1
|
Liddell BJ, Das P, Malhi GS, Jobson L, Lau W, Felmingham KL, Nickerson A, Askovic M, Aroche J, Coello M, Bryant RA. Self-construal modulates default mode network connectivity in refugees with PTSD. J Affect Disord 2024; 361:268-276. [PMID: 38866252 DOI: 10.1016/j.jad.2024.06.009] [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: 02/28/2024] [Revised: 05/28/2024] [Accepted: 06/03/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND While self-construal and posttraumatic stress disorder (PTSD) are independently associated with altered self-referential processes and underlying default mode network (DMN) functioning, no study has examined how self-construal affects DMN connectivity in PTSD. METHODS A final sample of 93 refugee participants (48 with DSM-5 PTSD or sub-syndromal PTSD and 45 matched trauma-exposed controls) completed a 5-minute resting state fMRI scan to enable the observation of connectivity in the DMN and other core networks. A self-construal index was calculated by substracting scores on the collectivistic and individualistic sub-scales of the Self Construal Scale. RESULTS Independent components analysis identified 9 active networks-of-interest, and functional network connectivity was determined. A significant interaction effect between PTSD and self-construal index was observed in the anterior ventromedial DMN, with spatial maps localizing this to the left ventromedial prefrontal cortex (vmPFC), extending to the ventral anterior cingulate cortex. This effect revealed that connectivity in the vMPFC showed greater reductions in those with PTSD with higher levels of collectivistic self-construal. LIMITATIONS This is an observational study and causality cannot be assumed. The specialized sample of refugees means that the findings may not generalize to other trauma-exposed populations. CONCLUSIONS Such a finding indicates that self-construal may shape the core neural architecture of PTSD, given that functional disruptions to the vmPFC underpin the core mechanisms of extinction learning, emotion dysregulation and self-referential processing in PTSD. Results have important implications for understanding the universality of neural disturbances in PTSD, and suggest that self-construal could be an important consideration in the assessment and treatment of post-traumatic stress reactions.
Collapse
Affiliation(s)
- Belinda J Liddell
- School of Psychological Sciences, University of Newcastle, Australia; School of Psychology, UNSW Sydney, Australia.
| | - Pritha Das
- School of Psychological Sciences, University of Newcastle, Australia; Academic Department of Psychiatry, Northern Sydney Local Health District, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia
| | - Gin S Malhi
- Academic Department of Psychiatry, Northern Sydney Local Health District, CADE Clinic, Royal North Shore Hospital, Northern Sydney Local Health District, St Leonards, NSW 2065, Australia; University of Sydney, Faculty of Medicine and Health, Northern Clinical School, Department of Psychiatry, Sydney, New South Wales, Australia.; Department of Psychiatry, University of Oxford, Oxford, UK
| | | | - Winnie Lau
- Phoenix Australia, University of Melbourne, Australia
| | - Kim L Felmingham
- School of Psychological Sciences, University of Melbourne, Australia
| | | | - Mirjana Askovic
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Jorge Aroche
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | - Mariano Coello
- NSW Service for the Treatment and Rehabilitation of Torture and Trauma Survivors (STARTTS), Sydney, Australia
| | | |
Collapse
|
2
|
Jobson L, Qiu LS, Wong J, Li H, Lies J, Lau W, Bryant RA, Liddell BJ. Cultural differences in appraisals of control and posttraumatic stress disorder symptoms. Eur J Psychotraumatol 2024; 15:2358685. [PMID: 38836340 PMCID: PMC11155424 DOI: 10.1080/20008066.2024.2358685] [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: 03/06/2024] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
Background: Appraisals are central to posttraumatic stress disorder (PTSD). Yet, few studies have examined how culture influences the associations between different types of trauma-related appraisals and PTSD symptoms.Objective: This study investigated cultural influences on appraisals of control and their associations with PTSD symptoms.Method: European Australian (n = 140, Mage = 35.80, SD = 12.44; 21 men, 97 women, 20 gender diverse/prefer not to report) and Chinese Australian (n = 129, Mage = 30.16, SD = 8.93, 21 men, 97 women, 20 gender diverse/prefer not to report) trauma survivors completed measures of appraisals, cultural values, and PTSD symptoms.Results: Findings showed that the Chinese Australian group was associated with greater Chinese cultural beliefs about adversity (i.e. emphasizing the value of adversity and people's ability to overcome adversity) and fewer fatalism appraisals (i.e. appraising one's destiny as externally determined), which in turn were atemporally associated with fewer PTSD symptoms; these atemporal indirect associations were moderated by self-construal and holistic thinking. The Chinese Australian group also reported fewer secondary control appraisals (i.e. attempts to change aspects of the self and accept current circumstances), which were atemporally associated with greater PTSD symptoms. In contrast, the European Australian group was associated with fewer primary control appraisals (i.e. perceived ability to personally change or control a situation), which were atemporally associated with greater PTSD symptoms.Conclusion: These findings highlight the importance of considering the influence of culture on appraisals in PTSD. However, it must be noted that causal relationships cannot be inferred from cross-sectional mediation analyses and thus, future longitudinal research is needed.
Collapse
Affiliation(s)
- Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia
| | - Larissa Shiying Qiu
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia
| | - Joshua Wong
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia
| | - July Lies
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, Australia
| | - Winnie Lau
- Phoenix Australia-Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Carlton, Australia
| | - Richard A. Bryant
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Belinda J. Liddell
- School of Psychology, University of New South Wales, Sydney, Australia
- School of Psychological Sciences, University of Newcastle, University Drive, Callaghan, Australia
| |
Collapse
|
3
|
Li X. Applicability of the Hebrew Bible to Post-traumatic Stress Disorder and Post-traumatic Growth. JOURNAL OF RELIGION AND HEALTH 2024:10.1007/s10943-023-01987-1. [PMID: 38219271 DOI: 10.1007/s10943-023-01987-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/14/2023] [Indexed: 01/16/2024]
Abstract
Since the new millennium, biblical scholars have begun to reread certain writings in the Hebrew Bible through the concepts of post-traumatic stress disorder and post-traumatic growth. Some scholars believe such a reading is legitimate, whereas others think it problematic, and still, others hold a midway perspective. This article argues for the midway, the position that accepts the applicability of the Hebrew Bible to today's psychological concepts but calls for caution. Because ancient Israelites reacted to traumatic events and distinguished the human mind from the body like modern people, it is reasonable to approach their thoughts and emotions in the Hebrew Bible through today's psychological concepts. However, the cultural differences between today's society and ancient Israelites in understanding and reacting to traumatic events should be considered.
