The Good, the Bad, and the Healthy: Impacts of Emotional Disclosure of Trauma on Resilient Self-Concept and Psychological Distress

Interventions to enhance eudaemonic psychological well-being: A meta-analytic review with Ryff's Scales of Psychological Well-being

This meta-analysis enhances our insight into the effectiveness of interventions aimed at improving eudaemonic well-being. The focal outcome of these interventions is Ryff's Scales of Psychological Well-being. We summarized experimental studies and concluded whether a specific intervention approach improves individual positive functioning by assessing the six dimensions of psychological well-being and the composite score of well-being. Our study confirmed that eudaemonic well-being can be improved. The strongest influence is seen in integral programs that link directly to Ryff's conceptual model. Breaking down to dimensional scores, existing interventions had the strongest influence on Environmental Mastery, Personal Growth, and Self-Acceptance. The weakest influence was on Autonomy and Positive Relations with Others. Overall, our result is an important contribution to the well-being literature in that it shows, more convincing than previous meta-analyses due to its exclusive and comprehensive focus on Ryff's model, that psychological eudaemonic well-being can be enhanced by targeted intervention programs.

Prolonged Grief Symptoms among Suicide-Loss Survivors: The Contribution of Intrapersonal and Interpersonal Characteristics

BACKGROUND

Suicide-loss survivors (SLSs) are a population with unique characteristics that place them at increased risk for developing grief complications and painful feelings of guilt that may impact their supportive social environment. However, no studies to date have examined the role of intrapersonal and interpersonal variables that may contribute to prolonged grief symptoms (PGS) as outlined by the new DSM-5 criteria. The present study aimed to extend knowledge regarding the role of interpersonal variables, such as perceived burdensomeness, thwarted belongingness, and self-disclosure, in determining the impact of guilt on the development of PGS among SLSs.

METHOD

This study is part of a longitudinal study, though, in this study, we used a cross-sectional examination of the recently completed fourth measurement. Study participants included 152 SLSs aged 22 to 76 who completed questionnaires measuring guilt, depression, perceived burdensomeness, thwarted belongingness, self-disclosure, and PGS using the Prolonged Grief-Revised Inventory. Participants' demographics and loss-related characteristics, such as time since suicide and participant's age at the time of suicide, were examined.

RESULTS

Confirming the hypotheses, intrapersonal variables (i.e., guilt and depression), as well as interpersonal variables (i.e., perceived burdensomeness, thwarted belongingness, and self-disclosure), contributed significantly to PGS beyond sociodemographic and loss-related factors. Perceived burdensomeness significantly moderated the contribution of guilt to PGS: for participants with high burdensomeness levels, guilt contributed to PGS more strongly than for participants with low burdensomeness.

CONCLUSION

Guilt is an important contributor to PGS among SLSs, and perceived burdensomeness plays a critical role in moderating this contribution. In light of these findings, it can be suggested that SLSs with high levels of guilt should receive special attention and may benefit from therapeutic interventions focusing on reducing maladaptive cognitions that elicit intense guilt or perceived burden.

Advancing a Three-Tier Personality Framework for Posttraumatic Growth

Adversity has been assumed to foster positive personality change under certain conditions. In this article, we examine this assumption within the context of the three-tier personality framework integrating traits, characteristic adaptations, and narrative identity to provide a comprehensive understanding of personality growth. We first review findings on how adverse events affect personality on each of these three levels. Second, we summarize knowledge on event-based and person-based predictors of personality change in the face of adversity. Third, we specify affective, behavioral, and cognitive processes that explain personality change across levels of personality. Innovatively, our proposed process model addresses change at all three levels of personality, as well as similarities and differences in processes across the levels. We conclude by discussing unresolved issues, asking critical questions, and posing challenging hypotheses for testing this framework.

Foreign Language Processing Undermines Affect Labeling

Identifying emotional states and explicitly putting them into words, known as affect labeling, reduces amygdala activation. Crucially, bilinguals do not only label emotions in their native language; they sometimes do it in their foreign language as well. However, one's foreign languages are less emotional and more cognitively demanding than one's native language. Because of these differences, it is unclear whether labeling emotions in a foreign language will also cause downregulation of affect. Here, 26 unbalanced bilinguals were scanned while labeling emotional faces either in their native or foreign languages. Results on affect labeling in a foreign language revealed that not only did it not reduce amygdala activation, but it also evoked higher activation than affect labeling in a native language. Overall, foreign language processing undermines affect labeling, and it suggests that the language in which people name their emotions has important consequences in how they experience them.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s42761-021-00039-9.

