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Rameckers SA, van Emmerik AAP, Grasman RPPP, Arntz A. Non-fear emotions in changes in posttraumatic stress disorder symptoms during treatment. J Behav Ther Exp Psychiatry 2024; 84:101954. [PMID: 38479086 DOI: 10.1016/j.jbtep.2024.101954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Revised: 12/31/2023] [Accepted: 02/19/2024] [Indexed: 05/15/2024]
Abstract
BACKGROUND AND OBJECTIVES Posttraumatic stress disorder (PTSD) is not only associated with fear but also with other emotions. The present study aimed to examine if changes in shame, guilt, anger, and disgust predicted changes in PTSD symptoms during treatment, while also testing if PTSD symptoms, in turn, predicted changes in these emotions. METHODS Participants (N = 155) with childhood-related PTSD received a maximum of 12 sessions of eye movement desensitization and reprocessing or imagery rescripting. The data was analyzed using Granger causality models across 12 treatment sessions and 6 assessment sessions (up until one year after the start of treatment). Differences between the two treatments were explored. RESULTS Across treatment sessions, shame, and disgust showed a reciprocal relationship with PTSD symptoms, while changes in guilt preceded PTSD symptoms. Across assessments, anger was reciprocally related to PTSD, suggesting that anger might play a more important role in the longer term. LIMITATIONS The individual emotion items were not yet validated, and the CAPS was not administered at all assessments. CONCLUSIONS These findings partly differ from earlier studies that suggested a unidirectional relationship in which changes in emotions preceded changes in PTSD symptoms during treatment. This is in line with the idea that non-fear emotions do play an important role in the treatment of PTSD and constitute an important focus of treatment and further research.
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Affiliation(s)
- Sophie A Rameckers
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands.
| | | | - Raoul P P P Grasman
- Department of Psychological Methods, University of Amsterdam, Amsterdam, the Netherlands
| | - Arnoud Arntz
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, the Netherlands
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Jones AC, Badour CL. Advancing the Measurement of Trauma-Related Shame Among Women With Histories of Interpersonal Trauma. Violence Against Women 2024; 30:2697-2720. [PMID: 36938626 DOI: 10.1177/10778012231163575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2023]
Abstract
Shame is a predominant emotion for many interpersonal trauma (IPT) survivors and is associated with more severe posttraumatic stress disorder (PTSD) symptoms. Measurement challenges have led to difficulties in understanding the impact of trauma-related shame. The Trauma-Related Shame Inventory (TRSI) was developed to address this limitation, yet additional psychometric support is needed. The present study evaluated and provided psychometric support for the TRSI among women with IPT histories, although recommendations for improvement are discussed. The impact of trauma-related shame, relative to trait shame and trauma-related guilt, on PTSD symptoms was also studied, with results suggesting that trauma-related shame had the strongest association.
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BOYACİOGLU İ, KONUKOĞLU K, ERGİYEN T. Effect of Emotional Content on Memory Characteristics: Emotional Valence, Emotional Intensity, and Individual Emotions. PSIKIYATRIDE GUNCEL YAKLASIMLAR - CURRENT APPROACHES IN PSYCHIATRY 2022. [DOI: 10.18863/pgy.1068175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The aim of the present study is to examine the relationships between the emotional valence and emotional intensity of autobiographical memories and the phenomenological characteristics of memories in the context of individual emotions and memory types. Seven hundred and sixty-four students (514 female, 250 male) from Dokuz Eylul University participated in the study. Participants were asked to recall an childhood memory, a self-defining memory, or a romantic relationship memory. After thinking about the memory they remember, they were requested to fill out the Autobiographical Memory Characteristics Questionnaire and a scale for intensity of individual emotions. Regression analyses showed that emotional intensity of the memories predicted the sensory details, rehearsal, and preoccupation with emotions. In moderated-mediation analyses, mediating effects for emotional intensity were detected between individual emotions and memory characteristics, except for the negative self-esteem emotions. Among these analyses, a moderating effect of memory types was detected only for the relationships between hostile emotions and anxiety-related emotions and the memory characteristics through the mediation of emotional intensity. While the intensity of singular emotions showed stronger relationship with emotional valence, the main variable that predicted memory characteristics overall was the emotional intensity.
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Wulfes N, von Fritschen U, Strunz C, Kröhl N, Scherer R, Kröger C. Cognitive-Emotional Aspects of Post-Traumatic Stress Disorder in the Context of Female Genital Mutilation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19094993. [PMID: 35564386 PMCID: PMC9105982 DOI: 10.3390/ijerph19094993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/04/2022] [Accepted: 04/15/2022] [Indexed: 11/16/2022]
Abstract
Around 200 million women and girls worldwide are affected by female genital mutilation/cutting (FGM/C). FGM/C is a procedure that harms or alters the external female genitals for non-medical reasons, and is usually performed on children. Often, this procedure leads to severe consequences for the women's physical and mental health. In a cross-sectional sample of 112 women seeking medical counseling, physical and mental health characteristics associated with FGM/C were examined and possible predictors for the development of post-traumatic stress disorder (PTSD) in women affected by FGM/C were identified. A total of 55.4% (n = 66) of the women reported symptom levels of probable PTSD. Predictors for higher PTSD symptomology were an older age at the time of the FGM/C procedure, feelings of guilt and the centrality of the event in the woman's life. Thus, cognitive-emotional processing was found to play an important role in the emergence of PTSD in women suffering from FGM/C. However, interventions taking into consideration these characteristics are mostly lacking and need to be investigated further in the context of FGM/C.
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Affiliation(s)
- Nele Wulfes
- Department of Clinical Psychology and Psychotherapy, University of Hildesheim, 31141 Hildesheim, Germany; (N.K.); (C.K.)
- Correspondence: ; Tel.: +49-5121-883-11062
| | | | - Cornelia Strunz
- Desert Flower Center Waldfriede, 14163 Berlin, Germany; (C.S.); (R.S.)
| | - Nadine Kröhl
- Department of Clinical Psychology and Psychotherapy, University of Hildesheim, 31141 Hildesheim, Germany; (N.K.); (C.K.)
| | - Roland Scherer
- Desert Flower Center Waldfriede, 14163 Berlin, Germany; (C.S.); (R.S.)
| | - Christoph Kröger
- Department of Clinical Psychology and Psychotherapy, University of Hildesheim, 31141 Hildesheim, Germany; (N.K.); (C.K.)
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Blackburn AM, Xu B, Gibson L, Wright EC, Ohye BY. The effect of intimate partner violence on treatment response in an intensive outpatient program for suicide-bereaved military widows. MILITARY PSYCHOLOGY 2022. [DOI: 10.1080/08995605.2022.2040918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Allyson M. Blackburn
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Bingyu Xu
- Home Base: A Massachusetts General Hospital and Boston Red Sox Foundation Program
| | - Lauren Gibson
- Home Base: A Massachusetts General Hospital and Boston Red Sox Foundation Program
- Department of Psychiatry, Harvard Medical School
- Corporal Michael J. Crescenz Philadelphia VA Medical Center
| | - Edward C. Wright
- Home Base: A Massachusetts General Hospital and Boston Red Sox Foundation Program
- Department of Psychiatry, Harvard Medical School
| | - Bonnie Y. Ohye
- Home Base: A Massachusetts General Hospital and Boston Red Sox Foundation Program
- Department of Psychiatry, Harvard Medical School
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Stynes G, Leão CS, McHugh L. Exploring the effectiveness of mindfulness-based and third wave interventions in addressing self-stigma, shame and their impacts on psychosocial functioning: A systematic review. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2022. [DOI: 10.1016/j.jcbs.2022.01.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Boring BL, Walsh KT, Nanavaty N, Mathur VA. Shame Mediates the Relationship Between Pain Invalidation and Depression. Front Psychol 2021; 12:743584. [PMID: 34925146 PMCID: PMC8677820 DOI: 10.3389/fpsyg.2021.743584] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 11/11/2021] [Indexed: 11/13/2022] Open
Abstract
The experience of pain is subjective, yet many people have their pain invalidated or not believed. Pain invalidation is associated with poor mental health, including depression and lower well-being. Qualitative investigations of invalidating experiences identify themes of depression, but also social withdrawal, self-criticism, and lower self-worth, all of which are core components of shame. Despite this, no studies have quantitatively assessed the interrelationship between pain invalidation, shame, and depression. To explore this relationship, participants recounted the frequency of experienced pain invalidation from family, friends, and medical professionals, as well as their feelings of internalized shame and depressive symptoms. As shame has been shown to be a precursor for depression, we further explored the role of shame as a mediator between pain invalidation and depressive symptoms. All sources of pain invalidation were positively associated with shame and depressive symptoms, and shame fully mediated the relationship between each source of pain invalidation and depression. Relative to other sources, pain invalidation from family was most closely tied to shame and depression. Overall, findings indicate that one mechanism by which pain invalidation may facilitate depression is via the experience of shame. Future research may explore shame as a potential upstream precursor to depression in the context of pain. Findings provide more insight into the harmful influence of pain invalidation on mental health and highlight the impact of interpersonal treatment on the experiences of people in pain.
