Nicole Buck

Psychosocial predictors of chronic Post-Traumatic Stress Disorder in Sri Lankan tsunami survivors.

This study aimed to determine whether psychological factors associated with Post-Traumatic Stress Disorder (PTSD) identified in Western samples generalize to low Social-Economical-Status (SES) populations in an underdeveloped Asian country. The study included 113 survivors of the 2004-tsunami on the south coast of Sri Lanka, recruited from 4 preschools and 10 villages for displaced persons. With logistic regressions the relations between interview-based PTSD diagnosis and psychological factors were assessed, controlling for putative confounders. Fifteen months post-trauma the prevalence of PTSD was 52.2%. Multivariate analyses indicated that negative interpretation of tsunami-memories was significantly (P<0.005) related to PTSD. Of the putative confounders, gender and (non-replaced) lost work equipment were related to current PTSD (P<0.05). The results indicate that the relation between negative interpretation of trauma memories and PTSD is quite universal, suggesting that interventions focusing on this factor may be important in treatment of tsunami survivors who are suffering from chronic PTSD.

Perceptual memory representations and memory fragmentation as predictors of post-trauma symptoms

Ehlers and Clark (2000) hypothesize that persistent PTSD is explained by a predominance of data-driven processing and a lack of conceptually-driven processing of the trauma. Data-driven/conceptually-driven processing is thought to relate to perceptual memory representations and memory fragmentation. The present study measured the result of data-driven/conceptually-driven processing in three ways: on utterance level by assessing 1) the ratio between perceptual and conceptual memory representations and 2) utterance disorganization, and 3) on narrative level by assessing the incoherence of the trauma narrative. Twenty-nine patients discharged from the Intensive Care Unit (ICU) were assessed within two weeks after ICU discharge and at 4 months follow-up. The present study tested whether perceptual memory representations, narrative disorganization and narrative incoherence immediately after ICU discharge are related to post-trauma symptomatology. If so, whether these variables are specific for PTSD as compared to depression. Data-driven/conceptually-driven processing was related to PTSD and Depression symptoms on utterance level. Although narrative incoherence did not predict PTSD symptoms, it was predictive of depression symptoms. The present study showed the viability of the data-driven/conceptually-driven conceptualization in explaining post-trauma symptomatology.

Explaining the Relationship Between Insecure Attachment and Partner Abuse: The Role of Personality Characteristics

Studies have found that male batterers are more often insecurely attached as compared with nonbatterers. However, it is still not clear how insecure attachment is related to domestic violence. Many studies compared batterers and nonbatterers regarding pathological personality characteristics that are related to attachment (e.g., dependency, jealousy) and generally found that batterers report more personality characteristics. However, these studies did not investigate which role these characteristics played in the relationship between insecure attachment and battering. The first aim of this study is to test which personality characteristics are good candidates to explain the relationship between insecure attachment and domestic violence. The second aim is to test whether personality characteristics are predictive of battering over and above attachment. Seventy-two mainly court-mandated family-only males who were in group treatment for battering are allocated to a securely and an insecurely attached group and compared with 62 nonbatterers. Using questionnaires, self-esteem, dependency, general distrust, distrust in partner, jealousy, lack of empathy, separation anxiety, desire for control, and impulsivity were assessed. This was the first study that examined distrust, separation anxiety, and desire for control in relation to battering. The results show that the relationship between insecure attachment and domestic violence can be explained by separation anxiety and partner distrust. Moreover, only partner distrust increased the risk for battering over and above insecure attachment. The findings suggest the presence of two subtypes among batterers based on attachment style, which has similarities to the family-only and dysphoric-borderline subtypes suggested by Holtzworth-Munroe and Stuart. Implications of the present findings for therapy are discussed.

Unraveling sexual associations in contact and noncontact child sex offenders using the single category - implicit association test

Previous studies found associations between children and sex in child sex offenders (CSOs) using the Implicit Association Test (IAT). We used a modification of this task, the Single Category–Implicit Association Test (SC-IAT) to unravel child-sex associations in CSOs. Using the SC-IAT, we were able to test whether CSOs indeed hold stronger child-sex associations relative to adult-sex associations, compared to adult sex offenders and nonoffenders. Furthermore, we examined whether contact CSOs differed from noncontact CSOs in their child-sex associations. The hypothesis that CSOs would have stronger child-sex associations, relative to their adult-sex associations, than adult sex offenders and nonoffenders was confirmed. No difference between contact CSOs and noncontact CSOs was found. Although the Sex SC-IAT was able to distinguish CSOs from nonoffenders, the sensitivity and specificity of the test was poor (AUC of .65) and needs refinement. The results of this study support the existence of a child-sex association as a distinctive characteristic of CSOs. These findings are discussed in the context of theories on deviant cognitions in CSOs and risk for sexual offending.