Psychedelic Communitas: Intersubjective Experience During Psychedelic Group Sessions Predicts Enduring Changes in Psychological Wellbeing and Social Connectedness

Background: Recent years have seen a resurgence of research on the potential of psychedelic substances to treat addictive and mood disorders. Historically and contemporarily, psychedelic studies have emphasized the importance of contextual elements ('set and setting') in modulating acute drug effects, and ultimately, influencing long-term outcomes. Nevertheless, current small-scale clinical and laboratory studies have tended to bypass a ubiquitous contextual feature of naturalistic psychedelic use: its social dimension. This study introduces and psychometrically validates an adapted Communitas Scale, assessing acute relational experiences of perceived togetherness and shared humanity, in order to investigate psychosocial mechanisms pertinent to psychedelic ceremonies and retreats. Methods: In this observational, web-based survey study, participants (N = 886) were measured across five successive time-points: 2 weeks before, hours before, and the day after a psychedelic ceremony; as well as the day after, and 4 weeks after leaving the ceremony location. Demographics, psychological traits and state variables were assessed pre-ceremony, in addition to changes in psychological wellbeing and social connectedness from before to after the retreat, as primary outcomes. Using correlational and multiple regression (path) analyses, predictive relationships between psychosocial 'set and setting' variables, communitas, and long-term outcomes were explored. Results: The adapted Communitas Scale demonstrated substantial internal consistency (Cronbach's alpha = 0.92) and construct validity in comparison with validated measures of intra-subjective (visual, mystical, challenging experiences questionnaires) and inter-subjective (perceived emotional synchrony, identity fusion) experiences. Furthermore, communitas during ceremony was significantly correlated with increases in psychological wellbeing (r = 0.22), social connectedness (r = 0.25), and other salient mental health outcomes. Path analyses revealed that the effect of ceremony-communitas on long-term outcomes was fully mediated by communitas experienced in reference to the retreat overall, and that the extent of personal sharing or 'self-disclosure' contributed to this process. A positive relationship between participants and facilitators, and the perceived impact of emotional support, facilitated the emergence of communitas. Conclusion: Highlighting the importance of intersubjective experience, rapport, and emotional support for long-term outcomes of psychedelic use, this first quantitative examination of psychosocial factors in guided psychedelic settings is a significant step toward evidence-based benefit-maximization guidelines for collective psychedelic use.

Individuals' conceptions of COVID-19 pandemic through metaphor analysis

The main purpose of the current study is to investigate the perceptions of individuals' living in Turkey during the COVID-19 pandemic through metaphor analysis. The current study employed the descriptive phenomenological design, one of the qualitative research methods. A total of 210 individuals living in Turkey (114 females (68.6%) and 66 males (31.4%)) participated in the current study through an online questionnaire on a voluntary basis. As the data collection tool, the online questionnaire form developed by the researchers was used. The collected data were analyzed within the framework of five-stage metaphor analysis. As a result of the analysis, a total of seven metaphor categories called being restricted, restlessness, uncertainty/obscurity, deadly/dangerous, struggling, faith/destiny, and supernatural were obtained. These categories were subsumed under three themes called "anxiety/concern, risk, and faith".

You Name It: Interpersonal Affect Labeling Diminishes Distress in Romantic Couples

Although it is increasingly acknowledged that social interactions may provide support at times of adversity, whether or how such interactions can buffer distress remains unclear. The objective of the present study was to examine whether naming the emotions of our partner in aversive situations can effectively reduce distress and whether the regulator's empathy contributes to its effectiveness. We utilized a novel performance-based interpersonal affect labeling (IAL) paradigm. Seventy-four romantic couples were randomly divided into targets and regulators. The targets watched aversive pictures with low and high intensity and rated their level of distress after: (1) simply viewing the picture (control trials) (2) choosing a label that describes their emotional reaction (self-labeling trials), (3) viewing a label chosen for them by the regulator, their partner (IAL trials). It was found that IAL significantly reduced distress compared to self-labeling. Moreover, the effectiveness of IAL increased as a function of the regulator's level of empathy. The results highlight the importance of empathy in social support and suggest that as simple an action as naming our partner's emotions may be effective in reducing their distress. Moreover, it emphasizes the potential contribution of nonprofessional help in emotion regulation.