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Affiliation(s)
- Brandon L Boring
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Kaitlyn T Walsh
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Namrata Nanavaty
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States
| | - Vani A Mathur
- Department of Psychological and Brain Sciences, Texas A&M University, College Station, TX, United States.,Texas A&M Institute for Neuroscience, College Station, TX, United States
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Reuber M, Roberts NA, Levita L, Gray C, Myers L. Shame in patients with psychogenic nonepileptic seizure: A narrative review. Seizure 2021; 94:165-175. [PMID: 34844847 DOI: 10.1016/j.seizure.2021.10.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 10/02/2021] [Accepted: 10/21/2021] [Indexed: 10/20/2022] Open
Abstract
Psychogenic Nonepileptic Seizures (PNES) have been linked to dysregulated emotions and arousal. However, the question which emotions may be most relevant has received much less attention. In this multidisciplinary narrative review, we argue that the self-conscious emotion of shame is likely to be of particular importance for PNES. We summarize current concepts of the development of shame processing and its relationship with other emotional states. We demonstrate the potential of acute shame to cause a sudden disruption of normal cognitive function and trigger powerful behavioral, cognitive, physiological and secondary emotional responses which closely resemble key components of PNES. These responses may lead to the development of shame avoidance strategies which can become disabling in themselves. We discuss how excessive shame proneness and shame dysregulation are linked to several psychopathologies often associated with PNES (including depression and PTSD) and how they may predispose to, precipitate and perpetuate PNES disorders, not least by interacting with stigma. We consider current knowledge of the neurobiological underpinnings of shame and PNES. We explore how shame could be the link between PNES and a heterogeneous range of possible etiological factors, and how it may link historical aversive experiences with individual PNES events occurring much later and without apparent external trigger. We argue that, in view of the potential direct links between shame and PNES, the well-documented associations of shame with common comorbidities of this seizure disorder and the well-characterized relationship between chronic shame and stigma, there is a compelling case to pay greater attention to shame in relation to PNES. Its role in the treatment of patients with PNES is discussed in a separate, linked review incorporating case vignettes to highlight the complex interactions of different but interlinked shame-related issues in individual patients.
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Affiliation(s)
- M Reuber
- Academic Neurology Unit, University of Sheffield, Royal Hallamshire Hospital, Glossop Road, Sheffield, S10 2JF, United Kingdom.
| | - Nicole A Roberts
- School of Social and Behavioral Sciences, Arizona State University, Phoenix, AZ, USA
| | - Liat Levita
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Cordelia Gray
- Specialist Psychotherapist, Neurology Psychotherapy Service, Sheffield Teaching Hospital, Academic Neurology Unit, University of Sheffield, Sheffield, UK
| | - Lorna Myers
- Director, Northeast Regional Epilepsy Group, New York, United States
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Erdim NK, Koyuncu Z, Keleş H, Durcan G, Kadak MT, Doğangün B, Celkan T. Impact of having a sibling with cancer or type I diabetes mellitus on psychopathology and self-conscious emotions in adolescents: a comparative study including controls. Support Care Cancer 2021; 30:635-645. [PMID: 34363110 DOI: 10.1007/s00520-021-06456-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Accepted: 07/21/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND OBJECTIVE: Having a child diagnosed with cancer is stressful for the whole family and may cause significant psychological impact on parents and siblings. Chronic, life-altering diseases may also have similar effects in siblings due to the daily life changes in the family to accommodate the child with chronic disease. We investigated the impact of having a sibling with cancer or type 1 diabetes mellitus (T1DM) on the psychological features of adolescents, with particular focus on self-conscious emotions such as guilt and shame-which are associated with the development of psychopathologies. METHOD Sixty-four children who were siblings of patients diagnosed with cancer (CS group), 54 children who were siblings of patients diagnosed with T1DM (DMS group), and 200 adolescents with siblings who did not have any chronic disease (control group) were included in the study. The CS group was also divided into two subgroups with respect to cancer type (leukemia and non-leukemia). Feelings of guilt and shame were evaluated via the Test of Self-Consciousness Affect for Adolescents (TOSCA-A). The Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used to determine the levels of depression and anxiety symptoms. Comparisons between groups were performed and within-group directional relationships between scores were analyzed. RESULTS Guilt scores were significantly higher in CSs than controls (p = 0.009), and the guilt scores of CSs and DMSs were similar (p = 0.508). Other subdimension scores obtained from the TOSCA-A and the CDI and STAI scores were similar in all three groups. In the CS group, externalization scores of siblings with leukemia were significantly higher than that of siblings with non-leukemia cancer. Although shame scores were similar in the CS, DMS, and control groups, shame scores were found to be positively correlated with CDI and STAI total scores in each group (p < 0.05 for all), whereas guilt scores did not demonstrate any significant correlations. CONCLUSION Our results support prior studies in showing that CSs feel a greater level of guilt compared to adolescents without disease-stricken siblings, whereas, interestingly, CSs and DMSs were found to experience similar levels of guilt. Despite lack of significant increase in the CS and DMS groups, shame levels were positively correlated with depression and anxiety scores in all groups, but the lower correlation coefficients for the CS group indicate the presence of other factors influencing this relationship. We believe our results warrant the need for future studies evaluating the needs of the siblings of children with other chronic diseases, preferably with longitudinal follow-up to determine situations associated with need for psychosocial support.
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Affiliation(s)
| | - Zehra Koyuncu
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Cerrahpasa, Fatih/Istanbul, 34098, Turkey.
| | | | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Bakirkoy Research and Training Hospital of Psychiatry, Istanbul, Turkey
| | - Muhammed Tayyib Kadak
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Cerrahpasa, Fatih/Istanbul, 34098, Turkey
| | - Burak Doğangün
- Department of Child and Adolescent Psychiatry, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Kocamustafapasa Street No: 53, Cerrahpasa, Fatih/Istanbul, 34098, Turkey
| | - Tiraje Celkan
- Department of Pediatric Hematology and Oncology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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10
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Michelini G, Palumbo IM, DeYoung CG, Latzman RD, Kotov R. Linking RDoC and HiTOP: A new interface for advancing psychiatric nosology and neuroscience. Clin Psychol Rev 2021; 86:102025. [PMID: 33798996 PMCID: PMC8165014 DOI: 10.1016/j.cpr.2021.102025] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 03/11/2021] [Accepted: 03/19/2021] [Indexed: 12/14/2022]
Abstract
The Research Domain Criteria (RDoC) and the Hierarchical Taxonomy of Psychopathology (HiTOP) represent major dimensional frameworks proposing two alternative approaches to accelerate progress in the way psychopathology is studied, classified, and treated. RDoC is a research framework rooted in neuroscience aiming to further the understanding of transdiagnostic biobehavioral systems underlying psychopathology and ultimately inform future classifications. HiTOP is a dimensional classification system, derived from the observed covariation among symptoms of psychopathology and maladaptive traits, which seeks to provide more informative research and treatment targets (i.e., dimensional constructs and clinical assessments) than traditional diagnostic categories. This article argues that the complementary strengths of RDoC and HiTOP can be leveraged in order to achieve their respective goals. RDoC's biobehavioral framework may help elucidate the underpinnings of the clinical dimensions included in HiTOP, whereas HiTOP may provide psychometrically robust clinical targets for RDoC-informed research. We present a comprehensive mapping between dimensions included in RDoC (constructs and subconstructs) and HiTOP (spectra and subfactors) based on narrative review of the empirical literature. The resulting RDoC-HiTOP interface sheds light on the biobehavioral correlates of clinical dimensions and provides a broad set of dimensional clinical targets for etiological and neuroscientific research. We conclude with future directions and practical recommendations for using this interface to advance clinical neuroscience and psychiatric nosology. Ultimately, we envision that this RDoC-HiTOP interface has the potential to inform the development of a unified, dimensional, and biobehaviorally-grounded psychiatric nosology.
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Affiliation(s)
- Giorgia Michelini
- Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry & Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA 90024, United States of America.
| | - Isabella M Palumbo
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Colin G DeYoung
- Department of Psychology, University of Minnesota, Minneapolis, MN 55455, United States of America
| | - Robert D Latzman
- Department of Psychology, Georgia State University, Atlanta, GA 30303, United States of America
| | - Roman Kotov
- Department of Psychiatry & Behavioral Health, Stony Brook University, Stony Brook, NY 11790, United States of America
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11
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Ceclan AA, Nechita DM. The effects of self-compassion components on shame-proneness in individuals with depression: An exploratory study. Clin Psychol Psychother 2021; 28:1103-1110. [PMID: 33527476 DOI: 10.1002/cpp.2560] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 11/18/2020] [Accepted: 01/13/2021] [Indexed: 11/09/2022]
Abstract
To date, there is no evidence regarding how self-compassion's components, self-kindness, common humanity and mindfulness could work as distinct interventions. Thus, the main objective of the present study was exploring the effects that the three separate components of self-compassion would have on shame-proneness levels in individuals with clinical depression. All the participants (n = 122) with a diagnostic of Major Depressive Disorder were randomized in four experimental groups: the self-kindness exercises group, the mindfulness exercises group, the common humanity one and the control group. Results indicated that levels of depression and shame-proneness, as measured by BDI-II, TOSCA-3 and ESS decreased from baseline to post-intervention, but no significant differences were observed between groups. Therefore, we cannot conclude that one self-compassion component is more efficient than the others, but the present study does offer, though, a strong starting point for more complex, future studies.
