Maternal Reminiscing and Autobiographical Memory Features of Mother-Child Dyads in a Cross-Cultural Context

Maternal reminiscing styles and mother-child memory features were examined in a cross-cultural context. Fifty-five Chinese (Guangzhou, China) and 48 Australian (Melbourne, Australia) mother-child dyads (child age: 3-6 years) independently retrieved autobiographical memories and jointly discussed past events. Australian mothers used greater elaborative and supportive reminiscing and provided more specific memories than Chinese mothers. Australian children provided greater memory elaboration than Chinese children, but they did not differ in memory specificity. Maternal reminiscing styles and cultural group were independently predictive of child memory elaboration but not specificity. Nonetheless, moderation analyses showed that the two maternal reminiscing styles (elaborative and supportive) interacted to predict child memory specificity. These findings indicate the importance of culture and types of reminiscing on memory development.

Cross-cultural exploration of the characteristics, content and themes of intrusive autobiographical memories recalled during depression

The recall of intrusive memories is highly prevalent during depression. While past research has examined memory themes and characteristics (e.g., frequency), possible cultural differences in these variables have not been investigated. Furthermore, cross-cultural research has documented content differences in voluntary autobiographical remembering, but such content analyses have not been conducted in regard to intrusive memories. This study, therefore, investigated the characteristics, content and themes of intrusive memories using a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design. European Australian (n = 46) and East Asian (n = 45) participants living in Australia reported two memories in real-time using an online memory diary and rated the characteristics of their memories. East Asian participants reported more frequent and distressing memories, compared to European Australians, while the European Australian group reported more specific memories than the East Asian group. Most of the characteristics, themes and content variables, however, did not differ between cultural groups. Additionally, depressed participants, regardless of cultural group, reported more frequent, distressing and numbing memories, compared to healthy controls. These findings suggest that while depressive symptomatology impacts the experience of intrusive memories, memory content and characteristics are largely similar across the two cultural groups.

Predictors of positive and negative post-traumatic psychological outcomes in a sample of Iranian cancer survivors

Objectives This study aimed to identify predictors of positive and negative post-traumatic psychological outcomes within a sample of Iranian cancer survivors. Methods In this cross-sectional research, 300 (167 females; age M = 53.00, SD = 27.57) cancer survivors (breast cancer, leukaemia, colorectal cancer) were recruited from oncology outpatient clinics in Iran. Participants completed measures of post-traumatic stress disorder (PTSD), post-traumatic growth (PTG), cognitive processing, attentional biases, and autobiographical memory specificity. Results Using partial least square structural equation modelling, it was found that the proposed model was capable of predicting PTSD and PTG. Negative attentional biases were significantly associated with PTSD symptoms, but were not significantly associated with PTG. In contrast, memory specificity and positive attentional biases tended to be associated with PTG, but were not significantly associated with PTSD symptoms. Second, negative cognitive processing was significantly associated with PTSD symptoms, while positive cognitive processing was significantly associated with PTG. Finally, there was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing. Conclusions Our findings support growing evidence for differential trajectories to PTG and PTSD symptoms in cancer. Such cognitive factors may be important therapeutic targets in psycho-oncology interventions. Statement of contribution What is already known on this subject? The diagnosis of cancer and its subsequent treatment can result in symptoms of post-traumatic stress disorder (PTSD). Positive changes and psychosocial growth (post-traumatic growth; PTG) are also common as a result of patients' experience of cancer. What does this study add? This study identified predictors of positive (PTG) and negative trauma (PTSD) outcomes within a sample of Iranian cancer survivors (N = 300). General habitual cognitive tendencies (memory specificity, attentional biases) were associated with cognitive processing, which in turn contributed to psycho-traumatic adaption. There was support for indirect pathways between positive cognitive tendencies and PTG through positive cognitive processing, while there were indirect pathways between negative habitual cognitive tendencies and PTSD symptoms through negative cognitive processing.

Affective working memory capacity in refugee adolescents

OBJECTIVE

High numbers of adolescents today are exposed to conflict-related trauma, with trauma-exposure being associated with adverse biopsychosocial outcomes. Here we investigated the influence of trauma-exposure and high levels of posttraumatic stress disorder (PTSD) symptoms on cognitive functioning in trauma-related compared to neutral contexts.

METHOD

Afghan adolescent refugees with high levels of PTSD symptomatology and non-trauma-exposed Afghan adolescent refugee controls (N = 47; 43% female; aged 13-19 years, M = 15.49, SD = 1.40) completed a visual working memory task including affective (trauma-related) and neutral distractors.

