M. Rose Barlow

Emotion regulation difficulties mediate associations between betrayal trauma and symptoms of posttraumatic stress, depression, and anxiety

Emotion regulation difficulties following trauma exposure have received increasing attention among researchers and clinicians. Previous work highlights the role of emotion regulation difficulties in multiple forms of psychological distress and identifies emotion regulation capacities as especially compromised among survivors of betrayal trauma: physical, sexual, or emotional maltreatment perpetrated by someone to whom the victim is close, such as a parent or partner. It is unknown, however, whether links between emotion regulation difficulties and psychological symptoms differ following exposure to betrayal trauma as compared with other trauma types. In the present study, 593 male and female university undergraduates completed the Difficulties with Emotion Regulation Scale (Gratz & Roemer, 2004), the Brief Betrayal Trauma Scale (Goldberg & Freyd, 2006), the Impact of Event Scale (Horowitz, Wilner, & Alvarez, 1979), and the Trauma Symptom Checklist (Elliott & Briere, 1992). A path analytic model demonstrated that betrayal trauma indirectly impacted symptoms of intrusion (β = .11), avoidance (β = .13), depression (β = .17), and anxiety (β = .14) via emotion regulation difficulties, an effect consistent with mediation. Emotion regulation difficulties did not mediate the relationship between other trauma exposure and psychological symptoms. Results may inform treatment-matching efforts, and suggest that emotion regulation difficulties may constitute a key therapeutic target following betrayal trauma.

KNOWING AND NOT KNOWING ABOUT TRAUMA: IMPLICATIONS FOR THERAPY

Levels of awareness for trauma and their consequences for research, treatment, and prevention within professional psychology and society are considered. When people must endure chronically traumatic environments, it may be adaptive to isolate from awareness information that would produce cognitive dissonance and threaten necessary relationships. Unawareness may also facilitate functioning in environments that invalidate the prevalence and impact of trauma. In addition, characteristics of the posttraumatic environment can promote or impede individuals’ awareness of trauma and their psychological functioning. Though often initially adaptive, unawareness for trauma is linked to intergenerational transmission of trauma and its effects and may preclude public and professional attention to trauma treatment and prevention. Understanding the processes through which individuals become unaware or aware of traumatic experience is therefore essential to conducting effective psychotherapy with trauma survivors.

Trauma-Relevant Characteristics in a University Human Subjects Pool Population: Gender, Major, Betrayal, and Latency of Participation

ABSTRACT This study of over 700 participants is the first to examine whether students in a university human subjects pool (HSP) population differ systematically by gender, major, and participation time (early versus late in the term) on characteristics relevant to trauma research. Males and females reported equal amounts of overall child and adult trauma, and equal amounts of low-betrayal trauma. Females reported more child and adult high-betrayal trauma (i.e., trauma perpetrated by someone close) than did males. Females also reported more current post-traumatic stress disorder (PTSD) symptoms than did males. Psychology majors reported more high-betrayal trauma and low-betrayal traumatic events in childhood, as well as more adult low-betrayal trauma, than did non-majors. Dissociation was correlated with all types of trauma. Current age was positively correlated with reporting trauma, regardless of age at which the trauma was experienced. Additionally, students who participated later in the term were, on average, more than a year older than those who participated earlier in the same term. There was no significant difference between early and late participants on any measure of trauma, PTSD symptoms, or dissociation. Implications for the use of HSPS in studying trauma and future research directions are addressed.

Caring for Our Students in Courses With Potentially Threatening Content

We enjoy the challenge of teaching classes on gender and violence, including violence against women, psychology of trauma, and psychology of gender. Although various sources provide suggestions for teaching classes that provoke strong reactions in students (McCammon, 1995), we have found that one size does not fit all. Rather, we must first identify the needs and motivations of individual students, as well as the class dynamics that arise when students with different levels of trauma awareness begin interacting with each other and with us. We present here a typology of students’ awareness drawn from our experience with classes on gender and violence. This typology may also apply to classes on racism and other challenging topics. Often in our classes, we ask students to confront their own privilege and expectations and to reflect on how their personal experiences may be connected to larger issues in society. Challenging assumptions, although necessary, is often a stressful activity. Here we focus on undergraduate classes that are taken by a wide variety of students, most of whom do not plan to become counselors. We have found that most of the content in this article applies to classes of anywhere from 12 to 100 students, with some modifications needed for classes of over 40. In classes on gender and violence, students must manage their intellectual and emotional reactions to these topics. For example, learning about the prevalence of violence against women may lead students to feel sad or angry, betrayed by society, shocked at their ignorance, or to have pity for victims (Jones, 2002). Confusion and frustration at being unable to change the world can lead to a state of shock, or even to discounting others’ experience. Instructors also experience these reactions. It can be disheartening to hear students react in ways that discount violence survivors’ experiences, support rape myths, and describe one’s own traumatic experiences. Students’ and instructors’ personal reactions contribute to classroom dynamics that emerge during the course. Instructors may struggle with their own philosophies about the goals of the course and how often self-disclosure or personal reactions are appropriate, given the stated course goals (Newman, 2011). Because we are not clinicians, our goal is not to run a group therapy session but rather a college class based on the science of psychology. On the other hand, as feminists, we believe that the personal is political. Balancing viewpoints like these will be a different process for every teacher, and it is a factor to consider seriously before the course begins. It is helpful to explicitly state guidelines for self-disclosure in the syllabus and to model appropriate communication in class. Instructors should clarify expectations around confidentiality. For example, the instructor may state that class members are expected to keep personal information private; on the other hand, students should be cautioned not to share personal information that they want to be kept a secret in an academic classroom setting. One strategy is to review literature on disclosure early in the term to teach students helpful ways to respond to disclosure, as well as to warn students about the potential risk of not getting a helpful response when they disclose. Again, this balance will be different for every teacher and class. Depending on the makeup and location of the class, it can be effective to describe trauma symptoms in terms of common and widespread reactions during widely known disasters such as hurricanes, terrorist attacks, civil unrest, or earthquakes/tsunamis. The instructor might explicitly state that we consider these examples as a way to understand various kinds of trauma reactions, as opposed to understanding or supporting any individuals’ experience. The instructor might add that, unlike many personal traumas, no one is likely to disagree that a hurricane happened or that it was traumatic.