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Affiliation(s)
| | - Diana-Mirela Nechita
- Department of Clinical Psychology and Psychotherapy, Babeş-Bolyai University, Cluj-Napoca, Romania
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12
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Onu DU, Ugwu DI. Negative centralisation of HIV trauma influences health-related quality of life: Does posttraumatic growth buffer the link? INTERNATIONAL JOURNAL OF AFRICA NURSING SCIENCES 2021. [DOI: 10.1016/j.ijans.2021.100356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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13
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Webb H, Jobson L. Relationships between self‐consistency, trauma‐centred identity, and post‐traumatic adjustment. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/j.1742-9552.2011.00028.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Heather Webb
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, England
| | - Laura Jobson
- School of Medicine, Health Policy and Practice, University of East Anglia, Norwich, England
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14
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Roberts NA, Burleson MH, Torres DL, Parkhurst DK, Garrett R, Mitchell LB, Duncan CJ, Mintert M, Wang NC. Emotional Reactivity as a Vulnerability for Psychogenic Nonepileptic Seizures? Responses While Reliving Specific Emotions. J Neuropsychiatry Clin Neurosci 2020; 32:95-100. [PMID: 31662092 DOI: 10.1176/appi.neuropsych.19040084] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Dysfunction in emotional processes is a hypothesized contributor to functional neurological disorders (FNDs), yet few studies have evoked real-time emotion during multimethod assessment incorporating subjective, behavioral, and psychophysiological indicators. This approach may reveal clinical and neurobiological vulnerability to FND and clarify how dysfunctional emotional processes serve as perpetuating factors. METHODS Eleven participants with video-EEG-confirmed diagnoses of psychogenic nonepileptic seizures (PNES) were compared with 49 seizure-free trauma control subjects (TCs) with or without clinically elevated posttraumatic stress symptoms (25 clinically elevated [TC-clin], 24 not clinically elevated [TC-nonclin]). Participants recalled and described memories evoking anger, shame, happiness, and neutral feelings. RESULTS Even though PNES patients and TCs reported similar amounts of emotional experience, PNES patients reported more difficulty reliving emotions and were less likely to complete the relived shame task. During and after reliving happiness, PNES and TC-clin groups showed respiratory sinus arrhythmia (RSA) decreases, indicating parasympathetic withdrawal, whereas the TC-nonclin group showed RSA increases. CONCLUSIONS Findings from this pilot study are consistent with previous research and clinical observations that emotional engagement may be more effortful for PNES patients. Patterns of RSA change, which may also point to greater effortful engagement, were similar in PNES and TC-clin groups, suggesting that traumatic stress reactions may play a part. At the same time, experience of greater difficulty or avoidance may be even greater among PNES patients. Especially when regulatory resources are already limited, accumulated effort, coupled with self-threatening contexts such as shame, may be particularly problematic for those with PNES and perhaps other FNDs.
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Affiliation(s)
- Nicole A Roberts
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Mary H Burleson
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Dhannia L Torres
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - David K Parkhurst
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Robin Garrett
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Lauren B Mitchell
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Cayla J Duncan
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Mallory Mintert
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
| | - Norman C Wang
- School of Social and Behavioral Sciences, Arizona State University, Phoenix (Roberts, Burleson, Torres, Parkhurst, Mitchell, Duncan, Mintert); and Banner-University Medical Center Neuroscience Institute, Phoenix (Garrett, Wang)
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15
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Yeung RC, Fernandes MA. Recurrent involuntary autobiographical memories: characteristics and links to mental health status. Memory 2020; 28:753-765. [PMID: 32525740 DOI: 10.1080/09658211.2020.1777312] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Memories of events from one's personal past that come to mind unintentionally and effortlessly are termed involuntary autobiographical memories (IAMs). Recurrent IAMs are known as relevant to many disorders within clinical literature. However, less is known about their links with mental health status in the general population. In the current study, 2184 undergraduate students completed surveys assessing occurrence of any recurrent IAMs. Participants also wrote a description of their most frequently recurring IAM and rated it on phenomenological characteristics, such as frequency, valence, vividness, and centrality. Results showed that the majority of our sample experienced recurrent IAMs, replicating previous findings, but most of these memories were emotionally negative, unlike past work. Importantly, negative recurrent IAMs were associated with significantly more mental health concerns, including symptoms of depression, anxiety, and posttraumatic stress. We also found that frequency of IAM recurrence was predicted by the memory's age, level of completeness/detail, emotional intensity, and centrality to one's life story. Further, descriptions of positive recurrent IAMs contained significantly more episodic detail compared to negative or neutral ones, suggesting that emotional regulation may play a role in how recurrent IAMs are recounted. Recurrent IAMs, and their characteristics, serve as a window into mental health status.
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Affiliation(s)
- Ryan C Yeung
- Department of Psychology, University of Waterloo, Waterloo, Canada
| | - Myra A Fernandes
- Department of Psychology, University of Waterloo, Waterloo, Canada
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16
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Carlson RW, Maréchal MA, Oud B, Fehr E, Crockett MJ. Motivated misremembering of selfish decisions. Nat Commun 2020; 11:2100. [PMID: 32350253 PMCID: PMC7190661 DOI: 10.1038/s41467-020-15602-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2018] [Accepted: 03/12/2020] [Indexed: 11/09/2022] Open
Abstract
People often prioritize their own interests, but also like to see themselves as moral. How do individuals resolve this tension? One way to both pursue personal gain and preserve a moral self-image is to misremember the extent of one's selfishness. Here, we test this possibility. Across five experiments (N = 3190), we find that people tend to recall being more generous in the past than they actually were, even when they are incentivized to recall their decisions accurately. Crucially, this motivated misremembering effect occurs chiefly for individuals whose choices violate their own fairness standards, irrespective of how high or low those standards are. Moreover, this effect disappears under conditions where people no longer perceive themselves as responsible for their fairness violations. Together, these findings suggest that when people's actions fall short of their personal standards, they may misremember the extent of their selfishness, thereby potentially warding off threats to their moral self-image.
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Affiliation(s)
- Ryan W Carlson
- Department of Psychology, Yale University, New Haven, CT, USA.
| | | | - Bastiaan Oud
- Department of Economics, University of Zurich, Zurich, Switzerland
| | - Ernst Fehr
- Department of Economics, University of Zurich, Zurich, Switzerland
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17
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Left alone with the emotional surge – A qualitative study of midwives’ and obstetricians’ experiences of severe events on the labour ward. SEXUAL & REPRODUCTIVE HEALTHCARE 2020; 23:100483. [DOI: 10.1016/j.srhc.2019.100483] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Revised: 10/21/2019] [Accepted: 11/29/2019] [Indexed: 11/19/2022]
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18
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LeBlanc NJ, Toner ER, O’Day EB, Moore CW, Marques L, Robinaugh DJ, McNally RJ. Shame, guilt, and pride after loss: Exploring the relationship between moral emotions and psychopathology in bereaved adults. J Affect Disord 2020; 263:405-412. [PMID: 31969271 PMCID: PMC7307182 DOI: 10.1016/j.jad.2019.11.164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 09/20/2019] [Accepted: 11/30/2019] [Indexed: 12/22/2022]
Abstract
BACKGROUND Self-blame following bereavement has been implicated in the development of post-loss psychopathology. However, prior studies have not distinguished between the emotions of shame versus guilt. This study examined the cross-sectional associations among bereavement-related shame, bereavement-related guilt, and two mental disorders that commonly arise after bereavement: complicated grief and depression. In addition, exploratory analyses examined the associations between bereavement-related pride and post-loss psychopathology. METHODS Participants included 92 bereaved adults who experienced the death of a family member at least one year prior to the study. Participants completed self-report measures of complicated grief symptoms, depression symptoms, shame, guilt, and pride. RESULTS Shame and guilt were positively correlated with complicated grief and depression symptoms. When controlling for their shared variance, only shame remained a significant predictor of post-loss psychopathology. Follow-up analyses indicated that the effect of guilt on psychopathology depended on the level of shame, and vice versa. At low shame, guilt predicted psychopathology; however guilt did not predict psychopathology at moderate to high shame. At low to moderate guilt, shame predicted psychopathology; however shame did not predict psychopathology at high guilt. Pride negatively predicted depression symptoms, but not complicated grief symptoms, when we controlled for shame and guilt. LIMITATIONS Limitations include the cross-sectional design and modest sample size. CONCLUSIONS Our analyses identify shame as the more pathogenic moral emotion for bereaved adults. However, whereas guilt in the absence of shame is often considered adaptive, we found that guilt predicted greater psychological distress at low levels of shame in this sample.
