1
|
Johnson MS, Skjerdingstad N, Hoffart A, Ebrahimi OV, Johnson SU. Triggered by worry: A dynamic network analysis of COVID-19 pandemic-related anxiety and parental stress. J Affect Disord 2024; 346:329-337. [PMID: 37977301 DOI: 10.1016/j.jad.2023.10.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 10/19/2023] [Accepted: 10/20/2023] [Indexed: 11/19/2023]
Abstract
BACKGROUND Major disruptions to daily life routines made families and parents particularly vulnerable to psychological distress during the COVID-19 lockdowns. However, the specific psychopathological processes related to within-person variation and maintenance of anxiety symptomatology and parental distress components in the parental population have been largely unexplored in the literature. METHODS In this preregistered intensive longitudinal study, a multilevel dynamic network was used to model within-person interactions between anxiety symptomatology, psychopathological processes, parental distress, and protective lifestyle components in a sample of 495 parents-each responding to daily assessments over a 40-day period. A total of 30,195 observations were collected across the subjects. RESULTS Extensive worry, threat monitoring, and uncontrollability of worry were identified as overreaching psychopathological processes related to the aggravation of other symptoms of anxiety and parental distress. A strong association was found between parental stress and parental burnout. Anger toward one's child was associated with both parental stress and parental burnout. Protective factors showed the lowest strength centrality, with few and weak connections to other symptoms and processes in the network. LIMITATIONS Associations may exist between the study variables on a different time scale; hence, different time lags should be used in future research. CONCLUSIONS Accessible, low-cost interventions that address worry, threat monitoring, and the uncontrollability of worry could serve as potential targets for reducing the symptom burden of anxiety and distress in the parental population.
Collapse
Affiliation(s)
- Miriam S Johnson
- Department of Behavioural Sciences, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway.
| | - Nora Skjerdingstad
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway
| | - Asle Hoffart
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Modum Bad Psychiatric Hospital, and Research Center, Vikersund, Norway
| | - Omid V Ebrahimi
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Modum Bad Psychiatric Hospital, and Research Center, Vikersund, Norway
| | - Sverre Urnes Johnson
- Department of Psychology, Faculty of Social Sciences, University of Oslo, Norway; Modum Bad Psychiatric Hospital, and Research Center, Vikersund, Norway
| |
Collapse
|
2
|
Chouinard-Gaouette L, Blanchette I. An investigation of the mechanisms underlying the link between abstract reasoning and intrusive memories: A trauma analogue study. Conscious Cogn 2024; 117:103609. [PMID: 38029701 DOI: 10.1016/j.concog.2023.103609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 10/28/2023] [Accepted: 11/19/2023] [Indexed: 12/01/2023]
Abstract
Potentially traumatic events elicit intrusive memories to which some individuals are more vulnerable than others. Lower abstract reasoning capacity has been related to more intrusive memories. A more perceptual processing style when encoding the event may mediate this link. Another potential mechanism is lower attentional control, resulting in greater attentional bias toward trauma-related content. We examined both of these possibilities using a trauma-analogue paradigm. One hundred and twenty participants completed abstract reasoning tasks. Then, 90 participants watched a negative video, and 30 participants watched a neutral video. The level of perceptual processing (P1) and attentional bias (RT) towards trauma-related stimuli were measured with a pictorial Stroop task while recording EEG. Intrusive memories were recorded for 5 days. Abstract reasoning was not associated with intrusive memories. However, lower abstract reasoning tended to be associated with more perceptual processing (greater P1 amplitude) following the negative video. More perceptual processing also tended to be related to more intrusive memories for younger participants. A more pronounced attentional bias was related to more intrusive memories, but only for women. Unexpectedly, also for women, better verbal reasoning was linked to a more pronounced attentional bias. Results are compared to existing studies and future implications are discussed.
Collapse
Affiliation(s)
- Laurence Chouinard-Gaouette
- Département de Psychologie, Université du Québec à Trois-Rivières, C.P. 500, Trois-Rivières, Québec G9A 5H7, Canada.
| | - Isabelle Blanchette
- École de psychologie, Université Laval, 2325, rue des Bibliothèques, Québec, Québec G1V 0A6, Canada.
| |
Collapse
|
3
|
Ródenas-Perea G, Velasco-Barbancho E, Perona-Garcelán S, Rodríguez-Testal JF, Senín-Calderón C, Crespo-Facorro B, Ruiz-Veguilla M. Childhood and adolescent trauma and dissociation: The mediating role of rumination, intrusive thoughts and negative affect. Scand J Psychol 2023; 64:142-149. [PMID: 36240326 DOI: 10.1111/sjop.12879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 09/17/2022] [Accepted: 09/23/2022] [Indexed: 11/29/2022]
Abstract
Dissociation is a complex phenomenon which is present in a wide variety of psychiatric disorders and also in the general population. The objective of this study was to examine the relationship between childhood and adolescent traumas and development of dissociative phenomena in a nonclinical population, emphasizing the potentially mediating role of rumination, intrusive thoughts and negative affect in a population with no psychiatric pathology in adulthood. The sample was comprised of 337 participants from the general population (58.8% women) with a mean age of 33.10 years (SD: 14.08). They completed the Juvenile Victimization Questionnaire (JVQ), the Ruminative Response Scale (RRS), the White Bear Suppression Scale (WBSI), the Dissociative Experience Scale, 2d ver. Rev. (DES-II) and the Depression, Anxiety and Stress Scale (DASS-21). The results supported the starting hypotheses showing a positive correlation between childhood and adolescent trauma and dissociation, and between childhood and adolescent trauma and rumination, intrusive thoughts and negative affect, and mediation of these variables between childhood and adolescent trauma and dissociative states. The relationship between trauma in early ages and dissociation in adulthood is complex. Although the design used in this study was cross-sectional, the results are compatible with the starting hypothesis that rumination, intrusive thoughts and negative affect mediate this relationship.
Collapse
Affiliation(s)
| | | | | | - Juan F Rodríguez-Testal
- Personality, Evaluation and Psychological Treatment Department, University of Seville, Seville, Spain
| | | | | | - Miguel Ruiz-Veguilla
- Virgen del Rocío University Hospital, University of Sevilla/ IBiS/ CIBERSAM, Seville, Spain
| |
Collapse
|
4
|
Friesen E, Sopp MR, Cordi MJ, Rasch B, Michael T. Sleep-Directed Hypnosis Improves Subjective Sleep Quality but not Extinction Memory After Exposure to Analog Trauma. COGNITIVE THERAPY AND RESEARCH 2023. [DOI: 10.1007/s10608-022-10345-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Abstract
Background
Evidence-based treatments of posttraumatic stress disorder (PTSD) aim to promote fear extinction learning. Post-learning sleep, particularly slow wave sleep (SWS), promotes memory consolidation and recall. Thus, boosting SWS might strengthen extinction recall. The current study investigated whether sleep-directed hypnosis designed to increase SWS and sleep quality improves extinction recall and reduces analog PTSD symptoms.
Method
In two subsamples (remote/laboratory), 211 healthy individuals underwent fear conditioning with a traumatic film clip. On the next evening, they underwent extinction training. Thereafter, the experimental group received sleep-directed hypnosis, whereas the control group listened to a control text. Extinction recall and generalization and film-related intrusions and rumination were assessed on the following morning.
Results
Subjective sleep quality declined following exposure to an aversive film. No group differences were found in SWS though exploratory analyses indicated less rapid eye movement sleep after hypnosis. After hypnosis, the experimental group reported improved sleep quality, whereas the control group showed a further deterioration. Hypnosis had no effects on extinction retention and generalization nor on analog intrusions and rumination.
Conclusion
The current results indicate that sleep-directed hypnosis may be beneficial for improving subjective sleep quality after trauma but not for enhancing extinction memory and reducing analog PTSD symptoms.
