female undergraduate students (N = 91) completed three weekly 45-min sessions of MBSR-based hatha yoga or body scan, or were included in the waitlisted control condition. Results indicated that there were significant differences between groups (i.e., waitlist control, hatha yoga, and body scan) on indices of anxiety and stress. Women in both the hatha yoga and body scan conditions had significantly greater reductions in anxiety and stress compared to those in the waitlist control condition. Significant differences in postintervention indicators of mindfulness (i.e., present-moment awareness and acceptance) were not observed. Overall, findings are consistent with the argument that brief, discrete elements of the MBSR treatment protocol are effective at reducing symptoms of anxiety and stress, providing further evidence supporting the use of mindfulness-based skills training in psychotherapy.

Pathways from childhood abuse to prospective revictimization: depression, sex to reduce negative affect, and forecasted sexual behavior

Child abuse & neglect, 2014

Research suggests that adverse events in childhood, such as childhood physical, sexual, and emoti... more Research suggests that adverse events in childhood, such as childhood physical, sexual, and emotional abuse, confer risk for later sexual assault. Psychological distress, coping strategies, and sexual behavior may help explain the path from childhood abuse to revictimization. The present study explored how the use of sex to regulate negative affect (SRNA) operates independently, and in combination with other psychosocial factors to increase college women's (N=541) risk of experiencing prospective adult sexual assault (ASA). Sequential multiple mediator models in Mplus were used to assess the effect of three different forms of childhood abuse on prospective ASA, both independently and while controlling for other forms of childhood abuse. The indirect effect of adolescent sexual assault (AdolSA), depressive symptoms, SRNA, and participants' response to a sex-related vignette was tested using bias-corrected bootstrapping. In the full path model, childhood emotional abuse and Ad...

Childhood Abuse and Problematic Alcohol Use in College Females: The Role of Self-compassion

Self and Identity, 2014

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Prospective Trajectories of Posttraumatic Stress in College Women Following a Campus Mass Shooting

Journal of Traumatic Stress, 2014

In a sample with known levels of preshooting posttraumatic stress (PTS) symptoms, we examined the... more In a sample with known levels of preshooting posttraumatic stress (PTS) symptoms, we examined the impact of a campus mass shooting on trajectories of PTS in the 31 months following the shooting using latent growth mixture modeling. Female students completed 7 waves of a longitudinal study (sample sizes ranged from 812 to 559). We identified 4 distinct trajectories (n = 660): (a) minimal impact-resilience (60.9%), (b) high impact-recovery (29.1%), (c) moderate impact-moderate symptoms (8.2%), and (d) chronic dysfunction (1.8%). Individuals in each trajectory class remained at or returned to preshooting levels of PTS approximately 6 months postshooting. The minimal impact-resilience class reported less prior trauma exposure (η(2) = .13), less shooting exposure (η(2) = .07), and greater emotion regulation skills than all other classes (η(2) &amp;amp;amp;amp;amp;amp;amp;amp;gt; .30). The chronic dysfunction class endorsed higher rates of experiential avoidance prior to the shooting than the minimal-impact resilient and high impact-recovery classes (η(2) = .15), as well as greater shooting exposure than the high impact-recovery class (η(2) = .07). Findings suggest that preshooting functioning and emotion regulation distinguish between those who experience prolonged distress following mass violence and those who gradually recover.