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Affiliation(s)
- Nicole J. LeBlanc
- Department of Psychology, Harvard University,Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital
| | - Emma R. Toner
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital
| | | | - Cynthia W. Moore
- Division of Child and Adolescent Psychiatry, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
| | - Luana Marques
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School,Community Psychiatry Program for Research in Implementation and Dissemination of Evidence-Based Treatments, Massachusetts General Hospital
| | - Donald J. Robinaugh
- Center for Anxiety and Traumatic Stress Disorders, Massachusetts General Hospital,Department of Psychiatry, Harvard Medical School
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19
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Greene T, Gelkopf M, Fried EI, Robinaugh DJ, Lapid Pickman L. Dynamic Network Analysis of Negative Emotions and DSM-5 Posttraumatic Stress Disorder Symptom Clusters During Conflict. J Trauma Stress 2020; 33:72-83. [PMID: 31433530 DOI: 10.1002/jts.22433] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Revised: 12/10/2018] [Accepted: 12/15/2018] [Indexed: 01/01/2023]
Abstract
Investigating dynamic associations between specific negative emotions and PTSD symptom clusters may provide novel insights into the ways in which PTSD symptoms interact with, emerge from, or are reinforced by negative emotions. The present study estimated the associations among negative emotions and the four DSM-5 PTSD symptom clusters (intrusions, avoidance, negative alterations in cognitions and mood [NACM], and arousal) in a sample of Israeli civilians (n = 96) during the Israel-Gaza War of July-August 2014. Data were collected using experience sampling methodology, with participants queried via smartphone about PTSD symptoms and negative emotions twice a day for 30 days. We used a multilevel vector auto-regression model to estimate temporal and contemporaneous temporal networks. Contrary to our hypothesis, in the temporal network, PTSD symptom clusters were more predictive of negative emotions than vice versa, with arousal emerging as the strongest predictor that negative emotions would be reported at the next measurement point; fear and sadness were also strong predictors of PTSD symptom clusters. In the contemporaneous network, negative emotions exhibited the strongest associations with the NACM and arousal PTSD symptom clusters. The negative emotions of sadness, stress, fear, and loneliness had the strongest associations to the PTSD symptom clusters. Our findings suggest that arousal has strong associations to both PTSD symptoms and negative emotions during ongoing trauma and highlights the potentially relevant role of arousal for future investigations in primary or early interventions.
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Affiliation(s)
- Talya Greene
- Department of Community Mental Health, University of Haifa, Haifa, Israel
| | - Marc Gelkopf
- Department of Community Mental Health, University of Haifa, Haifa, Israel.,NATAL, Israel Trauma and Resiliency Center, Tel Aviv, Israel
| | - Eiko I Fried
- Department of Psychology, Leiden University, Leiden, the Netherlands.,Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands
| | - Donald J Robinaugh
- Department of Psychology, University of Amsterdam, Amsterdam, the Netherlands.,Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Liron Lapid Pickman
- Department of Community Mental Health, University of Haifa, Haifa, Israel.,NATAL, Israel Trauma and Resiliency Center, Tel Aviv, Israel
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20
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Beck JG, Dodson TS, Pickover AM, Woodward MJ, Lipinski AJ, Tran HN. The effects of shame on subsequent reactions to a trauma analog. J Anxiety Disord 2019; 66:102108. [PMID: 31387013 DOI: 10.1016/j.janxdis.2019.102108] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 05/07/2019] [Accepted: 06/21/2019] [Indexed: 11/25/2022]
Abstract
The current study examined the effects of experimentally-induced shame on subsequent reactions to a trauma analog. Participants were 88 college-aged women randomly assigned to a shame prime condition or to a control (neutral) condition. Participants then were presented with an analog trauma audiotape depicting dating violence. Participants reported intrusive thoughts relating to the trauma analog in the two days following the procedure. Negative (shame, guilt) and positive (pride, positive affect) emotions were monitored throughout the procedure. Results indicated that the shame prime successfully increased shame in the Shame condition alone. After the trauma analog, increases in shame were noted in both conditions. In contrast, guilt reduced in the Shame condition, while this emotion increased in the Control condition, contrary to hypothesis. Shame and guilt were somewhat volatile for participants in the Shame condition in the two days following the lab procedure, while individuals in the Control condition reported steadily decreasing levels of these emotions. No between-condition differences were noted in the frequency of intrusions in the two days following the laboratory procedure, contrary to hypothesis. Results are discussed in light of our current understanding of shame and its role in PTSD, with suggestions to guide future research.
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Affiliation(s)
- J Gayle Beck
- Department of Psychology, The University of Memphis, United States.
| | - Thomas S Dodson
- Department of Psychology, The University of Memphis, United States
| | | | - Matthew J Woodward
- Department of Psychological Sciences, Western Kentucky University, United States
| | | | - Han N Tran
- Department of Psychology, The University of Memphis, United States
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21
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López-Castro T, Saraiya T, Zumberg-Smith K, Dambreville N. Association Between Shame and Posttraumatic Stress Disorder: A Meta-Analysis. J Trauma Stress 2019; 32:484-495. [PMID: 31291483 PMCID: PMC7500058 DOI: 10.1002/jts.22411] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 01/16/2019] [Accepted: 01/19/2019] [Indexed: 11/09/2022]
Abstract
Posttraumatic stress disorder (PTSD) is a complex condition with affective components that extend beyond fear and anxiety. The emotion of shame has long been considered critical in the relation between trauma exposure and PTSD symptoms. Yet, to date, no meta-analytic synthesis of the empirical association between shame and PTSD has been conducted. To address this gap, the current study summarized the magnitude of the association between shame and PTSD symptoms after trauma exposure. A systematic literature search yielded 624 publications, which were screened for inclusion criteria (individuals exposed to a Criterion A trauma, and PTSD and shame assessed using validated measures of each construct). In total, 25 studies employing 3,663 participants met full eligibility criteria. A random-effects meta-analysis revealed a significant moderate association between shame and posttraumatic stress symptoms, r = .49, 95% CI [0.43, 0.55], p < .001. Moderator analyses were not completed due to the absence of between-study heterogeneity. Publication bias analyses revealed minimal bias, determined by small attenuation after the superimposition of weight functions. The results underscore that across a diverse set of populations, shame is characteristic for many individuals with PTSD and that it warrants a central role in understanding the affective structure of PTSD. Highlighting shame as an important clinical target may help improve the efficacy of established treatments. Future research examining shame's interaction with other negative emotions and PTSD symptomology is recommended.
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Affiliation(s)
- Teresa López-Castro
- Psychology Department, The City College of New York, The City University of New York, New York, NY, USA
| | - Tanya Saraiya
- Psychology Department, The City College of New York, The City University of New York, New York, NY, USA,Derner School of Psychology, Adelphi University, Garden City, New York, USA
| | - Kathryn Zumberg-Smith
- Division on Substance Use Disorders, New York State Psychiatric Institute, Columbia University College of Physicians and Surgeons
| | - Naomi Dambreville
- Psychology Department, The City College of New York, The City University of New York, New York, NY, USA,Department of Psychology, The Graduate Center, The City University of New York
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22
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23
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Thomson P, Jaque SV. History of childhood adversity and coping strategies: Positive flow and creative experiences. CHILD ABUSE & NEGLECT 2019; 90:185-192. [PMID: 30802732 DOI: 10.1016/j.chiabu.2018.12.019] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 11/29/2018] [Accepted: 12/20/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Acquiring more complex coping strategies despite a history of childhood adversity may transpire in settings outside the family home. OBJECTIVES The objectives of this cross-sectional study included investigating coping strategies under stressful situations in a non-clinical sample of active athletes and performing artists. PARTICIPANTS AND SETTING In this community and university sample (n = 577), 40.4% had no ACEs, 43.4% had 1-3 ACEs, and 16.3% had ≥4 ACEs. METHODS A series of multivariate analyses (gender and age included as covariates) were conducted to examine differences between the three ACE groups. RESULTS Results indicated no between-subject differences between the three ACE groups for flow-like experiences during preferred activities, although gender differences were significant (p < .001). Individuals in the ≥4 ACEs group endorsed more intense creative experiences compared to the no-ACE and 1-3 ACEs groups (p = .006, η2 = .048); however, in the third MANCOVA they had heightened anxiety, internalized shame, dissociative processing, emotion-oriented coping, and cumulative trauma (p < .001, η2 = .132). There were no group differences for task-oriented and avoidant-oriented coping, a finding that highlights the ability of active individuals to engage in effective coping strategies under stressful situations. CONCLUSION Regardless of past childhood adversity history, this non-clinical high achieving sample was able to engage in a range of coping strategies under stress.