RESULTS

Working memory capacity in the context of trauma-related distractors (and not neutral distractors) was significantly poorer in trauma-exposed refugees with high levels of PTSD when compared to non-trauma-exposed controls.

CONCLUSIONS

The findings highlight the importance of investigating posttraumatic cognitive functioning within affective contexts and suggest that affective working memory capacity may constitute a promising target for intervention. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Exploring cultural differences in the use of emotion regulation strategies in posttraumatic stress disorder

Background: Emotion regulation difficulties are central to posttraumatic stress disorder (PTSD). While cultural differences exist in the ways in which individuals regulate their emotions, researchers have not examined cultural differences in emotion regulation in PTSD.Objective: This study explored emotion regulation in individuals from European and East Asian cultures with and without PTSD. Method: Emotion regulation measures were administered to Caucasian Australian (n = 31) and East Asian Australian (n = 38) trauma survivors with and without PTSD. Results: Caucasian Australians with PTSD scored significantly higher on measures of worry, expressive suppression, thought suppression, rumination, experiential avoidance, and general emotion dysregulation compared to Caucasian Australians without PTSD. Similarly, East Asian Australians with PTSD scored significantly higher on measures of rumination and experiential avoidance than East Asian Australians without PTSD. However, worry, expressive suppression, thought suppression and general emotion dysregulation did not differentiate between East Asian Australians with and without PTSD. Conclusion: These findings suggest that there may be cultural differences in emotion regulation difficulties in PTSD and highlight the need for further research in this area.

A review of autobiographical memory studies on patients with schizophrenia spectrum disorders

BACKGROUND

Patients suffering from schizophrenia spectrum disorders demonstrate various cognitive deficiencies, the most pertinent one being impairment in autobiographical memory. This paper reviews quantitative research investigating deficits in the content, and characteristics, of autobiographical memories in individuals with schizophrenia. It also examines if the method used to activate autobiographical memories influenced the results and which theoretical accounts were proposed to explain the defective recall of autobiographical memories in patients with schizophrenia.

METHODS

PsycINFO, Web of Science, and PubMed databases were searched for articles published between January 1998 and December 2018. Fifty-seven studies met the inclusion criteria. All studies implemented the generative retrieval strategy by inducing memories through cue words or pictures, the life-stage method, or open-ended retrieval method. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement guidelines were followed for this review.

RESULTS

Most studies reported that patients with schizophrenia retrieve less specific autobiographical memories when compared to a healthy control group, while only three studies indicated that both groups performed similarly on memory specificity. Patients with schizophrenia also exhibited earlier reminiscence bumps than those for healthy controls. The relationship between comorbid depression and autobiographical memory specificity appeared to be independent because patients' memory specificity improved through intervention, but their level of depression remained unchanged. The U-shaped retrieval pattern for memory specificity was not consistent. Both the connection between the history of attempted suicide and autobiographical memory specificity, and the relationship between psychotic symptoms and autobiographical memory specificity, remain inconclusive. Patients' memory specificity and coherence improved through cognitive training.

CONCLUSIONS

The overgeneral recall of autobiographical memory by patients with schizophrenia could be attributed to working memory, the disturbing concept of self, and the cuing method implemented. The earlier reminiscence bump for patients with schizophrenia may be explained by the premature closure of the identity formation process due to the emergence of psychotic symptoms during early adulthood. Protocol developed for this review was registered in PROSPERO (registration no: CRD42017062643).

Maternal reminiscing and child autobiographical memory elaboration: A meta-analytic review

Significant research has investigated the relationship between mother-child reminiscing and children's autobiographical memory development. It has been suggested that mothers who adopt a high elaborative reminiscing style tend to have children who provide greater memory elaboration during joint reminiscing, yet the empirical findings are somewhat mixed. To address this issue, a systematic review and meta-analyses were conducted to investigate the relationship between maternal elaborative reminiscing and child autobiographical memory elaboration. Thirty-four cross-sectional and longitudinal studies from peer-reviewed journals and published dissertations were included in the review. Of those, 31 studies had available data for meta-analytic analyses of the maternal reminiscing variables identified in the review. Findings from this study provided strong evidence indicating that high elaborative maternal reminiscing was associated with children's ability to provide greater detailed personal memory, both concurrently and longitudinally. Among maternal elaborative reminiscing elements identified, mothers' open-ended elaboration and positive evaluation were found to be most related to child memory elaboration. More research is needed to identify the effects of sociocultural contexts on the relationship between maternal elaborative reminiscing and child memory elaboration. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

The impact of depression and culture on responses to intrusive autobiographical memories: Cognitive appraisals, cognitive avoidance, and brooding rumination

OBJECTIVES

Those with depression ascribe more negative appraisals to intrusive autobiographical memories and use maladaptive strategies to regulate intrusive memory distress. However, it is unknown whether these patterns extend to East Asian samples. This study investigated the influence of culture and depression on intrusive remembering.

