Anne P. DePrince

Executive function performance and trauma exposure in a community sample of children

OBJECTIVE Though children exposed to familial violence are reported to have difficulties with a range of emotional and behavioral problems (e.g., lower school achievement) that implicate executive function (EF) deficits, relatively little research has specifically examined EF as a function of trauma exposure in children. METHODS Based on parent report of childrens exposure to potentially traumatic events, children (N=110; Age(Mean)=10.39) from an ethnically diverse community sample were compared across three trauma-exposure groups: familial trauma, non-familial trauma, and no trauma. Children completed a battery of tests to assess working memory, behavioral inhibition, processing speed, auditory attention, and interference control. RESULTS Familial trauma (relative to non-familial and no trauma exposure) was associated with poorer performance on an EF composite (composed of working memory, inhibition, auditory attention, and processing speed tasks); the effect size was medium. Both trauma-exposure status and dissociation symptoms explained unique variance in EF performance after controlling for anxiety symptoms, socio-economic status, and potential traumatic brain injury. While IQ and EF performance were related, SES predicted unique variance in IQ (and not EF) scores, while familial-trauma exposure did not. CONCLUSIONS The contribution of trauma exposure to basic executive functioning held after taking into account symptoms (anxiety and dissociation), socio-economic status, and possible traumatic brain injury exposure. EF problems may provide one route via which maltreated children become at risk for peer, academic, and behavior problems relative to their peers. PRACTICE IMPLICATIONS EF problems may provide one route via which maltreated children become at risk for peer, academic, psychological, and behavior problems relative to their peers. Recently, intervention strategies have emerged in the anxiety and mood disorder treatment literatures that appear to effectively target EFs. As future research continues to specify the relationship between child trauma exposure and EF performance, these innovative treatments may have important practice implications for addressing EF deficits.

Dissociative Tendencies, Attention, and Memory

Two groups of college students were selected on the basis of their scores on the Dissociative Experiences Scale (DES). The high-DES group (score > 20, M = 29.6; n = 54) and low-DES group (score < 10, M = 5.1; n = 54) both completed the standard and a new dualtask version of the Stroop ink-naming task with xs (baseline condition) and color, neutral, and emotionally charged words. Free recall results indicated that high-DES participants remembered fewer emotionally charged words than low-DES participants. We found a crossover interaction for Stroop interference: High-DES participants showed more interference (conflicting color – baseline latency for ink naming) in a selective-attention Stroop task and less interference in the dualtask Stroop task. The interaction between attentional context and dissociation for Stroop interference and the free recall results are consistent with a cognitive-environments view of dissociative tendencies. In this view, dissociative tendencies, which have been otherwise speculated to be largely deleterious, can be advantageous in certain contexts.

Forgetting Trauma Stimuli

Previous work reported in this journal suggested that the cognitive capacities of high dissociators are impaired under conditions of focused (selective) attention, but not under conditions of divided attention, compared with the cognitive capacities of low dissociators. Using a directed-forgetting paradigm, the current study demonstrated that under divided-attention demands, high dissociators have impaired memory for words associated with trauma (e.g., incest) but not for neutral words, as compared with low dissociators. In addition, high dissociators reported significantly more trauma history and significantly more betrayal trauma (abuse by a caregiver) than low dissociators. These results are consistent with the proposal that dissociation may aid individuals with histories of betrayal traumas to keep threatening information out of awareness.

Self-Reported Memory for Abuse Depends Upon Victim-Perpetrator Relationship

Abstract We present preliminary results from the Betrayal Trauma Inventory (BTI) testing predictions from betrayal trauma theory (Freyd. 1994, 1996, in press) about the relationship between amnesia and betrayal by a caregiver. The ??? assesses trauma history using behaviorally defined events in the domains of sexual, physical, and emotional childhood abuse, as well as other lifetime traumatic events. When participants endorse an abuse experience, follow-up questions assess a variety of factors including memory impairment and perpetrator relationship. Preliminary results support our prediction that abuse perpetrated by a caregiver is related to less persistent memories of abuse. This relationship is significant for sexual and physical abuse. Regression analyses revealed that age was not a significant predictor of memory impairment and that duration of abuse could not account for the findings.

Social Cognition and Revictimization Risk

ABSTRACT The ability to accurately detect violations in social contracts likely helps people to avoid or to withdraw from relationships in which they are at risk of being cheated or harmed. Betrayal trauma theory argues that detecting violations of social contracts may be counter-productive to survival under certain conditions, such as when a victim is dependent on a perpetrator. When dependent on a perpetrator (as in the case of child abuse perpetrated by a caregiver), the victim may be better able to preserve the necessary attachment with the caregiver by remaining unaware of the abuse. Thus, the victim may develop a compromised capacity to detect violations of social contracts in the caregiving relationship. Over time, the victim may develop more generalized problems detecting violations in social exchange rules; in turn, generalized problems in detecting violations of social contracts may increase risk for later victimization. Participants in the current study were asked to detect violations in three types of conditional (if-then) rules: abstract, social contract (rules involving a social exchange), and precautionary (rules involving safety). Young adults who reported experiences of revictimization made more errors on social contract and precautionary problems than a no revictimization group; group performance did not differ for abstract problems, suggesting these findings are not explained by general deficits in conditional reasoning. Pathological dissociation significantly predicted errors on social contract and precautionary problems.