Collapse
Affiliation(s)
- Xi Li
- Center for Judaic and Interreligious Studies of Shandong University, Qingjiao Building 4-1-202, Erhuangdong Road, 12550, Shizhong Qu, Jinan, 250002, Shandong, China.
| |
Collapse
|
4
|
Reyneke T, Lee B, Li H, Haque S, Abdullah SZ, Tan BKW, Liddell B, Jobson L. Examining the associations between control (primary and secondary) appraisals and posttraumatic stress disorder symptoms in Malaysian and Australian trauma survivors. Front Psychol 2023; 14:1017566. [PMID: 38144986 PMCID: PMC10739294 DOI: 10.3389/fpsyg.2023.1017566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Accepted: 11/23/2023] [Indexed: 12/26/2023] Open
Abstract
Background Little research has considered the influence of culture on control appraisals in the context of posttraumatic stress disorder (PTSD). Objectives This study aimed to investigate whether cultural group moderated the relationship between control (primary and secondary) appraisals and PTSD symptoms in trauma survivors from Western (Australian) and Asian (Malaysian) cultural contexts. Methods Trauma survivors (107 Australian with European cultural heritage; 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an online survey assessing PTSD symptoms and appraisals of control. Results Cultural group moderated the association between primary control and PTSD symptoms; the positive association was significant for the Australian group but not the Malaysian group. While cultural group did not moderate the association between secondary control and PTSD symptoms, there was an indirect pathway between secondary control appraisals and PTSD symptoms through interdependent self-construal for both cultural groups. Conclusion The findings indicate that cultural group and self-construal influence the associations between different types of control appraisals and PTSD. Further research exploring the role of culture and different appraisal types in PTSD is needed.
Collapse
Affiliation(s)
- Tamsyn Reyneke
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Bryan Lee
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| | - Shamsul Haque
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Siti Zainab Abdullah
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Britney Kerr Wen Tan
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
| | - Belinda Liddell
- School of Psychology, University of New South Wales, Sydney, NSW, Australia
| | - Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC, Australia
| |
Collapse
|
5
|
Xiu D, Maercker A, Killikelly C, Yang Y, Jia X. Grieving Parents' Meaning-Making Narration in Relation to Value Orientations: A Cross-Cultural Study. Transcult Psychiatry 2023; 60:905-916. [PMID: 33238808 DOI: 10.1177/1363461520970735] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study investigated the association between prolonged grief (PG) severity and meaning-making narration in a cross-cultural context, and specifically aimed to illustrate the role of value orientation in shaping the grieving process. 30 Chinese and 22 Swiss parents who lost their child were asked to narrate and appraise specific memories to reflect their self-evaluation of traditional and modern values. The self-reported Prolonged Grief Disorder Scale (ref ICD-11) assessed PG severity. Compared with the Swiss sample, the Chinese sample provided more elaborated memories, which was not associated with symptom severity. Both Chinese and Swiss bereaved parents with more severe PG provided more narratives of loss-related memories, particularly in response to modern values. They also provided more appraisals of negative meanings for self-defining memories, particularly in relation to their traditional values. These findings indicate that, despite cultural differences in narration tendency, PG severity in bereaved parents was associated with the maladaptive integration of autobiographical memories across different cultures, in relation to value orientations. A clinical implication is the potential value of facilitating narrations of grieving clients that center on value orientations to mitigate the hardship of the personal loss.
Collapse
Affiliation(s)
- Daiming Xiu
- University of Zurich
- The University of Hong Kong
| | | | | | | | | |
Collapse
|
6
|
Jobson L, Willoughby C, Specker P, Wong J, Draganidis A, Lau W, Liddell B. Investigating the associations between cognitive appraisals, emotion regulation and symptoms of posttraumatic stress disorder among Asian American and European American trauma survivors. Sci Rep 2022; 12:18127. [PMID: 36307529 PMCID: PMC9616820 DOI: 10.1038/s41598-022-22995-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 10/21/2022] [Indexed: 12/30/2022] Open
Abstract
This study investigated whether the associations between emotion regulation and cognitive appraisals and symptoms of posttraumatic stress disorder (PTSD) differ between Asian American and European American trauma survivors. Asian American (n = 103) and European American (n = 104) trauma survivors were recruited through mTurk and completed an on-line questionnaire assessing cognitive appraisals, emotion regulation and PTSD symptomatology. The European American group reported greater trauma-specific rumination, psychological inflexibility, seeking out others for comfort, and negative self-appraisals than the Asian American group. The Asian American group reported greater secondary control appraisals and cultural beliefs about adversity than the European American group. Second, cultural group moderated the associations between (a) brooding rumination, (b) fatalism, (c) self-blame, and (d) negative communal self-appraisals and PTSD symptoms. These associations were larger for the European American group than the Asian American group. Third, there was an indirect pathway from self-construal (independent and interdependent) to PTSD symptoms through certain emotion regulation approaches and cognitive appraisals. Additionally, cultural group was found to moderate several of these indirect effects. These findings highlight the importance of considering cultural background and cultural values in understanding the processes involved in PTSD. Further research in this area is needed.
Collapse
Affiliation(s)
- Laura Jobson
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800 Australia
| | - Casey Willoughby
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800 Australia ,grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Philippa Specker
- grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Joshua Wong
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800 Australia ,grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| | - Adriana Draganidis
- grid.1002.30000 0004 1936 7857Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800 Australia
| | - Winnie Lau
- grid.1008.90000 0001 2179 088XPhoenix Australia-Centre for Posttraumatic Mental Health and Department of Psychiatry, University of Melbourne, Carlton, VIC 3053 Australia
| | - Belinda Liddell
- grid.1005.40000 0004 4902 0432School of Psychology, University of New South Wales, Sydney, NSW 2052 Australia
| |
Collapse
|
7
|
Daneshvar S, Shafiei M, Basharpoor S. Compassion-Focused Therapy: Proof of Concept Trial on Suicidal Ideation and Cognitive Distortions in Female Survivors of Intimate Partner Violence With PTSD. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP9613-NP9634. [PMID: 33375899 DOI: 10.1177/0886260520984265] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
This proof of concept trial aimed to assess the pre-post differences in suicidal ideation and cognitive distortions in the compassion-focused therapy (CFT), and to compare the psychological improvement in the experimental group to a control group. A total of 42 women suffering from PTSD due to exposure to intimate partner violence (IPV) were randomized to the experimental and control groups (21 per group). All participants completed the questionnaires of suicidal ideation and cognitive distortions as pretest measures. Subjects of the experimental group received 8 CFT sessions, while the controls did not receive any therapy. Then, all subjects responded to the questionnaires of suicidal ideation and cognitive distortions as the posttest measures. Data were analyzed using one-way repeated measures MANOVA. Subjects of the experimental group indicated a greater reduction in post-test scores of suicidal ideation and its subscales including passive suicidal ideation, preparation for suicide, and active suicidal ideation when compared to the controls. Moreover, the subjects of the experimental group indicated a greater reduction in the post-test scores of cognitive distortions than controls. These results provide support for a larger trial focusing on the efficacy of CFT on psychological outcomes of PTSD following exposure to IPV. This intervention has the potential to be deployed at higher scales for IPV-affected women with PTSD.