DESIGN

The study used a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design, with an online intrusive memory diary.

METHODS

European Australian (n = 46) and East Asian (n = 45) participants living in Australia, with and without depression, reported two intrusive memories in real-time and completed self-report measures indexing their appraisals of the memories, and their use of cognitive avoidance and brooding rumination in response to the memories.

RESULTS

East Asian participants reported significantly greater negative, control, and responsibility appraisals than European Australian participants. Regardless of cultural group, depressed participants endorsed greater maladaptive memory appraisals and brooding compared to controls. Additionally, among East Asian participants, those with depression cognitively avoided memories significantly more than controls. When comparing the two depressed groups, East Asians reported significantly greater brooding and avoidance in response to intrusive memories than Australians.

CONCLUSIONS

The findings suggest that depression may be associated with some similar maladaptive responses to intrusive autobiographical memories across cultural groups. Clinical interventions targeting unhelpful responses may, therefore, be beneficial for those with depression, regardless of cultural background.

PRACTITIONER POINTS

Across both European Australian and East Asian cultures, depressed participants endorsed higher maladaptive intrusive memory appraisals and brooded more in response to memories. Clinical interventions targeting appraisals and emotion regulation in response to intrusive memories may be beneficial for those with depression across both cultural groups. Language and acculturation may have impacted findings, as measures were administered in English and in Australia. Replication using a cross-country design and larger sample would be beneficial to confirm findings.

Investigating the mediating role of self-construal on the relationship between cultural group (Malay and Australian) and the characteristics and functional use of autobiographical memory

Cultural differences in autobiographical memory characteristics and function have often been presumed to be associated with different cultural beliefs related to the self. The current research aimed to investigate whether self-construal mediated the relationship between cultural group and the characteristics and functional use of autobiographical memory. Caucasian Australians (n = 71) and Malay Malaysians (n = 50) completed an online questionnaire that included the Self-Defining Memory task, the Thinking About Life Experiences Revised Questionnaire and the Self Construal Scale. As expected, the Australian group provided longer, more autonomously oriented, specific memories than the Malay group. However, contrary to our predictions, self-construal did not mediate the relationships between cultural group and memory characteristics. The Malay group reported more frequently using autobiographical memories for self-continuity than the Australian group. Finally, there was support for an indirect pathway between cultural group and use of autobiographical memories for self-continuity and social-bonding through self-construal (i.e. independent self relative to interdependent self). The findings highlight the importance of explicitly examining values assumed to be associated with autobiographical remembering, and relating these values to memory characteristics and function.

Culturally modified cognitive processing therapy for Karen refugees with posttraumatic stress disorder: A pilot study

Karen refugees, many originating from Myanmar, have suffered one of the longest civil wars in history and have thus witnessed and experienced substantial trauma. Refugees from Myanmar are currently one of the largest refugee groups being resettled in Western countries. This study investigated the feasibility and acceptability of a modified cognitive processing therapy (CPT) group program for Karen refugees with posttraumatic stress disorder (PTSD; N =7). It was found that the CPT program was well accepted, with high satisfaction and no drop-outs. At posttreatment all participants no longer met PTSD diagnostic criteria and had a reliable improvement in PTSD symptoms when compared with pretreatment scores. At 3-month follow-up four participants (57% of sample) did not meet PTSD diagnostic criteria and three participants (43%) had a reliable improvement in PTSD symptoms when compared with pretreatment scores. However, at follow-up four participants (57% of the sample) had a reliable worsening in PTSD symptoms when compared with their posttreatment PTSD symptom levels. Although the study found that the modified CPT was acceptable and feasible, future research is needed to develop and enhance strategies to ensure that refugees benefit from empirically supported treatments.