An Exploration of the Relationship Between Culture and Resilience Capacity in Trauma Survivors

Resilience capacity has been found to be associated with individuals’ flexibility and adaptability when dealing with adversity-related stress. Previous research suggested that resilience capacity may play an important role in moderating the relationships between exposure to traumatic events and severity of post-traumatic stress disorder (PTSD) symptoms and cultural factors may be associated with that process. However, adequate research of the mechanisms on how culture may relate to the relationship between resilience and PTSD is still lacking. The present study attempted to explore potential mediators associated with the relationship between culture and resilience capacity among trauma survivors and focused on the potential mediating associations of cultural variables (independent/interdependent self-construal, dialectical thinking, and familism). Levels of culture-related variables among three cultural regions (America, Hong Kong, and Mainland China) were assessed and analyzed. The results of a bootstrapping analysis indicated that independent self-construal and dialectical thinking each significantly mediated the relationship between culture and resilience capacity. Cultural and clinical implications of these findings and suggestions for future research were explored.

"Let's Talk About It": The Moderating Role of Self-Disclosure on Complicated Grief over Time among Suicide Survivors

Suicide often imparts highly stressful ramifications to those left behind. Previous research on suicide survivors (SUSs) has demonstrated their being at high risk for developing anxiety and depression, including pathological complicated grief (CG). Self-disclosure (S-D)--the tendency to share one's personal feelings--has been found to be an important component of dealing with grief. In this study, we examined the effect of S-D on CG in an 18-month longitudinal design following one hundred fifty-six SUSs. We found that SUSs suffering from pathological CG at Time 1 (T1) were lower in S-D at T1 and T2 and higher in depression at T2. We also found that SUSs with lower S-D at T1 had higher CG at T2. Using a structural equation model, we found that S-D at T1 contributed significantly (and negatively) to CG at T1, above and beyond the natural fading of CG over time. Our findings emphasize that while CG is highly prevalent among SUSs, S-D has a beneficial effect which can serve as a protective factor against CG for this group. Implications regarding possible interventions with SUSs were discussed.

Haitian Children’s Disaster Trauma: Validation of Pictorial Assessment of Resilience and Vulnerability

The House-Tree-Person (HTP) drawing test has been culturally adapted for Haitian children and objectively scored for resilience and vulnerability (Roysircar, Colvin, Afolayan, Thompson, & Robertson, 2017). The HTP was used to assess 88 Haitian children’s adjustment to the 2010 earthquake and the continuous trauma of societal inequalities. The study examined the validity of the adapted HTP test and its dimensionality. The study included participant interviews with child self-report measures of self-esteem, as perceived by self, peers, and family; posttraumatic symptoms; and self-concept. All measures were translated and administered in Créole. Analyses included standardized sample scores; descriptive statistics; internal consistency reliability; interscale correlations; a generalizability study showing that there were no differences in HTP scores due to novice or expert raters; and an exploratory factor analysis of HTP scores indicating three factors and accounting for just under 50% of the variance. The three dimensions, HTP Resilience-Vulnerability Integrated, House Feeling Safe, and Person Feeling Unloved, are discussed within the international literature on child disaster trauma assessed pictorially, and within Haitians’ spiritual worldview of suffering and endurance.

Characteristics and components of children's and adolescents' resilience in disasters in Iran: a qualitative study

Children and adolescents are vulnerable in times of disaster and they will suffer more severely if neglected. The concept of resilience differs between cultures, and identifying the components of resilience is essential for decision making and interventions in disasters such as risk management. This study aimed to identify the components of children's resilience in disasters in Iran. This qualitative study took a content-analysis approach. Data were collected through semi-structured interviews with 23 people and three group meetings. Conventional content analysis was used for data analysis. MAXQDA 10 software was used for classification. The resilience components derived from the data were categorized into two main categories, internal and external, and eight subcategories covering psychological, emotional, cognitive, mental, spiritual, physical, social, and behavioral factors. The results also showed that the nature of resilience is both intrinsic and extrinsic. Recognizing the dimensions of children's resilience in disasters can lead to a new perspective for authorities and planners in disaster and emergency situations. The results of this study could be used by planners and policymakers to develop interventions to enhance children's and adolescents' resilience at the time of disasters, which is also underlined and highlighted by international documents.

How should a virtual agent present psychoeducation? Influence of verbal and textual presentation on adherence

BACKGROUND AND OBJECTIVE

With the rise of autonomous e-mental health applications, virtual agents can play a major role in improving trustworthiness, therapy outcome and adherence. In these applications, it is important that patients adhere in the sense that they perform the tasks, but also that they adhere to the specific recommendations on how to do them well. One important construct in improving adherence is psychoeducation, information on the why and how of therapeutic interventions. In an e-mental health context, this can be delivered in two different ways: verbally by a (virtual) embodied conversational agent or just via text on the screen. The aim of this research is to study which presentation mode is preferable for improving adherence.