Collapse
|
5
|
Ouhmad N, Deperrois R, Combalbert N, El Hage W. The Role of Anxiety and Depression in the Emotion Regulation Strategies of People Suffering from Post-Traumatic Stress Disorder. THE JOURNAL OF PSYCHOLOGY 2023; 157:143-159. [PMID: 36796009 DOI: 10.1080/00223980.2022.2134279] [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: 02/18/2023] Open
Abstract
Researchers have explored the links between cognitive emotion regulation, impaired cognitive functioning, and anxiety-depression, including the link to anxiety and depression levels. However, very few studies have examined these dimensions in clinical populations with post-traumatic stress disorder (PTSD). A sample of 183 participants was divided into three groups: 59 trauma-exposed with PTSD, 61 trauma-exposed without PTSD, and 63 non-trauma-exposed non-PTSD (controls). All participants were assessed on the following dimensions: PTSD (PCL-5), cognitive emotion regulation (CERQ), anxiety and depression (HADS). Results indicate a specific profile of emotion regulation associated with PTSD. Compared to other groups, participants with PTSD showed more difficulty managing their emotions, with more rumination, self-blame, and catastrophizing. Moreover, these difficulties were also correlated with levels of anxiety and depression, that is, participants with PTSD who had higher anxiety and depression scores used more maladaptive strategies. The PTSD group used significantly more maladaptive cognitive emotion regulation strategies than the other groups, with distinct profiles related to anxiety and depressive symptomatology.
Collapse
|
6
|
Jiang W, Tian Y, Fan F, Fu F, Wei D, Tang S, Chen J, Li Y, Zhu R, Wang L, Shi Z, Wang D, Zhang XY. Effects of comorbid posttraumatic stress disorder on cognitive dysfunction in Chinese male methamphetamine patients. Prog Neuropsychopharmacol Biol Psychiatry 2022; 119:110611. [PMID: 35907518 DOI: 10.1016/j.pnpbp.2022.110611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2022] [Revised: 07/21/2022] [Accepted: 07/23/2022] [Indexed: 10/16/2022]
Abstract
OBJECTIVES Cognitive dysfunction and posttraumatic stress disorder (PTSD) are common in methamphetamine patients. However, few studies have investigated the cognitive performance of methamphetamine patients with PTSD. The purpose of this study was to investigate the impact of comorbid PTSD on cognitive function in Chinese male methamphetamine patients. METHODS We analyzed 464 methamphetamine patients and 156 healthy volunteers. The PTSD Screening Scale (PCL-5) was used to assess PTSD and the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) was used to assess cognitive function. RESULTS Compared with healthy controls, methamphetamine patients had more cognitive dysfunction in immediate memory, visuospatial/constructional, language, attention and delayed memory. Moreover, methamphetamine patients with PTSD had less cognitive dysfunction in immediate memory, attention, and delayed memory than methamphetamine patients without PTSD. Further stepwise regression analysis showed that PTSD alterations in arousal and reactivity cluster were risk predictors for language, and PTSD negative alteration in cognition and mood cluster were risk predictors for delayed memory. CONCLUSIONS Our results indicate that methamphetamine patients without PTSD have poorer cognitive dysfunction than those with PTSD. Some demographic and PTSD symptom clusters are protective or risk factors for cognitive dysfunction in methamphetamine patients.
Collapse
Affiliation(s)
- Wei Jiang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yang Tian
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Fusheng Fan
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Fabing Fu
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | - Dejun Wei
- Xin Hua Drug Rehabilitation Center, Sichuan, China
| | | | - Jiajing Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Yuqing Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Rongrong Zhu
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Li Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhanbiao Shi
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Dongmei Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| | - Xiang-Yang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China.
| |
Collapse
|
7
|
Aberrant ventral dentate gyrus structure and function in trauma susceptible mice. Transl Psychiatry 2022; 12:502. [PMID: 36473832 PMCID: PMC9723770 DOI: 10.1038/s41398-022-02264-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 11/18/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Post-traumatic stress disorder (PTSD) is a psychiatric disorder vulnerable individuals can develop following a traumatic event, whereas others are resilient. Enhanced insight into the mechanistic underpinnings contributing to these inter-individual differences in trauma susceptibility is key to improved treatment and prevention. Aberrant function of the hippocampal dentate gyrus (DG) may contribute to its psychopathology, with the dorsal DG potentially encoding trauma memory generalization and the ventral DG anxiety. Using a mouse model, we hypothesized that susceptibility to develop PTSD-like symptoms following trauma will be underpinned by aberrant DG structure and function. Mice were exposed to a traumatic event (unpredictable, inescapable foot shocks) and tested for PTSD-like symptomatology following recovery. In four independent experiments, DG neuronal morphology, synaptic protein gene and protein expression, and neuronal activity during trauma encoding and recall were assessed. Behaviorally, trauma-susceptible animals displayed increased anxiety-like behavior already prior to trauma, increased novelty-induced freezing, but no clear differences in remote trauma memory recall. Comparison of the ventral DG of trauma susceptible vs resilient mice revealed lower spine density, reduced expression of the postsynaptic protein homer1b/c gene and protein, a larger population of neurons active during trauma encoding, and a greater presence of somatostatin neurons. In contrast, the dorsal DG of trauma-susceptible animals did not differ in terms of spine density or gene expression but displayed more active neurons during trauma encoding and a lower amount of somatostatin neurons. Collectively, we here report on specific structural and functional changes in the ventral DG in trauma susceptible male mice.
Collapse
|
8
|
Dirven BCJ, Botan A, van der Geugten D, Kraakman B, van Melis L, Merjenburgh S, van Rijn R, Waajen L, Homberg JR, Kozicz T, Henckens MJAG. Longitudinal assessment of amygdala activity in mice susceptible to trauma. Psychoneuroendocrinology 2022; 145:105912. [PMID: 36113379 DOI: 10.1016/j.psyneuen.2022.105912] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 07/20/2022] [Accepted: 08/26/2022] [Indexed: 10/31/2022]
Abstract
Resilience to consequences of trauma exposure contains relevant information about the processes that contribute to the maintenance of mental health in the face of adversity; information that is essential to improve treatment success of stress-related mental diseases. Prior literature has implicated aberrant amygdala (re)activity as potential factor contributing to trauma susceptibility. However, it remains to be resolved which amygdalar subregions and neuronal subclasses are involved, and when - i.e., pre-, peri- or post-trauma exposure - and under what conditions changes in amygdala (re)activity manifest themselves. Here, we implemented a preclinical rodent model for PTSD that entailed exposure to a traumatic event (severe, unpredictable foot shock) followed by a trigger (mild, predictable foot shock). Using behavioral phenotyping, trauma susceptible vs. resilient mice were identified and pre-, peri- or post-trauma amygdala activity was compared. Neuronal activity was tagged in living mice by the use of the ArcTRAP transgenic mouse line, labeling all activated (i.e., Arc-expressing) neurons by a systemic injection of tamoxifen. Furthermore, we assessed amygdala responses during fear memory recall, induced by either (re-)exposure to the trauma, trigger, or a novel, yet similar context, and analyzed behavioral fear responses under these conditions, as well as basal anxiety in the mice. Results revealed no major differences dissociating susceptible vs. resilient mice prior to trauma exposure, but exaggerated activity in specifically the basolateral amygdala (BLA) peri-trauma that predicted susceptibility to later PTSD-like symptoms. Post-trauma, susceptible mice did not display altered basal amygdala activity, but BLA hyperreactivity in response to trigger context re-exposure, and BLA hyporesponsivity in response to the trauma context. Exposure to the novel, similar context evoked a differential temporal pattern of freezing behavior in susceptible mice and an increased activity of amygdalar somatostatin-expressing neurons specifically. As such, these results for the first time show that deviant BLA activity during fear learning predicts susceptibility to its long-term consequences and that aberrant subsequent BLA responses to stressful contexts depend on the exact context.
