Associations between Thematic Content and Memory Detail in Trauma Narratives

This study examined whether thematic content (e.g., fear, anger, alienation, self‐blame, and spirituality) in trauma narratives predicted memory detail. Trauma‐specific memory models suggest that trauma narrative themes are associated with much sensory detail; general autobiographical memory models suggest that themes are associated with little context detail. Seventy‐one narratives from a diverse community sample exposed to a variety of traumatic events (e.g., sexual assault, natural disasters) were coded for themes and detail. Analyses controlled for narrative length, childhood or adulthood occurrence, self‐reported post‐traumatic stress disorder, depression and dissociation symptoms. Fear themes were associated with greater sensory detail; anger and spirituality themes were associated with less context detail. Findings support a link between thematic content and detail, and may partially explain why details in memory for traumatic events sometimes appear better and other times worse than memory for other events. Memory models may benefit from specification based on themes in trauma narratives. Copyright © 2013 John Wiley & Sons, Ltd.     

Behavioural Treatment of Post-Traumatic Stress Disorder Associated with Recovered Memories

Post-traumatic stress disorder (PTSD) is sometimes associated with recovered memories (RMs) of traumatic events. That is, the sufferer reports having forgotten traumatic events for a period of time, only to recall them later on. As the memories of traumatic events are recalled, post-traumatic stress disorder may emerge. The cause of recovered memories is uncertain and is the subject of debate. Some recovered memories may be reasonably accurate, while others may be ''recollections'' of imagined rather than actual events. It is unclear whether conventional PTSD therapies, such as behaviour therapy, are appropriate and effective in treating PTSD-RM. The present article considers these issues in the context of a case study, in which a patient with PTSD-RM was treated with behaviour therapy ( in vivo and imaginal exposure). The patient sought treatment because he wanted relief from his PTSD symptoms, regardless of whether his recovered memories were accurate (he was completely convinced in the accuracy of the memories). Treatment outcome was compared with the outcome of 13 PTSD patients who did not have recovered memories, who were also treated with behaviour therapy. Results suggest that PTSD-RM can be effectively treated with behaviour therapy. However, such treatment is unlikely to be appropriate for all cases of PTSD- RM. Selection criteria are discussed.     

PTSD Severity and Cognitive Reactions to Trauma Among a College Sample

ABSTRACT

Two hundred twenty-one undergraduate education students were assessed to determine trauma history and cognitive responses to traumatic events. Participants completed a demographic questionnaire, the Cognitive Distortions Scale, and the PTSD Symptom Scale (for those reporting a trauma history). The most common types of traumatic events were domestic violence, natural disasters, and severe transportation accidents. Differences in cognitive distortions of individuals with and without a trauma history also were assessed. Individuals with a trauma history were significantly higher on Preoccupation with Danger and Self-Blame subscales. Number of previous traumatic events and the subscale of Preoccupation of Danger significantly predicted PTSD severity.     

Where the Whole Thing Fell Apart

Abstract

This article examines the intersection of societal prejudice and psychological trauma. In an instrumental case study created through a layered narrative analysis, the author highlights the potentially traumatic effects of racism and discrimination, while also exploring the phenomenon of resilience in a complex ecological system. The findings suggest that the enduring and continual strain of racial prejudice may cause significant psychological distress, particularly when those experiences reinforce early negative experiences within a family; and that assessments of resilience need to consider the contribution of ecological context to psychological outcomes as well as to an individual's ability to mobilize personal resources when such a context finally shifts.     

Psychological Adjustment,Coping, and Emotion Regulation as Predictors of Posttraumatic Growth

Abstract

The present study examined factors contributing to reported benefits of traumatic experiences or posttraumatic growth (PTG) in a college sample. Specifically, we examined dimensions typically associated with trauma recovery (i.e., psychological functioning, coping, emotion regulation) and features of the trauma (i.e., number and recency of traumatic events, average, and maximal distress). Participants (N= 193) completed standardized questionnaires measuring these constructs. Results indicated that active coping and subjective well-being independently contributed to PTG, but social desirability and symptom distress were independent of growth. These results were consistent with study expectations. Although not specifically predicted, maximal trauma distress also uniquely predicted PTG. Contrary to expectations, effective emotion regulation did not contribute to PTG.     