METHODS

This study takes the approach of evaluating a specific part of a therapy, namely psychoeducation. This was done in a non-clinical sample, to first test the general constructs of the human-computer interaction. We performed an experimental study on the effect of presentation mode of psychoeducation on adherence. In this study, we took into account the moderating effects of attitude towards the virtual agent and recollection of the information. Within the paradigm of expressive writing, we asked participants (n= 46) to pick one of their worst memories to describe in a digital diary after receiving verbal or textual psychoeducation.

RESULTS AND CONCLUSION

We found that both the attitude towards the virtual agent and how well the psychoeducation was recollected were positively related to adherence in the form of task execution. Moreover, after controlling for the attitude to the agent and recollection, presentation of psychoeducation via text resulted in higher adherence than verbal presentation by the virtual agent did.

Quality of life of older adults with cancer in Korea

This study examines the quality of life (QoL) of older adults with cancer (N = 176), by comparing them with age- and gender-matched groups without cancer (N = 176), and investigates factors associated with their QoL. The results of Medical Outcome Study Short Form-36 (MOS SF-36) showed that the study group had significantly lower scores than the noncancer group on all eight scales and on the Physical Component Summary and the Mental Component Summary. Comparison with gender and age groups revealed some differences. Optimism and social support were positively related to QoL while comorbidity, cancer-related concerns, and financial worries were inversely related.

The Narrative Effects of Shamanic Mythology in Palliative Care

We make meaning of disease, suffering, and death through narrative, by telling a story. In a therapeutic narrative approach, this article explores the influence of shamanic intervention in psycho-oncology. This qualitative study seeks to present the narrative effects of detailed shamanic sessions (the use of the drum and telling and interpreting visions according to the shamanic mythology) in the context of psycho-oncological treatment. In particular, the narrative positions of a patient (Mrs. AA) are described (using a software linguistic analysis, T-LAB) as they occurred before and after shamanistic sessions. The authors suggested that the shamanism sessions enabled Mrs. AA to produce a larger and more singular narrative about her end-of-life experience: from the initial narrative position of feeling “the acute consciousness of finiteness” to an emergent narrative position based on “consciousness of an interdependence/interconnection in all human and spiritual relationships.”

Neural activity during affect labeling predicts expressive writing effects on well-being: GLM and SVM approaches

Affect labeling (putting feelings into words) is a form of incidental emotion regulation that could underpin some benefits of expressive writing (i.e. writing about negative experiences). Here, we show that neural responses during affect labeling predicted changes in psychological and physical well-being outcome measures 3 months later. Furthermore, neural activity of specific frontal regions and amygdala predicted those outcomes as a function of expressive writing. Using supervised learning (support vector machines regression), improvements in four measures of psychological and physical health (physical symptoms, depression, anxiety and life satisfaction) after an expressive writing intervention were predicted with an average of 0.85% prediction error [root mean square error (RMSE) %]. The predictions were significantly more accurate with machine learning than with the conventional generalized linear model method (average RMSE: 1.3%). Consistent with affect labeling research, right ventrolateral prefrontal cortex (RVLPFC) and amygdalae were top predictors of improvement in the four outcomes. Moreover, RVLPFC and left amygdala predicted benefits due to expressive writing in satisfaction with life and depression outcome measures, respectively. This study demonstrates the substantial merit of supervised machine learning for real-world outcome prediction in social and affective neuroscience.

"You Blame Me, Therefore I Blame Me": The Importance of First Disclosure Partner Responses on Trauma-Related Cognitions and Distress