Collapse
Affiliation(s)
- Bart C J Dirven
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands; Department of Medical Imaging, Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Andriana Botan
- Department of Medical Imaging, Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Dewi van der Geugten
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Blom Kraakman
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Lennart van Melis
- Department of Medical Imaging, Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Sanne Merjenburgh
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Rebecca van Rijn
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Liz Waajen
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Judith R Homberg
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands
| | - Tamas Kozicz
- Department of Medical Imaging, Anatomy, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands; Department of Clinical Genomics, and Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Marloes J A G Henckens
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen 6500 HB, the Netherlands.
| |
Collapse
|
9
|
Mathew AS, Lotfi S, Bennett KP, Larsen SE, Dean C, Larson CL, Lee HJ. Association between spatial working memory and Re-experiencing symptoms in PTSD. J Behav Ther Exp Psychiatry 2022; 75:101714. [PMID: 34906826 PMCID: PMC9173718 DOI: 10.1016/j.jbtep.2021.101714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/13/2021] [Accepted: 12/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Few studies have evaluated the link between working memory (WM) and post-traumatic stress disorder (PTSD). Further, it is unknown whether this relationship is accounted for by other relevant variables including negative affect, emotional dysregulation, or general non-WM-related cognitive control deficits, which are associated with PTSD. The purpose of this study was to determine the extent to which a computerized WM task could predict PTSD symptomology incrementally beyond the contribution of other relevant variables associated with PTSD. METHODS Thirty veterans were eligible to complete emotional symptom questionnaires, a heart-rate variability measure, and computerized tasks (i.e., emotional Stroop and automated complex span tasks). A three-stage hierarchical regression was conducted with the PCL-5 total score and symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and negative cognition/mood) as the dependent variable. RESULTS Results revealed that only the re-experiencing symptom cluster was significantly predicted by executive, verbal, and visuospatial WM tasks, which explained an additional 29.7% of the variance over and above other relevant variables. Most notably, the visuospatial task was the only WM task that significantly explained PCL-5 re-experiencing symptoms. LIMITATIONS This study was based on a small sample of veterans with PTSD and causality cannot be determined with this cross-sectional study. CONCLUSIONS Overall, the results suggest that deficits in visuospatial WM are significantly associated with PTSD re-experiencing symptoms after controlling for other relevant variables. Further research should evaluate whether an intervention to improve visuospatial WM capacity can be implemented to reduce re-experiencing symptoms.
Collapse
Affiliation(s)
- Abel S Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Salahadin Lotfi
- Department of Psychology, University of Wisconsin-Milwaukee, USA; Rogers Behavioral Health, Research Center and Clinical Effectiveness Department, USA
| | | | - Sadie E Larsen
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | - Caron Dean
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | | | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, USA.
| |
Collapse
|
10
|
McKinnon A, Lorenz H, Salkovskis P, Wild J. Abstract thinking as a risk factor for the development of posttraumatic stress disorder symptoms in student paramedics. J Trauma Stress 2022; 35:375-385. [PMID: 34708439 DOI: 10.1002/jts.22749] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 07/10/2021] [Accepted: 07/12/2021] [Indexed: 11/06/2022]
Abstract
cognitive processing is characterized by "why?" and "what if?" questions and associated with processes such as rumination and worry. The tendency to think abstractly in response to stress has not been examined as a longitudinal risk factor for later stress reactions. The present study evaluated the extent to which an abstract thinking style could represent a risk factor for posttraumatic stress disorder (PTSD) symptoms in student paramedics over a 6-month follow-up period. Student paramedics (N = 89) recruited from universities in the United Kingdom were assessed for baseline symptoms, abstract thinking, and cognitive responses to stressful memories; a follow-up assesment was conducted 6 months later in their training. All participants were exposed to a potentially traumatic event between baseline and follow-up. Baseline symptoms and trauma history accounted for 45% of the variation in follow-up posttraumatic symptoms, with abstract thinking style explaining an additional 2.5% over and above what could be predicted from initial symptom levels. Abstract thinking was moderately related to rumination in response to stressful memories, r = .45, and correlated with follow-up symptoms of PTSD, r = .49; anxiety, r = .40; and depression, r = .27. This study builds on previous work suggesting that abstract processing mode and abstract rumination are risk factors for PTSD. Abstract thinking in response to stress represents a potentially modifiable risk factor that could be targeted by a resilience-focused intervention for individuals likely to encounter traumatic events.
Collapse
Affiliation(s)
- Aimee McKinnon
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.,Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Hjördis Lorenz
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.,Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Paul Salkovskis
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.,Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| | - Jennifer Wild
- Department of Experimental Psychology, University of Oxford, Oxford, United Kingdom.,Oxford Health NHS Foundation Trust, Oxford, United Kingdom
| |
Collapse
|
11
|
Lifetime adversity interacts with peritraumatic data-driven processing to predict intrusive memories. J Behav Ther Exp Psychiatry 2022; 74:101688. [PMID: 34717140 DOI: 10.1016/j.jbtep.2021.101688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVES Although most trauma survivors experience some intrusive recollections of the traumatic event, only few subsequently develop posttraumatic stress disorder (PTSD). A well-established proximal risk-factor predictive of post-trauma psychopathology is peritraumatic cognitive processing. Another, more distal risk-factor is pre-trauma lifetime adversity. The present experimental analogue study tested the hypothesis that pre-trauma lifetime adversity interacts with peritraumatic perceptual (i.e., data-driven) processing to predict intrusive memory development. METHODS Fifty-three young adult women (non-clinical sample) indicated how much data-driven and conceptual processing they had engaged in while watching aversive film-clips (i.e., analogue trauma). On the subsequent three days, they reported intrusions of those clips. Moderation analyses tested for an interaction effect between lifetime adversity and data-driven processing in predicting intrusion load (number of intrusions weighted for their overall distress). RESULTS Increased data-driven processing predicted intrusion load primarily in individuals reporting more than three lifetime adversities, explaining 55% of variance. No such relationship was found for conceptual processing. LIMITATIONS Present analogue findings have yet to be replicated in a clinical population. Moreover, the conceptual processing scale was restricted by low internal consistency. CONCLUSION Present findings support the idea that intrusions are the result of poorly elaborated and primarily perceptually-formed memory traces; however, this was primarily the case in vulnerable individuals reporting several lifetime adversities. Results replicate the importance of peritraumatic processing in intrusion development but additionally point to a moderating effect of lifetime adversity.
Collapse
|
12
|
Herzog P, Barth C, Rief W, Brakemeier EL, Kube T. How Expectations Shape the Formation of Intrusive Memories: An Experimental Study Using the Trauma Film Paradigm. COGNITIVE THERAPY AND RESEARCH 2022. [DOI: 10.1007/s10608-022-10290-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Abstract
Background
Although intrusions are the hallmark symptom of posttraumatic stress disorder, there is still limited knowledge about the processes that contribute to the development of intrusions. Here, we used the well-established trauma film paradigm (TFP) to investigate how expectations about the intensity and controllability of intrusions influence their occurrence.
Methods
90 healthy participants underwent the TFP before they were randomized to one of three conditions manipulating their expectations about intrusions: positive expectations group; negative expectations group; control group. The primary outcome was the frequency and severity of intrusive memories as assessed with an intrusion diary over seven days.
Results
The TFP was well implemented, as indicated by significant post-film anxiety and a substantial number of intrusions reported for the subsequent week. The three groups did not differ in their expectations about intrusions and, relatedly, in their experience of intrusions. A mediation analysis revealed that the influence of post-film anxiety on intrusive memories was fully mediated by expectations.
Conclusions
Despite the failure of the expectation manipulation, the results of the mediation analysis support the hypothesis that post-film expectations influence the formation of intrusive memories, suggesting that intrusions may result from maladaptive dynamics between emotional and cognitive processes following trauma(like) experiences.
