Posttraumatic stress disorder in the emergency room: exploration of a cognitive model

Ehlers and Clark (Behav. Res. Ther., 38 (2000) 319) recently proposed a cognitive model of posttraumatic stress disorder (PTSD). In this study, we examined two facets of this model, appraisal and peritraumatic dissociation, in the context of a hospital emergency room. Fifty-one emergency room personnel completed questionnaires measuring posttraumatic stress symptoms, interpretations of traumatic events experienced while working in the emergency room and subsequent intrusive recollections, and peritraumatic dissociation. Twelve percent of participants met formal diagnostic criteria for PTSD, and 20% met PTSD symptom criteria. As predicted, both negative appraisals of the trauma and of intrusive recollections were associated with increased PTSD severity. Although peritraumatic dissociation did not correlate with overall PTSD symptom severity, it was associated with the reexperiencing symptom cluster. Discussion focuses on the factors associated with PTSD in emergency room professionals and implications for intervention.     

Integrating personality, daily life events and emotion: Role of anxiety and positive affect in emotion regulation dynamics

We investigated the roles of anxiety and positive affect in emotion regulation, looking simultaneously at personality, daily life events, and affects. We hypothesized that individual differences in the temporal dynamics of affective experience related to trait anxiety would manifest themselves both in affective responsiveness to life events and in homeostatic regulatory forces. Data were collected from 49 adults, who rated their affective state three times a day over a 40-day period. Data were analyzed using a dynamical system model and graphical representations in the form of vector fields. Results showed that anxiety chiefly interacted with home base (attractor) positions as a function of life events. It also influenced the shape of positive affectivity trajectories in response to negative events.     

Individual differences in stress and fatigue in two field studies of driving

This paper reports the findings of two field studies of Australian drivers in which individual differences in stress and fatigue were investigated. In the first study, 58 professional drivers completed measures of mood, fatigue and other subjective stress state measures, before and after performing a prolonged driving trip. The results indicated that the scales were sensitive to increased fatigue following the driving trip, and correlated appropriately with Fatigue Proneness, a driver stress trait. In the second study, 104 non-professional drivers completed identical subjective stress state measures as the professional drivers, before and after performing a driving trip. Drivers completed a measure of driving-related stress traits, the Driver Stress Inventory (DSI), and a measure of coping, the Driving Coping Questionnaire (DCQ). Both measures were predictive of state response to driving, and the association between Fatigue Proneness and post-drive fatigue found in the first study was replicated. Findings from these studies suggest that fatigue and stress reactions to driving are psychometrically distinct, but may have some common antecedents, such as use of emotion-focused coping. The studies confirm the importance of fatigue and stress as potential safety problems, but also highlight the role of individual differences in response to the demands of driving.     

The linkages of cognitive processes, stress propensity, affect, and strain: experimental test of a cognitive model of the stress response

This research examined a model of the stress response that includes cognitive-affective stress propensity, cognitive-affective processes, experienced affective reactions, subjective stress, and strain constructs. Using partial least squares analysis, this model was found to provide a good fit with the data. Moderated multiple regression analyses found support for the hypothesized moderating effects of individual stress propensity on the relationships of stressors with cognitive-affective processes. The research and practical implications of these findings are discussed.     

The relationship between working memory capacity and cortical activity during performance of a novel motor task

ObjectivesThis study assessed whether individual differences in working memory capacity influenced verbal-analytical processes when performing a novel motor skill.DesignParticipants performed a tennis-hitting task in two conditions: no pressure and high-pressure.MethodsEighteen young adults participated in the study. EEG coherence between the T3-F3 and T4-F4 regions in the Beta1 and Alpha2 frequencies was recorded during performance in each condition. Verbal and visuo-spatial working memory capacity were assessed using the Automated Working Memory Assessment.ResultsNo differences were found between the two conditions for hitting performance and EEG activity. However, across both conditions, verbal and visuo-spatial working memory were significant predictors of EEG coherence between the T3-F3 and T4-F4 regions in the Beta1 and Alpha2 frequencies. Larger verbal working memory capacity was associated with greater coherence while the opposite trend was observed for visuo-spatial working memory capacity.ConclusionsThese results indicate that larger verbal working memory capacity is associated with a greater tendency to use explicit processes during motor performance, whereas larger visuo-spatial working memory capacity is associated more with implicit processes. The findings are discussed with relevance to the theory of implicit motor learning.     

The effect of security-related stress on dyadic closeness among Jews and Arabs in Israel: a daily diary study

An important aspect of Israeli life is its continuous state of conflict with the neighboring Palestinian people and Arab countries. Given that security-related stress is so intensely experienced by all Israeli residents, we examined the effects of daily fluctuations in security-related stress on dyadic closeness among Jewish and Arab couples. Time sampling approach was used to study repeated sequences of associations between stress and dyadic closeness. Data were collected from 188 Jewish and 93 Arab couples by means of daily diaries. Hierarchical multivariate linear modeling was used to analyze the data. The findings indicate that stress results in increasing distance between intimate partners, but the effect varies with the level of marital quality and socioethnic affiliation.     

