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Monti E, D’Andrea W, Carroll LM, Norton K, Miron N, Resto O, Toscano K, Williams J, Harris D, Irene L, Maass A. Can perpetrators discern survivors from voice? Eur J Psychotraumatol 2024; 15:2358681. [PMID: 38837122 PMCID: PMC11188952 DOI: 10.1080/20008066.2024.2358681] [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: 02/01/2024] [Accepted: 05/14/2024] [Indexed: 06/06/2024] Open
Abstract
Background: Research has shown that potential perpetrators and individuals high in psychopathic traits tend to body language cues to target a potential new victim. However, whether targeting occurs also by tending to vocal cues has not been examined. Thus, the role of voice in interpersonal violence merits investigation.Objective: In two studies, we examined whether perpetrators could differentiate female speakers with and without sexual and physical assault histories (presented as rating the degree of 'vulnerability' to victimization).Methods: Two samples of male listeners (sample one N = 105, sample two, N = 109) participated. Each sample rated 18 voices (9 survivors and 9 controls). Listener sample one heard spontaneous speech, and listener sample two heard the second sentence of a standardized passage. Listeners' self-reported psychopathic traits and history of previous perpetration were measured.Results: Across both samples, history of perpetration (but not psychopathy) predicted accuracy in distinguishing survivors of assault.Conclusions: These findings highlight the potential role of voice in prevention and intervention. Gaining a further understanding of what voice cues are associated with accuracy in discerning survivors can also help us understand whether or not specialized voice training could have a role in self-defense practices.
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Affiliation(s)
- Elisa Monti
- Voice and Trauma Research and Connection Group, Inc., New York, NY, USA
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Wendy D’Andrea
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | | | - Katherine Norton
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Noga Miron
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Olivia Resto
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - Kayla Toscano
- Voice and Trauma Research and Connection Group, Inc., New York, NY, USA
- Department of Psychology, The New School for Social Research, New York, NY, USA
| | - John Williams
- Department of Biostatistics, Columbia University, New York, NY, USA
| | | | | | - Anne Maass
- Department of Psychology, New York University Abu Dhabi, Abu Dhabi, UAE
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Cruz D, Lichten M, Berg K, George P. Developmental trauma: Conceptual framework, associated risks and comorbidities, and evaluation and treatment. Front Psychiatry 2022; 13:800687. [PMID: 35935425 PMCID: PMC9352895 DOI: 10.3389/fpsyt.2022.800687] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 06/27/2022] [Indexed: 11/17/2022] Open
Abstract
Children exposed to adverse childhood experiences (ACEs) and pervasive interpersonal traumas may go on to develop PTSD and, in most cases, will further undergo a significant shift in their developmental trajectory. This paper examines contemporary research on Developmental Trauma (DT), which is inextricably linked to disruptions in social cognition, physiological and behavioral regulation, and parent-child attachments. Developmental trauma associated with early experiences of abuse or neglect leads to multi-faceted and longstanding consequences and underscores critical periods of development, complex stress-mediated adaptations, and multilevel, trans-theoretical influences in the diagnostic formulation and treatment of traumatized children, adolescents, and adults. Psychological and medical correlates of Developmental Trauma Disorder are considered, and directions for future research are discussed.
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Affiliation(s)
- Daniel Cruz
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | | | - Kevin Berg
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
| | - Preethi George
- Hackensack Meridian Health Mountainside Medical Center, Montclair, NJ, United States
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3
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Guineau MG, Jones PJ, Bellet BW, McNally RJ. A Network Analysis of DSM-5 Posttraumatic Stress Disorder Symptoms and Event Centrality. J Trauma Stress 2021; 34:654-664. [PMID: 33650190 DOI: 10.1002/jts.22664] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 01/23/2021] [Accepted: 01/25/2021] [Indexed: 01/22/2023]
Abstract
The centrality of a traumatic event to one's autobiographical memory has been associated with posttraumatic stress disorder (PTSD) symptom severity. In the present study, we investigated the associations between specific features of event centrality (EC), as measured using the Centrality of Event Scale, and specific symptoms of PTSD. We computed a cross-sectional graphical lasso network of PTSD symptoms and specific features of EC in a sample of trauma-exposed individuals (n = 451), many of whom met the clinical threshold for a PTSD diagnosis. The graphical lasso revealed intrusive memories, negative trauma-related feelings, and the perception that the traumatic event was central to one's identity to be influential nodes. Viewing the future through the lens of one's trauma exposure was the EC feature most strongly linked to PTSD. Among all PTSD symptoms, blaming oneself or others for the traumatic event showed the strongest link to EC. The network was stable, allowing for reliable interpretations. Future longitudinal research is needed to clarify the associations among EC features and PTSD symptoms over time.