Collapse
|
13
|
Friesen E, Michael T, Schäfer SK, Sopp MR. COVID-19-related distress is associated with analogue PTSD symptoms after exposure to an analogue stressor. Eur J Psychotraumatol 2022; 13:2127185. [PMID: 36353527 PMCID: PMC9640168 DOI: 10.1080/20008066.2022.2127185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: The COVID-19 outbreak in early 2020 was associated with an immediate increase in mental health problems in a significant percentage of the general population. Therefore, it is crucial to investigate how the COVID-19 pandemic - as a psychosocial stressor - affected the aetiological processes of mental disorders. Previous research has shown that stress potentiates associative (fear) learning and analogue symptoms of posttraumatic stress disorder (PTSD) and that analogue PTSD symptoms can emerge in response to associative learning. Objective: We investigated whether distress in response to the COVID-19 outbreak support the development of intrusions and rumination after exposure to a non-COVID-19-related analogue trauma. Moreover, we examined if these effects are mediated by the strength of associative learning during analogue trauma. Method: 122 undergraduate university students participated in an online experiment between March and July 2020. They completed questionnaires measuring distress and rumination related to the COVID-19 outbreak. On a subsequent day, they went through an associative learning task, in which neutral stimuli were paired with the appearance of a highly aversive film clip. Subjective ratings were assessed as indicators of associative learning. On the next day, participants documented film-related intrusions and rumination. Results: COVID-19-related distress but not rumination was associated with post-film intrusion and rumination load. These effects were mediated by associative learning. Conclusions: The current findings are in line with the assumptions that stress enhanced both associative learning and PTSD symptoms. Specifically, they indicate that prolonged psychosocial stress - like during the COVID-19 outbreak - is linked to individual differences in memory processing of aversive events. Further confirmatory research is needed to replicate these results.
Collapse
Affiliation(s)
- Edith Friesen
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Sarah K Schäfer
- Leibniz Institute for Resilience Research, Research Group Lieb, Leibniz Association, Mainz, Germany
| | - M Roxanne Sopp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| |
Collapse
|
14
|
Varma MM, Hu X. Prosocial behaviour reduces unwanted intrusions of experimental traumatic memories. Behav Res Ther 2021; 148:103998. [PMID: 34864480 DOI: 10.1016/j.brat.2021.103998] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 10/07/2021] [Accepted: 11/11/2021] [Indexed: 11/25/2022]
Abstract
Following trauma exposure, people often experience involuntary intrusions of traumatic memories, i.e., flashbacks. How to reduce such unwanted intrusions attracts attention from basic and translational memory research, with a goal to safeguard mental well-being and promote resilience. Here, based on prosocial behaviour's well-documented psychological benefits, we hypothesized that post-trauma prosocial behaviour would causally reduce trauma-related symptoms, including involuntary intrusions. To test this novel hypothesis, we conducted two pre-registered lab studies (N = 180) using trauma films to induce lab-analogue trauma exposure. Following trauma exposure, participants were randomly assigned to prosocial or non-prosocial conditions. Specifically, in the prosocial condition, participants donated money to their preferred charities. In the non-prosocial conditions, participants completed either a neutral, number judgement task (Experiment 1) or a proself task (Experiment 2). Participants completed a 1-week intrusion diary and Impact of Event Scale-Revised (IES-R), to assess frequencies of traumatic intrusions and post-trauma stress disorder symptoms, respectively. Results showed that compared to non-prosocial behaviour, prosocial engagement (i.e. performing charitable donations) reduced involuntary traumatic intrusions in both lab settings and in their daily life as evidenced by 1-week intrusion diaries. While exploratory mediation analyses suggested that intrusion reduction was partly driven by enhanced positive affect afforded by prosocial behaviour, future studies are required to illuminate the underlying mechanisms. To the extent that post-trauma prosociality alleviated trauma-related symptoms, future research is warranted to investigate how various forms of prosocial behaviour in naturalistic setting could promote resilience following trauma exposure.
Collapse
Affiliation(s)
- Mohith M Varma
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Xiaoqing Hu
- Department of Psychology, The University of Hong Kong, Hong Kong, China; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, China; HKU-Shenzhen Institute of Research and Innovation, Shenzhen, China.
| |
Collapse
|
15
|
Schumm H, Krüger-Gottschalk A, Dyer A, Pittig A, Cludius B, Takano K, Alpers GW, Ehring T. Mechanisms of Change in Trauma-Focused Treatment for PTSD: The Role of Rumination. Behav Res Ther 2021; 148:104009. [PMID: 34823161 DOI: 10.1016/j.brat.2021.104009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Revised: 09/26/2021] [Accepted: 11/16/2021] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Cognitive behavioral therapy (CBT) has been well established in the treatment of posttraumatic stress disorder (PTSD). In recent years, researchers have begun to investigate its underlying mechanisms of change. Dysfunctional cognitive content, i.e. excessively negative appraisals of the trauma or its consequences, has been shown to predict changes in PTSD symptoms over the course of treatment. However, the role of change in cognitive processes, such as trauma-related rumination, needs to be addressed. The present study investigates whether changes in rumination intensity precede and predict changes in symptom severity. We also explored the extent to which symptom severity predicts rumination. METHOD As part of a naturalistic effectiveness study evaluating CBT for PTSD in routine clinical care, eighty-eight patients with PTSD completed weekly measures of rumination and symptom severity. Lagged associations between rumination and symptoms in the following week were examined using linear mixed models. RESULTS Over the course of therapy, both ruminative thinking and PTSD symptoms decreased. Rumination was a significant predictor of PTSD symptoms in the following week, although this effect was at least partly explained by the time factor (e.g., natural recovery or inseparable treatment effects). Symptom severity predicted ruminative thinking in the following week even with time as an additional predictor. CONCLUSIONS The present study provides preliminary evidence that rumination in PTSD is reduced by CBT for PTSD but does not give conclusive evidence that rumination is a mechanism of change in trauma-focused treatment for PTSD.
Collapse
Affiliation(s)
- Hannah Schumm
- Department of Psychology, LMU Munich, Leopoldstr. 13, Munich, Germany.
| | | | - Anne Dyer
- ZISG Mannheim, Central Institute of Mental Health, J 5, 68159, Mannheim, Germany.
| | - Andre Pittig
- Translational Psychotherapy, Department of Psychology, Friedrich-Alexander University Erlangen-Nürnberg (FAU), Nägelsbachstr. 49a, 91051, Erlangen, Germany.
| | - Barbara Cludius
- Department of Psychology, LMU Munich, Leopoldstr. 13, Munich, Germany.
| | - Keisuke Takano
- Department of Psychology, LMU Munich, Leopoldstr. 13, Munich, Germany.
| | - Georg W Alpers
- Department of Psychology, School of Social Sciences, University of Mannheim, L 13, 17, 68163, Mannheim, Germany.
| | - Thomas Ehring
- Department of Psychology, LMU Munich, Leopoldstr. 13, Munich, Germany.
| |
Collapse
|
16
|
Stirling NS, Nixon RD, Takarangi MK. No more than discomfort: the trauma film paradigm meets definitions of minimal-risk research. ETHICS & BEHAVIOR 2021. [DOI: 10.1080/10508422.2021.1997603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
17
|
Cavicchioli M, Scalabrini A, Northoff G, Mucci C, Ogliari A, Maffei C. Dissociation and emotion regulation strategies: A meta-analytic review. J Psychiatr Res 2021; 143:370-387. [PMID: 34592484 DOI: 10.1016/j.jpsychires.2021.09.011] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 08/24/2021] [Accepted: 09/01/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Clinical and neurobiological models posited that dissociative mechanisms might affect processes involved in emotional generation and regulation. However, there is a lack of a comprehensive theoretical framework that systematically includes dissociation within emotional functioning. METHODS The current study aims at conducting a meta-analytic review on the relationship between dissociation and emotion regulation in order to empirically estimate to what extent dissociation is related to emotion regulation processes. The meta-analysis was based on r coefficient as effect size measure, using a random-effect approach. RESULTS The meta-analysis included 57 independent studies for a total of 11596 individuals. Findings showed an overall moderate relationship between dissociation and emotion regulation (rw = .32; p < .05). The association between dissociation and emotion regulation was the same among clinical samples than non-clinical ones. Furthermore, dissociation showed moderate to large relationships with maladaptive domains of emotion regulation, namely disengagement (rw = 0.34; p < .01) (i.e., behavioral avoidance, experiential avoidance, thought and emotional suppression) and aversive cognitive perseveration (rw = 0.38; p < .001) (i.e., rumination, worry and nonacceptance). The analysis did not find significant relationship between dissociation and adaptive domain of emotional regulation (i.e., problem solving, mindfulness). CONCLUSION Dissociation in the context of emotion regulation might be viewed as a basic neuro-mental mechanism that automatically contribute to the over-modulation of emotional states through avoidance reactions from internal and external reality. Future longitudinal studies are needed to clarify the causal relationships between dissociation and emotion regulation.