Trauma recovery processes may be understood within a socioecological model. Individual factors (such as sex of the survivor) and microsystem factors (including trauma characteristics) have been studied extensively. However, there is a paucity of research examining the effects of macrosystem factors on the impact of trauma-especially examining how the response of the first person to whom the survivor disclosed affects trauma-related cognitions and distress. Sixty-three college student participants reported a history of disclosing at least one traumatic event in an online, anonymous survey. Participants also provided information on the first person they told about the trauma, the social reactions of that person, general social reactions to trauma disclosure, the participants' trauma-related cognitions and psychological distress (PTSD, other mental health issues), details about the traumatic event, and basic demographic information. Paired sample t tests showed that participants experienced the responses of the first person they told about their trauma as more favorable than the responses of the all of the people to whom they told about the event. Women and survivors of non-interpersonal trauma reported more supportive responses than men and survivors of interpersonal trauma. Hierarchical linear regressions showed that interpersonal trauma and victim blame on the part of the first person the survivor told were associated with more negative trauma-related cognitions. Interpersonal trauma, emotional support, and victim blame were associated with a greater degree of trauma-related distress. The results suggest that participants perceived the response of the first person they told as more beneficial than the response of the rest of their exosystem. However, the reactions of the first person the survivor told differed based on the sex of the survivor and the type of trauma they experienced. Consistent with previous research, interpersonal trauma and victim blame by the first person the survivor told about the trauma were associated with more trauma-related distress and negative cognitions. Trauma-related distress was also associated with greater emotional support by the disclosure partner. The results support the use of the socioeological model to better understand the complex nature of trauma recovery and have implications for prevention.

Writing About Past Failures Attenuates Cortisol Responses and Sustained Attention Deficits Following Psychosocial Stress

Acute stress can harm performance. Paradoxically, writing about stressful events—such as past failures—has been shown to improve cognitive functioning and performance, especially in tasks that require sustained attention. Yet, there is little physiological evidence for whether writing about past failures or other negative events improves performance by reducing stress. In this experiment, we studied the effects of an acute psychosocial stressor, the Trier Social Stress Test, on attentional performance and salivary cortisol release in humans. Additionally, we investigated whether an expressive writing task could reduce the detrimental effects of stress, both on performance and physiological response. We found that when individuals were asked to write about a past failure before experiencing a stressor, they exhibited attenuated stress responses. Moreover, those who wrote about a past failure before being exposed to stress also exhibited better behavioral performance. Our results suggest that writing about a previous failure may allow an individual to experience a new stressor as less stressful, reducing its physiological and behavioral effects.

Virtual agent-mediated appraisal training: a single case series among Dutch firefighters

Background: First responders are a prime example of professionals that are at a high risk of being exposed to traumatic experiences. Reappraisal as a coping strategy might help first responders to better cope with their emotional responses to traumatic events. Objective: This study investigated the effects of repeated sessions of a digital reappraisal training among seven firefighters. The training consisted of four sessions supported by a virtual agent, conducted at home or at work, over a two-week period in a single case series. Method: Sixteen data points were collected from each participant in the eight days pre- and post-training. Results: Significantly more themes were used at post-training than at pre-training, implying more flexibility and confirming the main hypothesis of the study. Negative side effects were not reported during or in the week after the training. Conclusions: More controlled studies into the short- and long-term effects of a training of this nature are needed. Furthermore, it provides a reference for developers in this field.

To share or not to share? The contribution of self-disclosure to stress-related growth among suicide survivors

This study examined to what extent suicide survivors can experience growth in the aftermath of suicide loss, as well as the role of self-disclosure and coping strategies in stress-related growth (SRG) among suicide survivors, compared to bereavement following sudden and expected death types. One hundred forty-five bereaved individuals (aged 18-73) completed questionnaires measuring SRG, self-disclosure, and coping strategies. Significant interaction between self-disclosure and types of death was found, in which suicide survivors with low levels of self-disclosure manifested the lowest level of SRG compared to other subgroups. This finding suggests that sharing intimate information can be beneficial in struggling with a situation of suicide in the family.

The role of language in emotion: predictions from psychological constructionism

Common sense suggests that emotions are physical types that have little to do with the words we use to label them. Yet recent psychological constructionist accounts reveal that language is a fundamental element in emotion that is constitutive of both emotion experiences and perceptions. According to the psychological constructionist Conceptual Act Theory (CAT), an instance of emotion occurs when information from one's body or other people's bodies is made meaningful in light of the present situation using concept knowledge about emotion. The CAT suggests that language plays a role in emotion because language supports the conceptual knowledge used to make meaning of sensations from the body and world in a given context. In the present paper, we review evidence from developmental and cognitive science to reveal that language scaffolds concept knowledge in humans, helping humans to acquire abstract concepts such as emotion categories across the lifespan. Critically, language later helps individuals use concepts to make meaning of on-going sensory perceptions. Building on this evidence, we outline predictions from a psychological constructionist model of emotion in which language serves as the "glue" for emotion concept knowledge, binding concepts to embodied experiences and in turn shaping the ongoing processing of sensory information from the body and world to create emotional experiences and perceptions.