A pilot randomized controlled trial evaluating a web-based training program on pediatric medical traumatic stress and trauma-informed care for emergency department staff

This pilot parallel group superiority randomized controlled trial investigated the efficacy and acceptability of a web-based training program on pediatric medical traumatic stress and trauma-informed care (Australian and New Zealand Clinical Trials Registry number: ACTRN12617001148369). Eligibility criteria for this study included being a nurse or physician working in an ED in Australia or New Zealand, being fluent in English and having Internet access. Emergency department (ED) staff (N = 71) were randomly assigned into the training (n = 32) or control group n = 39). We hypothesized that compared to the control group, ED staff in the training group would show a greater improvement in knowledge of pediatric medical traumatic stress 1-week post training and that improvement would be maintained at 1-month post training. At baseline participants completed a brief questionnaire assessing knowledge of pediatric medical traumatic stress. The training group then completed the 15-min online training program. The knowledge questionnaire was readministered to all participants' 1 week and 1 month posttraining, after which the control group gained access to the training. Acceptability was based on a program evaluation measure utilizing quantitative and qualitative items. The training group had significantly greater knowledge following training and at follow-up than the control group (p > .001, f = .42) and reported high rates of satisfaction. The results demonstrated an improvement in ED staff knowledge as a result of the training and provide preliminary support for the efficacy and acceptability of brief online training to improve the knowledge of ED staff interested in pediatric medical traumatic stress and trauma-informed care. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

A cluster randomized controlled platform trial comparing group MEmory specificity training (MEST) to group psychoeducation and supportive counselling (PSC) in the treatment of recurrent depression

Impaired ability to recall specific autobiographical memories is characteristic of depression, which when reversed, may have therapeutic benefits. This cluster-randomized controlled pilot trial investigated efficacy and aspects of acceptability, and feasibility of MEmory Specificity Training (MEST) relative to Psychoeducation and Supportive Counselling (PSC) for Major Depressive Disorder (N = 62). A key aim of this study was to determine a range of effect size estimates to inform a later phase trial. Assessments were completed at baseline, post-treatment and 3-month follow-up. The cognitive process outcome was memory specificity. The primary clinical outcome was symptoms on the Beck Depression Inventory-II at 3-month follow-up. The MEST group demonstrated greater improvement in memory specificity relative to PSC at post-intervention (d = 0.88) and follow-up (d = 0.74), relative to PSC. Both groups experienced a reduction in depressive symptoms at 3-month follow-up (d = 0.67). However, there was no support for a greater improvement in depressive symptoms at 3 months following MEST relative to PSC (d = -0.04). Although MEST generated changes on memory specificity and improved depressive symptoms, results provide no indication that MEST is superior to PSC in the resolution of self-reported depressive symptoms. Implications for later-phase definitive trials of MEST are discussed.

Investigating whether maternal memory specificity is indirectly associated with child memory specificity through maternal reminiscing

Maternal reminiscing and remembering has a profound influence on the development of children's autobiographical remembering skills. The current study investigated the relationships between maternal memory specificity, maternal reminiscing and child memory specificity. Participants consisted of 40 mother-child dyads. Children's age ranged between 3.5 and 6 years. Mothers and children participated in individual assessments of autobiographical memory specificity. Dyads participated in a joint reminiscing task about three past emotional (happy, sad, stressful) events. A positive moderate association was found between maternal autobiographical memory specificity and child autobiographical memory specificity. Maternal autobiographical memory specificity was significantly correlated with mothers' focus on the task, involvement and reciprocity, resolution of negative feelings, and structuring of narratives in the mother-child reminiscing task. Moderate positive associations were found between maternal focus and structuring and child memory specificity. There was no evidence to suggest maternal elaborative reminiscing style was significantly positively correlated with mother or child memory specificity. Finally, there was support for an indirect pathway between maternal memory specificity and child memory specificity through quality of support and guidance provided by the mother in maternal reminiscing. Theoretical and clinical implications are considered.

Impact of culture on autobiographical life structure in depression

OBJECTIVES

Distortions in autobiographical memory have been implicated in major depressive disorder (MDD). Those with MDD demonstrate a 'depressogenic' autobiographical life structure. Research has not examined how culture influences this process. We investigated whether Malay individuals (members of an interdependent culture) with MDD demonstrated a 'depressogenic' autobiographical life structure similar to that of British individuals (members of an independent culture) with MDD.

DESIGN

A 2 (Culture; Malay, British) × 2 (Mood; depressed, control) cross-sectional design using a card sort task and self-report measures was used.

