Mental contamination, PTSD symptoms, and coping following sexual trauma: Results from a daily monitoring study

"I Felt Dirty in a Way a Shower Wouldn't Fix": A Qualitative Examination of Sexual Trauma-Related Mental Contamination

Trauma-related mental contamination (MC) is a distressing sense of dirtiness that arises absent a contaminant following a traumatic event. Existing work has linked MC to more severe posttraumatic stress disorder symptoms among individuals with sexual trauma histories and has begun to characterize some aspects of the experience of trauma-related MC. However, a more nuanced understanding of how individuals experience and respond to trauma-related MC is lacking. The present study explored lived experiences of trauma-related MC among a sample of 34 women with sexual trauma histories using semi-structured qualitative interviews. Women were asked about MC across several domains, including somatic locations where trauma-related MC is experienced; triggers for trauma-related MC; and engagement in MC-related coping strategies, including washing behaviors. Women reported experiencing trauma-related MC in various bodily locations (internal, external, and both). Both overtly trauma-related triggers (e.g., trauma-relevant people or words, sexual contact) and non-trauma-related triggers (e.g., sweating, being around other people) were mentioned. Women also reported experiencing a variety of emotions alongside trauma-related MC (e.g., disgust, shame, anger) and using a range of strategies to cope with trauma-related MC, including washing behaviors, distraction, and substance use. Findings suggest that triggers for and responses to trauma-related MC are heterogeneous. Future work should explore the role of context in individuals' experiences of and responses to trauma-related MC, as well as whether experiences of trauma-related MC may differ by gender or across settings. Increased understanding of trauma-related MC may inform efforts to more readily and effectively identify and target MC in clinical practice.

Randomized trial on the effects of an EMDR intervention on traumatic and obsessive symptoms during the COVID-19 quarantine: a psychometric study

Introduction

It has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery.

Methods

In order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention.

Results

The EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms.

Conclusions

EMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined.

Clinical trial registration

https://www.clinicaltrials.gov, identifier NCT06110702.

The contribution of guilt sensitivity in the prediction of obsessive-compulsive disorder symptom dimensions: Replication and extension

BACKGROUND

Obsessive-compulsive disorder (OCD) is associated with particular cognitive processes, such as beliefs about the importance of intrusive thoughts. The present study examined the explanatory power of guilt sensitivity to OCD symptom dimensions after controlling for well-established cognitive predictors.

METHODS

164 patients with OCD completed self-reported measures of OCD and depressive symptoms, obsessive beliefs, and guilt sensitivity. Bivariate correlations were examined, and latent profile analysis (LPA) was used to generate groups based on symptom severity scores. Differences in guilt sensitivity were examined across latent profiles.

RESULTS

Guilt sensitivity was most strongly associated with unacceptable thoughts and responsibility for harm OCD symptoms, and moderately with symmetry. After controlling for depression and obsessive beliefs, guilt sensitivity added explanatory power to the prediction of unacceptable thoughts. LPA identified 3 profiles; profile-based subgroups significantly differed from one another in terms of guilt sensitivity, depression, and obsessive beliefs.

CONCLUSIONS

Guilt sensitivity is relevant to various OCD symptom dimensions. Above and beyond depression and obsessive beliefs, guilt sensitivity contributed to the explanation of repugnant obsessions. Theory, research, and treatment implications are discussed.

Daily Associations Between Trauma-Related Mental Contamination and Use of Specific Coping Strategies: Results of a Daily Monitoring Study

Mental contamination (MC)-a sense of dirtiness experienced without contacting an identifiable pollutant-is a distressing and enduring experience among many survivors of sexual trauma. MC has been linked to more frequent use of avoidant coping behaviors (e.g., washing behavior, substance use, binge eating) and approach coping. However, it is unclear if specific approach and avoidant coping strategies are more consistently related to perseverative experiences of trauma-related MC, if the use of certain strategies predicts changes in MC, and if fluctuations in MC predict the use of certain strategies. The present study evaluated contemporaneous and prospective relationships between sexual trauma-related MC and use of 11 specific coping strategies among 41 women with a history of sexual trauma using an experience sampling design. Women completed twice-daily assessments of coping strategy use and MC for 14 days. Between-persons, women reporting more intense MC on average reported more frequent use of distraction, denial, giving up, self-blame, thought suppression, washing behavior, emotional processing, and emotional expression than those experiencing less intense MC. Within-person increases in MC were associated with more frequent concurrent use of all coping strategies except seeking support. Lastly, within-person increases in MC predicted more frequent use of giving up, substance use, and seeking support at the next assessment and within-person increases in substance use predicted less severe MC at the next assessment. Future work should aim to identify factors influencing the selection and/or quality of use of these specific coping strategies among individuals experiencing MC.