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Affiliation(s)
- Paula Thomson
- California State University, Northridge, Northridge, CA, United States.
| | - S Victoria Jaque
- California State University, Northridge, Northridge, CA, United States
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24
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Ford JD. Trauma Memory Processing in Posttraumatic Stress Disorder Psychotherapy: A Unifying Framework. J Trauma Stress 2018; 31:933-942. [PMID: 30444287 DOI: 10.1002/jts.22344] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 09/05/2018] [Accepted: 09/08/2018] [Indexed: 12/19/2022]
Abstract
Trauma memory processing (TMP) is an empirically supported approach to psychotherapy for posttraumatic stress disorder (PTSD). However, TMP is not a single, uniform intervention but instead a paradigm that can be operationalized through a variety of component procedures that have not been systematically elucidated and formally tested. Based on findings from phenomenological/structural and neuroimaging research, a central feature of PTSD is theorized to be the involuntary immersion in trauma memories with diminished awareness or negative appraisals of self and current context. Such intrusive reexperiencing-which is epitomized by, but not limited to, flashbacks-is postulated to underlie PTSD's avoidance, altered emotions and cognitions, dissociative, and hyperarousal/hypervigilance symptoms; it is thus a logical target for TMP. The varied approaches to TMP for PTSD are conceptualized as having the common goal of activation of the neural networks in the brain that underlie two key capacities disrupted by intrusive reexperiencing in PTSD: intentional self-referential retrieval of memories and suppression of memory retrieval. Therefore, TMP is postulated to involve two core functions (purposeful reflective remembering and memory awareness in situ) and three essential types (in vivo, imaginal, and cognitive reappraisal). Several implications of this framework for clinical practice and research on TMP for PTSD are discussed.
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Affiliation(s)
- Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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25
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Mooren N, Krans J, Näring G, van Minnen A. Vantage perspective in analogue trauma memories: an experimental study. Cogn Emot 2018; 33:1261-1270. [PMID: 30354926 DOI: 10.1080/02699931.2018.1538010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Vantage perspective during recall is thought to affect the emotionality and accessibility of distressing memories. This study aimed to test the effects of vantage perspective during recall on memory associated distress and intrusion development. An adapted version of the trauma film paradigm was used in an experimental design with three conditions. Participants were asked to listen to eyewitness reports of car accidents (e.g. Trauma Analogue Induction) and imagine the scenes vividly using mental imagery. Afterwards, they were asked to recall the most distressing scene from field perspective, observer perspective, or to recall a neutral image from observer perspective (control condition) (e.g. Trauma Analogue Recall). Recall from field perspective resulted in higher negative mood, state-anxiety, and a higher number of short-term intrusions compared to the observer perspective condition and control condition. Negative mood and state-anxiety were mediators in the relationship between vantage perspective and intrusions. In comparison to observer perspective, field perspective increased the amount of short-term intrusions as a result of higher levels of negative mood and state-anxiety after memory retrieval. Future research on the interaction between vantage perspective at recall and negative mood and anxiety effects is warranted.
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Affiliation(s)
- Nora Mooren
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands
| | - Julie Krans
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands.,b Pro Persona Research , Overwaal Centre for Anxiety, OCD, and PTSD , Nijmegen , the Netherlands
| | - Gérard Näring
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands
| | - Agnes van Minnen
- a Behavioural Science Institute , Radboud University Nijmegen , Nijmegen , the Netherlands.,b Pro Persona Research , Overwaal Centre for Anxiety, OCD, and PTSD , Nijmegen , the Netherlands
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26
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Gehrt TB, Berntsen D, Hoyle RH, Rubin DC. Psychological and clinical correlates of the Centrality of Event Scale: A systematic review. Clin Psychol Rev 2018; 65:57-80. [PMID: 30138786 DOI: 10.1016/j.cpr.2018.07.006] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 07/25/2018] [Accepted: 07/29/2018] [Indexed: 10/28/2022]
Abstract
The Centrality of Event Scale (CES) was introduced to examine the extent to which a traumatic or stressful event is perceived as central to an individual's identity and life story, and how this relates to Posttraumatic Stress Disorder (PTSD) symptoms. In addition, the CES has been examined in relation to a range of other conditions and dispositions. We present a systematic review of the correlates of the CES. Results from 92 publications resulted in 25 measurement categories in the six theoretical domains of trauma, negative affect and distress, autobiographical memory, personality, positive affect, and gender. The mean weighted correlations of the 25 measurement categories ranged from -.17 to .55, with standard errors from .01 to .02, allowing us to distinguish empirically among effects. Consistent with the theoretical motivation for the CES and predictions predating the review, the CES correlated positively with a range of measures, correlating most highly with measures related to trauma, PTSD, grief, and autobiographical memory. The findings show that the CES probes aspects of autobiographical memory of broad relevance to clinical disorders, and with specific implications for theories of PTSD.
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Affiliation(s)
- Tine B Gehrt
- Center on Autobiographical Memory Research, Aarhus University, Denmark.
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Aarhus University, Denmark
| | - Rick H Hoyle
- Department of Psychology and Neuroscience, Duke University, United States
| | - David C Rubin
- Center on Autobiographical Memory Research, Aarhus University, Denmark; Department of Psychology and Neuroscience, Duke University, United States
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27
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Cavalera C, Pepe A, Zurloni V, Diana B, Realdon O, Todisco P, Castelnuovo G, Molinari E, Pagnini F. Negative social emotions and cognition: Shame, guilt and working memory impairments. Acta Psychol (Amst) 2018; 188:9-15. [PMID: 29800767 DOI: 10.1016/j.actpsy.2018.05.005] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Revised: 03/09/2018] [Accepted: 05/13/2018] [Indexed: 12/13/2022] Open
Abstract
Negative emotions can have an impact on a variety of cognitive domains, including Working Memory (WM). The present work investigated whether shame and guilt modulate WM performance in a dual-task test both in a non-clinical and a clinical population. In Experiment 1, 76 non-clinical participants performed a dual-task before and after being randomly assigned to shame, guilt or neutral inductions elicited by the writing of autobiographical past experiences. Shame and guilt elicitations were related to impaired WM performances. In Experiment 2, 65 clinical inpatients with eating disorders were assigned to the same procedure. The negative relationship of self-conscious emotions and WM was confirmed. Taken together these results suggest that shame and guilt are related to impairments of WM in both clinical and non-clinical participants.
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28
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Del Palacio-Gonzalez A, Berntsen D. Emotion Regulation of Events Central to Identity and Their Relationship With Concurrent and Prospective Depressive Symptoms. Behav Ther 2018; 49:604-616. [PMID: 29937261 DOI: 10.1016/j.beth.2017.11.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 11/08/2017] [Accepted: 11/08/2017] [Indexed: 10/18/2022]
Abstract
Dispositional emotion regulation is related to the severity and maintenance of depressive symptoms. However, whether emotion regulation specific to an event highly central for an individual's identity is predictive of depressive symptoms has not been examined. Nonclinical participants (N = 220) reported the extent to which they employed a selection of emotion regulation strategies when recalling low- and high-centrality events. Dispositional emotion regulation and depressive symptoms were also assessed. A 7-week follow-up was conducted. High-centrality events were associated with more emotion regulation efforts. Greater brooding and expressive suppression in relation to high-centrality memories predicted concurrent depressive symptoms after controlling for event valence and dispostional emotion regulation. Effects were absent for low-centrality memories. Emotion regulation in response to high-centrality memories did not predict depressive symptoms at follow-up beyond baseline depressive symptoms. Overall, the findings showed that maladaptive emotion regulation in response to memories of high-centrality events is important for explaining depressive symptomatology.
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Affiliation(s)
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, Aarhus University
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29
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Changes in perceived centrality of anxious events following cognitive behavioral therapy for social anxiety disorder and panic disorder. J Behav Ther Exp Psychiatry 2018; 59:150-156. [PMID: 29425950 DOI: 10.1016/j.jbtep.2018.01.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 01/12/2018] [Accepted: 01/19/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND AND OBJECTIVE The purpose of the present study was to explore the association between reductions in symptoms of psychopathology and perceived centrality of negative autobiographical memories in participants with social anxiety disorder (SAD) or panic disorder (PD). METHODS Thirty-nine individuals with SAD or PD recalled and rated four negative autobiographical memories before and after ten sessions of cognitive behavioral therapy (CBT) over a three-month period. Twenty-eight healthy controls did the same before and after a three-month period. RESULTS As hypothesized, results showed a decrease in perceived centrality following CBT. This decrease in perceived centrality was larger, although at the trend level, for individuals who experienced reliable change on disorder-specific symptoms. LIMITATIONS The correlational nature of the study prevents establishing the causal relationship between changes in perceived centrality and psychopathology, and future studies should explore such mechanisms. CONCLUSIONS The present study adds to the emerging body of literature, investigating changes in centrality of event following psychotherapy.
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30
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Abstract
OBJECTIVES It remains unclear whether there are age-related changes in the experience of strong self-conscious emotion, such as shame, guilt, pride and embarrassment. Because shame and guilt figure prominently in the aetiology of depressive symptoms and other mental health problems, a better understanding of how age affects the strong experience of these two negative self-conscious emotions is of particular importance. METHODS Thirty younger, 30 middle-aged and 30 older adults were compared on standardised cognitive assessments, in addition to an interview-based measure that assessed whether there are age differences in the likelihood of strongly experiencing four different types of self-conscious emotion within the past five years (shame, guilt, embarrassment and pride). RESULTS The three groups did not differ in their likelihood of reporting an event that strongly elicited the positive self-conscious emotion of pride. However, older adults were more likely to report sources of pride that were other (as opposed to self) focused. Older adults were also less likely to report experiencing events that elicited all three negative self-conscious emotions, in particular, shame. CONCLUSIONS Strong negative self-conscious emotion, and in particular shame, appears to be experienced less by older than younger adults.