A community long-term hotline therapeutic intervention model for coping with the threat and trauma of war and terror

Long-term tele-counseling can potentially be a potent intervention mode in war- and terror-related community crisis situations. We aimed to examine a unique long-term telephone-administered intervention, targeting community trauma-related crisis situations by use of various techniques and approaches. 142 participants were evaluated using a non-intrusive by-proxy methodology appraising counselors' standard verbatim reports. Various background measures and elements in the intervention were quantitatively assessed, along with symptomatology and functioning at the onset and end of intervention. About 1/4 of the wide variety of clients called for someone else in addition to themselves, and most called due to a past event rather than a present crisis situation. The intervention successfully reduced posttraumatic stress symptoms and improved functioning. Most interventions included psychosocial education with additional elements, e.g., self-help tools, and almost 60% included also in-depth processes. In sum, tele-counseling might be a viable and effective intervention model for community-related traumatic stress.

Detecting Changes in Suicide Content Manifested in Social Media Following Celebrity Suicides

The Werther effect describes the increased rate of completed or attempted suicides following the depiction of an individual's suicide in the media, typically a celebrity. We present findings on the prevalence of this effect in an online platform: r/SuicideWatch on Reddit. We examine both the posting activity and post content after the death of ten high-profile suicides. Posting activity increases following reports of celebrity suicides, and post content exhibits considerable changes that indicate increased suicidal ideation. Specifically, we observe that post-celebrity suicide content is more likely to be inward focused, manifest decreased social concerns, and laden with greater anxiety, anger, and negative emotion. Topic model analysis further reveals content in this period to switch to a more derogatory tone that bears evidence of self-harm and suicidal tendencies. We discuss the implications of our findings in enabling better community support to psychologically vulnerable populations, and the potential of building suicide prevention interventions following high-profile suicides.

Psychological well-being revisited: advances in the science and practice of eudaimonia

This article reviews research and interventions that have grown up around a model of psychological well-being generated more than two decades ago to address neglected aspects of positive functioning such as purposeful engagement in life, realization of personal talents and capacities, and enlightened self-knowledge. The conceptual origins of this formulation are revisited and scientific products emerging from 6 thematic areas are examined: (1) how well-being changes across adult development and later life; (2) what are the personality correlates of well-being; (3) how well-being is linked with experiences in family life; (4) how well-being relates to work and other community activities; (5) what are the connections between well-being and health, including biological risk factors, and (6) via clinical and intervention studies, how psychological well-being can be promoted for ever-greater segments of society. Together, these topics illustrate flourishing interest across diverse scientific disciplines in understanding adults as striving, meaning-making, proactive organisms who are actively negotiating the challenges of life. A take-home message is that increasing evidence supports the health protective features of psychological well-being in reducing risk for disease and promoting length of life. A recurrent and increasingly important theme is resilience - the capacity to maintain or regain well-being in the face of adversity. Implications for future research and practice are considered.

An investigation of the efficacy of online expressive writing for trauma-related psychological distress in Hispanic individuals

This study compared the efficacy of 2 online expressive writing protocols for a traumatic/stressful life event in a Hispanic student sample. Participants who had reported a traumatic event were randomly assigned to either the emotion-focused group or the fact-focused group. The emotion-focused group focused their written accounts on emotions and feelings as well as facts about a stressful/traumatic experience, whereas the fact-focused group focused on facts of a stressful/traumatic event. Both groups completed 3 online writing sessions scheduled for 3 consecutive days, a 1-week online follow-up assessment, and a 5-week online follow-up assessment. Both groups statistically significantly reduced trauma symptoms over time with the emotion-focused group demonstrating statistically significantly greater trauma symptom reductions than the fact-focused group at the 5-week follow-up assessment.

Confronting destruction: social context and life story in the diaries of two adolescents in eastern European ghettos during the shoah

Life-writing, such as in diaries and memoirs, offers a means for managing misfortune and fosters an enhanced sense of self-coherence. The devastation that accompanied the effort by the Third Reich to destroy Europe's Jewish citizens challenged resilience, sense of personal agency, and the capacity to deal with personal loss and the destruction of community. The capacity for writing a coherent life story first emerges during adolescence. Reporting on the diaries of two adolescents living in Eastern European ghettos, this study considers the coping techniques that these adolescent diarists used even as they confronted their own demise. At the same time, the differing social contexts of the Łódź and Vilna ghettos posed somewhat different challenges to the resilience of these diarists. This study considers both life-writing and coping in the context both of adolescent psychological development and social context using Lazarus' portrayal of problem-focused and emotion-focused coping as conditions became ever more dire in each ghetto.