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Affiliation(s)
- Melissa G Guineau
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA.,Behavioural Science Institute, Radboud University, Nijmegen, The Netherlands
| | - Payton J Jones
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Benjamin W Bellet
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
| | - Richard J McNally
- Department of Psychology, Harvard University, Cambridge, Massachusetts, USA
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Park AH, Protopopescu A, Pogue ME, Boyd JE, O'Connor C, Lanius RA, McKinnon MC. Dissociative symptoms predict severe illness presentation in Canadian public safety personnel with presumptive post-traumatic stress disorder (PTSD). Eur J Psychotraumatol 2021; 12:1953789. [PMID: 34512927 PMCID: PMC8425686 DOI: 10.1080/20008198.2021.1953789] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Post-traumatic stress disorder affects 9% of individuals across their lifetime and increases nearly fourfold to 35% in Canadian public safety personnel (PSP). On-the-job experiences of PSP frequently meet criteria for traumatic events, making these individuals highly vulnerable to exposures of trauma and the negative consequences of PTSD. Few studies have reported on the clinical characteristics of Canadian samples of PSP and even fewer have examined the dissociative subtype of PTSD, which is associated with more severe, chronic traumatic experiences, and worse outcomes. OBJECTIVE This study aimed to characterize dissociative symptoms, PTSD symptom severity, and other clinical variables among Canadian PSP with presumptive PTSD. METHODS We sampled current and past PSP in Canada from both inpatient and outpatient populations (N = 50) that were enrolled in a psychological intervention. Only baseline testing data (prior to any intervention) were analysed in this study, such as PTSD symptom severity, dissociative symptoms, emotion dysregulation, and functional impairment. RESULTS In our sample, 24.4% self-reported elevated levels of dissociation, specifically symptoms of depersonalization and derealization. Depersonalization and derealization symptoms were associated with more severe PTSD symptoms, greater emotion dysregulation, and functional impairment. CONCLUSIONS Nearly a quarter of this sample of Canadian PSP reported experiencing elevated levels of PTSD-related dissociation (depersonalization and derealization). These high levels of depersonalization and derealization were consistently positively associated with greater illness severity across clinical measures. It is imperative that dissociative symptoms be better recognized in patient populations that are exposed to chronic traumatic events such as PSP, so that treatment interventions can be designed to target a more severe illness presentation.
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Affiliation(s)
- Anna H Park
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada.,Homewood Research Institute, Guelph, Canada
| | - Alina Protopopescu
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada.,Homewood Research Institute, Guelph, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada
| | - Michelle E Pogue
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada.,Homewood Research Institute, Guelph, Canada
| | - Jenna E Boyd
- Homewood Research Institute, Guelph, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | | | - Ruth A Lanius
- Homewood Research Institute, Guelph, Canada.,Department of Neuroscience, Robarts Research Institute, RRI 3203, Western University, London, Canada.,Department of Psychiatry, Parkwood Institute, Mental Health Care Building, F4-430, Western University, London, Canada.,Lawson Health Research Institute, London, Canada
| | - Margaret C McKinnon
- Homewood Research Institute, Guelph, Canada.,Mood Disorders Program, St. Joseph's Healthcare Hamilton, Hamilton, Canada.,Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Herzog S, Fogle BM, Harpaz-Rotem I, Tsai J, DePierro J, Pietrzak RH. Dissociative symptoms predict risk for the development of PTSD: Results from the National Health and Resilience in Veterans Study (NHRVS). J Psychiatr Res 2020; 131:215-219. [PMID: 32998083 DOI: 10.1016/j.jpsychires.2020.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 09/15/2020] [Accepted: 09/17/2020] [Indexed: 10/23/2022]
Abstract