A preliminary investigation of sex differences in associations between emotion regulation difficulties and higher-order cognitive abilities

The present study sought to clarify the cognitive correlates of emotion regulation difficulties (ERD). Further, because prior evidence suggests sex differences in emotion regulation, sex was examined as a moderator of associations between cognitive abilities and ERD. Participants (N = 154) completed self-report measures of ERD, and were administered neuropsychological tests assessing crystallized and fluid intelligence, as well as various components of executive functioning. Bivariate correlations and results from regression analyses suggested sex-dependent associations among cognitive processes and ERD. For men, inhibition of dominant response tendencies was associated with lower ERD, whereas for women, a host of executive abilities (e.g., greater inhibition, cognitive flexibility, semantic processing, abstract reasoning) were associated with greater ERD. Implications for the neurocognitive conceptualization of emotion dysregulation will be discussed.     

Constructions of work stress and coping in a female- and a male-dominated department

In the present study the nature of stress and coping was investigated and considered as socially constructed. Thirty small group interviews were performed using the Critical Incident Technique in one female- and one male-dominated customer service department of a telecom company. The main themes about stress among both women and men were often expressed as collective phenomena and were connected to the organizational change and downsizing process, problems when carrying out the work and lack of autonomy. However, a striking difference between female and male interviews was found in the way that women to a greater extent expressed lack of autonomy and their working situation was described as strictly regulated. The findings illustrate that a traditional gender difference regarding autonomy could be found when comparing a female- and a male-dominated department even though they were performing the same type of job. Both women and men portrayed coping as a mixture of collective and individual strategies. They often mentioned collective acceptance, resignation and hardening. There is a need for further research about women and men at work, taking into consideration the interpersonal context and the collective nature of stress and coping.     

Individual differences in cognitive-flexibility: the influence of spontaneous eyeblink rate, trait psychoticism and working memory on attentional set-shifting

Individual differences in psychophysiological function have been shown to influence the balance between flexibility and distractibility during attentional set-shifting [e.g., Dreisbach et al. (2005). Dopamine and cognitive control: The influence of spontaneous eyeblink rate and dopamine gene polymorphisms on perseveration and distractibility. Behavioral Neuroscience, 119(2), 483-490]. Here we replicate both the facilitatory and detrimental influence of spontaneous eyeblink rate upon switch costs across the two distinct conditions of a set-shifting task. We extend this by presenting additional, putatively dopamine related, individual differences that also influence attentional control. Whereas trait psychoticism showed a pattern of effects opposite to that of eyeblink rate, greater working memory served to decrease switch costs across both conditions. These results highlight the need for further exploration of the role of dopaminergic neurotransmission and component processes involved in such attentional paradigms, and illustrates the importance of considering individual differences in cognitive control.     

A model of stress and coping and their influence on individual and organizational outcomes

A model of coping with stress is proposed in which coping mediates the relationship among organizational stressors and personal characteristics, and job-related strains and organizational outcomes. Study results, based on a sample of professional salespeople, provide overall support for most of the hypothesized relationships among work-related stressors, personal characteristics, and coping styles. Findings also support the influence of emotion-focused coping on the psychological outcomes of emotional exhaustion and job-induced anxiety; which in turn are found to influence job satisfaction and intention to withdraw. While problem-focused coping had no effect on job-induced anxiety, problem-focused coping did effect emotional exhaustion, which in turn influences job satisfaction and intention to withdraw. Minor differences were found when the proposed model was applied to saleswomen versus salesmen. Overall, however, the model was robust across both genders.     

The centrality of event scale: a measure of integrating a trauma into one's identity and its relation to post-traumatic stress disorder symptoms

We introduce a new scale that measures how central an event is to a person's identity and life story. For the most stressful or traumatic event in a person's life, the full 20-item Centrality of Event Scale (CES) and the short 7-item scale are reliable (alpha's of .94 and .88, respectively) in a sample of 707 undergraduates. The scale correlates .38 with PTSD symptom severity and .23 with depression. The present findings are discussed in relation to previous work on individual differences related to PTSD symptoms. Possible connections between the CES and measures of maladaptive attributions and rumination are considered along with suggestions for future research.     

