Gerrit J. F. P. Hanewald

Long-term effects of childhood sexual abuse: Objective and subjective characteristics of the abuse and psychopathology in later life.

This study investigates the association between objective and subjective characteristics of childhood sexual abuse and psychopathology in later life. The sample consists of 404 Dutch female adults who had been sexually abused in their childhood or adolescence. The participants were recruited by means of articles about childhood sexual abuse in major Dutch newspapers. The characteristics and severity of the sexual abuse were assessed with the Questionnaire Unwanted Sexual Experiences in the Past (QUSEP). General psychopathology was measured with the Symptom Checklist (SCL-90), the degree of dissociation was measured with the Dissociation Questionnaire (DIS-Q). Stepwise multiple regression analyses showed a moderate association between psychopathology and objective characteristics of the abuse, such as number of different types of abusive events and the duration of the abuse. However, more strongly associated with later psychopathology were variables reflecting coping style, such as the degree of self-blame, and circumstantial factors, such as the emotional atmosphere in the family of origin and the reactions after disclosure. Whether or not the abuse was incestuous did not explain additional variance in later psychopathology.

Structured Writing and Processing Major Stressful Events: A Controlled Trial

Background: Traumatic events may result in a variety of physical and psychological health problems. Self-confrontation with traumatic memories, by putting painful emotions and thoughts into (verbal) words, is associated with psychophysiological benefits. Self-confrontation may be invoked during sessions and enhanced by structural assignments, which the client carries out between the sessions. In this context, writing assignments could be a useful tool in reprocessing traumatic events. The effects of writing assignments have been demonstrated in several case studies and in a number of experimental studies. However, the experimental studies have several limitations, for example the effects of writing on the impact of trauma are not examined. Furthermore, the psychological mechanisms that mediate the effects of trauma on health are less clear. These two issues are the main issues of the current study. Methods: A group of 26 participants were instructed to write about their negative events during five 45-min sessions over a period of 2 weeks. They were compared at pre-treatment, post-treatment and at 6-week follow-up to a waiting-list control group (n = 22). Results: The trauma-writing groups experienced fewer intrusions and showed less avoidance behavior from pre-treatment to follow-up, whereas the waiting-list control group did not change significantly. Similar results were found on depressive symptoms. No effects on mood measures were found. Conclusions: Implications for future research and clinical practice are discussed.

Predicting medically unexplained physical symptoms and health care utilization: A symptom-perception approach

OBJECTIVES The present study investigated the contribution of demographic characteristics (age, gender, socioeconomic status [SES]) and symptom-perception variables to unexplained physical symptoms and health care utilization. In addition, the consequences of the use of four frequently applied symptom-detection methods for relations among study variables were examined. METHOD A group of 101 men and women were administered a standardized interview and several questionnaires. Their general practitioners (GPs) rated (un)explained symptoms and consultations over the previous year. RESULTS Path analyses showed that direct and indirect effects on symptoms and GP consultations depend on method of symptom detection, the largest difference being between self-reported symptoms and registered symptoms. The model including self-reported common symptoms demonstrated the direct and indirect effects of the symptom-perception variables: chronic disease, negative affectivity, selective attention to bodily sensations, and somatic attribution. In the model including registered symptoms, only chronic disease and SES showed effects on symptoms and GP consultations. CONCLUSION This study demonstrates the usefulness of a symptom-perception approach to the experience of unexplained symptoms, the importance of selection of a symptom-detection method, and the need for different models for the explanation of daily experienced symptoms and their presentation in health care.

A symptom perception approach to common physical symptoms

This study investigated variables assumed to influence the symptom perception process, as well as the sociodemographic variables of age, gender and socioeconomic status, regarding their relation to common physical symptoms. In addition, it ascertained the predictors of two symptom measurement methods (prospective and retrospective). A group of 152 men and women completed a standardized interview as well as several questionnaires and kept a diary for 4 weeks. Path analyses showed an adequate data fit irrespective of symptom measure. Two main routes to both prospectively and retrospectively measured physical symptoms were found: one from more negative affectivity via a stronger tendency to selective attention and the other from unemployment or a higher number of chronic diseases via a lower quantity of external information. The effect of age on physical symptoms was mediated by the number of chronic diseases and the tendency to selectively attend to bodily sensations. The effects on physical symptoms proved to depend partly on the method of symptom measurement and varied according to the mediating role of negative mood and the tendency to make psychological attributions. Overall, this study highlights the importance of estimating the independent contribution of variables to the experience of common physical symptoms in a comprehensive model while taking into account the method of symptom measurement. In addition, it demonstrates the usefulness of a symptom perception approach for further study.