Dissociative symptoms following trauma exposure, such as derealization (i.e., feeling that one's experience is strange and unreal) and depersonalization (i.e., feeling detached from oneself) have been implicated in the development and maintenance of posttraumatic stress disorder (PTSD). In the current study, we analyzed data from a 3-year prospective cohort study of a nationally representative sample of U.S. veterans to examine whether trait dissociative symptoms, which may impair adaptive emotion regulation following trauma exposure, predict risk for the development of PTSD in trauma-exposed veterans. Results revealed that derealization symptoms predicted a nearly 5-fold increase in relative risk of incident PTSD (relative risk ratio = 4.57, 95% confidence interval = 1.55-13.52), even after adjusting for relevant sociodemographic and trauma-related factors, and severity of PTSD symptoms at baseline. To our knowledge, this study is the first to suggest that trait dissociative symptoms-specifically derealization-may be an important population-based risk factor for the development of PTSD in trauma-exposed U.S. military veterans. These findings add to a body of literature on the prediction of PTSD that largely focuses on stable or immutable risk factors such as sociodemographic and trauma characteristics, or peritraumatic emotional reactions, and underscores the potential clinical utility of assessing, monitoring, and treating derealization symptoms in trauma-exposed U.S. military veterans at risk for PTSD.
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Affiliation(s)
- Sarah Herzog
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA.
| | - Brienna M Fogle
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA
| | - Ilan Harpaz-Rotem
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA
| | - Jack Tsai
- Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA; U.S. Department of Veterans Affairs National Center on Homelessness Among Veterans, 13000 Bruce B. Downs Blvd, Tampa, FL, 33612, USA
| | - Jonathan DePierro
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1230, New York, NY, 10029, USA
| | - Robert H Pietrzak
- U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, 950 Campbell Avenue, West Haven, CT, 06516, USA; Department of Psychiatry, Yale School of Medicine, 300 George St #901, New Haven, CT, 06511, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, 60 College St, New Haven, CT, 06510, USA
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Herzog S, D'Andrea W, DePierro J. Zoning out: Automatic and conscious attention biases are differentially related to dissociative and post-traumatic symptoms. Psychiatry Res 2019; 272:304-310. [PMID: 30597381 DOI: 10.1016/j.psychres.2018.12.110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2017] [Revised: 12/20/2018] [Accepted: 12/20/2018] [Indexed: 10/27/2022]
Abstract
Few studies of attention bias in traumatized samples directly compare automatic and conscious (e.g. supraliminal) attentional strategies. Additionally, research to-date indicates inconsistent evidence for threat-related attention bias in individuals with PTSD symptoms. This may be due to the heterogeneity in PTSD symptoms and concurrent dissociation, particularly derealization and depersonalization, since these may contribute to decreased awareness of, or slower responding to, threatening stimuli. Using an internet-based paradigm, the current study measured attention biases in a visual dot-probe task using rapid (250 ms), brief supraliminal (500 ms), and long-latency supraliminal (2000 ms) exposures. One hundred and forty-seven adult participants completed a range of trauma-related symptom measures. Results indicated a significant association between PTSD symptoms and bias toward threat in the 2000 ms exposure. Both state and trait derealization were significantly related to a bias away from threat at the 250 ms exposure, indicating a reflexive avoidance of rapidly presented threat cues. State measures of dissociation were also related to avoidance of threat in the 500 ms condition. Findings highlight the disparate effects of trauma-related symptoms on attention, and have significant clinical implications for dissociative symptoms as a target of treatment in traumatized samples.
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Affiliation(s)
- Sarah Herzog
- Department of Psychology, The New School for Social Research, 80 Fifth Avenue, 7th Floor, New York, NY 10011, United States.
| | - Wendy D'Andrea
- Department of Psychology, The New School for Social Research, 80 Fifth Avenue, 7th Floor, New York, NY 10011, United States
| | - Jonathan DePierro
- World Trade Center Health Program, Icahn School of Medicine at Mount Sinai, 1468 Madison Avenue, Annenberg Building, 3rd Floor, New York, NY 10029, United States
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