Effects of state dissociation on objectively and subjectively assessed memory disturbances

Dissociation often occurs after a traumatic experience and has detrimental effects on memory. If these supposed detrimental effects are the result of disturbances in information processing, not only subjectively assessed but also objectively assessed memory disturbances should be observed. Most studies assessing dissociation and memory in the context of trauma have studied trauma victims. However, this study takes a new approach in that the impact of experimentally induced state dissociation on memory is investigated in people with spider phobia. Note that the aim of the present study was not to test the effect of trauma on memory disturbances. We found indeed significant relations between state dissociation and subjectively assessed memory disturbances: intrusions and self-rated memory fragmentation. Moreover, although no relation was found between state dissociation and experimenter-rated memory fragmentation, we observed a relation between state dissociation and experimenter-rated perceptual memory representations. These results show that state dissociation indeed has detrimental effects on the processing of aversive events.

The role of ideational distress in the relation between persecutory ideations and reactive aggression

BACKGROUND People with schizophrenia are more likely to be violent than the people without it. Feeling driven to act on persecutory delusions may be one explanation for this, but it remains unclear why some should act on such delusions but some not. Acquisition of data from people who are very ill is problematic. Our study explores testing of hypotheses on similar ideational and behavioural associations among healthy recruits from the general population. AIMS This study aims to test the effect of distress induced by persecutory ideas on any relationships between those ideas and aggressive behaviour, and the effect of gender. METHODS Twenty-four men and 53 women from the general population participated in this study. The measures of aggressive behaviour were experimentally induced aggressive responding, self-reported aggressive behaviour in general, and self-reported reactive and proactive aggressive behaviours. RESULTS Among men, persecutory ideation predicted reactive aggressive responding and aggressive style of behaviour only in those who experienced higher levels of persecutory ideational distress. Among women, with generally lower levels of aggression, the role of ideational distress was more complicated; Women in the low distress group responded with higher aggression on the task. Women in the higher distress group responded with higher aggressive style. For neither men nor women were there links between persecutory ideation and proactive aggression, regardless of distress. CONCLUSIONS Ideational distress moderates the relation between persecutory ideation and aggression in different measures of aggression in men and women. IMPLICATIONS FOR PRACTICE AND/OR RESEARCH: Recognition of a relation between persecutory ideations and aggression is also important in the general population. Insight in the theory of acting upon delusions may lead to more accurate violence risk assessment. Facilitation of early detection of experienced delusional distress may lead to development of more specific psychotherapeutic interventions to manage violence risk.

The Effects of Conceptual Processing Versus Suppression on Analogue PTSD Symptoms after a Distressing Film

BACKGROUND Researchers have begun to scrutinize the assumption that active processing in response to a traumatic event is beneficial whereas avoidance of thoughts, emotions and reminders about the traumatic event is detrimental. Indications that avoidance is not always detrimental come from studies on grief and debriefing. AIMS In an analogue experimental study, the hypothesis was tested that conceptually-driven processing immediately after a distressing film is more successful in reducing analogue PTSD symptoms than suppression of thoughts and images related to the film. METHOD Ninety students watched a distressing film after which they were instructed to either elaborate on the meaning of the film (conceptual processing) (n = 31), suppress all thoughts and images of the film by performing a task (n = 29), or were given no instruction (n = 30). Four hours later, analogue PTSD symptoms were assessed. RESULTS The results showed that conceptually-driven processing does not result in fewer analogue PTSD symptoms than suppression. CONCLUSIONS It is speculated that suppression may only be dysfunctional when individuals interpret their symptoms negatively or when suppression is believed to be dysfunctional.

Psychometric properties of the Trauma Relevant Assumptions Scale

This article describes the psychometric properties of a novel questionnaire, i.e. the Trauma Relevant Assumptions Scale (TRAS). The added value of the TRAS over previous trauma relevant belief questionnaires is that the TRAS enables measuring valence and rigidity of beliefs simultaneously. Both aspects are thought to be predictive of the development of chronic PTSD symptoms. For the exploratory factor analysis, the TRAS was administered to 309 adult volunteers. Principal components analysis yielded two factors: Assumptions about Self and Assumptions about the World. The two-factor structure was confirmed in a sample of 185 traumatized individuals. The TRAS seems to be a valid and reliable instrument, which is strongly related to post-trauma symptoms and has good discriminative validity. Apart from research settings, the TRAS may also be suitable in therapeutic settings to identify the severity of dysfunctional assumptions, and to assess the progress in change from negative assumptions to more positive assumptions.

On the Explanation of the Hostile Attributional Bias: Traumatic Experiences, Schemas, and Migrant Status

Aggressive individuals often exhibit a hostile attributional bias (HAB). To examine why some people exhibit the HAB to a higher degree than others, we tested the hypothesis put forth by Dodge (2006). Dodge hypothesized HAB results from traumatic experiences and this relation is mediated by schemas. This hypothesis was tested among 135 Dutch and migrant participants. Among Dutch participants, traumatic experiences were not related to the HAB but were related to schemas. However, among migrants, traumatic experiences were related both to the HAB and schemas, but schemas were not related to the HAB. Therefore, traumatic experiences are related to a HAB only in migrants. Furthermore, in both groups, schemas do not mediate the relation between traumatic experiences and the HAB.