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Affiliation(s)
- Julie D Henry
- a School of Psychology , University of Queensland , St Lucia , Australia
| | - William von Hippel
- a School of Psychology , University of Queensland , St Lucia , Australia
| | - Matthew R Nangle
- b School of Dentistry , University of Queensland , Herston , Australia
| | - Michele Waters
- a School of Psychology , University of Queensland , St Lucia , Australia
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31
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Broadbridge CL. Is the centralization of potentially traumatic events always negative? An expansion of the Centrality of Events Scale. APPLIED COGNITIVE PSYCHOLOGY 2018. [DOI: 10.1002/acp.3403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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32
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Zhang H, Carr ER, Garcia-Williams AG, Siegelman AE, Berke D, Niles-Carnes LV, Patterson B, Watson-Singleton NN, Kaslow NJ. Shame and Depressive Symptoms: Self-compassion and Contingent Self-worth as Mediators? J Clin Psychol Med Settings 2018; 25:408-419. [PMID: 29488038 DOI: 10.1007/s10880-018-9548-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Research has identified the experience of shame as a relevant predictor of depressive symptoms. Building upon resilience theory, this is the first study to investigate if self-compassion and/or contingent self-worth (i.e., family support and God's love) mediate the link between shame and depressive symptoms. Participants were 109 African Americans, within the age range of 18 and 64, who sought service following a suicide attempt from a public hospital that serves mostly low-income patients. Findings suggest that shame was related to depressive symptoms through self-compassion but not through contingent self-worth, underscoring the significant role that self-compassion plays in ameliorating the aggravating effect of shame on depressive symptoms. Results highlight the value of incorporating self-compassion training into interventions for suicidal African Americans in an effort to reduce the impact of shame on their depressive symptoms and ultimately their suicidal behavior and as a result enhance their capacity for resilience.
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Affiliation(s)
- Huaiyu Zhang
- University of California San Francisco, 2727 Mariposa St, Suite 100, San Francisco, CA, 94110, USA.
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Schoenleber M, Berghoff CR, Gratz KL, Tull MT. Emotional lability and affective synchrony in posttraumatic stress disorder pathology. J Anxiety Disord 2018; 53:68-75. [PMID: 29197703 PMCID: PMC5748357 DOI: 10.1016/j.janxdis.2017.11.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 10/26/2017] [Accepted: 11/27/2017] [Indexed: 11/17/2022]
Abstract
This study examined the relations of PTSD pathology to both the lability of three specific emotions (anxiety, anger, self-conscious emotions [SCE]) and the extent to which changes in one emotional state co-occur with changes in another emotional state (i.e. affective synchrony). Moreover, given evidence that emotional responding in PTSD may be heightened in response to trauma-related cues, these relations were explored in the context of a trauma cue versus neutral cue. Trauma-exposed patients in residential substance use disorder treatment (N=157) completed a diagnostic interview and two laboratory sessions involving presentation of neutral and individualized trauma scripts. State anxiety, anger, and SCE were assessed at five points throughout each laboratory session. Hierarchical linear modeling indicated that participants (regardless of PTSD status) exhibited greater lability of all emotions following the trauma script versus neutral script. Only anger lability was elevated among those with (versus without) a current PTSD diagnosis following the neutral script. Results also revealed synchrony (i.e., positive covariation) between each possible pair of emotions, regardless of PTSD status. Findings suggest that concurrent changes in anxiety and anger may be especially relevant to PTSD symptom severity.
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Affiliation(s)
- Michelle Schoenleber
- Department of Psychology, St. Norbert College, 100 Grant St., De Pere, WI 54115, United States.
| | - Christopher R Berghoff
- Department of Psychology, University of South Dakota, 414 E. Clark St., Vermillion, SD 57069, United States.
| | - Kim L Gratz
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606-3390, United States.
| | - Matthew T Tull
- Department of Psychology, University of Toledo, 2801 W. Bancroft St., Toledo, OH 43606-3390, United States.
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Chukwuorji JC, Ifeagwazi CM, Eze JE. Role of event centrality and emotion regulation in posttraumatic stress disorder symptoms among internally displaced persons. ANXIETY STRESS AND COPING 2017; 30:702-715. [PMID: 28766372 DOI: 10.1080/10615806.2017.1361936] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Event centrality and emotion regulation in relation to posttraumatic stress disorder (PTSD) have been documented in various global samples especially in Western cultures; but internally displaced persons (IDPs) still constitute an underrepresented population in psychotraumatology literature. This study tested the roles of event centrality and emotion regulation strategies (cognitive reappraisal and expressive suppression) in PTSD symptoms among IDPs in Nigeria. DESIGN The multi-group cross-sectional design was adopted. METHODS Tiv language versions of the Centrality of Events Scale, Emotion Regulation Questionnaire, and Harvard Trauma Questionnaire were completed by 859 IDPs in two camps located in Benue State, North-central region of Nigeria. RESULTS Hierarchical multiple linear regression results indicated that event centrality positively predicted PTSD symptoms. Cognitive reappraisal was a negative predictor of PTSD symptoms while expressive suppression was a positive predictor of PTSD symptoms. Bonferroni corrections indicated that expressive suppression was the strongest predictor of total PTSD symptoms, avoidance/numbing symptoms, and hyper-arousal symptoms; but event centrality was the most robust predictor of PTSD intrusion/re-experiencing symptoms. CONCLUSION The findings underscore recent developments in psychotraumatology indicating that the extent to which individual differences impact the development of PTSD is essential in clinical psychology research and practice.
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Affiliation(s)
| | | | - John E Eze
- a Department of Psychology , University of Nigeria , Nsukka , Nigeria
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Hart RP, Bagrodia R, Rahman N, Bryant RA, Titcombe-Parekh R, Marmar CR, Brown AD. Neuropsychological Predictors of Trauma Centrality in OIF/OEF Veterans. Front Psychol 2017; 8:1120. [PMID: 28713319 PMCID: PMC5492846 DOI: 10.3389/fpsyg.2017.01120] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 06/16/2017] [Indexed: 11/13/2022] Open
Abstract
This study examined whether reduced performance on two neuropsychological tasks, cognitive flexibility and working memory, were associated with higher levels of trauma centrality. A growing body of research has shown that trauma centrality, the extent to which a person believes a potentially traumatic event has become central to their self-identity and life story, is associated with post-traumatic stress disorder (PTSD). Furthermore, PTSD is often associated with alterations in neuropsychological functioning. The relationship between neuropsychological processes and trauma centrality, however, has yet to be explored. OEF/OIF combat veterans (N = 41) completed the Post-traumatic Diagnostic Scale (PDS), the Beck Depression Inventory-II (BDI-II), the Centrality of Event Scale (CES), and on-line measures of cognitive flexibility and working memory assessed via WebNeuro. Bivariate Pearson correlations showed that CES scores were positively correlated with PDS and BDI scores, and negatively correlated with cognitive flexibility and working memory. Linear regressions revealed that working memory significantly predicted CES when controlling for depression and PTSD severity while cognitive flexibility approached significance when controlling for these same variables. This study employed a cross-sectional design, precluding causality. The small sample size, entirely male sample, and use of an online neuropsychological assessment warrant follow-up research. Although numerous studies have found an association between CES and PTSD, this is the first to suggest that neuropsychological processes underlie the construct of trauma centrality. Given the importance of maladaptive cognitive processes underlying the pathogenesis of PTSD, these data suggest that future studies aimed at examining the link between neuropsychological processes and maladaptive cognitive processes, such as trauma centrality, may help to characterize and treat PTSD.
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Affiliation(s)
- Roland P Hart
- Department of Psychiatry, School of Medicine, New York University, New YorkNY, United States
| | - Rohini Bagrodia
- Department of Psychiatry, School of Medicine, New York University, New YorkNY, United States
| | - Nadia Rahman
- Department of Psychiatry, School of Medicine, New York University, New YorkNY, United States
| | - Richard A Bryant
- School of Psychology, University of New South Wales, KensingtonNSW, Australia
| | - Roseann Titcombe-Parekh
- Department of Psychiatry, School of Medicine, New York University, New YorkNY, United States
| | - Charles R Marmar
- Department of Psychiatry, School of Medicine, New York University, New YorkNY, United States
| | - Adam D Brown
- Department of Psychiatry, School of Medicine, New York University, New YorkNY, United States.,Department of Psychology, Sarah Lawrence College, BronxvilleNY, United States
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Gentry JE, Baranowsky AB, Rhoton R. Trauma Competency: An Active Ingredients Approach to Treating Posttraumatic Stress Disorder. JOURNAL OF COUNSELING AND DEVELOPMENT 2017. [DOI: 10.1002/jcad.12142] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- J. Eric Gentry
- International Association of Trauma Professionals; Sarasota Florida
- Now at the Arizona Trauma Institute; Mesa Arizona
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Shame proneness and eating disorders: a comparison between clinical and non-clinical samples. Eat Weight Disord 2016; 21:701-707. [PMID: 27704341 DOI: 10.1007/s40519-016-0328-y] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2016] [Accepted: 09/17/2016] [Indexed: 10/20/2022] Open
Abstract
PURPOSE To explore the relationship between shame proneness, eating disorders outcomes and psychological aspects of patients with eating disorders (ED). METHODS Sixty-six girls applying for inpatient treatment for ED and 110 female undergraduate students were assessed using the Eating Disorder Inventory-3 and the Shame Proneness Scale of the Test of Self-Conscious Affect. RESULTS Shame proneness showed significant correlations with several ED components and psychological scales of EDI-3, with some variations across the subgroups. Shame proneness levels were significantly higher in the clinical group than in controls. CONCLUSIONS Shame proneness can be an important component for the development and the maintenance of ED due to a strong correlation not only with ED symptoms but also with psychological aspects of this disease, in both clinical and non-clinical samples.