Collapse
|
8
|
Rajkumar RP. The Contributions of Pandemic Severity, Government Stringency, Cultural Values and Internet Usage to Post-traumatic Stress Disorder During the COVID-19 Pandemic: An Analysis of Data From 35 Countries. FRONTIERS IN SOCIOLOGY 2022; 7:881928. [PMID: 35620119 PMCID: PMC9127200 DOI: 10.3389/fsoc.2022.881928] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 04/20/2022] [Indexed: 06/15/2023]
Abstract
Emergent symptoms of post-traumatic stress disorder (PTSD) have been frequently reported in the context of the COVID-19 pandemic, and may affect up to 17-18% of individuals. There is preliminary evidence that pandemic severity, cultural values, restrictions imposed by governments, and Internet usage may all influence the emergence of PTSD symptomatology. In this study, possible linear- and non-linear associations between these factors and the prevalence of PTSD symptoms across 35 countries were examined based on data from existing research. Evidence was found for a positive logarithmic relationship between the COVID-19 case-fatality ratio and PTSD (p = 0.046), a positive logarithmic relationship between power distance and PTSD (p = 0.047), and a trend toward a negative quadratic association with Internet usage (p = 0.051). No significant cross-national effect was observed for government restrictiveness. These findings suggest that strategies aimed at minimizing COVID-19 deaths, and at ensuring equitable access to essential resources, may be of use in reducing the emergence of PTSD symptoms at a population level during this pandemic.
Collapse
|
9
|
Daneshvar S, Shafiei M, Basharpoor S. Group-based Compassion-focused Therapy on Experiential Avoidance, Meaning-in-life, and Sense of Coherence in Female Survivors of Intimate Partner Violence with PTSD: A Randomized Controlled Trial. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP4187-NP4211. [PMID: 32933348 DOI: 10.1177/0886260520958660] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current study was carried out to investigate the effects of compassion-focused therapy (CFT) on experiential avoidance, meaning-in-life, and sense of coherence (SoC) in women suffering from post-traumatic stress disorder (PTSD) due to the intimate partner violence (IPV).42 women suffering from PTSD due to the IPV exposure were randomized to the two groups of experimental and control (21 per group). All participants completed the questionnaires of experiential avoidance, meaning-in-life, and SoC as pre-test measures. The experimental group received eight sessions of CFT, while the controls did not receive any treatment. After that, all subjects responded to the questionnaires of experiential avoidance, meaning-in-life, and SoC as the post-test measures. Data were analyzed using one-way repeated measures MANOVA.Subjects of the experimental group indicated a greater reduction in post-test scores of experiential avoidance, and a significant rise in the level of meaning-in-life and its subscales including the presence of meaning-in-life and search for meaning-in-life when compared to the controls. Nevertheless, there was no change in the level of SoC as a function of CFT.Applying CFT can result in reducing experiential avoidance and raising the meaning of life in women with PTSD due to IPV exposure. CFT is highly recommended to strengthen the well-being of patients with PTSD and reduce the PTSD symptoms.
Collapse
|
10
|
Heim E, Karatzias T, Maercker A. Cultural concepts of distress and complex PTSD: Future directions for research and treatment. Clin Psychol Rev 2022; 93:102143. [DOI: 10.1016/j.cpr.2022.102143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 01/06/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022]
|
11
|
Jobson L, Haque S, Abdullah SZ, Lee B, Li H, Reyneke T, Tan BKW, Lau W, Liddell B. Examining Cultural Differences in the Associations between Appraisals and Emotion Regulation and PostTraumatic Stress Disorder in Malaysian and Australian Trauma Survivors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031163. [PMID: 35162187 PMCID: PMC8834521 DOI: 10.3390/ijerph19031163] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/10/2022] [Accepted: 01/17/2022] [Indexed: 12/04/2022]
Abstract
Appraisals and emotional regulation play a central role in posttraumatic stress disorder (PTSD). Despite research demonstrating cultural differences in everyday appraisals and emotion regulation, little research has investigated the influence of culture on these processes in PTSD. This study examined cultural differences in the associations between appraisals, emotion regulation and PTSD symptoms using trauma survivors from an individualistic Western culture (Australia) and a collectivistic Asian culture (Malaysia). Trauma survivors (N = 228; 107 Australian with European cultural heritage, 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an on-line survey assessing PTSD (PTSD Checklist for the DSM-5 with Life Events Checklist), appraisals (trauma-related, fatalism, cultural beliefs about adversity) and emotion regulation (suppression, reappraisal, interpersonal). The Malaysian group reported significantly greater fatalism, cultural beliefs about adversity, suppression and interpersonal emotion regulation than the Australian group. Greater trauma-specific appraisals, greater suppression, fewer cultural beliefs about adversity, and less use of social skills to enhance positivity were generally associated with greater PTSD symptom severity, with little evidence of cultural group moderating these associations. Interdependent self-construal mediated the relationships between cultural adversity beliefs, enhanced positivity, reappraisal, perspective taking and PTSD symptoms. Independent self-construal mediated the relationships between fatalism and perspective taking and PTSD symptoms. Cultural group did not moderate these indirect effects. Interdependent self-construal mediated the associations between interpersonal regulation strategies of soothing and social modelling with PTSD symptoms for the Malaysian but not the Australian group. These findings demonstrate the importance of considering self-construal and culture in understanding factors associated with PTSD.
Collapse
Affiliation(s)
- Laura Jobson
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
- Correspondence: ; Tel.: +61-399-053-945
| | - Shamsul Haque
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia; (S.H.); (S.Z.A.); (B.K.W.T.)
| | - Siti Zainab Abdullah
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia; (S.H.); (S.Z.A.); (B.K.W.T.)
| | - Bryan Lee
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
| | - Haoxiang Li
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
| | - Tamsyn Reyneke
- Turner Institute for Brain and Mental Health and School of Psychological Sciences, Monash University, Clayton, VIC 3800, Australia; (B.L.); (H.L.); (T.R.)
| | - Britney Kerr Wen Tan
- Department of Psychology, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya 47500, Malaysia; (S.H.); (S.Z.A.); (B.K.W.T.)