Childhood Neglect, Attachment to Companion Animals, and Stuffed Animals as Attachment Objects in Women and Men

ABSTRACT Childhood neglect has severe, pervasive, negative outcomes that often continue into adulthood. As a potential source of support for both children and adults, companion animals (pets) can both give and receive affection and therefore may be sources of healthy attachment for people who were raised in negative situations. Toy stuffed animals, in contrast, can only receive affection but may still be useful as transitional objects, particularly for people who experienced interpersonal neglect in childhood and who are in the midst of a transition away from the family home and into college. The current study examined the relationships among childhood neglect, companion animal attachment, and attachment to toy stuffed animals. Undergraduate participants (n = 457) from a large regional university answered questionnaires online. The first hypothesis, that self-reported childhood neglect would be positively related to attachment to companion animals, was supported for women only. Neglected women were more attached to companion animals than were non-neglected women, with a medium effect size. For men, there was no significant effect. The second hypothesis was that childhood neglect would be positively related to attachment to stuffed animals; this hypothesis was not supported. The third hypothesis, that women would be more attached to both companion animals and stuffed animals than would men, was supported. Attachment to companion animals and attachment to stuffed animals were positively related. Results are discussed within a framework of attachment and transitional objects as potential aids to therapy in people who were neglected in childhood.

Memory for Complex Emotional Material in Dissociative Identity Disorder

Eleven women with dissociative identity disorder (DID) participated in an experiment that included a variety of memory measures. DID participants were faster than a group of 13 female students at producing autobiographical memories in response to cue words. DID participants had difficulty answering detailed questions about a story containing fear compared with a neutral story; the student group did not. The DID group reported experiencing significantly more childhood trauma than did the student group. Effect sizes were moderate to high. This preliminary study uses a broad conceptualization of memory functioning, combining ecologically valid testing with experimental paradigms and addressing the impact of emotion on memory in trauma survivors.

Measuring fragmentation in dissociative identity disorder: the integration measure and relationship to switching and time in therapy

Background Some people with dissociative identity disorder (DID) have very little communication or awareness among the parts of their identity, while others experience a great deal of cooperation among alternate identities. Previous research on this topic has been sparse. Currently, there is no empirical measure of integration versus fragmentation in a person with DID. In this study, we report the development of such a measure. Objective The goal of this study was to pilot the integration measure (IM) and to address its psychometric properties and relationships to other measures. The IM is the first standardized measure of integration in DID. Method Eleven women with DID participated in an experiment that included a variety of tasks. They filled out questionnaires about trauma and dissociation as well as the IM. They also provided verbal results about switching among alternate identities during the study sessions. Results Participants switched among identities an average of 5.8 times during the first session, and switching was highly correlated with trauma. Integration was related to switching, though this relationship may be non-linear. Integration was not related to time in psychotherapy. Conclusions The IM provides a useful beginning to quantify and study integration and fragmentation in DID. Directions for future research are also discussed, including expanding the IM from this pilot. The IM may be useful in treatment settings to assess progress or change over time.

Researching Dissociative Identity Disorder: Practical Suggestions and Ethical Implications

ABSTRACT This articles purpose is to aid researchers who are interested in conducting research with dissociative populations, but who may not have extensive experience in this area. Researching dissociative identity disorder (DID) comes with many challenges. In this article, the ethics and logistics involved in selecting and implementing research methodology with DID samples are considered. This advice is centered in the authors experience of conducting research with adults in North American hospital and community settings. Researchers in this area should design data collection procedures for maximum flexibility and participant comfort, while maintaining an acceptable level of scientific rigor. Training is essential so that both principal investigators and assistants are able to deal sensitively with trauma survivors. Psychology researchers have a unique ability to be aware of hierarchy and power in the experimental setting, and to consider these issues in order to convey respect for participants.

Predicting posttraumatic growth in survivors of interpersonal trauma: Gender role adherence is more important Than gender

While research supports a relationship between gender and posttraumatic growth (PTG), the relationship between gender norms and PTG is understudied. The purpose of the present study was to examine the relationship of gender role adherence to PTG in male and female survivors of interpersonal violence. Grounded in previous research, we hypothesized that men would report greater levels of experiencing nonsexual interpersonal violence than women and women would report greater levels of sexual interpersonal violence and PTG than men (Hypothesis 1); masculine traits would negatively predict PTG for all participants (Hypothesis 2); and feminine traits would positively predict PTG (Hypothesis 3). A sample of 119 college students who filled out questionnaires online and reported experiencing interpersonal violence was selected for this study. Hierarchical linear regressions were conducted predicting PTG. In contrast to previous research, gender did not predict PTG. Hypotheses 1 and 3 were supported and Hypothesis 2 was not supported. Masculine role adherence was the strongest positive predictor of PTG. Altruism paired with healthy masculine norms predicted PTG better than masculine norms alone. Feminine role adherence also positively predicted PTG. For intervention, changing how we look at gender roles can help address the wide-ranging effects of violence. Gender role adherence, rather than gender, may be a strong predictor of PTG after interpersonal violence.