Derealization and self-harm strategies are used to regulate disgust, fear, and sadness in adult survivors of childhood sexual abuse

Trauma reminders and disgust: The roles of posttraumatic stress disorder symptom severity, trauma type, and reminder type

Disgust is a common emotional response to trauma but is studied less frequently than fear or other negative emotions. In laboratory settings, individuals with a history of sexual assault report more disgust following exposure to trauma reminders than those exposed to other trauma types, and people with more severe posttraumatic stress disorder (PTSD) symptoms typically report more disgust than those with lower symptom levels. It remains unknown whether this association is also present in ecological contexts and if these associations vary by trauma reminder type. The present sample included 80 trauma-exposed community members (PTSD: n = 39, no PTSD: n = 41) who completed up to 17 prompts per day for 3 days (2,158 total completed surveys). Multilevel models indicated that trauma reminders were associated with increased feelings of disgust, B = 0.16, SE = 0.06, p < .001, which was consistent across trauma reminder types, p < .001-p = .001. PTSD symptom severity moderated the association between trauma reminders and disgust such that it was stronger for participants with higher CAPS-5 scores, B = 0.02, SE = 0.01, p = .011. All trauma reminder types demonstrated the same pattern of moderation, ps = .003-.022, except flashbacks, p = .070. Trauma type was not a significant moderator of any trauma reminder type, ps = .193-.929. These findings suggest that trauma reminders encountered in daily life are associated with feelings of disgust. The results underscore the importance of exploring disgust as a trauma-related emotional experience among trauma survivors.

Do young people who self-harm experience cognitions and emotions related to post-traumatic growth?

Background

Adolescent self-harm is a vast public health concern with self-harm rates increasing each year. Looked-after adolescents are a group at increased risk of self-harm owing to adverse life-events and attachment issues, giving rise to difficulties with problem solving and relationship difficulties (Ogundele, 2020). Whilst research into risk factors of self-harm is plentiful, fewer studies have explored what factors might facilitate self-harm recovery. This paper investigates whether looked-after adolescents with experience of self-harm can experience cognitions and emotions related to post-traumatic growth (PTG).

Methods

Secondary Data Analysis was conducted on a primary qualitative data set from a study including twenty-four looked-after young people aged between 14 and 21 with experience of self-harm; 20 females and 4 males. An Interpretive Phenomenological Analysis was conducted.

Results

Five themes were identified, four of which shared similarities to prior research into the recovery of self-harm and manifestations of PTG: 1) Self-Reflection, 2) Communication, 3) Embracing and Appreciating Support, 4) Better Management of feelings. The fifth theme suggested a potential barrier to experiencing PTG; 5) Reliance on Self-Harm. Findings revealed four relevant themes suggesting that individuals who self-harm can indeed experience cognitions and emotions relevant to PTG.

Limitations

This study utilised a homogeneous sample, limiting the generalisability of the findings to other populations. Perhaps future research should consider other populations of individuals who self-harm.

Conclusions

We suggest there is a need for interventions for self-harm to focus on protective factors to increase PTG within an individual, potentially moderating the risk of suicide.

"I Was Trying to Be the Mother to Her That I Didn't Have": Mothers' Experiences of Child Sexual Abuse and Intergenerational Maltreatment

Child sexual abuse (CSA) can have lasting negative impacts on one's sense of safety and trust, ultimately affecting the quality of relationships, and increasing the likelihood of future victimization experiences. The present study provides a qualitative description of the themes that were generated through interviews conducted with 23 mothers who experienced CSA (dis)continuity (12 continuity, 11 discontinuity). The mothers described a variety of experiences related to parent-child and romantic relationships and parenting behaviors, which could be further researched and targeted by interventions to reduce the risk of intergenerational cycles of maltreatment.

Dissociative episodes characterised by hair-pulling in a late adolescent woman

A woman in late adolescence with a history of sickle cell disease, moyamoya disease, cerebrovascular accident, mild intellectual disability, post-traumatic stress disorder, functional seizures, generalised anxiety disorder and transient psychosis was referred for a psychiatry consultation. She presented with worsening episodes of dissociation characterised by compulsory hair-pulling. Limited research exists regarding patients engaging in activities of automated behaviour during episodes of dissociation. Thus, we aim to describe a case of a patient with episodes of hair-pulling during dissociative events to discuss the aetiology and treatment. We are describing the aetiology and treatment of a patient with episodes of hair-pulling during dissociative events.

The reasons dissociative disorder patients self-injure

BACKGROUND

Most individuals with dissociative disorders (DDs) report engaging in self-injury.