Perspectives on Memory for Trauma and Cognitive Processes Associated with Dissociative Tendencies

Summary

Cognitive science approaches can inform research in traumatic stress studies by articulating separate scientific issues that may be relevant to understanding alterations in memory and awareness for trauma. This article will first address general issues about disrupted memory and “knowledge isolation” for trauma, as well as introduce specific aspects of “betrayal trauma theory” (Freyd 1994, 1996) that inform our understanding of memory impairment. According to betrayal trauma theory, a potent motivation for knowledge isolation (including amnesia, dissociation, and unawareness) in the face of trauma is to preserve apparently necessary human relationships in which betrayal occurs. Results from three recent laboratory investigations of cognitive processes associated with dissociative tendencies are summarized. These laboratory investigations suggest that the attentional capacities of high dissocators are impaired under conditions of selective attention, but not divided attention. Furthermore, in our laboratory tasks high dissocators have impaired memory for emotionally charged words associated with sexual assault and abuse (e.g., “incest”) but not neutral words, as compared with low dissociators. The findings suggest that high dissociators use divided attention and multi-tasking as a way to control the flow of information. Such a view is consistent with betrayal trauma theory. Though in its infancy, this research draws on cognitive science and observations of traumatic response and offers much promise.     

The relation between emotion regulation choice and posttraumatic growth

ABSTRACT

Previous research has examined emotion regulation (ER) and trauma in the context of psychopathology, yet little research has examined ER in posttraumatic growth (PTG), the experience of positive psychological change following a traumatic event. ER typically involves decreasing negative affect by engaging (e.g. reappraisal) or disengaging (e.g. distraction) with emotional content. To investigate how ER may support PTG, participants who experienced a traumatic event in the past 6 months completed a PTG questionnaire and an ER choice task in which they down regulated their negative emotion in response to negative pictures of varying intensity by choosing to distract or reappraise. Latent growth curve analyses revealed that an increase in reappraisal choice from low to high subjective stimulus intensity predicted higher PTG, suggesting that individuals who chose reappraisal more as intensity increased reported higher PTG. Findings suggest that reappraisal of negative stimuli following a traumatic event may be a key component of PTG.     

Pharmacotherapy to Blunt Memories of Sexual Violence: What's a Feminist to Think?

It has recently been discovered that propranolol—a beta‐blocker traditionally used to treat cardiac arrhythmias and hypertension—might disrupt the formation of the emotionally disturbing memories that typically occur in the wake of traumatic events and consequently prevent the onset of trauma‐induced psychological injuries such as Post‐traumatic Stress Disorder. One context in which the use of propranolol is generating interest in both the popular and scientific press is sexual violence. Nevertheless, feminists have so far not weighed in on propranolol. I suggest that the time is ripe for a careful feminist analysis of the moral and political implications of propranolol use in the context of sexual violence. In this paper, I map the feminist issues potentially raised by providing propranolol to victims of sexual assault, focusing in particular on the compatibility of propranolol use and availability with an understanding of the social and systematic dimensions of rape's harms. I do not deliver a final verdict on propranolol; in fact, I show that we do not yet have enough information about propranolol's effects to do so. Rather, I provide a feminist framework for evaluating the possibilities and perils opened up by therapeutic memory manipulation in the context of sexual violence against women.     

‘Misery Loves Company’: Sexual Trauma, Psychoanalysis and the Market for Misery

This article examines sexual 'misery memoirs', focusing on author/reader and genre/market relationships in the context of models of trauma and child sexual abuse. It shows that the success of sexual 'misery memoirs' is inextricably bound up with the popular dissemination of a feminist-psychoanalytic model of traumatic memory that has taken place since the 1970s. It also argues that, as the 'truth' of recovered and traumatic memories has been fundamental to its success, anxieties about false memory and hoax 'misery memoirs' have posed a challenge to the genre and established a market for 'retractor' narratives.     

Recovered Memories of Child Abuse:

In this paper we exemplify the ongoing and inconclusive nature of empirical research examining the validity of adults' recovered memories of childhood abuse. In view of increasing evidence that the processes underlying traumatic memories differ in fundamental ways from those underlying memories for nontraumatic events, experimental studies of everyday memory processes are likely to have little relevance for our understanding of the memory processes underlying traumatic child abuse. Further, given ethical concerns, it is unlikely that research will ever establish a definitive 'scientific' conclusion regarding the accuracy of recovered memories. Nevertheless, both laypersons and professionals are taking a stand on the recovered memory issue. In this regard, we discuss social psychological research that suggests that people's beliefs about recovered memories and other aspects of child abuse are tied to their personal needs and sociopolitical interests rather than to science or social values. These personal needs and interests include people's inability to acknowledge the injustice of child abuse and their opposition to women's equality, both of which vary as a function of people's authoritarian inclinations. The implications of these findings for social action, as opposed to social research, are discussed.     