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Ashamed and Afraid: A Scoping Review of the Role of Shame in Post-Traumatic Stress Disorder (PTSD). J Clin Med 2016; 5:jcm5110094. [PMID: 27809274 PMCID: PMC5126791 DOI: 10.3390/jcm5110094] [Citation(s) in RCA: 69] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 10/24/2016] [Accepted: 10/26/2016] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Despite considerable progress in the treatment of post-traumatic stress disorder (PTSD), a large percentage of individuals remain symptomatic following gold-standard therapies. One route to improving care is examining affective disturbances that involve other emotions beyond fear and threat. A growing body of research has implicated shame in PTSD's development and course, although to date no review of this specific literature exists. This scoping review investigated the link between shame and PTSD and sought to identify research gaps. METHODS A systematic database search of PubMed, PsycInfo, Embase, Cochrane, and CINAHL was conducted to find original quantitative research related to shame and PTSD. RESULTS Forty-seven studies met inclusion criteria. Review found substantial support for an association between shame and PTSD as well as preliminary evidence suggesting its utility as a treatment target. Several design limitations and under-investigated areas were recognized, including the need for a multimodal assessment of shame and more longitudinal and treatment-focused research. CONCLUSION This review provides crucial synthesis of research to date, highlighting the prominence of shame in PTSD, and its likely relevance in successful treatment outcomes. The present review serves as a guide to future work into this critical area of study.
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Weiss NH, Duke AA, Overstreet NM, Swan SC, Sullivan TP. Intimate partner aggression-related shame and posttraumatic stress disorder symptoms: The moderating role of substance use problems. Aggress Behav 2016; 42:427-40. [PMID: 26699821 DOI: 10.1002/ab.21639] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 11/09/2015] [Accepted: 11/10/2015] [Indexed: 11/11/2022]
Abstract
A dearth of literature has examined the consequences of women's use of aggression in intimate relationships. Women's use of aggression against their intimate partners, regardless of their motivation (e.g., self-defense, retaliation), may elicit shame. Shame, in turn, may contribute to the maintenance and/or exacerbation of posttraumatic stress disorder (PTSD) symptoms, which are commonly experienced in this population. Further, emerging research suggests that emotionally avoidant coping strategies, such as substance use, may strengthen the relation between shame and PTSD symptoms. The goal of the present study was to examine whether women's shame concerning their use of intimate partner aggression is associated with their PTSD symptoms, and whether drug and alcohol use problems moderate this association. Participants were 369 community women who had used and been victimized by physical aggression in an intimate relationship with a male partner in the past six months. The intimate partner aggression-related shame × drug (but not alcohol) use problems interaction on PTSD symptom severity was significant. Analysis of simple slopes revealed that women's intimate partner aggression-related shame was positively associated with their PTSD symptoms when drug use problems were high, but not when drug use problems were low. Findings have implications for the potential utility of PTSD treatments targeting a reduction in shame and maladaptive shame regulation strategies (i.e., drug use) in this population. Aggr. Behav. 42:427-440, 2016. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Nicole H. Weiss
- Department of Psychiatry; Yale University School of Medicine; New Haven Connecticut
| | - Aaron A. Duke
- Department of Psychiatry; Yale University School of Medicine; New Haven Connecticut
| | | | - Suzanne C. Swan
- Department of Psychology; University of South Carolina; Columbia South Carolina
| | - Tami P. Sullivan
- Department of Psychiatry; Yale University School of Medicine; New Haven Connecticut
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Fitzgerald JM, Berntsen D, Broadbridge CL. The Influences of Event Centrality in Memory Models of PTSD. APPLIED COGNITIVE PSYCHOLOGY 2015. [DOI: 10.1002/acp.3160] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | - Dorthe Berntsen
- Center on Autobiographical Memory Research, School of Business and Social Sciences; Aarhus University; Aarhus Denmark
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Pugh LR, Taylor PJ, Berry K. The role of guilt in the development of post-traumatic stress disorder: A systematic review. J Affect Disord 2015; 182:138-50. [PMID: 25997098 DOI: 10.1016/j.jad.2015.04.026] [Citation(s) in RCA: 56] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2014] [Revised: 04/13/2015] [Accepted: 04/14/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD) can be a debilitating condition associated with a myriad of emotions. Guilt is an important associated feature of PTSD that has received far less recognition than other symptoms often associated with fear and intense threat. The nature of the relationship between guilt and PTSD remains elusive and requires further clarification. The aim of the current paper was to review the extant literature regarding the link between guilt and PTSD. METHOD A systematic database search of PsycINFO, Medline, Embase and Web of Science identified articles that enabled examination of the guilt-PTSD relationship. A total of 27 articles met inclusion criteria for this review. RESULTS There were cross-sectional relationships between guilt and PTSD symptomology with evidence of associations between PTSD symptoms and cognitions related to perceived wrong doing and self-blame. However, the direction of association between guilt and PTSD is unclear and possibly confounded by overlapping constructs such as shame. LIMITATIONS The review is constrained by the absence of longitudinal and experimental research and studies, which control for potential confounding variables. The reliability and validity of measures of guilt and PTSD is also not consistently reported. CONCLUSION This review outlines four competing models of the guilt-PTSD relationship and examines existing evidence linking the two constructs. The current literature is too preliminary to offer any strong support for one model over the other. However, in critically appraising existing studies, this review helps to inform the design of future studies investigating the association between guilt and PTSD.
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Affiliation(s)
- Lauren R Pugh
- Salford Primary Care Psychology Service, Gloucester House, Back Duncan Street, Manchester M7 2EY, England.
| | - Peter J Taylor
- Institute of Psychology, Health & Society, The University of Liverpool, Brownlow Hill, Liverpool L69 3GB, England
| | - Katherine Berry
- School of Psychological Sciences, The University of Manchester, Oxford Road, Manchester M13 9PL, England
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Bynum WE. Filling the feedback gap: the unrecognised roles of shame and guilt in the feedback cycle. MEDICAL EDUCATION 2015; 49:644-7. [PMID: 26077209 DOI: 10.1111/medu.12754] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Luchetti M, Sutin AR. Measuring the phenomenology of autobiographical memory: A short form of the Memory Experiences Questionnaire. Memory 2015; 24:592-602. [PMID: 25894806 DOI: 10.1080/09658211.2015.1031679] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The Memory Experiences Questionnaire (MEQ) is a theoretically driven and empirically validated 63-item self-report scale designed to measure 10 phenomenological qualities of autobiographical memories: Vividness, Coherence, Accessibility, Time Perspective, Sensory Details, Visual Perspective, Emotional Intensity, Sharing, Distancing and Valence. To develop a short form of the MEQ to use when time is limited, participants from two samples (N = 719; N = 352) retrieved autobiographical memories, rated the phenomenological experience of each memory and completed several scales measuring psychological distress. For each MEQ dimension, the number of items was reduced by one-half based on item content and item-total correlations. Each short-form scale had acceptable internal consistency (median alpha = .79), and, similar to the long-form version of the scales, the new short scales correlated with psychological distress in theoretically meaningful ways. The new short form of the MEQ has similar psychometric proprieties as the original long form and can be used when time is limited.
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Affiliation(s)
- Martina Luchetti
- a Department of Psychology, University of Bologna , Bologna , Italy
| | - Angelina R Sutin
- b Department Behavioral Sciences and Social Medicine , Florida State University College of Medicine , Tallahassee , FL , USA
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Browne KC, Trim RS, Myers US, Norman SB. Trauma-related guilt: conceptual development and relationship with posttraumatic stress and depressive symptoms. J Trauma Stress 2015; 28:134-41. [PMID: 25864504 DOI: 10.1002/jts.21999] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Despite high prevalence and concerning associated problems, little effort has been made to conceptualize the construct of posttraumatic guilt. This investigation examined the theoretical model of trauma-related guilt proposed by Kubany and Watson (2003). This model hypothesizes that emotional and physical distress related to trauma memories partially mediates the relationship between guilt cognitions and posttraumatic guilt. Using path analysis, this investigation (a) empirically evaluated relationships hypothesized in Kubany and Watson's model, and (b) extended this conceptualization by evaluating models whereby guilt cognitions, distress, and posttraumatic guilt were related to posttraumatic stress disorder (PTSD) symptoms depression symptom severity. Participants were male U.S. Iraq and Afghanistan veterans (N = 149). Results yielded a significant indirect effect from guilt cognitions to posttraumatic guilt via distress, providing support for Kubany and Watson's model (β = .14). Findings suggested distress may be the strongest correlate of PTSD symptoms (β = .47) and depression symptoms (β = .40), and that guilt cognitions may serve to intensify the relationship between distress and posttraumatic psychopathology. Research is needed to evaluate whether distress specific to guilt cognitions operates differentially on posttraumatic guilt when compared to distress more broadly related to trauma memories.