| | - Winnie Lau
- Phoenix Australia-Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC 3053, Australia;
| | - Belinda Liddell
- School of Psychology, University of New South Wales, Sydney, NSW 2052, Australia;
| |
Collapse
|
12
|
Liddell BJ, Byrow Y, O'Donnell M, Mau V, Batch N, McMahon T, Bryant R, Nickerson A. Mechanisms underlying the mental health impact of family separation on resettled refugees. Aust N Z J Psychiatry 2021; 55:699-710. [PMID: 33111540 DOI: 10.1177/0004867420967427] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Many refugees experience prolonged separation from family members, which research suggests has adverse effects on mental health and post-displacement outcomes in refugee populations. We examine mental health differences in refugees separated and not separated from their families, and key post-migration factors and cultural mechanisms that may underlie this impact. METHODS A sample of 1085 refugees resettled in Australia, of which 23.3% were separated from all of their immediate family, took part in an online battery of survey measures indexing pre- and post-migration refugee experiences, mental health symptoms, disability and individualistic/collectivistic self-identity. Family separation was used as a predictor of mental health outcomes in a series of linear regressions, and the separated and non-separated groups were compared in multigroup path analysis models to examine group-specific indirect effects. RESULTS The separated group reported greater exposure to pre-migration potentially traumatic events and higher levels of post-migration living difficulties compared to the non-separated group. Family separation predicted higher post-traumatic stress and depression symptoms, but not disability, after controlling for potentially traumatic event exposure, age and sex. Path analyses revealed distinct indirect effects for separated and non-separated groups. Principally, higher collectivistic self-identity was associated with elevated post-traumatic stress, depression and disability symptoms via social-related post-migration living difficulties such as isolation and loneliness in the separated group; whereas collectivism was linked with increased depression symptoms via economic-related post-migration living difficulties in the non-separated group. CONCLUSION These findings indicate that family separation powerfully influences mental health outcomes, but that its effect may be mediated by the type of post-migration stress experienced in the settlement environment and culturally bound differences in how the sense of self is interconnected with family.
Collapse
Affiliation(s)
| | - Yulisha Byrow
- School of Psychology, UNSW Sydney, Sydney, NSW, Australia
| | | | - Vicki Mau
- Australian Red Cross, North Melbourne, VIC, Australia
| | - Nicole Batch
- Australian Red Cross, North Melbourne, VIC, Australia
| | - Tadgh McMahon
- Settlement Services International, Ashfield, NSW, Australia
| | - Richard Bryant
- School of Psychology, UNSW Sydney, Sydney, NSW, Australia
| | | |
Collapse
|
13
|
Daneshvar S, Taghavi MR, Jobson L. Proactive Interference in Posttraumatic Stress Disorder. J Trauma Stress 2021; 34:641-653. [PMID: 33175438 DOI: 10.1002/jts.22605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 08/12/2020] [Accepted: 08/27/2020] [Indexed: 11/07/2022]
Abstract
Deficits in working memory (WM) have a role in maintaining posttraumatic stress disorder (PTSD) symptoms, including intrusions, which are a hallmark of PTSD symptomatology. As intrusions are distressing and uncontrollable, it is important to investigate whether PTSD is associated with altered control of proactive interference in WM. Moreover, it is important to consider both verbal and visual WM, as previous research has demonstrated a visual versus verbal dissociation in PTSD. Although previous studies have explored proactive interference in visual and verbal stimuli using a recent probe task, the stimuli used thus far have been non-trauma-related. Therefore, we aimed to investigate proactive interference in PTSD using trauma-related verbal and visual stimuli. Road traffic accident (RTA) survivors with (n = 60) and without PTSD (n = 30) completed a recent probe task to assess proactive interference of visual and verbal trauma-related material. Participants with PTSD displayed significantly more proactive interference than trauma-exposed controls for visual, ηp 2 = .40, and verbal material, ηp 2 = .10, indicating that proactive interference is significantly impaired in PTSD. This demonstrates that further research is warranted and highlights the possibility of considering proactive interference of trauma-related stimuli in therapeutic approaches.
Collapse
Affiliation(s)
| | | | - Laura Jobson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Australia
| |
Collapse
|
14
|
Bernardi J, Engelbrecht A, Jobson L. The impact of culture on cognitive appraisals: Implications for the development, maintenance, and treatment of posttraumatic stress disorder. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12161] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Jessica Bernardi
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia,
| | - Alberta Engelbrecht
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia,
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK,
| | - Laura Jobson
- Monash Institute of Cognitive and Clinical Neuroscience, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia,
| |
Collapse
|
15
|
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
| |
Collapse
|
16
|
Mihailova S, Jobson L. Cross-cultural exploration of the characteristics, content and themes of intrusive autobiographical memories recalled during depression. Memory 2020; 28:1-11. [PMID: 32422070 DOI: 10.1080/09658211.2020.1767143] [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: 07/22/2019] [Accepted: 05/04/2020] [Indexed: 10/24/2022]
Abstract
The recall of intrusive memories is highly prevalent during depression. While past research has examined memory themes and characteristics (e.g., frequency), possible cultural differences in these variables have not been investigated. Furthermore, cross-cultural research has documented content differences in voluntary autobiographical remembering, but such content analyses have not been conducted in regard to intrusive memories. This study, therefore, investigated the characteristics, content and themes of intrusive memories using a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design. European Australian (n = 46) and East Asian (n = 45) participants living in Australia reported two memories in real-time using an online memory diary and rated the characteristics of their memories. East Asian participants reported more frequent and distressing memories, compared to European Australians, while the European Australian group reported more specific memories than the East Asian group. Most of the characteristics, themes and content variables, however, did not differ between cultural groups. Additionally, depressed participants, regardless of cultural group, reported more frequent, distressing and numbing memories, compared to healthy controls. These findings suggest that while depressive symptomatology impacts the experience of intrusive memories, memory content and characteristics are largely similar across the two cultural groups.
Collapse
Affiliation(s)
- Stella Mihailova
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Laura Jobson
- School of Psychological Sciences and Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
17
|
Mihailova S, Jobson L. The impact of depression and culture on responses to intrusive autobiographical memories: Cognitive appraisals, cognitive avoidance, and brooding rumination. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2019; 59:66-79. [PMID: 31364774 DOI: 10.1111/bjc.12232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 07/10/2019] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Those with depression ascribe more negative appraisals to intrusive autobiographical memories and use maladaptive strategies to regulate intrusive memory distress. However, it is unknown whether these patterns extend to East Asian samples. This study investigated the influence of culture and depression on intrusive remembering. DESIGN The study used a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design, with an online intrusive memory diary. METHODS European Australian (n = 46) and East Asian (n = 45) participants living in Australia, with and without depression, reported two intrusive memories in real-time and completed self-report measures indexing their appraisals of the memories, and their use of cognitive avoidance and brooding rumination in response to the memories. RESULTS East Asian participants reported significantly greater negative, control, and responsibility appraisals than European Australian participants. Regardless of cultural group, depressed participants endorsed greater maladaptive memory appraisals and brooding compared to controls. Additionally, among East Asian participants, those with depression cognitively avoided memories significantly more than controls. When comparing the two depressed groups, East Asians reported significantly greater brooding and avoidance in response to intrusive memories than Australians. CONCLUSIONS The findings suggest that depression may be associated with some similar maladaptive responses to intrusive autobiographical memories across cultural groups. Clinical interventions targeting unhelpful responses may, therefore, be beneficial for those with depression, regardless of cultural background. PRACTITIONER POINTS Across both European Australian and East Asian cultures, depressed participants endorsed higher maladaptive intrusive memory appraisals and brooded more in response to memories. Clinical interventions targeting appraisals and emotion regulation in response to intrusive memories may be beneficial for those with depression across both cultural groups. Language and acculturation may have impacted findings, as measures were administered in English and in Australia. Replication using a cross-country design and larger sample would be beneficial to confirm findings.