METHODS

Malay individuals with MDD or no history of MDD completed the life-structure card-sorting task, which provided a novel method for investigating organizational structure of the life narrative. These data were compared to previously collected data in which British individuals with MDD or without MDD had completed the same task within the same experimental protocol.

RESULTS

Pan-culturally those with MDD had greater negativity (i.e., used more negative attributes), negative redundancy (i.e., used the same negative attributes repeatedly across life chapters) and negative emodiversity (i.e., had greater variety and relative abundance of negative attributes), and reduced positive redundancy (i.e., used the same positive attributes repeatedly across chapters) in their structuring relative to controls. While the British MDD group had greater compartmentalization (i.e., the negative and positive attributes were clustered separately across different chapters) than British controls, the Malay MDD group had lower levels of compartmentalization than Malay controls.

CONCLUSIONS

The findings suggest culture may shape aspects of the autobiographical life structure in MDD.

PRACTITIONER POINTS

The majority of the literature investigating depression pertains to individuals from European Western cultures, despite recognition that depression ranks as one of the most debilitating diseases worldwide. This raises questions as to whether current depression models and interventions can be applied universally or whether they are limited to European Western groups. The current study found that pan-culturally those with MDD had similar structuring of their life story relative to controls. However, there were some cultural differences that need to be considered (e.g., Malay individuals provided less detailed, less elaborate and less emotionally diverse life stories and while the British MDD group had greater compartmentalization than British controls, the Malay MDD group had lower levels of compartmentalization than Malay controls). Limitations of the study included group differences in gender and mood at the time of testing. Cultural differences in the number of attributes used may have influenced findings. Only the Malay group completed the individualism-collectivism measure.

Association between intrusive negative autobiographical memories and depression: A meta-analytic investigation

The study investigated several associations between depression and intrusive negative autobiographical memories. A systematic literature search identified 23 eligible studies (N = 2,582), which provided 59 effect sizes. Separate meta-analyses indicated that depression was moderately, positively associated with intrusive memory frequency, memory distress, maladaptive memory appraisals, memory avoidance, and memory rumination. Intrusive memory vividness was not significantly associated with depression. There were insufficient data to examine the relationship between depression and memory vantage perspective. Between-study heterogeneity was high for intrusive memory frequency and memory avoidance, and the percentage of females in studies significantly moderated the relationship between these variables and depression. An additional exploratory meta-analysis (3 studies; N = 257) indicated that intrusive memories were experienced more frequently by those with posttraumatic stress disorder than those with depression. Overall, the findings suggest that intrusive memories warrant clinical attention as they may contribute to the maintenance of depressive symptomatology.

Knowledge and training in paediatric medical traumatic stress and trauma-informed care among emergency medical professionals in low- and middle-income countries

Background: Provision of psychosocial care, in particular trauma-informed care, in the immediate aftermath of paediatric injury is a recommended strategy to minimize the risk of paediatric medical traumatic stress. Objective: To examine the knowledge of paediatric medical traumatic stress and perspectives on providing trauma-informed care among emergency staff working in low- and middle-income countries (LMICs). Method: Training status, knowledge of paediatric medical traumatic stress, attitudes towards incorporating psychosocial care and barriers experienced were assessed using an online self-report questionnaire. Respondents included 320 emergency staff from 58 LMICs. Data analyses included descriptive statistics, t-tests and multiple regression. Results: Participating emergency staff working in LMICs had a low level of knowledge of paediatric medical traumatic stress. Ninety-one percent of respondents had not received any training or education in paediatric medical traumatic stress, or trauma-informed care for injured children, while 94% of respondents indicated they wanted training in this area. Conclusions: There appears to be a need for training and education of emergency staff in LMICs regarding paediatric medical traumatic stress and trauma-informed care, in particular among staff working in comparatively lower income countries.

Perspectives of hospital emergency department staff on trauma-informed care for injured children: An Australian and New Zealand analysis

AIM

To examine Australian and New Zealand emergency department (ED) staff's training, knowledge and confidence regarding trauma-informed care for children after trauma, and barriers to implementation.

METHODS

ED staff's perspectives on trauma-informed care were assessed using a web-based self-report questionnaire. Participants included 468 ED staff (375 nursing and 111 medical staff) from hospitals in Australia and New Zealand. Data analyses included descriptive statistics, χ² tests and multiple regressions.