Cross-National constancy of dimensions of parental rearing style: The Dutch version of the Parental Bonding Instrument (PBI)

Abstract The Dutch version of the Parental Bonding Instrument was administered to students, community residents and to phobic outpatients in order to examine whether the two-dimensional model of Care and Protection described originally in Australian data, could be replicated. In line with previous findings with a similar, originally Swedish, instrument (the EMBU), clear evidence was found for replicability of the corresponding factors. In addition, the factor structure of the PBI proved to be robust across ‘sex’ and ‘age-groups’. The findings support both the cross-sample invariance and the cross-national constancy of the major dimensions of parental rearing behaviour. Findings with respect to the internal consistency of the PBI scales and the homogeneity of the item sets which make up the scales were very encouraging. The dimensions were generally moderately negatively correlated with each other, a finding which tallies with Australian and British figures. Sex influences on the PBI scores were negligible, as were those of age in sample in which its distribution was not extremely skewed.

Psychometric characteristics and validity of the Dutch adaptation of the Buss-Durkee Hostility Inventory (the BDHI-D)

Data are presented on the factorial structure, internal consistency, and validity of the Dutch adaptation of the Buss-Durkee Hostility Inventory (the BDHI-D). Factor analyses of the responses of 463 subjects revealed two scales measuring Overt Aggression and Covert Aggression. The reliability of both subscales is good. Concordance with other self-report measures reveals satisfactory convergent and divergent validity.

Monitoring and blunting coping styles: The Miller behavioural style scale and its correlates, and the development of an alternative questionnaire

Abstract The present article presents two studies concerning the measurement of monitoring (information seeking under threat) and blunting (information avoidance) coping styles. Study 1 (n = 69) showed that the widely used Miller Behavioural Style Scale suffers from a number of weaknesses such as insufficient internal consistency, susceptibility to correlate with measures of anxiety and other psychopathology, poor quality of scenarios, and moderate face validity. In study 2 (n = 42), an alternative instrument is presented: the Monitoring-Blunting Questionnaire (MBQ). The MBQ has high face validity, good reliability, and is unrelated to trait anxiety. Furthermore, in a “thought experiment” some indications were found for the predictive validity of the MBQ.

Self-statements of test-anxious children: Thought-listing and questionnaire approaches.

Two methods of assessing cognition in high, moderate, and low test-anxious children, thought listing and self-statement questionnaire approaches, were investigated under naturalistic test-taking conditions. The amount of cognition, its content, and its relation to level of anxiety and task performance were examined. States of mind (SOM) analyses were performed. Furthermore, the comparability of findings from both methods was examined. Results showed that, relative to the questionnaire method, the thought-listing procedure underestimated positive and coping cognition. The benefits of the questionnaire approach were seen in the power of its scores to predict task performance. Implications for cognitive assessment and treatment of anxious children are discussed.

The effects of structured writing assignments on overcoming major stressful events: an uncontrolled study

In the present study the effectiveness of writing assignments in the treatment of individuals who have suffered traumatic or stressful life events is investigated. Thirty-two undergraduates participated in the study. The treatment consisted of five writing sessions of 45 min duration that took place over a period of 2 weeks. Immediately following the intervention, subjects showed significant improvement in their ratings of depression, anxiety and fear. The positive effects of the treatment were still evident after a period of 8 weeks. Two possible explanations of the beneficial effects of writing assignments are discussed: self-confrontation and cognitive reappraisal.

Coping self-talk and cognitive interference in anxious children.

The present study addressed the as-yet-unresolved issue of whether coping self-talk facilitates or interferes with effective task performance. Tests of the relationship between coping cognition and task performance are reported when potentially confounding relationships of negative cognition and task performance are controlled. The results indicate that coping self-talk of high-anxious children was positively correlated with negative thoughts but did not contribute significantly to performance. Implications for the functional value of coping self-talk are discussed.