Collapse
Affiliation(s)
- Stella Mihailova
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| | - Laura Jobson
- School of Psychological Sciences, Turner Institute for Brain and Mental Health, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|
18
|
Keshet H, Gilboa-Schechtman E. The Focality of Sexual Trauma and Its Effects on Women’s Symptoms and Self-Perceptions. PSYCHOLOGY OF WOMEN QUARTERLY 2019. [DOI: 10.1177/0361684319861100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Sexual trauma is associated with particularly harmful consequences in comparison to other types of trauma. Studies investigating differences between trauma-types usually focus on the most distressing (i.e., main) trauma of each participant and do not consider the cumulative effects of multiple traumas, which many individuals experience. We sought to fill this gap by examining the effects of trauma-type (sexual vs. nonsexual), as well as the focality assigned to the sexual trauma (whether it was perceived as a main vs. background trauma), on symptoms and self-perceptions. Our sample comprised 231 Jewish-Israeli women: 96 with a single trauma-type and 135 with multiple (two to three) trauma-types. Women completed online measures of trauma history, symptoms, and self-perceptions. Women who were exposed to sexual trauma reported greater symptom severity and self-perception impairments than women with a history of nonsexual trauma-type(s). Among women with multiple trauma-types, those with a main sexual trauma reported greater symptom severity and self-perception impairments than women with a background sexual trauma. When controlling for levels of posttraumatic symptoms, differences in self-perceptions ceased to be significant. Our findings highlight the importance of collecting a detailed trauma history, with attention to trauma-centrality, and of addressing various symptoms and self-perceptions among sexual trauma survivors.
Collapse
Affiliation(s)
- Hadar Keshet
- Department of Psychology, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
| | - Eva Gilboa-Schechtman
- Department of Psychology, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
- Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Tel Aviv, Israel
| |
Collapse
|
19
|
Shorer S, Goldblatt H, Caspi Y, Azaiza F. Culture as a Double-Edged Sword: The Posttraumatic Experience of Indigenous Ethnic Minority Veterans. QUALITATIVE HEALTH RESEARCH 2018; 28:766-777. [PMID: 29424278 DOI: 10.1177/1049732318756041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
The applicability of Western concepts regarding the treatment of trauma in soldiers from indigenous ethnic minority backgrounds has scarcely been researched. This study explored the subjective meaning of living with chronic posttraumatic stress disorder (PTSD) among indigenous Bedouin veterans of the Israel Defense Forces (IDF), who are of Arab ethnicity and Muslim faith. In-depth, semistructured qualitative interviews were conducted with 10 Bedouin veterans suffering from PTSD and three Bedouin mental health clinicians working with this population. Two themes emerged: "I wanted to be like everyone else," referring to participants' experiences during their military service, and "Fluctuating between belonging and abandonment," referring to veterans' experiences of living with mental health problems in a traditional minority community. These findings highlight the importance of conducting a comprehensive inquiry into the complex cultural and social backgrounds of indigenous minority veterans suffering from PTSD, and the interplay between the conflicted identities and multiple "realities" they experience.
Collapse
Affiliation(s)
- Shai Shorer
- 1 HaEmek Medical Center, Afula, Israel
- 2 Bar-Ilan University, Ramat Gan, Israel
| | | | - Yael Caspi
- 4 Rambam Health Care Campus, Haifa, Israel
| | | |
Collapse
|
20
|
Jobson L, Miskon N, Dalgleish T, Hitchcock C, Hill E, Golden AM, Zulkefly NS, Mukhtar F. Impact of culture on autobiographical life structure in depression. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2018; 57:382-396. [PMID: 29572886 DOI: 10.1111/bjc.12181] [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] [Received: 10/26/2017] [Revised: 02/20/2018] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Distortions in autobiographical memory have been implicated in major depressive disorder (MDD). Those with MDD demonstrate a 'depressogenic' autobiographical life structure. Research has not examined how culture influences this process. We investigated whether Malay individuals (members of an interdependent culture) with MDD demonstrated a 'depressogenic' autobiographical life structure similar to that of British individuals (members of an independent culture) with MDD. DESIGN A 2 (Culture; Malay, British) × 2 (Mood; depressed, control) cross-sectional design using a card sort task and self-report measures was used. METHODS Malay individuals with MDD or no history of MDD completed the life-structure card-sorting task, which provided a novel method for investigating organizational structure of the life narrative. These data were compared to previously collected data in which British individuals with MDD or without MDD had completed the same task within the same experimental protocol. RESULTS Pan-culturally those with MDD had greater negativity (i.e., used more negative attributes), negative redundancy (i.e., used the same negative attributes repeatedly across life chapters) and negative emodiversity (i.e., had greater variety and relative abundance of negative attributes), and reduced positive redundancy (i.e., used the same positive attributes repeatedly across chapters) in their structuring relative to controls. While the British MDD group had greater compartmentalization (i.e., the negative and positive attributes were clustered separately across different chapters) than British controls, the Malay MDD group had lower levels of compartmentalization than Malay controls. CONCLUSIONS The findings suggest culture may shape aspects of the autobiographical life structure in MDD. PRACTITIONER POINTS The majority of the literature investigating depression pertains to individuals from European Western cultures, despite recognition that depression ranks as one of the most debilitating diseases worldwide. This raises questions as to whether current depression models and interventions can be applied universally or whether they are limited to European Western groups. The current study found that pan-culturally those with MDD had similar structuring of their life story relative to controls. However, there were some cultural differences that need to be considered (e.g., Malay individuals provided less detailed, less elaborate and less emotionally diverse life stories and while the British MDD group had greater compartmentalization than British controls, the Malay MDD group had lower levels of compartmentalization than Malay controls). Limitations of the study included group differences in gender and mood at the time of testing. Cultural differences in the number of attributes used may have influenced findings. Only the Malay group completed the individualism-collectivism measure.
Collapse
Affiliation(s)
- Laura Jobson
- Monash Institute of Cognitive and Clinical Neuroscience and School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
| | | | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Caitlin Hitchcock
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Emma Hill
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Ann-Marie Golden
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | | | | |
Collapse
|
21
|
Ter Heide FJJ, Sleijpen M, van der Aa N. Posttraumatic world assumptions among treatment-seeking refugees. Transcult Psychiatry 2017; 54:824-839. [PMID: 29226792 DOI: 10.1177/1363461517741811] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The clinical relevance of negative changes in cognitions about oneself, others, and the world is reflected in the diagnostic criteria for posttraumatic stress disorder (PTSD) in the DSM-5 and complex posttraumatic stress disorder in the ICD-11. Although such changes in cognition have been posited to be especially relevant for traumatised refugees, few studies have examined this in refugee populations. The present study used a cross-sectional design to compare negative cognitions among 213 adult treatment-seeking refugees with those in previously published samples from the general population, veterans with combat-related PTSD, and whiplash victims. Measures included the World Assumptions Scale (WAS) and the Events and DSM-IV PTSD subscales of the Harvard Trauma Questionnaire (HTQ). Path models examined the relation of the WAS subscales to five demographic and trauma-related variables. Results showed that world assumptions were especially negative with regard to Benevolence of World, Benevolence of People, and Luck subscales, on which refugees scored lower than all reference samples. Differences between the refugee sample and the reference samples were smallest with regard to self-worth and self-controllability. World assumptions were associated with gender and PTSD symptom severity but not with age, length of residence in the Netherlands, and number of traumatic event types. The DSM-5 criterion of negative changes in belief about oneself, others, and the world appears more applicable to refugees than the more narrowly formulated ICD-11 criterion of diminished and defeated sense of self. Prevention and treatment efforts with refugees may need to be especially aimed at preventing a further decline of trust as well as restoration of trust in others and the world.