Collapse
Affiliation(s)
- Marco Cavicchioli
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona 20, 20127, Milano (MI), Italy.
| | - Andrea Scalabrini
- Department of Psychological, Health and Territorial Sciences (DiSPuTer), G. d'Annunzio University of Chieti-Pescara, Via dei Vestini 33, 66100, Chieti (CH), Italy.
| | - Georg Northoff
- Mental Health Centre, Zhejiang University School of Medicine, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China; Centre for Cognition and Brain Disorders, Hangzhou Normal University, Tianmu Road 305, Hangzhou, Zhejiang Province, 310013, China; The Royal's Institute of Mental Health Research & University of Ottawa. Brain and Mind Research Institute, Centre for Neural Dynamics, Faculty of Medicine, University of Ottawa, 145 Carling Avenue, Rm. 6435, Ottawa, Ontario, K1Z 7K4, Canada
| | - Clara Mucci
- Department of Human and Social Science, University of Bergamo, Bergamo, Italy
| | - Anna Ogliari
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy; Child in Mind Lab, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy
| | - Cesare Maffei
- Department of Psychology, University "Vita-Salute San Raffaele", Via Stamira d'Ancona 20, 20127, Milano (MI), Italy; Unit of Clinical Psychology and Psychotherapy, San Raffaele-Turro Hospital, Via Stamira d'Ancona 20, 20127, Milano (MI), Italy
| |
Collapse
|
18
|
Guzey M, Funk J, Kustermann J, Ehring T. The effect of concreteness training on peri-traumatic processing and intrusive memories following an analogue trauma. Behav Res Ther 2021; 147:103970. [PMID: 34592609 DOI: 10.1016/j.brat.2021.103970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 08/23/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022]
Abstract
High levels of rumination are a risk factor for developing posttraumatic stress disorder (PTSD). Theoretical models of rumination as well as earlier empirical findings suggest that the dysfunctional effects of rumination are due to an abstract processing style, and that a more concrete style of thinking has beneficial effects on mental well-being. The present study therefore examined whether concreteness training prior to watching a trauma film prevents analogue PTSD symptoms in the form of intrusive memories. Healthy participants either received concreteness training or were allocated to a no-intervention control condition, and watched a distressing film three days later. We examined differences in intrusive memories related to the film scenes between conditions, and tested whether concreteness training reduces the link between trait rumination and analogue PTSD symptoms. Furthermore, the interacting effect of concreteness training and trait rumination on peri-traumatic processing was investigated. In line with the hypotheses, concreteness training was associated with less frequent intrusive memories and moderated the association between trait rumination and intrusive memories as well as trait rumination and dissociation during the film. These findings lend support to the hypothesis that processing style contributes to the negative impact of rumination on posttraumatic stress symptoms. In addition, they provide preliminary evidence that concreteness training may be a promising intervention for the prevention of PTSD following trauma.
Collapse
Affiliation(s)
- Melike Guzey
- Ankara University, Department of Psychology, Turkey.
| | - Julia Funk
- LMU Munich, Department of Psychology, Germany.
| | | | | |
Collapse
|
19
|
Boersma-van Dam E, van de Schoot R, Geenen R, Engelhard IM, Van Loey NE. Prevalence and course of posttraumatic stress disorder symptoms in partners of burn survivors. Eur J Psychotraumatol 2021; 12:1909282. [PMID: 34025925 PMCID: PMC8128122 DOI: 10.1080/20008198.2021.1909282] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background: Partners of burn survivors may develop posttraumatic stress disorder (PTSD) symptoms in response to the potential life threatening nature of the burn event and the burn survivor's medical treatment. Objective: This longitudinal study examined the prevalence, course and potential predictors of partners' PTSD symptoms up to 18 months post-burn. Methods: Participants were 111 partners of adult burn survivors. In a multi-centre study, PTSD symptoms were assessed with the Impact of Event Scale-Revised during the acute phase and subsequently at 3, 6, 12 and 18 months post-burn. Partners' appraisal of life threat, anger, guilt and level of rumination were assessed as potential predictors of PTSD symptoms in an exploratory piecewise latent growth model. Results: Acute PTSD symptoms in the clinical range were reported by 30% of the partners, which decreased to 4% at 18 months post-burn. Higher acute PTSD symptoms were related to perceived life threat and higher levels of anger, guilt, and rumination. Over time, mean symptom levels decreased, especially in partners with high levels of acute PTSD symptoms, perceived life threat and rumination. From three months onward, PTSD symptoms decreased less in partners of more severely burned survivors. At 18 months post-burn, higher levels of PTSD symptoms were related to higher acute PTSD symptoms and more severe burns. Conclusions: One in three partners reported clinical levels of acute PTSD symptoms, of which the majority recovered over time. Perceived life threat, feelings of anger and guilt, and rumination may indicate the presence of acute PTSD symptoms, whereas more severe burns predict long-term PTSD symptom levels. The results highlight the need to screen for acute PTSD symptoms and offer psychological help to partners to alleviate acute elevated stress levels if indicated.
Collapse
Affiliation(s)
- Elise Boersma-van Dam
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Department of Behavioural Research, Association of Dutch Burn Centres, Beverwijk, The Netherlands
| | - Rens van de Schoot
- Department of Methodology and Statistics, Faculty of Social and Behavioral Sciences, Utrecht University, Utrecht, The Netherlands.,Optentia Research Program, Faculty of Humanities, North-West University, Vanderbijlpark, South Africa
| | - Rinie Geenen
- Department of Psychology, Utrecht University, Utrecht, The Netherlands
| | - Iris M Engelhard
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands
| | - Nancy E Van Loey
- Department of Clinical Psychology, Utrecht University, Utrecht, The Netherlands.,Department of Behavioural Research, Association of Dutch Burn Centres, Beverwijk, The Netherlands
| |
Collapse
|
20
|
Distinguishing between rumination and intrusive memories in PTSD using a wearable self-tracking instrument: a proof-of-concept case study. COGNITIVE BEHAVIOUR THERAPIST 2021. [DOI: 10.1017/s1754470x2100012x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Abstract
Rumination has been shown to play a part in post-traumatic stress disorder (PTSD), but its relation to the intrusions characteristic of PTSD has mainly been investigated experimentally. This proof-of-concept case study explored the occurrence, personal experiences, and possible relation between rumination and intrusions in two PTSD patients in their daily living using a mixed method approach. A novel wearable self-tracking instrument was employed which provided fine-grained temporal resolution of observation data and could eliminate recall bias. Furthermore, quantitative and qualitative data were collected on participants’ symptoms, rumination and experiences of using the self-tracking instrument. First, without distinguishing between the two phenomena, the participants tracked both for a week. After receiving psychoeducational training for distinguishing between rumination and intrusions, the differentiated phenomena were tracked for a week. Both participants reported being subjectively able to distinguish between rumination and intrusions and made observations with high adherence during the project. Data hinted at a possible temporal relation between the phenomena in line with theories posing rumination as a maladaptive coping strategy as well as an exacerbator of PTSD symptoms. However, relations to mood were inconclusive. Furthermore, by using the self-tracking instrument, participants gained a heightened awareness of the characteristics of rumination and intrusions and contextual cues for occurrence, as well as a greater sense of momentary agency. Results reveal promising prospects in using the wearable self-tracking instrument for further investigation of the relation between rumination and intrusions in the lived lives of PTSD patients, as well as potential for incorporating this method in clinical treatment.