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Affiliation(s)
- Kendall C Browne
- Mental Illness Research, Education, and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington, USA; Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, USA
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Freed S, D'Andrea W. Autonomic Arousal and Emotion in Victims of Interpersonal Violence: Shame Proneness But Not Anxiety Predicts Vagal Tone. J Trauma Dissociation 2015; 16:367-83. [PMID: 25894989 PMCID: PMC4499010 DOI: 10.1080/15299732.2015.1004771] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The redefinition of posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has highlighted a range of posttraumatic affects beyond fear and anxiety. For survivors of interpersonal violence, shame has been shown to be an important contributor of self-reported symptomatology. Although biological models of PTSD emphasize physiological arousal secondary to fear and anxiety, evidence suggests that shame might be related to increased arousal as well. This study tested the contributions of anxiety, fear, and shame to autonomic arousal in a sample of female victims (N = 27) of interpersonal violence with PTSD. Shame proneness was the only significant correlate of autonomic arousal during a trauma reminder paradigm. These findings indicate that shame corresponds to important indicators of changes to the autonomic nervous system that have previously been assumed to be fear related.
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Affiliation(s)
- Steven Freed
- a The New School for Social Research , New York , New York , USA
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46
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Ojserkis R, McKay D, Badour CL, Feldner MT, Arocho J, Dutton C. Alleviation of Moral Disgust, Shame, and Guilt in Posttraumatic Stress Reactions. Behav Modif 2014; 38:801-36. [DOI: 10.1177/0145445514543465] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Research suggests that moral disgust, shame, and guilt are present in posttraumatic psychopathology. However, it is unclear that these emotional states are responsive to empirically supported interventions for posttraumatic stress symptoms (PTSS). This study explored the relations among moral disgust, shame, guilt, and PTSS, and examined comprehensive distancing (CD) as a novel intervention for these emotional states in undergraduates with elevated PTSS. Participants were randomly assigned to use a CD or a cognitive challenge task in response to personalized scripts of a traumatic event. Both interventions were associated with decreases in disgust, moral disgust, shame, and guilt. Contrary to predictions, there were no significant differences between the exercises in the reduction of negative emotions. In addition, PTSS severity was correlated with trauma-related guilt as well as state guilt and shame, but not trait or state measures of disgust or moral disgust. This proof of concept project sets the stage for further research examining CD as an alternative or adjunctive intervention for posttraumatic stress reactions with strong features of moral disgust, shame, and guilt.
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Affiliation(s)
| | | | - Christal L. Badour
- University of Arkansas, Fayetteville, AR, USA
- Medical University of South Carolina, Charleston, SC, USA
- Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - Matthew T. Feldner
- University of Arkansas, Fayetteville, AR, USA
- Laureate Institute for Brain Research, Tulsa, OK, USA
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Berntsen D, Rubin DC. Involuntary Memories and Dissociative Amnesia: Assessing Key Assumptions in PTSD Research. Clin Psychol Sci 2014; 2:174-186. [PMID: 25309832 PMCID: PMC4189812 DOI: 10.1177/2167702613496241] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
Autobiographical memories of trauma victims are often described as disturbed in two ways. First, the trauma is frequently re-experienced in the form of involuntary, intrusive recollections. Second, the trauma is difficult to recall voluntarily (strategically); important parts may be totally or partially inaccessible-a feature known as dissociative amnesia. These characteristics are often mentioned by PTSD researchers and are included as PTSD symptoms in the DSM-IV-TR (American Psychiatric Association, 2000). In contrast, we show that both involuntary and voluntary recall are enhanced by emotional stress during encoding. We also show that the PTSD symptom in the diagnosis addressing dissociative amnesia, trouble remembering important aspects of the trauma is less well correlated with the remaining PTSD symptoms than the conceptual reversal of having trouble forgetting important aspects of the trauma. Our findings contradict key assumptions that have shaped PTSD research over the last 40 years.
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Norman SB, Wilkins KC, Myers US, Allard CB. Trauma Informed Guilt Reduction Therapy With Combat Veterans. COGNITIVE AND BEHAVIORAL PRACTICE 2014; 21:78-88. [PMID: 25404850 DOI: 10.1016/j.cbpra.2013.08.001] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Guilt related to combat trauma is highly prevalent among veterans returning from Iraq and Afghanistan. Trauma-related guilt has been associated with increased risk for posttraumatic psychopathology and poorer response to treatment. Trauma Informed Guilt Reduction (TrIGR) therapy is a 4-module cognitive-behavioral psychotherapy designed to reduce guilt related to combat trauma. The goals of this study were to describe the key elements of TrIGR and report results of a pilot study with 10 recently deployed combat veterans. Ten combat veterans referred from a VA Posttraumatic Stress Disorder (PTSD) or mental health clinic completed TrIGR over 4 to 7 sessions. Nine veterans completed the posttreatment assessment. This initial pilot suggests that TrIGR may help to reduce trauma-related guilt severity and associated distress. Changes in trauma-related guilt were highly correlated with reductions in PTSD and depression symptoms over the course of treatment, suggesting a possible mechanistic link with severity of posttraumatic psychopathology. TrIGR warrants further evaluation as an intervention for reducing guilt related to traumatic experiences in combat.
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Affiliation(s)
- Sonya B Norman
- VA San Diego Healthcare System, University of California - San Diego, and National Center for PTSD
| | - Kendall C Wilkins
- San Diego State University/University of California, San Diego Joint Doctoral Program
| | - Ursula S Myers
- San Diego State University/University of California, San Diego Joint Doctoral Program
| | - Carolyn B Allard
- VA San Diego Healthcare System, University of California - San Diego
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Rubin DC, Boals A, Hoyle RH. Narrative centrality and negative affectivity: independent and interactive contributors to stress reactions. J Exp Psychol Gen 2013; 143:1159-70. [PMID: 24294867 DOI: 10.1037/a0035140] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Reactions to stressful negative events have long been studied using approaches based on either the narrative interpretation of the event or the traits of the individual. Here, we integrate these 2 approaches by using individual-differences measures of both the narrative interpretation of the stressful event as central to one's life and the personality characteristic of negative affectivity. We show that they each have independent contributions to stress reactions and that high levels on both produce greater than additive effects. The effects on posttraumatic stress symptoms are substantial for both undergraduates (Study 1, n = 2,296; Study 3, n = 488) and veterans (Study 2, n = 104), with mean levels for participants low on both measures near floor on posttraumatic stress symptoms and those high on both measures scoring at or above diagnostic thresholds. Study 3 included 3 measures of narrative centrality and 3 of negative affectivity to demonstrate that the effects were not limited to a single measure. In Study 4 (n = 987), measures associated with symptoms of posttraumatic stress correlated substantially with either measures of narrative centrality or measures of negative affectivity. The concepts of narrative centrality and negative affectivity and the results are consistent with findings from clinical populations using similar measures and with current approaches to therapy. In broad nonclinical populations, such as those used here, the results suggest that we might be able to substantially increase our ability to account for the severity of stress response by including both concepts.
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Affiliation(s)
- David C Rubin
- Department of Psychology and Neuroscience, Duke University, and Center on Autobiographical Memory Research, Aarhus University
| | - Adriel Boals
- Department of Psychology, University of North Texas
| | - Rick H Hoyle
- Department of Psychology and Neuroscience, Duke University
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Roland AG, Currier JM, Rojas-Flores L, Herrera S. Event centrality and posttraumatic outcomes in the context of pervasive violence: a study of teachers in El Salvador. ANXIETY STRESS AND COPING 2013; 27:335-46. [PMID: 24033152 DOI: 10.1080/10615806.2013.835402] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
It is well established that the importance assigned to a trauma can affect one's recovery and psychological health in numerous ways. Event centrality is an increasingly popular construct that captures the tendency among survivors to reevaluate and possibly accommodate their worldviews posttrauma. The centrality given to trauma appears to serve as a "double-edged sword" in that this construct might factor prominently in both posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). Focusing on 257 violence-exposed teachers from educational departments throughout El Salvador, we examined whether the centrality assigned by the teachers to stressful life events uniquely predicted both PTSD symptomatology and PTG. Results revealed that event centrality was positively related to both PTSD and PTG, even when controlling for demographic factors, violence exposure, and depression. In addition, PTSD symptomatology and PTG were not associated with one another in this sample. In summary, these findings support the role of event centrality as a contributing factor for PTSD and PTG among persons exposed to pervasive trauma.
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Affiliation(s)
- Ashli G Roland
- a Department of Clinical Psychology, Graduate School of Psychology , Fuller Theological Seminary , 180 N Oakland Avenue, Pasadena , CA 91101 , USA
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