Collapse
Affiliation(s)
| | - Marieke Sleijpen
- Foundation Centrum '45
- partner in Arq Psychotrauma Expert Group, the Netherlands
| | | |
Collapse
|
22
|
Xiu D, Maercker A, Yang Y, Jia X. Prolonged Grief, Autobiographical Memory, and Its Interaction With Value Orientations in China and Switzerland. JOURNAL OF CROSS-CULTURAL PSYCHOLOGY 2017. [DOI: 10.1177/0022022117723529] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
23
|
Self-Complexity and Perceived Self-Aspect Control in Post-Traumatic Stress Disorder. Behav Cogn Psychother 2017; 46:50-65. [PMID: 28756781 DOI: 10.1017/s1352465817000431] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Post-traumatic stress disorder often brings about profound, lasting, structural changes to one's sense of self. AIMS This study investigated self-complexity and self-aspect control in post-traumatic stress disorder (PTSD). METHOD Trauma survivors with (n = 103) and without (n = 102) PTSD completed an online questionnaire which involved the completion of a self-complexity task and measures of PTSD. RESULTS It was found that those with PTSD had significantly greater overall self-complexity than those without PTSD. Furthermore, when considering self-description valence, it was found that those with PTSD had significantly greater negative self-complexity than those without PTSD, but the groups did not differ in terms of positive self-complexity. Second, those with PTSD reported significantly less control over their self-aspects. Third, for those with PTSD, lower levels of self-aspect control were significantly correlated with greater negative self-complexity and lower positive self-complexity. Finally, self-aspect control mediated the relationship between self-complexity and PTSD symptoms. CONCLUSION The theoretical implications for PTSD models and the clinical implications for the treatment of those with PTSD are explored.
Collapse
|
24
|
Mordeno IG, Nalipay MJN, Sy DJS, Luzano JGC. PTSD factor structure and relationship with self-construal among internally displaced persons. J Anxiety Disord 2016; 44:102-110. [PMID: 27842239 DOI: 10.1016/j.janxdis.2016.10.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2016] [Revised: 08/15/2016] [Accepted: 10/28/2016] [Indexed: 10/20/2022]
Abstract
The present study examined the factor structure of six competing posttraumatic stress disorder (PTSD) models based on the recent changes in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) in a sample that, while highly vulnerable to PTSD, very few studies have focused on-Asians, particularly Filipino internally displaced persons (IDPs). In recognition of the role of culture in PTSD factor structure, we also investigated the associations of the factors of the best-fitting model with self-construal. A sample of 460 IDPs in government resettlement communities participated in the study. Results of confirmatory factor analyses revealed the seven-factor hybrid model composed of intrusion, avoidance, negative affect, anhedonia, externalizing behaviors, anxious arousal, and dysphoric arousal as the best-fitting model. Furthermore, it was found that associations between independent self-construal and PTSD factors were higher than that of interdependent self-construal and PTSD factors.
Collapse
Affiliation(s)
- Imelu G Mordeno
- Mindanao State University, Iligan Institute of Technology, Philippines
| | | | | | | |
Collapse
|
25
|
Engelbrecht A, Jobson L. Exploring trauma associated appraisals in trauma survivors from collectivistic cultures. SPRINGERPLUS 2016; 5:1565. [PMID: 27652138 PMCID: PMC5023649 DOI: 10.1186/s40064-016-3043-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/14/2015] [Accepted: 08/11/2016] [Indexed: 11/10/2022]
Abstract
Appraisals are a key feature in understanding an individual’s experience; this is especially important when the experience is a traumatic one. However, research is diminutive when looking at the interaction between trauma appraisals and culture in relation to posttraumatic stress disorder using qualitative methodologies. This study explored cultural differences in perceptions and appraisals of trauma using three qualitative focus groups with community members (n = 11) from collectivistic cultures who had experienced a traumatic event and three qualitative individual key informant interviews with mental health practitioners (n = 3) routinely working with trauma survivors. Using template analysis, eight emergent themes were highlighted from the data sets [(1) trauma and adjustment; (2) cultural and social roles; (3) traumatised self; (4) relationships; (5) external attribution; (6) future; (7) education; (8) language] that potentially have significant consequences for posttrauma psychological adjustment and recovery. Cumulatively, while a number of themes are similar to that which is emphasised in current literature (e.g. damaged self, negative appraisals of the world, others, future) a number of themes were also resonant and warrant further scrutiny. For instance, the importance and interconnectedness of the group to the individual and the impact trauma has on this; the importance of social roles, cultural appropriateness and violations of cultural values and norms; findings and implications are discussed.
Collapse
Affiliation(s)
- Alberta Engelbrecht
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | | |
Collapse
|
26
|
Abstract
This study investigates clinical expressions of prolonged grief in samples of 32 Chinese and 33 Swiss bereaved parents, according to the proposed International Classification of Diseases, 11th Revision model of prolonged grief disorder (PGD). Sex differences and predictors (cultural attitudes, sense of coherence, and posttraumatic growth) of PGD were analyzed. In result, after controlling for sociodemographic and loss-related sample differences, both samples showed similar PGD symptom profiles, with Swiss parents exhibiting more severe grief-related preoccupation and Chinese parents exhibiting some accessory symptoms and functional impairment to a greater extent. Multivariate analyses revealed for the Chinese sample primary predictions of PGD by life satisfaction, general health and one's world view (social cynicism) and for the Swiss sample by female sex, sense of coherence, and life satisfaction. The findings substantiate the basic appropriateness of the International Classification of Diseases, 11th Revision PGD in distinct cultural groups and may contribute to a better understanding of grief expression and its potential predictors across different cultures.