Key learning aims
(1)
Self-tracking with the One Button Tracker is a novel symptom registration method, particularly suited for use in psychotherapeutic treatment and research.
(2)
Rumination and intrusions appear to the participants as distinct cognitive phenomena and treatment targets in PTSD.
(3)
Registering rumination and intrusions in real-time could reveal important temporal relations between them and the contexts in which they occur.
(4)
The data obtained with this self-tracking method can potentially be used as a tool in, and for the further development of psychotherapy for PTSD.
Collapse
|
21
|
Roxanne Sopp M, Streb M, Brueckner AH, Schäfer SK, Lass-Hennemann J, Mecklinger A, Michael T. Prospective associations between intelligence, working memory capacity, and intrusive memories of a traumatic film: Potential mediating effects of rumination and memory disorganization. J Behav Ther Exp Psychiatry 2021; 70:101611. [PMID: 32890890 DOI: 10.1016/j.jbtep.2020.101611] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/22/2020] [Accepted: 08/17/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Field research indicates that lower intelligence may predispose trauma-exposed individuals towards the development of re-experiencing symptoms. However, this assumption requires further testing in controlled prospective studies. In the current analog study, we tested whether lower fluid intelligence and lower working memory capacity (WMC) independently contribute to intrusion development. Moreover, we investigated potential mediating effects of trauma memory characteristics and trait rumination. METHODS 118 healthy participants completed tests measuring fluid intelligence and WMC. Two days later, they were exposed to a film clip depicting traumatic events (i.e., so-called trauma film). After exposure to the film, intrusions were assessed using a diary and an intrusion triggering task. RESULTS Our analyses revealed a negative correlation between fluid intelligence and intrusions during the intrusion triggering task. WMC did not correlate with any intrusion measure. Moreover, planned analyses did not yield any mediation effects. LIMITATIONS We used the trauma film paradigm to examine analog posttraumatic stress symptoms. This approach limits the generalizability of our findings with regard to symptom development following real-life traumatic events. CONCLUSIONS Our results show for the first time that higher fluid intelligence is associated with fewer intrusions of a trauma film. This association was evident for laboratory but not for ambulatory intrusions. By demonstrating this association using a prospective experimental design, our study importantly corroborates previous field research.
Collapse
Affiliation(s)
- M Roxanne Sopp
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany.
| | - Markus Streb
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany
| | - Alexandra H Brueckner
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany
| | - Sarah K Schäfer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany
| | - Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany
| | - Axel Mecklinger
- Experimental Neuropsychology Unit, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Campus A1 3, Saarland University, D-66123, Saarbrücken, Germany
| |
Collapse
|
22
|
Danböck SK, Rattel JA, Franke LK, Liedlgruber M, Miedl SF, Wilhelm FH. Peritraumatic dissociation revisited: associations with autonomic activation, facial movements, staring, and intrusion formation. Eur J Psychotraumatol 2021; 12:1991609. [PMID: 34868483 PMCID: PMC8635573 DOI: 10.1080/20008198.2021.1991609] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/29/2022] Open
Abstract
BACKGROUND Peritraumatic dissociation is purported to emerge together with attenuated autonomic arousal, immobility, and staring. However, empirical evidence is scarce and heterogeneous. Moreover, it is still a matter of debate whether these responses predict intrusion formation. OBJECTIVE The present trauma-analogue study examined associations between peritraumatic dissociation, autonomic activation, facial movements, staring, and intrusion formation. METHOD Seventy-one healthy women watched a highly aversive film, while autonomic activation (heart rate, respiratory sinus arrhythmia, skin conductance level), facial movements (temporal variations in corrugator electromyography), and staring (fixation duration, tracklength) were assessed. Afterwards, participants rated the intensity of dissociation during film viewing and reported intrusions and associated distress in a smartphone application for 24 hours. RESULTS Peritraumatic dissociation was linked to higher autonomic arousal (higher heart rate and, on a trend-level, lower respiratory sinus arrhythmia), increased facial movements, and staring (lower tracklength). Peritraumatic dissociation, higher autonomic arousal (higher heart rate and lower respiratory sinus arrhythmia), staring (higher fixation duration), and, on a trend-level, more facial movements were linked to higher intrusion load (number x distress of intrusions) and together explained 59% of variance. Skin conductance level was neither linked to peritraumatic dissociation nor intrusion load. CONCLUSIONS Our results suggest that, at low-dissociation-levels observed in trauma-analogue studies, peritraumatic dissociation may occur together with heightened autonomic arousal and facial movements, indexing increased negative affect. Staring might, irrespectively of dissociation-levels, serve as objective marker for dissociation. Together, peritraumatic dissociation and its psychophysiological correlates might set the stage for later intrusion formation.
Collapse
Affiliation(s)
- Sarah K Danböck
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Julina A Rattel
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Laila K Franke
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Michael Liedlgruber
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Stephan F Miedl
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| | - Frank H Wilhelm
- Division of Clinical Psychology and Psychopathology, Department of Psychology, Paris Lodron University of Salzburg, Salzburg, Austria
| |
Collapse
|
23
|
Iyadurai L, Visser RM, Lau-Zhu A, Porcheret K, Horsch A, Holmes EA, James EL. Intrusive memories of trauma: A target for research bridging cognitive science and its clinical application. Clin Psychol Rev 2019; 69:67-82. [PMID: 30293686 PMCID: PMC6475651 DOI: 10.1016/j.cpr.2018.08.005] [Citation(s) in RCA: 94] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 08/17/2018] [Accepted: 08/17/2018] [Indexed: 01/01/2023]
Abstract
Intrusive memories of a traumatic event can be distressing and disruptive, and comprise a core clinical feature of post-traumatic stress disorder (PTSD). Intrusive memories involve mental imagery-based impressions that intrude into mind involuntarily, and are emotional. Here we consider how recent advances in cognitive science have fueled our understanding of the development and possible treatment of intrusive memories of trauma. We conducted a systematic literature search in PubMed, selecting articles published from 2008 to 2018 that used the terms "trauma" AND ("intrusive memories" OR "involuntary memories") in their abstract or title. First, we discuss studies that investigated internal (neural, hormonal, psychophysiological, and cognitive) processes that contribute to intrusive memory development. Second, we discuss studies that targeted these processes using behavioural/pharmacological interventions to reduce intrusive memories. Third, we consider possible clinical implications of this work and highlight some emerging research avenues for treatment and prevention, supplemented by new data to examine some unanswered questions. In conclusion, we raise the possibility that intrusive memories comprise an alternative, possibly more focused, target in translational research endeavours, rather than only targeting overall symptoms of disorders such as PTSD. If so, relatively simple approaches could help to address the need for easy-to-deliver, widely-scalable trauma interventions.