OBJECTIVE

The present study aimed to understand the reasons for self-injury among a clinical sample of 156 DD patients enrolled in the TOP DD Network study.

METHOD

Participants answered questions about self-injury, including a prompt asking how often they are aware of the reasons they have urges to self-injure, as well as a prompt asking them to list three reasons they self-injure.

RESULTS

Six themes of reasons for self-injury, each with subthemes, were identified in the qualitative data: (1) Trauma-related Cues, (2) Emotion Dysregulation, (3) Stressors, (4) Psychiatric and Physical Health Symptoms, (5) Dissociative Experiences, and (6) Ineffective Coping Attempts. Participants reported that they were able to identify their reasons for self-injuring sometimes (60.26%) or almost always (28.85%), with only 3.20% unable to identify any reasons for their self-injury.

CONCLUSION

Results suggest that the vast majority of DD patients (92.31%) reported being at least partially unaware of what leads them to have self-injury urges, and many individuals with DDs experience some reasons for self-injury that are different from those with other disorders. The treatment implications of these findings are discussed.

The Experience and Meaning of Repeated Self-Harm Among Patients Presenting to Irish Hospital Emergency Departments

BACKGROUND

Self-harm is a global public health concern in terms of increasing morbidity in addition to causing considerable financial implications for the health sector. Patients presenting with a history of self-harm are at increased risk of self-harm repetition and suicide. Research exploring the patient's experience of engaging in multiple self-harm episodes is lacking. This study aimed to explore the experiences and meaning of self-harm repetition, among patients who presented to three urban hospital emergency departments in Ireland.

METHOD

A subset of participants with a history of five or more self-harm attempts from an ongoing study, 'Improving Prediction and Risk Assessment of Self-Harm and Suicide' was selected for this article. Interview transcripts from four participants were selected for analysis using Interpretative Phenomenological Analysis. The qualitative software package NVivo 11 was used to store and organise data into themes.

RESULTS

Data were analysed based on four participants (two males and two females) ranging in age from 25 to 56 years. Three of the four participants reported a history of early traumatic emotional, physical and sexual abuse. Four superordinate themes were generated from the data, 'Significance of self-harm to the person', 'Trajectory of self-harm progression', 'Impact of abuse in adult life' and 'The road to recovery'.

CONCLUSION

Self-harm was used as a coping mechanism for participants who experienced distressing life events such as emotional and sexual abuse. The qualitative themes identified in this study have implications for the development of adequate medical and mental health support systems for patients with histories of repeated self-harm.

Sadness regulation strategies and measurement: A scoping review

BACKGROUNDS

Accurate measurement and suitable strategies facilitate people regulate their sadness in an effective manner. Regulating or mitigating negative emotions, particularly sadness, is crucial mainly because constant negative emotions may lead to psychological disorders, such as depression and anxiety. This paper presents an overview of sadness regulation strategies and related measurement.

METHOD

Upon adhering to five-step scoping review, this study combed through articles that looked into sadness regulation retrieved from eight databases.

RESULTS

As a result of reviewing 40 selected articles, 110 strategies were identified to regulate emotions, particularly sadness. Some of the most commonly reported strategies include expressive suppression, cognitive reappraisal, distraction, seeking social or emotional support, and rumination. The four types of measures emerged from the review are self-reported, informant report (parents or peers), open-ended questions, and emotion regulation instructions. Notably, most studies had tested psychometric properties using Cronbach's alpha alone, while only a handful had assessed validity (construct and factorial validity) and reliability (Cronbach's alpha or test-retest) based on responses captured from questionnaire survey.

CONCLUSION

Several sadness regulation strategies appeared to vary based on gender, age, and use of strategy. Despite the general measurement of emotion regulation, only one measure was developed to measure sadness regulation exclusively for children. Future studies may develop a comprehensive battery of measures to assess sadness regulation using multi-component method.

Introduction to the Special Section on Complex Posttraumatic Stress Disorder (CPTSD): The Evolution of a Disorder

The inclusion of complex posttraumatic stress disorder (CPTSD) in the 11th revision of the International Classification of Diseases is an important development in the field of psychotraumatology. Complex PTSD was developed as a response to a clinical need to describe difficulties commonly associated with exposure to traumatic stressors that are predominantly of an interpersonal nature. With this special section, we bring attention to this common condition following exposure to traumatic stressors that only recently has been designated an official diagnosis. In this introduction, we review the history of CPTSD as a new condition and we briefly introduce the papers for the special section in the present issue of the Journal of Traumatic Stress. It is our hope that the work presented in the special section will add to an ever-expanding evidence base. We also hope that this work inspires further research on the cultural validity of CPTSD, its assessment, and treatment.