Collapse
|
27
|
Liddell BJ, Jobson L. The impact of cultural differences in self-representation on the neural substrates of posttraumatic stress disorder. Eur J Psychotraumatol 2016; 7:30464. [PMID: 27302635 PMCID: PMC4908066 DOI: 10.3402/ejpt.v7.30464] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2015] [Revised: 05/12/2016] [Accepted: 05/14/2016] [Indexed: 11/23/2022] Open
Abstract
A significant body of literature documents the neural mechanisms involved in the development and maintenance of posttraumatic stress disorder (PTSD). However, there is very little empirical work considering the influence of culture on these underlying mechanisms. Accumulating cultural neuroscience research clearly indicates that cultural differences in self-representation modulate many of the same neural processes proposed to be aberrant in PTSD. The objective of this review paper is to consider how culture may impact on the neural mechanisms underlying PTSD. We first outline five key affective and cognitive functions and their underlying neural correlates that have been identified as being disrupted in PTSD: (1) fear dysregulation; (2) attentional biases to threat; (3) emotion and autobiographical memory; (4) self-referential processing; and (5) attachment and interpersonal processing. Second, we consider prominent cultural theories and review the empirical research that has demonstrated the influence of cultural variations in self-representation on the neural substrates of these same five affective and cognitive functions. Finally, we propose a conceptual model that suggests that these five processes have major relevance to considering how culture may influence the neural processes underpinning PTSD.
Collapse
Affiliation(s)
- Belinda J Liddell
- School of Psychology, University of New South Wales Australia, Sydney, Australia;
| | - Laura Jobson
- School of Psychological Sciences, Monash University, Clayton, Australia
- Monash Institute of Cognitive and Clinical Neurosciences, Clayton, Australia
| |
Collapse
|
28
|
Jobson L, Cheraghi S, Moradi AR. Brief Report: Comparing the Autobiographical Remembering of Iranian Immigrant Trauma Survivors with That of Iranian and British Trauma Survivors. APPLIED COGNITIVE PSYCHOLOGY 2016. [DOI: 10.1002/acp.3230] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- Laura Jobson
- School of Psychological Sciences; Monash University; Melbourne Australia
| | | | - Ali Reza Moradi
- Iran and Institute for Cognitive Sciences Studies; Kharazmi University, Tehran; Tehran Iran
| |
Collapse
|
29
|
Haghighat F, Moradi AR, Mazaheri MA, Hantoushzade S, Allahyari AA, Pasandide A. The Effect of Iranian-Islamic Mindful Motherhood Training on Maternal-fetal Attachmen. ACTA ACUST UNITED AC 2015. [DOI: 10.29252/ijn.27.92.33] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
|
30
|
The functional profile of the human amygdala in affective processing: Insights from intracranial recordings. Cortex 2014; 60:10-33. [DOI: 10.1016/j.cortex.2014.06.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2013] [Revised: 01/30/2014] [Accepted: 06/04/2014] [Indexed: 11/21/2022]
|
31
|
Zaragoza Scherman A, Salgado S, Shao Z, Berntsen D. Event centrality of positive and negative autobiographical memories to identity and life story across cultures. Memory 2014; 23:1152-71. [DOI: 10.1080/09658211.2014.962997] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
32
|
Jobson L, Dalgleish T. Cultural differences in the relationship between intrusions and trauma narratives using the trauma film paradigm. PLoS One 2014; 9:e106759. [PMID: 25203300 PMCID: PMC4159286 DOI: 10.1371/journal.pone.0106759] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 08/09/2014] [Indexed: 11/18/2022] Open
Abstract
Two studies explored the influence of culture on the relationship between British and East Asian adults’ autobiographical remembering of trauma film material and associated intrusions. Participants were shown aversive film clips to elicit intrusive images. Then participants provided a post-film narrative of the film content (only Study 1). In both studies, participants reported intrusive images for the film in an intrusion diary during the week after viewing. On returning the diary, participants provided a narrative of the film (delayed). The trauma film narratives were scored for memory-content variables. It was found that for British participants, higher levels of autonomous orientation (i.e. expressions of autonomy and self-determination) and self-focus in the delayed narratives were correlated significantly with fewer intrusions. For the East Asian group, lower levels of autonomous orientation and greater focus on others were correlated significantly with fewer intrusions. Additionally, Study 2 found that by removing the post-film narrative task there was a significant increase in the number of intrusions relative to Study 1, suggesting that the opportunity to develop a narrative resulted in fewer intrusions. These findings suggest that the greater the integration and contextualization of the trauma memory, and the more the trauma memory reflects culturally appropriate remembering, the fewer the intrusions.
Collapse
Affiliation(s)
- Laura Jobson
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
- University of East Anglia, Norwich, United Kingdom
- * E-mail:
| | - Tim Dalgleish
- Medical Research Council Cognition and Brain Sciences Unit, Cambridge, United Kingdom
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| |
Collapse
|
33
|
Graham B, Herlihy J, Brewin CR. Overgeneral memory in asylum seekers and refugees. J Behav Ther Exp Psychiatry 2014; 45:375-80. [PMID: 24799151 DOI: 10.1016/j.jbtep.2014.03.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2013] [Revised: 03/06/2014] [Accepted: 03/17/2014] [Indexed: 11/28/2022]
Abstract
BACKGROUND AND OBJECTIVES Studies in western samples have shown that post-traumatic stress disorder (PTSD) and depression are associated with overgeneral autobiographical memory retrieval. This study assesses whether this association extends to asylum seekers and refugees from diverse cultural backgrounds. We discuss implications for those providing testimony of their experiences when seeking asylum. METHOD 38 asylum seekers and refugees were recruited through clinics and community groups. Clinical interviews assessed PTSD and depression and participants completed a test of autobiographical memory specificity. RESULTS When accounting for omissions, participants with PTSD and depression recalled a lower proportion of specific memories. Those with PTSD also failed more frequently to report any memory. LIMITATIONS The sample did not permit separate evaluation of the effects of PTSD and depression on specificity. CONCLUSIONS Lower memory specificity observed in people experiencing PTSD and depression in western populations extends to asylum seekers and refugees from diverse cultural backgrounds. This study adds to the literature suggesting that being recognised as a refugee fleeing persecution is more difficult for those with post-traumatic symptoms and depression.
Collapse
Affiliation(s)
- Belinda Graham
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
| | - Jane Herlihy
- Centre for the Study of Emotion and Law, 1 Quality Court, Chancery Lane, London WC2A 1HR, UK.
| | - Chris R Brewin
- Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London WC1E 7HB, UK.
| |
Collapse
|
34
|
Freeman A, Adams M, Ashworth F. An exploration of the experience of self in the social world for men following traumatic brain injury. Neuropsychol Rehabil 2014; 25:189-215. [DOI: 10.1080/09602011.2014.917686] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
|
35
|
Rathbone CJ, Steel C. Autobiographical memory distributions for negative self-images: memories are organised around negative as well as positive aspects of identity. Memory 2014; 23:473-86. [PMID: 24730721 DOI: 10.1080/09658211.2014.906621] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
The relationship between developmental experiences, and an individual's emerging beliefs about themselves and the world, is central to many forms of psychotherapy. People suffering from a variety of mental health problems have been shown to use negative memories when defining the self; however, little is known about how these negative memories might be organised and relate to negative self-images. In two online studies with middle-aged (N = 18; study 1) and young (N = 56; study 2) adults, we found that participants' negative self-images (e.g., I am a failure) were associated with sets of autobiographical memories that formed clustered distributions around times of self-formation, in much the same pattern as for positive self-images (e.g., I am talented). This novel result shows that highly organised sets of salient memories may be responsible for perpetuating negative beliefs about the self. Implications for therapy are discussed.
