Sirko Rabe

Posttraumatic Growth in Accident Survivors: Openness and Optimism as Predictors of Its Constructive or Illusory Sides

Posttraumatic growth (PTG), the phenomenon of self-reported positive outcomes of trauma, is assumed to consist of two sides: a constructive and an illusory side. This study investigates the relationship between PTG and its possible illusory and constructive predictors, as well as the moderating role of posttraumatic stress disorder (PTSD) severity. One-hundred two motor vehicle accident (MVA) survivors with full, subsyndromal, and without PTSD were assessed by multiple psychometric measures targeting PTSD severity, posttraumatic growth, optimism, and openness to experience. Hierarchical regression analysis yielded differential interaction effects between PTSD severity and optimism, as well as openness facets pointing to the moderating role of PTSD severity in the prediction of an illusory and a constructive factor in PTG.

Neural correlates of posttraumatic growth after severe motor vehicle accidents.

Frontal brain asymmetry has been associated with emotion- and motivation-related constructs. The authors examined the relationship between frontal brain asymmetry and subjective perception of posttraumatic growth (PTG) after severe motor vehicle accidents (MVAs). Eighty-two survivors of MVAs completed self-report measures of PTG, trait and state affect, and diagnostic interviews assessing clinical status, and underwent measurement of resting electroencephalographic activity. As predicted, increased relative left frontal activation was significantly related to PTG, even when statistically controlling for dispositional positive affect. The authors assume that approach-related motivational tendencies associated with higher relative left frontal brain activity may be involved in the process and outcome of PTG.

Regional brain electrical activity in posttraumatic stress disorder after motor vehicle accident

This study examined whether patients with posttraumatic stress disorder (PTSD) related to motor vehicle accidents (MVAs) would show an abnormal pattern of electroencephalographic (EEG) alpha asymmetries, which has been proposed for particular types of anxiety. Patients with PTSD (n = 22) or subsyndromal PTSD (n = 21), traumatized controls without PTSD (non-PTSD with MVA; n = 21), and healthy controls without MVA (n = 23) underwent measurement of EEG activity during baseline and exposure to a neutral, a positive, a negative, and an accident-related picture. Differences in brain asymmetry between groups were observed only during exposure to trauma-related material. PTSD and subsyndromal PTSD patients showed a pattern of enhanced right anterior and posterior activation, whereas non-PTSD with MVA participants showed the opposite pattern. Furthermore, posterior asymmetry in nontraumatized healthy controls varied with gender, with female participants showing a pattern of higher right posterior activation. The results support the hypothesis that symptomatic MVA survivors are characterized by a pattern of right hemisphere activation that is associated with anxious arousal and symptoms of PTSD during processing of trauma-specific information.

Negative self appraisals in treatment-seeking survivors of motor vehicle accidents

Recent cognitive models stress the impact that negative appraisals have on the maintenance of posttraumatic stress disorder (PTSD). The aim of this study was to investigate the role of posttraumatic negative cognitions in 110 survivors of motor vehicle accidents (MVAs) and to examine the effect of cognitive-behavioral treatment on negative appraisals in a sample of 42 patients with full or sub-syndromal PTSD. We investigated whether posttraumatic negative cognitions predicted PTSD diagnosis and symptom severity, and whether treatment-related changes in negative appraisals were associated with PTSD symptom reduction. Negative posttraumatic cognitions were significantly associated with PTSD diagnosis and severity, and explained 54% of the variance of the PTSD severity. Furthermore, treatment-related reductions in negative appraisals about the self were highly associated with PTSD-symptom-reduction. Our results raise question about whether there are factors that make the self more vulnerable in some people but not in others.

Changes in brain electrical activity after cognitive behavioral therapy for posttraumatic stress disorder in patients injured in motor vehicle accidents.

Objective: To explore changes for the first time in neural processing due to effective cognitive behavioral therapy (CBT) in posttraumatic stress disorder (PTSD) after severe motor vehicle accidents. Recent studies have highlighted the role of right hemisphere activation during withdrawal-related emotions (e.g., anxiety). There has been little research on changes in brain function due to cognitive-behavioral interventions in anxiety disorders. Methods: We conducted a randomized, controlled trial comparing cognitive-behavioral therapy with an assessment-only Wait-list condition. Spontaneous electroencephalographic activity was recorded from left and right anterior and posterior regions in participants with PTSD/subsyndromal PTSD receiving CBT (n = 17) before and after a CBT program. Wait-list controls (n = 18) were investigated before and after 3 months. Results: At the pretreatment assessment, a pattern of increased right-sided activation during exposure to a trauma-related picture (relative to a neutral picture) was observed in both CBT and Wait-list participants. At posttreatment, there was a greater reduction of right anterior activation in the CBT group as compared with Wait-list controls. Across both groups, PTSD symptom reduction was significantly positively correlated with a decrease in right anterior activation to the trauma stimulus. Conclusions: These findings suggest that effective CBT treatment of PTSD may be accompanied by adaptive changes in asymmetrical brain function. Future studies are needed to confirm our findings. CBT = cognitive behavioral therapy; PTSD = posttraumatic stress disorder; EEG = electroencephalography; MDD = major depression; CAPS = Clinician Administered PTSD Scale; PANAS = Positive and Negative Affective Scale; MANOVA = multivariate analysis of variance.