Partner preferences among survivors of betrayal trauma

Betrayal trauma theory suggests that social and cognitive development may be affected by early trauma such that individuals develop survival strategies, particularly dissociation and lack of betrayal awareness, that may place them at risk for further victimization. Several experiences of victimization in the context of relationships predicated on trust and dependence may contribute to the development of relational schema whereby abuse is perceived as normal. The current exploratory study investigates interpersonal trauma as an early experience that might impact the traits that are desired in potential romantic partners. Participants in the current study were asked to rate the desirability of several characteristics in potential romantic partners. Although loyalty was desirable to most participants regardless of their trauma history, those who reported experiences of high betrayal trauma rated loyalty less desirable than those who reported experiences of traumas that were low and medium in betrayal. Participants who reported experiences of revictimization (defined as the experience of trauma perpetrated by a close other during 2 different developmental periods) differed from participants who only reported 1 experience of high betrayal trauma in their self-reported desire for a romantic partner who possessed the traits of sincerity and trustworthiness. Preference for a partner who uses the tactic of verbal aggression was also associated with revictimization status. These preliminary findings suggest that victimization perpetrated by close others may affect partner preferences.

Resilience and distress: Israelis respond to the disengagement from Gaza and the second Lebanese war

Resilience and distress in Israeli society were assessed at three points in time: before and after the Israeli disengagement from Gaza, and after the second Lebanese war. A random sample of 366 Israelis was assessed for nation-related anxiety and hostility, personal resources and post-traumatic symptoms. The lowest levels of anxiety were observed at the second time point, after the disengagement. Respondents with high-resilience profiles showed lower levels of post-traumatic symptoms and higher levels of personal resources. The findings underscore Israelis' resilience and the importance of personal resources in ongoing nationally stressful situations.

Child abuse: betrayal and disclosure

OBJECTIVE

The current study tested several hypotheses about disclosure of childhood sexual, physical, and emotional abuse derived from Betrayal Trauma Theory [Freyd, J. J. (1996). Betrayal trauma: The logic of forgetting childhood abuse. Cambridge, MA: Harvard University Press]. We predicted that the duration of time from abuse to its disclosure would vary as a function of victim-perpetrator closeness.

METHODS

Data collected from 202 undergraduate participants using a survey methodology were submitted to logistic regression analyses. The relative variance explained by other variables was also examined.

RESULTS

Compared to survivors of emotional abuse (EA) who were in not very close (NVC) victim-perpetrator relationships, EA survivors in very close (VC) victim-perpetrator relationships were significantly more likely to wait 1 or more years to disclose, or never to disclose, than to wait a period of time less than 1 year (OR=2.65). Further, survivors of physical abuse (PA) in VC victim-perpetrator relationships were significantly more likely to wait 1 or more years to disclose their abuse, if it was disclosed at all, than PA survivors of NVC victim-perpetrator relationships (OR=3.99). Results for sexual abuse were not significant.

CONCLUSIONS

For EA and PA, VC victim-perpetrator relationships predicted longer durations of time from abuse to its disclosure than NVC victim-perpetrator relationships.

PRACTICE IMPLICATIONS

Although delayed disclosure may support necessary (albeit abusive) attachments with caregivers, it may also prolong the abuse and prevent receipt of support. Increased awareness that VC victim-perpetrator relationships may predict longer durations of time from abuse to its disclosure, and that these delays may serve a functional purpose, can help guide supportive and empathic responses to traumatic disclosures.

Can the Lone Ranger, Molly Bloom, and Emile Durkheim Be Friends?

Bernard Rimé effectively reorients emotions and emotional disclosure in a more social and interpersonal direction, outlining the intricate interplay between emotion generation, emotional sharing, and social integration. However, he also takes a hard line on the intra-psychic emphasis of emotional disclosure, which he frames as the product of an individualistic “Lone Ranger” perspective. In many ways Rimé's critique is on target, but it does not fully credit research and theory demonstrating the benefits of private, self-to-self disclosure. This commentary proposes a reconciliation between Rimé's social structuralist perspective and an intra-psychic, self-based perspective. George Herbert Mead's symbolic interactionism, which suggests that the people can relate to their own selves as with another person, provides the basis for this accord.

