Wendy D'Andrea

Strengths of character and posttraumatic growth

How are strengths of character related to growth following trauma? A retrospective Web-based study of 1,739 adults found small, but positive associations among the number of potentially traumatic events experienced and a number of cognitive and interpersonal character strengths. It was concluded that growth following trauma may entail the strengthening of character.

Attention Biases in Female Survivors of Chronic Interpersonal Violence: Relationship to Trauma-Related Symptoms and Physiology

Background Exposure to chronic interpersonal violence (IPV) has been associated with psychiatric impairment; however, few studies have investigated attention processes and psychophysiology in this population. Objective We investigated self-report and physiological correlates of attention biases in 27 IPV-exposed women. Method Participants completed self-report measures of trauma history, posttraumatic stress disorder (PTSD) symptoms, and dissociation; were monitored physiologically during baseline; and responded to an emotional dot probe task. Results Participants showed bias away from positive and anxiety words, and toward IPV words. Lower baseline respiratory sinus arrhythmia (RSA) and higher skin conductance levels were associated with bias away from anxiety cues. Greater total PTSD symptoms were associated with bias toward IPV cues, and greater PTSD intrusion and avoidance symptoms were associated with lower RSA. Individuals exposed to more types of trauma had lower heart rates. Conclusions These data extend the research on emotion–cognition interactions in PTSD and other anxiety disorders to chronic IPV survivors, in part confirming avoidance and intrusion symptom and attention bias relations found in studies. The present work also draws attention to a group that tends to experience a range of severe symptoms associated with apparent blunting in autonomic activity, and suggests that self-report may not be sensitive to physiological and attention alterations in chronic IPV samples.

Assessing the family dynamics of childhood maltreatment history with the Childhood Attachment and Relational Trauma Screen (CARTS)

Background Existing survey measures of childhood trauma history generally fail to take into account the relational-socioecological environment in which childhood maltreatment occurs. Variables such as the relationship between the perpetrator and the victim, the emotional availability of caregivers, witnessing the abuse of others, and the respondents own thoughts, feelings, and actions in response to maltreatment are rarely assessed by current measures. Methods To address these concerns, the current study further investigated the family dynamics of childhood maltreatment using the Childhood Attachment and Relational Trauma Screen (CARTS) in 1,782 persons assessed online. Results Paired differences in means between item-rated descriptiveness of self, mothers, and fathers suggested that respondents’ relationship with their biological fathers was less positive and secure than their relationship with their biological mothers, and that biological fathers were more often the perpetrator of emotional, physical, and sexual abuse than biological mothers. However, results further suggested that ratings between self, mothers, and fathers were positively correlated such that, for example, reports of a mothers or a respondents own abusive behavior were more likely in the presence of reports of a fathers abusive behavior. In addition, analyses evaluating witnessing violence demonstrated that fathers were rated as more often violent toward mothers than the reverse, although intimate partner violence was also frequently bidirectional. Analyses of sibling ratings further demonstrated that older brothers were either as or more frequently abusive when compared with parents. Finally, results suggested that childhood emotional, physical, and sexual abuse were much more often perpetrated by family members than extra-familial and non-family members. Conclusions In so far as these findings are consistent with the prior childhood trauma and attachment literature, the current study further supports the utility of the CARTS as a means of assessing the family dynamics of childhood attachment and maltreatment within a relational-socioecological framework.

Autonomic Arousal and Emotion in Victims of Interpersonal Violence: Shame Proneness But Not Anxiety Predicts Vagal Tone

The redefinition of posttraumatic stress disorder (PTSD) in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, has highlighted a range of posttraumatic affects beyond fear and anxiety. For survivors of interpersonal violence, shame has been shown to be an important contributor of self-reported symptomatology. Although biological models of PTSD emphasize physiological arousal secondary to fear and anxiety, evidence suggests that shame might be related to increased arousal as well. This study tested the contributions of anxiety, fear, and shame to autonomic arousal in a sample of female victims (N = 27) of interpersonal violence with PTSD. Shame proneness was the only significant correlate of autonomic arousal during a trauma reminder paradigm. These findings indicate that shame corresponds to important indicators of changes to the autonomic nervous system that have previously been assumed to be fear related.

Prolonged physiological reactivity and loss: Association of pupillary reactivity with negative thinking and feelings.

Prolonged psychophysiological reactions to negative information have long been associated with negative thinking and feeling. This association is operationalized in the RDoC negative affect construct of loss, which is nominally indexed by prolonged physiological reactivity, cognitive loss-related constructs such as rumination and guilt, and more feeling-related constructs such as sadness, crying, and anhedonia. These associations have not been tested explicitly. If thinking and feeling aspects of loss reflect different physiological mechanisms, as might be suggested by their putative neurobiology, different intervention pathways might be suggested. Here we examined the extent to which self-reported negative thinking and feeling constructs were associated with prolonged pupillary reactivity following negative words and a subsequent cognitive distractor in a diverse heterogeneously diagnosed sample of N=84 participants. We also considered indices of abuse and variables associated with borderline personality disorder as possible moderators. Consistently, feeling-related negative affect constructs were related to prolonged pupillary reactivity during the distractor after a negative stimulus whereas thinking-related constructs were not. These data suggest that people who have sustained physiological reactions to emotional stimuli may be more strongly characterized by non-linguistic negative feelings than explicit cognitions related to loss. Sustained physiological reactions could reflect efforts to regulate feeling states. In contrast to cognitive and affective variables, abuse was associated with decreased physiological reactivity, consistent with decreased neural engagement. Interventions that target mechanisms underlying feelings and their regulation may be more mechanistically specific to sustained reactivity than those which directly address cognitions.

Alterations in positive affect: Relationship to symptoms, traumatic experiences, and affect ratings.

Objective: Intrusive negative affect and concurrent deficits in positive affect are hallmarks of posttraumatic stress disorder (PTSD). We sought to further extend the extant literature by exploring the experience of negative affect intrusion upon potentially positive situations (here termed, “negative affect interference,” NAI). Method: Two studies with adults endorsing at least 1 traumatic event (Study 1, N = 294; Study 2, N = 286) examined how NAI and more general hedonic deficits (HD) relate to psychopathology, trauma exposure characteristics, and ratings of normed visual stimuli. Results: Study 1 found that NAI and HD were positively correlated with PTSD symptoms and childhood trauma, and NAI incremented over depressive symptoms in predicting PTSD severity. Study 2 results indicated additional strong positive correlations between NAI and HD and anhedonia, affect regulation problems, negative affect, and neuroticism. NAI and HD were found to increment over trait NA in predicting PTSD symptoms. Individuals endorsing elevated NAI and HD rated positively valenced pictures (including food and erotic images) as less arousing, although not more negative. Conclusions: These findings expand conceptualizations of anhedonia and emotional numbing by drawing attention to negative affect in otherwise positive contexts.

Neural correlates of heart rate variability in PTSD during sub- and supraliminal processing of trauma-related cues

Posttraumatic stress disorder (PTSD) is characterized by dysregulated arousal and altered cardiac autonomic response as evidenced by decreased high‐frequency heart rate variability (HF‐HRV), an indirect measure of parasympathetic modulation of the heart. Indeed, subtle threatening cues can cause autonomic dysregulation, even without explicit awareness of the triggering stimulus. Accordingly, examining the neural underpinnings associated with HF‐HRV during both sub‐ and supraliminal exposure to trauma‐related cues is critical to an enhanced understanding of autonomic nervous system dysfunction in PTSD.