The self-regulating brain: Cortical-subcortical feedback and the development of intelligent action

To speak of cognitive regulation versus emotion regulation may be misleading. However, some forms of regulation are carried out by executive processes, subject to voluntary control, while others are carried out by “automatic” processes that are far more primitive. Both sets of processes are in constant interaction, and that interaction gives rise to a stream of activity that is both cognitive and emotional. Studying the brain helps us understand these reciprocal regulatory influences in some detail. Cortical activities regulate subcortical activities through executive modulation of prepotent appraisals and emotional responses. Subcortical systems regulate the cortex by tuning its activities to the demands or opportunities provided by the environment. Cortical controls buy us time, as needed for planning and intelligent action. Subcortical controls provide energy, focus, and direction, as needed for relevant emotion-guided behaviour. We review the neural processes at work in both directions of regulatory activity, looking at the anterior cingulate cortex (ACC) as a hub of cortical systems mediating downward control, and discussing limbic, hypothalamic, and brainstem systems that mediate upward control. A macrosystem that displays both directions of control includes the ACC and the amygdala within a feedback circuit whose features vary with clinical-personality differences. Developmental changes in ACC-mediated self-regulation support advances in directed attention, response inhibition, and self-monitoring. Developmental changes in amygdala-mediated self-regulation involve the compilation of meanings that direct thought and behaviour, thus consolidating individual differences over the lifespan. In this way, the capacity to exert voluntary control develops alongside the accumulation of associations that trigger the responses that demand control. The balance between these developmental progressions has implications for personality formation and mental health.     

Losing control in front of a fearful face: The effect of emotional information on cognitive control

How is our cognitive control system modulated by emotional information, especially fearful stimuli? An intuitive hypothesis is that fearful stimuli would enhance cognitive control so that people could switch from the ongoing task to emergent events more quickly to secure themselves. To test this hypothesis, we investigated the influence of emotional information on the shift function of cognitive control by using the task-cueing procedure, in which face images were presented as cues. With the gender of faces indicating which task to do, we manipulated the emotional valence of faces (neutral vs. fearful), finding that the switch costs were larger in the trials containing fearful cues than in the trials containing neutral cues (Experiment 1). This effect was not caused by enlarging task-set interference (Experiment 2), nor by slowing down cue encoding (Experiment 3). Contrary to the intuitive hypothesis, our results suggested that the endogenous task-set reconfiguration process was impaired when fearful faces were presented. We speculated that the benefit of decreasing cognitive flexibility in face of fearful stimuli is to speed up response in a dangerous environment, and this accelerating response is achieved by suppressing the goal-directed system to permit the fast, automatic stimulus-driven system to govern behaviours.     

The role of gratitude in the development of social support, stress, and depression: Two longitudinal studies

In two longitudinal studies, the authors examined the direction of the relationships between trait gratitude, perceived social support, stress, and depression during a life transition. Both studies used a full cross-lagged panel design, with participants completing all measures at the start and end of their first semester at college. Structural equation modeling was used to compare models of direct, reverse, and reciprocal models of directionality. Both studies supported a direct model whereby gratitude led to higher levels of perceived social support, and lower levels of stress and depression. In contrast, no variable led to gratitude, and most models of mediation were discounted. Study 2 additionally showed that gratitude leads to the other variables independently of the Big Five factors of personality. Overall gratitude seems to directly foster social support, and to protect people from stress and depression, which has implications for clinical interventions.     

Stress and coping in mothers caring for a child with severe learning difficulties: A test of Lazarus' transactional model of coping

The literature on psychological stress among women consistently points to the adverse effects of child rearing on mothers, particularly those caring for children with physical or mental handicaps. Early studies of the effects on family functioning of caring for a child with severe learning difficulties adopted a pathological approach in which it was assumed that psychological distress was inevitable among family members, particularly mothers. Recent research has emphasised that many families cope with and adapt to the stress they experience, and seeks to discover how they do so. The paper reports on a study of 166 mothers caring for a child with severe learning difficulties. The aim of the study was to investigate both the factors associated with maternal stress and those which might mediate or buffer the effects of stress. The study used the Folkman and Lazarus' (1979) transactional model of stress. Stress is the condition that results when person/environment transactions lead the individual to perceive a discrepancy between the demands of a situation and his/her resources or ability to cope with those demands. The nature and type of coping generated by a person will be determined by the coping resources in the person's environment. The model identifies five categories of coping resource: utilitarian resources, health/morale, social networks, general and specific beliefs, and problem solving skills. In our study, the five coping resources were represented by the mother's social class and appraisal of her financial worries, physical health, social support, acceptance of and adjustment to the child, and assessment of coping skills. Stress was measured by the Malaise Inventory (Rutter, 1970). Four of the five coping resources were found to be significant contributors in a hierarchical regression analysis of stress scores, contributing additional variance beyond that of behavioural and other child characteristics. Altogether, 55% of the variance in stress scores was explained.     