The lasting effect of words on feelings: words may facilitate exposure effects to threatening images

Previous studies have shown that mere words, particularly affective words, can dampen emotional responses. However, the effect of affective labels on emotional responding in the long term is unknown. The authors examined whether repeated exposure to aversive images would lead to more reduction in autonomic reactivity a week later if the images were exposed with single-word labels than without labels. In Experiment 1, healthy individuals were exposed to pictures of disturbing scenes with or without labels on Day 1. On Day 8, the same pictures from the previous week were exposed, this time without labels. In Experiment 2, participants were spider fearful and were exposed to pictures of spiders. In both experiments, although repeated exposure to aversive images (without labels) led to long-term attenuation of autonomic reactivity, exposure plus affective labels, but not nonaffective labels, led to more attenuation than exposure alone. Thus, affective labels may help dampen emotional reactivity in both the short and long terms. Implications for exposure therapy and translational studies are discussed.

Putting feelings into words: affect labeling disrupts amygdala activity in response to affective stimuli

Putting feelings into words (affect labeling) has long been thought to help manage negative emotional experiences; however, the mechanisms by which affect labeling produces this benefit remain largely unknown. Recent neuroimaging studies suggest a possible neurocognitive pathway for this process, but methodological limitations of previous studies have prevented strong inferences from being drawn. A functional magnetic resonance imaging study of affect labeling was conducted to remedy these limitations. The results indicated that affect labeling, relative to other forms of encoding, diminished the response of the amygdala and other limbic regions to negative emotional images. Additionally, affect labeling produced increased activity in a single brain region, right ventrolateral prefrontal cortex (RVLPFC). Finally, RVLPFC and amygdala activity during affect labeling were inversely correlated, a relationship that was mediated by activity in medial prefrontal cortex (MPFC). These results suggest that affect labeling may diminish emotional reactivity along a pathway from RVLPFC to MPFC to the amygdala.

Social cognitive neuroscience: a review of core processes

Social cognitive neuroscience examines social phenomena and processes using cognitive neuroscience research tools such as neuroimaging and neuropsychology. This review examines four broad areas of research within social cognitive neuroscience: (a) understanding others, (b) understanding oneself, (c) controlling oneself, and (d) the processes that occur at the interface of self and others. In addition, this review highlights two core-processing distinctions that can be neurocognitively identified across all of these domains. The distinction between automatic versus controlled processes has long been important to social psychological theory and can be dissociated in the neural regions contributing to social cognition. Alternatively, the differentiation between internally-focused processes that focus on one's own or another's mental interior and externally-focused processes that focus on one's own or another's visible features and actions is a new distinction. This latter distinction emerges from social cognitive neuroscience investigations rather than from existing psychological theories demonstrating that social cognitive neuroscience can both draw on and contribute to social psychological theory.

Homeopathy--what are the active ingredients? An exploratory study using the UK Medical Research Council's framework for the evaluation of complex interventions

Background

Research in homeopathy has traditionally addressed itself to defining the effectiveness of homeopathic potencies in comparison to placebo medication. There is now increasing awareness that the homeopathic consultation is in itself a therapeutic intervention working independently or synergistically with the prescribed remedy. Our objective was to identify and evalute potential "active ingredients" of the homeopathic approach as a whole, in a prospective formal case series, which draws on actual consultation data, and is based on the MRC framework for the evaluation of complex interventions.

Methods

Following on from a theoretical review of how homeopathic care might mediate its effects, 18 patients were prospectively recruited to a case series based at Bristol Homeopathic Hospital. Patients, who lived with one of three index conditions, were interviewed before and after a five visit "package of care". All consultations were recorded and transcribed verbatim. Additional data, including generic and condition-specific questionnaires, artwork and "significant other" reports were collected. Textual data was subject to thematic analysis and triangulated with other sources.

Results

We judged that around one third of patients had experienced a major improvement in their health over the study period, a third had some improvement and a third had no improvement. Putative active ingredients included the patients' "openness to the mind-body connection", consultational empathy, in-depth enquiry into bodily complaints, disclosure, the remedy matching process and, potentially, the homeopathic remedies themselves.

Conclusion

This study has has identified, using primary consultation and other data, a range of factors that might account for the effectiveness of homeopathic care. Some of these, such as empathy, are non-specific. Others, such as the remedy matching process, are specific to homeopathy. These findings counsel against the use of placebo-controlled RCT designs in which both arms would potentially be receiving specific active ingredients. Future research in homeopathy should focus on pragmatic trials and seek to confirm or refute the therapeutic role of constructs such as patient "openness", disclosure and homeopathicity.