Collapse
Affiliation(s)
| | - Renée M Visser
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; University of Amsterdam, Department of Psychology, Amsterdam, The Netherlands
| | - Alex Lau-Zhu
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK; Kings College London, Institute of Psychiatry, Psychology and Neuroscience, Social, Genetic and Developmental Psychiatry Centre, London, UK
| | - Kate Porcheret
- University of Oxford, Sleep and Circadian Neuroscience Institute, Nuffield Department of Clinical Neurosciences, Oxford, UK
| | - Antje Horsch
- Lausanne University Hospital, Woman-Mother-Child Department, Lausanne, Switzerland; Institute of Higher Education and Research in Healthcare, University of Lausanne, Lausanne University Hospital, Lausanne, Switzerland
| | - Emily A Holmes
- Karolinska Institutet, Division of Psychology, Department of Clinical Neuroscience, Stockholm, Sweden
| | - Ella L James
- MRC Cognition and Brain Sciences Unit, University of Cambridge, UK
| |
Collapse
|
24
|
Rattel JA, Miedl SF, Franke LK, Grünberger LM, Blechert J, Kronbichler M, Spoormaker VI, Wilhelm FH. Peritraumatic Neural Processing and Intrusive Memories: The Role of Lifetime Adversity. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2019; 4:381-389. [PMID: 30773472 DOI: 10.1016/j.bpsc.2018.12.010] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Revised: 12/07/2018] [Accepted: 12/07/2018] [Indexed: 12/12/2022]
Abstract
BACKGROUND Pathological peritraumatic encoding is proposed as a proximal risk factor for the development of posttraumatic stress disorder (PTSD), with trauma-analog studies linking increased neural processing of trauma films to intrusive trauma recollections, a core symptom of PTSD. Cumulative lifetime adversity is proposed as a more distal risk factor, with research indicating a tipping point at about five events with regard to PTSD development following re-exposure to trauma. Thus, within a diathesis × stress framework, increased peritraumatic neural processing may constitute a specific risk factor for PTSD, particularly in individuals with several lifetime adversities. METHODS Fifty-three healthy women watched highly aversive films depicting severe interpersonal violence versus neutral films during functional magnetic resonance imaging, and they reported involuntary recollections during subsequent days. Moderation analyses tested the interactive relationship between peritraumatic neural processing and lifetime adversity in predicting intrusion load, i.e., the total number of intrusions weighted for their average distress. RESULTS Increased processing of aversive versus neutral films in the amygdala, anterior insula, dorsal and rostral anterior cingulate cortices, and hippocampus predicted increased intrusion load only in participants reporting above five lifetime adversities; for participants reporting few to none, no such relationship was found. This interactive relationship explained ≤59% of variance. Conditioned stimuli preceding film viewing mirrored this pattern. CONCLUSIONS Peritraumatic neural processing in multiple salience network regions and cumulative lifetime adversity interactively predicted PTSD-like symptomatology, representing a diathesis × stress framework that might guide identification of at-risk individuals and potential targets for symptom prevention after traumatic incidents.
Collapse
Affiliation(s)
- Julina A Rattel
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria.
| | - Stephan F Miedl
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| | - Laila K Franke
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| | - Lisa M Grünberger
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| | - Jens Blechert
- Department of Psychology, University of Salzburg, Salzburg, Austria; Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria
| | - Martin Kronbichler
- Center for Cognitive Neuroscience, University of Salzburg, Salzburg, Austria; Neuroscience Institute, Christian-Doppler-Clinic, Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Victor I Spoormaker
- Max Planck Institute of Psychiatry, Department of Translational Research in Psychiatry and Neuroimaging, Munich, Germany
| | - Frank H Wilhelm
- Clinical Stress and Emotion Laboratory, Division of Clinical Psychology, Psychotherapy, and Health Psychology, University of Salzburg, Salzburg, Austria
| |
Collapse
|
25
|
Schweizer T, Renner F, Sun D, Becker-Asano C, Tuschen-Caffier B. Cognitive Processing and Regulation Modulates Analogue Trauma Symptoms in a Virtual Reality Paradigm. COGNITIVE THERAPY AND RESEARCH 2018. [DOI: 10.1007/s10608-018-9967-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
|
26
|
Trautmann S, Reineboth M, Trikojat K, Richter J, Hagenaars MA, Kanske P, Schäfer J. Susceptibility to others' emotions moderates immediate self-reported and biological stress responses to witnessing trauma. Behav Res Ther 2018; 110:55-63. [PMID: 30243101 DOI: 10.1016/j.brat.2018.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 08/20/2018] [Accepted: 09/07/2018] [Indexed: 12/30/2022]
Abstract
BACKGROUND The peri-traumatic stress response is a strong predictor of symptom development after trauma exposure. Regarding witnessing trauma, the stress response might depend on the susceptibility to others' emotions (emotional contagion, EC). This study investigated whether EC moderates the immediate stress response using a trauma film paradigm. METHODS Ninety-five healthy participants were randomly exposed to a trauma or a neutral film. Perceived stressfulness of the film and pre-to post-film changes in self-reported anxiety, heart rate and saliva cortisol levels were assessed. EC towards negative and positive emotions was measured using the emotional contagion scale and its emotion-specific subscales. RESULTS Overall, the trauma film was perceived as distressing and elicited an increase in self-reported anxiety, heart rate and saliva cortisol levels relative to the neutral film. EC towards negative emotions was positively related to the perceived stressfulness of the film, increased anxiety and increased heart rate. The association with saliva cortisol levels was also in the expected direction, but not statistically significant. These associations were not found for EC towards positive emotions. DISCUSSION EC towards negative emotions may be an important predictor of trauma exposure outcomes. Further research should clarify its specific contribution in witnessing and undergoing trauma.
Collapse
Affiliation(s)
- Sebastian Trautmann
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany.
| | - Magdalena Reineboth
- Department of Personality Psychology and Assessment, Technische Universität Chemnitz, Chemnitz, Germany
| | - Katharina Trikojat
- Department of Biological Psychology, Technische Universität Dresden, Dresden, Germany
| | - Jan Richter
- Department of Biological and Clinical Psychology/Psychotherapy, University of Greifswald, Greifswald, Germany
| | - Muriel A Hagenaars
- Department of Clinical Psychology, Utrecht University, Utrecht, Netherlands
| | - Philipp Kanske
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| | - Judith Schäfer
- Behavioral Epidemiology, Institute of Clinical Psychology and Psychotherapy, Technische Universität Dresden, Dresden, Germany
| |
Collapse
|
27
|
Marks EH, Franklin AR, Zoellner LA. Can't get it out of my mind: A systematic review of predictors of intrusive memories of distressing events. Psychol Bull 2018; 144:584-640. [PMID: 29553763 PMCID: PMC5938103 DOI: 10.1037/bul0000132] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Intrusive memories, when persistent and distressing, are theorized to underlie a range of transdiagnostic psychological symptoms and associated impairment. However, little is known about factors predicting the development and persistence of intrusive memories. The aim of this systematic review is to evaluate the literature on pre-event, event-based, and post-event predictors of intrusive memories. A systematic review was conducted, searching for studies that examined intrusive, event-based memories. One hundred and six articles were identified from PsycInfo, PubMed, and Medline databases. Experimental and prospective studies with clinical (N = 14) and nonclinical (N = 92) samples were critically reviewed, provided the inclusion of an analogue stressor with nonclinical samples, and that intrusive memories frequency and/or distress were assessed as primary dependent variables. Pre-existing psychopathology and pre-event appraisal style appear to predict intrusive memories (small to medium effects), whereas trait dissociation did not predict intrusive memories. Of studies examining event-based predictors, higher data-driven processing appears to predict intrusive memories with generally large effects. Post-event negative appraisals consistently predicted intrusive memories (medium to large effects), and preliminary evidence suggests higher post-event conceptual processing predicting fewer intrusive memories. This review synthesizes findings regarding a broad range of pre-event, event-based, and post-event factors that may influence the development of intrusive memories. Methodological issues of current paradigms and the lack of emphasis on memory retrieval processes limit our understanding of what predicts intrusive memory persistence. These limitations are particularly important given that individuals typically seek treatment for distressing intrusive memories once a memory has been fully consolidated, where retrieval processes are of utmost importance. (PsycINFO Database Record
Collapse
|
28
|
Schweizer T, Schmitz J, Plempe L, Sun D, Becker-Asano C, Leonhart R, Tuschen-Caffier B. The impact of pre-existing anxiety on affective and cognitive processing of a Virtual Reality analogue trauma. PLoS One 2017; 12:e0190360. [PMID: 29287111 PMCID: PMC5747458 DOI: 10.1371/journal.pone.0190360] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 12/13/2017] [Indexed: 01/26/2023] Open
Abstract
Dysfunctional processing of traumatic events may be in particular related to high trait anxiety as a pre-traumatic risk factor for the development of post-traumatic stress disorder (PTSD). However, as this has rarely been investigated in prospective, experimental studies, we aimed to analyse the association between high trait anxiety and affective as well as cognitive processing of stress using a new prospective Virtual Reality analogue trauma paradigm to overcome limitations of retrospective or current analogue designs. Individuals with high and low trait anxiety (N = 80) were exposed to a multi-sensory Virtual Reality emergency scenario while psychophysiological stress response, emotion regulation and intrusive memories were assessed. Our results showed that high trait anxiety individuals display increased (i) subjective stress responses, (ii) emotion dysregulation and (iii) intrusive memories upon VR analogue trauma exposure. In particular, our sample of high trait anxiety individuals displayed limited access to different emotion regulation strategies as well as increased worry and rumination regarding perceived intrusive memories. Considering the complex interplay of multiple risk factors, our findings suggests that peri-traumatic affective processing seems to mediate high trait anxiety and post-traumatic intrusive memories thereby pointing out the central role of peri-traumatic processes for intrusion development. In addition, HA as a modulating pre-traumatic risk factor might further increase the risk of later dysfunctional processing of an analogue trauma by interacting with factors of affective processing during analogue trauma exposure. Implications of these findings which may contribute to a higher risk to develop PTSD are discussed.