RESULTS

Over 90% of respondents had not received training in trauma-informed care and almost all respondents (94%) wanted training in this area. While knowledge was associated with a respondent's previous training and profession, confidence was associated with the respondent's previous training, experience level and workplace. Dominant barriers to the implementation of trauma-informed care were lack of time and lack of training.

CONCLUSIONS

There is a need and desire for training and education of Australian and New Zealand ED staff in trauma-informed care. This study demonstrates that experience alone is not sufficient for the development of knowledge of paediatric traumatic stress reactions and trauma-informed care practices. Existing education materials could be adapted for use in the ED and to accommodate the training preferences of Australian and New Zealand ED staff.

Protocol for a between-group experimental study examining cultural differences in emotion processing between Malay and Caucasian adults with and without major depressive disorder

INTRODUCTION

Depression is a mood disorder that affects a significant proportion of the population worldwide. In Malaysia and Australia, the number of people diagnosed with depression is on the rise. It has been found that impairments in emotion processing and emotion regulation play a role in the development and maintenance of depression. This study is based on Matsumoto and Hwang's biocultural model of emotion and Triandis' Subjective Culture model. It aims to investigate the influence of culture on emotion processing among Malaysians and Australians with and without major depressive disorder (MDD).

METHODS AND ANALYSIS

This study will adopt a between-group design. Participants will include Malaysian Malays and Caucasian Australians with and without MDD (N=320). There will be four tasks involved in this study, namely: (1) the facial emotion recognition task, (2) the biological motion task, (3) the subjective experience task and (4) the emotion meaning task. It is hypothesised that there will be cultural differences in how participants with and without MDD respond to these emotion tasks and that, pan-culturally, MDD will influence accuracy rates in the facial emotion recognition task and the biological motion task.

ETHICS AND DISSEMINATION

This study is approved by the Universiti Putra Malaysia Research Ethics Committee (JKEUPM) and the Monash University Human Research Ethics Committee (MUHREC). Permission to conduct the study has also been obtained from the National Medical Research Register (NMRR; NMRR-15-2314-26919). On completion of the study, data will be kept by Universiti Putra Malaysia for a specific period of time before they are destroyed. Data will be published in a collective manner in the form of journal articles with no reference to a specific individual.

Exploring trauma associated appraisals in trauma survivors from collectivistic cultures

Appraisals are a key feature in understanding an individual’s experience; this is especially important when the experience is a traumatic one. However, research is diminutive when looking at the interaction between trauma appraisals and culture in relation to posttraumatic stress disorder using qualitative methodologies. This study explored cultural differences in perceptions and appraisals of trauma using three qualitative focus groups with community members (n = 11) from collectivistic cultures who had experienced a traumatic event and three qualitative individual key informant interviews with mental health practitioners (n = 3) routinely working with trauma survivors. Using template analysis, eight emergent themes were highlighted from the data sets [(1) trauma and adjustment; (2) cultural and social roles; (3) traumatised self; (4) relationships; (5) external attribution; (6) future; (7) education; (8) language] that potentially have significant consequences for posttrauma psychological adjustment and recovery. Cumulatively, while a number of themes are similar to that which is emphasised in current literature (e.g. damaged self, negative appraisals of the world, others, future) a number of themes were also resonant and warrant further scrutiny. For instance, the importance and interconnectedness of the group to the individual and the impact trauma has on this; the importance of social roles, cultural appropriateness and violations of cultural values and norms; findings and implications are discussed.

The impact of cultural differences in self-representation on the neural substrates of posttraumatic stress disorder

A significant body of literature documents the neural mechanisms involved in the development and maintenance of posttraumatic stress disorder (PTSD). However, there is very little empirical work considering the influence of culture on these underlying mechanisms. Accumulating cultural neuroscience research clearly indicates that cultural differences in self-representation modulate many of the same neural processes proposed to be aberrant in PTSD. The objective of this review paper is to consider how culture may impact on the neural mechanisms underlying PTSD. We first outline five key affective and cognitive functions and their underlying neural correlates that have been identified as being disrupted in PTSD: (1) fear dysregulation; (2) attentional biases to threat; (3) emotion and autobiographical memory; (4) self-referential processing; and (5) attachment and interpersonal processing. Second, we consider prominent cultural theories and review the empirical research that has demonstrated the influence of cultural variations in self-representation on the neural substrates of these same five affective and cognitive functions. Finally, we propose a conceptual model that suggests that these five processes have major relevance to considering how culture may influence the neural processes underpinning PTSD.