The state of betrayal trauma theory: Reply to McNally—Conceptual issues, and future directions

Betrayal trauma theory (Freyd, 1994, 1996, 2001) is an approach to conceptualising trauma that points to the importance of social relationships in understanding post-traumatic outcomes, including reduced recall. We argue in this paper that child sexual abuse very often constitutes a severe betrayal trauma and that it is thus “genuinely traumatic”. We will also argue that one reasonably common effect of child sexual abuse—particularly the more it involves betrayal trauma—is some degree of forgetting or “knowledge isolation” about the event. This last claim speaks to the heart of betrayal trauma theory that McNally has summarised and critiqued. In this paper we will respond to aspects of McNallys critique as well as offer our own perspective on the state of betrayal trauma theory. We discuss (1) conceptual issues, (2) critiques of empirical studies, and (3) future directions. Although our interpretation of data diverges from McNallys in many places, we have all arrived at a surprisingly common endpoint. McNally suggests a child may not think about the abuse for several reasons, such as fears that disclosure may break up the family. In accord with betrayal trauma theory, we note that the failure to think about events will contribute to poorer memory for the event and that these processes are mediated by the unique demands placed on a child exposed to betrayal traumas.

Betrayal Trauma: Associations with Psychological and Physical Symptoms in Young Adults.

Betrayal trauma, or trauma perpetrated by someone with whom a victim is close, is strongly associated with a range of negative psychological and physical health outcomes. However, few studies have examined associations between different forms of trauma and emotional and physical symptoms. The present study compared betrayal trauma to other forms of trauma as predictors of young adults’ psychological and physical symptoms, and explored potential mediators. A total of 185 university undergraduate students completed the Brief Betrayal Trauma Survey, the Trauma Symptom Checklist, the Toronto Alexithymia Scale, and the Pennebaker Inventory of Limbic Languidness. For each set of symptoms, simultaneous multiple regressions assessed the relative contributions of low versus high betrayal trauma to psychological and physical health reports. Structural equation models examined traumatic stress symptoms and alexithymia as mediators of the relationship between betrayal trauma and physical health symptoms. A total of 151 participants (82%) reported exposure to at least 1 of 11 forms of trauma queried (M = 2.08, SD = 1.94); 96 participants (51.9%) reported at least 1 betrayal trauma. Traumas characterized by high betrayal predicted alexithymia, anxiety, depression, dissociation, physical health complaints, and the number of days students reported being sick during the past month, whereas other traumas did not. Structural equation modeling revealed that traumatic stress symptoms and alexithymia mediated the association between betrayal trauma and physical health complaints. These results indicate that betrayal trauma is associated with young adults’ physical and mental health difficulties to a greater extent than are other forms of trauma. Results may inform assessment, intervention, and prevention efforts.

Perceived benefits in trauma research: examining methodological and individual difference factors in responses to research participation.

This study examined methodological and individual difference factors in relation to perceived benefits and cost-benefit ratios among adult participants in trauma-related research. In two samples (Ns = 72 and 118), ethnically-diverse community participants completed trauma-related questionnaires plus an in-depth interview. In separate community (N = 213) and undergraduate (N = 130) samples, participants completed trauma-related questionnaires, but no interviews. Participants rated their perceptions of the research process using the Response to Research Participation Questionnaire (RRPQ). Cost-benefit ratios were favorable in all samples. The research procedures (questionnaires only versus questionnaires plus interviews) explained unique variance in RRPQ scale scores and cost-benefit ratios, as did trauma-related distress. Implications of these findings for developing trauma research protocols are discussed.

Motivated Forgetting and Misremembering: Perspectives from Betrayal Trauma Theory

Individuals are sometimes exposed to information that may endanger their well-being. In such cases, forgetting or misremembering may be adaptive. Childhood abuse perpetrated by a caregiver is an example. Betrayal trauma theory (BTT) proposes that the way in which events are processed and remembered will be related to the degree to which a negative event represents a betrayal by a trusted, needed other. Full awareness of such abuse may only increase the victims risk by motivating withdrawal or confrontation with the perpetrator, thus risking a relationship vital to the victims survival. In such situations, minimizing awareness of the betrayal trauma may be adaptive. BTT has implications for the larger memory and trauma field, particularly with regard to forgetting and misremembering events. This chapter reviews conceptual and empirical issues central to the literature on memory for trauma and BTT as well as identifies future research directions derived from BTT.

Development of the Trauma Appraisal Questionnaire

This study describes the development and psychometric properties of the Trauma Appraisal Questionnaire (TAQ). Items were generated based on interviews with 72 ethnically diverse community participants exposed to a range of trauma types. From the interviews, more than 600 items that tapped beliefs, emotions, and behaviors were generated for 9 appraisal categories (e.g., fear, betrayal, shame). Based on expert feedback, 108 items were retained for initial testing in a sample of 714 undergraduate volunteers. Using a factor analytic strategy, we arrived at a 6-scale, 54-item solution. The reliability and validity of the new measure were evaluated in community (N = 119) and undergraduate (Ns = 139 and 79) samples. The measure demonstrated excellent reliability (test–retest and internal consistency) and validity (convergent, discriminant, and concurrent).