Dresden PTSD treatment study: randomized controlled trial of motor vehicle accident survivors

BackgroundWe translated, modified, and extended a cognitive behavioral treatment (CBT) protocol by Blanchard and Hickling (2003) for the purpose of treating survivors of MVA with full or subsyndromal posttraumatic stress disorder (PTSD) whose native language is German. The treatment manual included some additional elements, e. g. cognitive procedures, imaginal reliving, and facilitating of posttraumatic growth. The current study was conducted in order to test the efficacy of the modified manual by administering randomized controlled trial in which a CBT was compared to a wait-list control condition.MethodsForty-two motor vehicle accident survivors with chronic or severe subsyndromal posttraumatic stress disorder (PTSD) completed the treatment trial with two or three detailed assessments (pre, post, and 3-month follow-up).ResultsCAPS-scores showed significantly greater improvement in the CBT condition as compared to the wait list condition (group × time interaction effect size d = 1.61). Intent-to-treat analysis supported the outcome (d = 1.34). Categorical diagnostic data indicated clinical recovery of 67% (post-treatment) and 76% (3 months FU) in the treatment group. Additionally, patients of the CBT condition showed significantly greater reductions in co-morbid major depression than the control condition. At follow-up the improvements were stable in the active treatment condition.ConclusionThe degree of improvement in our treatment group was comparable to that in previously reported treatment trials of PTSD with cognitive behavioral therapy.Trial registrationISRCTN66456536

Cardiovascular Correlates of Motor Vehicle Accident Related Posttraumatic Stress Disorder and its Successful Treatment

Persons with posttraumatic stress disorder (PTSD) have been shown to display elevated baseline cardiovascular activity and a heightened physiological reactivity to trauma-related stimuli. Study 1 examined differences in baseline heart rate (HR) and HR reactivity in 68 survivors of motor vehicle accidents (MVAs) and healthy controls without MVA. MVA survivors with PTSD (n=26), subsyndromal PTSD (n=22), traumatized controls without PTSD (non-PTSD with MVA, n=20) and healthy controls without MVA (HC, n=27) underwent measurement of HR during baseline and exposure to a neutral, positive, negative, and trauma-related picture. PTSD patients showed elevated baseline HR and increased HR reactivity only during exposure to the trauma-related picture. Study 2 investigated whether the elevated physiological responses observed in Study 1 normalized after cognitive behavioral therapy (CBT). We conducted a randomized, controlled treatment trial comparing CBT (n=17) to a Wait-list condition (WLC, n=18). Results showed a greater decrease in HR reactivity for CBT than for WLC. The change in HR reactivity was associated with clinical improvement.

Coping Strategies in Daily Life as Protective and Risk Factors for Post Traumatic Stress in Motor Vehicle Accident Survivors

To investigate the role of a general coping style in the development and maintainance of PTSD-like symptoms, we investigated 44 survivors of severe motor vehicle accidents. Coping was assessed using a German instrument. We also included personality traits such as neuroticism and extraversion, peritraumatic and cognitive factors that are linked to both PTSD and coping in daily life. Stepwise regressions were computed to explain overall PTSD symptoms and symptom clusters (intrusion, avoidance, hyperarousal). Extraversion and neuroticism, cognitive factors, and subjective trauma characteristics predicted total PTSD severity and the symptom clusters, respectively. Additionally, the results indicate that the coping of a person in daily life plays a role in the development and maintenance of PTSD symptoms. We identified both protective factors such as situation control and self-aggrandizement and risk factors such as avoidance and self-blame.

Model-related factor score predictors for confirmatory factor analysis

The present paper introduces model-related (MR) factor score predictors, which reflect specific aspects of confirmatory factor models. The development is mainly based on Schönemann and Steigers regression score components, but it can also be applied to the factor score coefficients. It is shown that the rotation of factor score predictors has no impact on the covariance matrix reproduced from the corresponding regression component patterns. Thus, regression score components or factor score coefficients can be rotated in order to obtain the required properties. This idea is the basis for MR factor score predictors, which are computed by means of a partial Procrustes rotation towards a target pattern representing the interesting properties of a confirmatory factor model. Two examples demonstrate the construction of MR factor score predictors reflecting specific constraints of a factor model.