The Social Context of Adaptation to Traumatic Events: Soviet Jews and the Holocaust

Much of the literature on trauma focuses on the impact of a single traumatic event and its psychological sequelae on a given individual. Little attention has been paid to the effects of multiple traumatic events within one lifetime, or the importance of understanding the relation of the social context of the trauma(s) to the experience of the trauma survivor. This study presents a qualitative analysis of interviews with older survivors of the Nazi attempt to exterminate the Jews (the Holocaust), who had recently migrated from the former Soviet Union to the United States. In-depth depictions of the effects of multiple traumas on the mental health of single individuals are presented. Further emphasis is placed on the specific social context of trauma to more fully understand the older adult trauma survivor.     

Predicting adolescent posttraumatic stress in the aftermath of war: Differential effects of coping strategies across trauma reminder,loss reminder,and family conflict domains

Background and Objectives: The vast majority of youth who lived through the Bosnian war were exposed to multiple traumatic events, including interpersonal violence, community destruction, and the loss of a loved one. This study examined factors that predict post-war psychological adjustment, specifically posttraumatic stress, in Bosnian adolescents. Design: Regression analyses evaluated theorized differential relations between three types of post-war stressors – exposure to trauma reminders, loss reminders, and intrafamilial conflict – specific coping strategies, and posttraumatic stress symptom dimensions. Methods: We examined 555 Bosnian adolescents, aged 15–19 years, to predict their long-term posttraumatic stress reactions in the aftermath of war. Results: Findings indicated that post-war exposure to trauma reminders, loss reminders, and family conflict, as well as engagement and disengagement coping strategies, predicted posttraumatic stress symptoms. Secondary control engagement coping responses to all three types of post-war stressors were inversely associated with posttraumatic stress symptoms, whereas primary control engagement coping responses to family conflict were inversely associated with hyperarousal symptoms. Disengagement responses to trauma reminders and family conflict were positively associated with re-experiencing symptoms. Conclusions: These findings shed light on ways in which trauma reminders, loss reminders, and family conflict may intersect with coping responses to influence adolescent postwar adjustment.     

Traumatic Loss: Conceptual and Empirical Links Between Trauma and Bereavement

Abstract

This article focuses on conceptual issues and empirical studies regarding the topic of traumatic loss (i.e., loss that occurs suddenly and under violent circumstances) as a method for linking the field of trauma, and that of grief and bereavement. Several definitions of trauma are presented that include the concept of loss, and additional concepts are suggested that may be helpful in thinking about the two areas together. Also, modes of death associated with poor recovery are noted, and it is argued that these modes are those that make a bereavement more “traumatic”. Some empirical studies on the psychological outcomes associated with traumatic loss are reviewed, and preliminary findings from a new study of traumatically bereaved women are briefly presented     

Traumatic Incident Reduction

Abstract

Traumatic Incident Reduction (TIR) is a person-centered, yet intensely focused approach to trauma resolution, based on the principle that the very act of trying to repress painful memories is what holds them in place and gives them power over the individual. TIR consists of a safe and structured method for reviewing the contents of a past trauma repeatedly at a pace and with a degree of exposure determined by the client. By applying the TIR technique to a traumatic memory in a one-on-one setting with a trained facilitator, the client can discover what he or she needs to know in order to achieve a permanent reduction or elimination of the memory's traumatic aftereffects.     

Violence Exposure and PTSD Among Delinquent Girls

Summary

This study focuses on the unique trauma histories of incarcerated girls. In particular, this study draws upon data obtained from 100 incarcerated adolescent girls, highlighting areas of similarity to and difference from incarcerated boys, including: overall levels of traumatic violence exposure, exposure to unique forms of traumatic violence, psychological symptomatology, and hypothesized trajectories of involvement in serious delinquent activity. In addition, a case example is presented to illustrate our hypotheses about the trajectories of adolescent girls' involvement in serious delinquent behavior, as well as the prominent role of early trauma histories and repeat victimization in these trajectories.     