Collapse
Affiliation(s)
- Clare J Rathbone
- a Department of Psychology , Oxford Brookes University , Oxford , UK
| | | |
Collapse
|
36
|
Engelbrecht A, Jobson L. An investigation of trauma-associated appraisals and posttraumatic stress disorder in British and Asian trauma survivors: the development of the Public and Communal Self Appraisals Measure (PCSAM). SPRINGERPLUS 2014; 3:44. [PMID: 24516784 PMCID: PMC3913797 DOI: 10.1186/2193-1801-3-44] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2013] [Accepted: 01/15/2014] [Indexed: 12/04/2022]
Abstract
Two studies examined the role of culture on cognitive appraisals of trauma and associated implications for posttraumatic psychological adjustment. Study 2 also investigated the reliability and validity of a new measure assessing public and communal aspects of trauma-associated appraisals (Public and Communal Self Appraisals Measure; PCSAM). Study 1′s non-clinical sample (N = 75) and Study 2′s sample of British and Asian trauma survivors with and without PTSD (N = 95) provided an everyday and trauma memory, completed an Appraisal Inventory, the Posttraumatic Cognitions Inventory and measures of PTSD. Study 2 participants also completed the PCSAM. Conjoined, there were cultural differences in appraisals of everyday and trauma experiences. Nonetheless, there appeared to be cultural similarities in the dysfunctional appraisals of those with PTSD. The PSCAM had good internal consistency, test-retest reliability, convergent validity, and discriminative validity. Findings are discussed in terms of combining cultural models of self with current PTSD models.
Collapse
Affiliation(s)
| | - Laura Jobson
- University of East Anglia, Norwich, UK ; Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| |
Collapse
|
37
|
Humphries C, Jobson L. Short report: Influence of culture and trauma history on autobiographical memory specificity. Memory 2012; 20:915-22. [DOI: 10.1080/09658211.2012.710432] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
38
|
Moradi AR, Abdi A, Fathi-Ashtiani A, Dalgleish T, Jobson L. Overgeneral autobiographical memory recollection in Iranian combat veterans with posttraumatic stress disorder. Behav Res Ther 2012; 50:435-41. [PMID: 22542534 DOI: 10.1016/j.brat.2012.03.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Revised: 03/19/2012] [Accepted: 03/20/2012] [Indexed: 11/30/2022]
Abstract
This study examined the recollection of autobiographical material in memory among Iranian military veterans with and without posttraumatic stress disorder (PTSD), and healthy non-trauma-exposed control subjects. Participants completed the Autobiographical Memory Test, Autobiographical Memory Interview (counterbalanced), Impact of Event Scale-Revised, Beck Depression Inventory-II, Wechsler Memory Scale-III and Wechsler Adult Intelligence Scale-Revised. The PTSD group generated fewer specific episodic and semantic details of autobiographical memory compared to the non-PTSD and control groups. Working memory did not significantly moderate the relationship between PTSD diagnosis and reduced autobiographical memory specificity but did moderate the relationship between PTSD diagnosis and semantic recall; semantic memory recall was not significantly related to working memory ability for those with PTSD but was related to working memory ability for trauma survivors without PTSD. While the data provide some support for the expectation that higher working memory ability is associated with an increased ability to retrieve specific memories (i.e. semantic memory recall in those without PTSD), the findings are also consistent with the view that for those with PTSD the demands on working memory required for affect regulation cancel out this influence of working memory in augmenting access to specific memories.
Collapse
Affiliation(s)
- Ali Reza Moradi
- Department of Psychology, Tarbiat Moallem University, Tehran, Iran.
| | | | | | | | | |
Collapse
|
39
|
Friedman MJ, Resick PA, Bryant RA, Brewin CR. Considering PTSD for DSM-5. Depress Anxiety 2011; 28:750-69. [PMID: 21910184 DOI: 10.1002/da.20767] [Citation(s) in RCA: 352] [Impact Index Per Article: 27.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2010] [Revised: 09/24/2010] [Accepted: 09/29/2010] [Indexed: 11/08/2022] Open
Abstract
This is a review of the relevant empirical literature concerning the DSM-IV-TR diagnostic criteria for PTSD. Most of this work has focused on Criteria A1 and A2, the two components of the A (Stressor) Criterion. With regard to A1, the review considers: (a) whether A1 is etiologically or temporally related to the PTSD symptoms; (b) whether it is possible to distinguish "traumatic" from "non-traumatic" stressors; and (c) whether A1 should be eliminated from DSM-5. Empirical literature regarding the utility of the A2 criterion indicates that there is little support for keeping the A2 criterion in DSM-5. The B (reexperiencing), C (avoidance/numbing) and D (hyperarousal) criteria are also reviewed. Confirmatory factor analyses suggest that the latent structure of PTSD appears to consist of four distinct symptom clusters rather than the three-cluster structure found in DSM-IV. It has also been shown that in addition to the fear-based symptoms emphasized in DSM-IV, traumatic exposure is also followed by dysphoric, anhedonic symptoms, aggressive/externalizing symptoms, guilt/shame symptoms, dissociative symptoms, and negative appraisals about oneself and the world. A new set of diagnostic criteria is proposed for DSM-5 that: (a) attempts to sharpen the A1 criterion; (b) eliminates the A2 criterion; (c) proposes four rather than three symptom clusters; and (d) expands the scope of the B-E criteria beyond a fear-based context. The final sections of this review consider: (a) partial/subsyndromal PTSD; (b) disorders of extreme stress not otherwise specified (DESNOS)/complex PTSD; (c) cross- cultural factors; (d) developmental factors; and (e) subtypes of PTSD.
Collapse
Affiliation(s)
- Matthew J Friedman
- National Center for PTSD, U.S. Department of Veterans Affairs, Vermont, USA.
| | | | | | | |
Collapse
|
40
|
Expression of locus coeruleus mineralocorticoid receptor and glucocorticoid receptor in rats under single-prolonged stress. Neurol Sci 2011; 32:625-31. [DOI: 10.1007/s10072-011-0597-1] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2009] [Accepted: 04/13/2011] [Indexed: 10/18/2022]
|
41
|
Maercker A, Forstmeier S. Torture and Atrocity Sequelae in Methodologically Sophisticated Studies. ZEITSCHRIFT FUR PSYCHOLOGIE-JOURNAL OF PSYCHOLOGY 2011. [DOI: 10.1027/2151-2604/a000066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Andreas Maercker
- Division of Psychopathology and Clinical Intervention, University of Zurich, Switzerland
| | - Simon Forstmeier
- Division of Psychopathology and Clinical Intervention, University of Zurich, Switzerland
| |
Collapse
|