Collapse
Affiliation(s)
- Tina Schweizer
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Julian Schmitz
- Department of Clinical Child and Adolescent Psychology, Institute of Psychology, University of Leipzig, Leipzig, Germany
- Leipzig Research Centre for Early Child Development, University of Leipzig, Leipzig, Germany
| | - Laura Plempe
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Dali Sun
- Department of Artificial Intelligence, Institute of Computer Science, University of Freiburg, Freiburg, Germany
| | - Christian Becker-Asano
- Department of Artificial Intelligence, Institute of Computer Science, University of Freiburg, Freiburg, Germany
| | - Rainer Leonhart
- Department of Social Psychology and Methodology, Institute of Psychology, University of Freiburg, Freiburg, Germany
| | - Brunna Tuschen-Caffier
- Department of Clinical Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany
| |
Collapse
|
29
|
Dorahy MJ, McKendry H, Scott A, Yogeeswaran K, Martens A, Hanna D. Reactive dissociative experiences in response to acute increases in shame feelings. Behav Res Ther 2017; 89:75-85. [DOI: 10.1016/j.brat.2016.11.007] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 10/30/2016] [Accepted: 11/14/2016] [Indexed: 11/27/2022]
|
30
|
James EL, Lau-Zhu A, Clark IA, Visser RM, Hagenaars MA, Holmes EA. The trauma film paradigm as an experimental psychopathology model of psychological trauma: intrusive memories and beyond. Clin Psychol Rev 2016; 47:106-42. [PMID: 27289421 DOI: 10.1016/j.cpr.2016.04.010] [Citation(s) in RCA: 169] [Impact Index Per Article: 21.1] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2015] [Revised: 03/09/2016] [Accepted: 04/15/2016] [Indexed: 12/26/2022]
Affiliation(s)
- Ella L James
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, United Kingdom; University of Oxford Department of Psychiatry, Warneford Hospital, Oxford OX3 7NG, United Kingdom
| | - Alex Lau-Zhu
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, United Kingdom
| | - Ian A Clark
- University of Oxford Department of Psychiatry, Warneford Hospital, Oxford OX3 7NG, United Kingdom
| | - Renée M Visser
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, United Kingdom
| | - Muriel A Hagenaars
- Utrecht University, Department of Clinical Psychology, 3584 CS Utrecht, The Netherlands
| | - Emily A Holmes
- Medical Research Council Cognition and Brain Sciences Unit, 15 Chaucer Road, Cambridge CB2 7EF, United Kingdom; Department of Clinical Neuroscience, Karolinska Institutet, Sweden.
| |
Collapse
|
31
|
White R, Wild J. "Why" or "How": The Effect of Concrete Versus Abstract Processing on Intrusive Memories Following Analogue Trauma. Behav Ther 2016; 47:404-15. [PMID: 27157033 PMCID: PMC4871812 DOI: 10.1016/j.beth.2016.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2014] [Revised: 01/27/2016] [Accepted: 02/11/2016] [Indexed: 01/01/2023]
Abstract
Emergency service workers, military personnel, and journalists working in conflict zones are regularly exposed to trauma as part of their jobs and suffer higher rates of posttraumatic stress compared with the general population. These individuals often know that they will be exposed to trauma and therefore have the opportunity to adopt potentially protective cognitive strategies. One cognitive strategy linked to better mood and recovery from upsetting events is concrete information processing. Conversely, abstract information processing is linked to the development of anxiety and depression. We trained 50 healthy participants to apply an abstract or concrete mode of processing to six traumatic film clips and to apply this mode of processing to a posttraining traumatic film. Intrusive memories of the films were recorded for 1week and the Impact of Events Scale-Revised (IES-R; Weiss & Marmar, 1997) was completed at 1-week follow-up. As predicted, participants in the concrete condition reported significantly fewer intrusive memories in response to the films and had lower IES-R scores compared with those in the abstract condition. They also showed reduced emotional reactivity to the posttraining film. Self-reported proneness to intrusive memories in everyday life was significantly correlated with intrusive memories of the films, whereas trait rumination, trait dissociation, and sleep difficulties were not. Findings suggest that training individuals to adopt a concrete mode of information processing during analogue trauma may protect against the development of intrusive memories.
Collapse
|
32
|
Lancaster SL, Klein KR, Nadia C, Szabo L, Mogerman B. An Integrated Model of Posttraumatic Stress and Growth. J Trauma Dissociation 2015; 16:399-418. [PMID: 26011515 DOI: 10.1080/15299732.2015.1009225] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A number of recent models have examined cognitive predictors of posttraumatic stress and posttraumatic growth (S. Barton, A. Boals, & L. Knowles, 2013; J. Groleau, L. Calhoun, A. Cann, & G. Tedeschi, 2013; K. N. Triplett, R. G. Tedeschi, A. Cann, L. G. Calhoun, & C. L. Reeve, 2012). The current study examined an integrated model of predictors of distress and perceived growth in 194 college undergraduates. Domains covered included the roles of core belief challenge, event centrality, posttrauma cognitions, and event-related rumination. Negative cognitions about the self and the centrality of the event directly predicted both growth and distress, although intrusive rumination predicted only posttraumatic stress disorder symptoms, and deliberate rumination predicted only posttraumatic growth. Future research should continue to examine the shared and unique predictors of postevent growth and distress.
Collapse
|
33
|
Kleim B, Graham B, Bryant RA, Ehlers A. Capturing intrusive re-experiencing in trauma survivors' daily lives using ecological momentary assessment. JOURNAL OF ABNORMAL PSYCHOLOGY 2014; 122:998-1009. [PMID: 24364602 PMCID: PMC3906879 DOI: 10.1037/a0034957] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Intrusive memories are common following traumatic events and among the hallmark symptoms of posttraumatic stress disorder (PTSD). Most studies assess summarized accounts of intrusions retrospectively. We used an ecological momentary approach and index intrusive memories in trauma survivors with and without PTSD using electronic diaries. Forty-six trauma survivors completed daily diaries for 7 consecutive days recording a total of 294 intrusions. Participants with PTSD experienced only marginally more intrusions than those without PTSD, but experienced them with more "here and now quality," and responded with more fear, helplessness, anger, and shame than those without PTSD. Most frequent intrusion triggers were stimuli that were perceptually similar to stimuli from the trauma. Individuals with PTSD experienced diary-prompted voluntary trauma memories with the same sense of nowness and vividness as involuntary intrusive trauma memories. The findings contribute to a better understanding of everyday experiences of intrusive reexperiencing in trauma survivors with PTSD and offer clinical treatment implications.
Collapse
Affiliation(s)
| | | | | | - Anke Ehlers
- Institute of Psychiatry, King's College London
| |
Collapse
|