Emplotting the traumatic self: Narrative revision and the construction of coherence

Abstract

In this article we provide a constructivist‐narrative conceptualization of the origins and psychotherapeutic methods for treating trauma. We believe that the experience of trauma ensues when lived events outpace peoples’ abilities to emplot or narrate these events from the perspective of dominant life narratives. The sights, sounds, and smells associated with traumatic events preclude such emplotment. The therapeutic objectives of narrative therapy include finding ways to develop meanings for the trauma and subsequently to integrate these with the dominant narrative. Two case studies are provided to illustrate our conceptualization and therapeutic approach.     

Intertraumatic Dissociative Attachment

SUMMARY

This article focuses on the treatment of couples with a collective personal history of multiple traumatic experiences, and central related concepts. Referred to as the intertrauma couples therapy (InTCT) model, this article outlines an approach to treating trauma victim couples in which each partner has suffered one or more traumatic experiences (i.e., war, rape, criminal assault, incest, community violence, etc.). InTCT is a structured five-phase model of care, derived from a long trauma treatment tradition, and the author's clinical experience in the treatment of multitrauma persons for over 20 years.

This comprehensive, integrative approach to treatment is designed to resolve chronic interpersonal hostility, isolation in marriage, fears of intimacy and engulfment, and the persistent revivifications of partners' traumatic memories as a painful product of daily relational encounters. Unfortunately, these encounters represent trauma structures interacting with trauma structures, with no end or relief to the mutual pain-generating interactional patterns. The phases of the treatment takes the couple from disorganization and intense emotional reactivity to stabilization through integration to an end phase with a post-integration life skills building program for lasting results. Also presented are issues such as attachment, specific trauma responses to include interactive concepts of trauma bonding and systems theory in the context of trauma and dissociation. The article also presents a multitrauma couple case study, and discusses the critical role of therapist's functions.     

Children in genocide: Extreme traumatization and the ‘affect propeller’1

The author bases this paper on extensive research concerning children in genocide with a starting point in the Holocaust and in the genocide in Rwanda 1994. She demonstrates indicators for psychological phenomena concerning the child survivors' affect regulating that appeared in life histories presented in videotaped in‐depth interviews. The psychological phenomena concern experiences of persecution and ways of coming to terms with recurring memory images and affects. The interviews that have been analysed in detail form a basis for an emerging conceptual model about trauma‐ and generational‐linking processes within each individual‐the ‘affect propeller’. An overall conclusion from this study is that past traumatic experiences are recovered not as memories in the usual sense of the word, but as affects invading the present. Accordingly, affects seem to tell the story of the past traumatic experiences.     

Working in the Midst of Unfolding Trauma and Traumatic Loss

Abstract

Training developed for New York City social workers in the evolving aftermath of September 11, 2001 is introduced, offering a conceptual framework for clinical practice in the midst of unfolding trauma and traumatic loss. A focus is placed on the shared, collective process of learning and discussion among colleagues, as an effort parallel to work with clients, progressing together to establish meaning and hope through relationships. Professional training framing this catastrophe within trauma and traumatic loss perspectives, and addressing its impact on clinician, client, work, and treatment relationship, is needed. Also providing on-going support, a process of continuity, and a context of community, this training becomes a collective response to the profound impact and complex, evolving needs of this time.     

Holding it together: Coping with vicarious trauma in sport

ObjectivesVicarious trauma refers to the negative effects that may be experienced after witnessing trauma (such as actual or threatened injury) in others. This study aims to examine vicarious trauma in sports coaches by drawing on the experiences of two trampoline coaches who have witnessed a serious athletic injury. In particular, this study focuses on how these coaches have responded to and coped with this traumatic event.DesignThe study draws on data from thematic, semi-structured, life history interviews that focus on the occurrence of one particular sports accident witnessed by both coaches.MethodMultiple interviews were conducted in which participants were invited to recall the accident, their own responses to the accident, and the coping strategies employed. Interviews were analyzed using a holistic-content analysis in which thematic similarities and differences between the narratives emerged.ResultsThere were three main themes that emerged, these were the need to make meaning following trauma, re-experiencing trauma, and acceptance and avoidance coping. Participants demonstrated the individual nature of coping with trauma. While one participant avoided the trauma by minimizing the events, blocking her emotions and giving support to others; the second participant showed acceptance of the trauma, was highly emotional, and received support from others.ConclusionsThis study demonstrates the difficulties that may be faced by coaches following vicarious trauma. Although each coach presents different experiences and coping strategies they provide some indications of the level and type of support that may be required after witnessing athletic injury.