The impact of hope, self-esteem, and attributional style on adolescents’ school grades and emotional well-being: A longitudinal study

We examined the distinctiveness of three “positive thinking” variables (self-esteem, trait hope, and positive attributional style) in predicting future high school grades, teacher-rated adjustment, and students’ reports of their affective states. Seven hundred eighty-four high school students (382 males and 394 females; 8 did not indicate their gender) completed Time 1 measures of verbal and numerical ability, positive thinking, and indices of emotional well-being (positive affect, sadness, fear, and hostility), and Time 2 measures of hope, self-esteem, and emotional well-being. Multi-level random coefficient modelling revealed that each positive thinking variable was distinctive in some contexts but not others. Hope was a predictor of positive affect and the best predictor of grades, negative attributional style was the best predictor of increases in hostility and fear, and low self-esteem was the best predictor of increases in sadness. We also found that sadness at Time 1 predicted decreases in self-esteem at Time 2. The results are discussed with reference to the importance of positive thinking for building resilience.     

The influence of state and trait affect on HIV risk behaviors: a daily diary study of MSM.

OBJECTIVE: To characterize the influence of state and trait affect on HIV risk behaviors. DESIGN: Men who have sex with men (N = 155) completed reports of trait affect and daily reports of affect and sexual behaviors each night for up to 30 days. MAIN OUTCOME MEASURES: Analyses focused on the role of state and trait positive activation (PA), negative activation (NA), anxious arousal (AA), and sexual activation (SA) on sexual risk taking, operationalized as having a sex partner, a partner-related risk composite, and an HIV risk behavior composite. RESULTS: State SA was positively associated with having a sex partner and HIV risk behaviors; trait SA was positively associated with partner-related risk. State AA was negatively associated with having a sex partner and positively associated with HIV risk behaviors. Trait AA had a negative association with partner-related risk and moderated the effects of state AA. State PA was negatively associated with HIV risk behaviors, and trait PA had a main effect on having a sex partner. NA had no significant trait or state effects. CONCLUSION: These data suggest a role for multiple affective states in sexual risk taking. Models of HIV risk-taking behaviors should be extended to include affective processes.     

Measuring post-traumatic stress: A psychometric evaluation of symptom- and coping questionnaires based on a Norwegian sample

The purpose of this study was to evaluate the psychometric characteristics of the Norweigian versions of the Impact of Event Scale, the Post Traumatic Stress Scale-10 item version and General Coping Questionnaire-30 item version. A group of 40 male and 56 female medical students was tested one week and four months after having started dissection of cadavers for the first time. The results showed that all scales had good internal consistency and test-retest reliability. The student sample scored lower on the IES and PTSS-10 than comparable groups of traumatized subjects. A gender difference emerged, with female subjects scoring higher than male subjects. The factor analysis of the instruments indicated good construct validity for the symptom scales. The analysis of content validity related to DSM IV criteria indicated that the IES and PTSS-10 may have some limitations in their predictive validity of PTSD. Taken together, the three scales have shown good psychometric properties and could be used in future research and clinical work.     

Influence of caregiver burden on the association between daily fluctuations in pleasant activities and mood: A daily diary analysis

Much research has focused on behavioral activation and its effect on depression, but less is known about the effects of leisure activities on the two distinct affective domains of depression: positive affect (PA) and negative affect (NA). Furthermore, individual factors (i.e., stress level) may moderate the impact of behavioral activation on affect. The present study utilized a daily diary approach to examine the moderating effect of stress on the relationship between leisure satisfaction and both PA and NA. Twenty-five dementia caregivers completed activity and affect measures four times daily for 14 days. Results were analyzed using multilevel modeling, an approach that considers intra-individual differences in activity and affect over time. Results supported the hypothesis that caregivers with higher burden display a stronger association between leisure satisfaction and affect than caregivers with lower burden. Specifically, caregivers with higher burden had a stronger positive relationship between leisure satisfaction and PA and a stronger negative relationship between leisure satisfaction and NA. These findings suggest that screening caregivers for level of burden may help identify those most likely to benefit from behavioral interventions.     

The influence of trait affect and the five-factor personality model on impulse buying

Research into the influence of affect on impulse buying has to date produced contradictory results, partly due to confusion between the potentially discrete influences of, respectively, state and trait affect. Additionally, studies on how the five-factor personality model’s dimensions influence impulse buying have also produced contradictory results. Moreover, while the established link between trait affect and personality suggests dimensions of this latter could account for whatever influence the former has on impulse buying, no study has yet attempted to examine this possibility. We draw on self-regulation theory to examine three unanswered questions: (1) the extent to which trait affect influences impulse buying whilst controlling for state affect; (2) establish which dimensions of the five-factor personality model predict impulse buying; and (3) test whether or not any influence of trait affect on impulse buying is additive to the effects of the five-factor personality model. Analyses of cross-sectional data (n = 842) find that trait affect does have a significant (p < .05) influence on impulse buying controlling for state affect, but that this influence is fully accounted for by the five-factor personality model (p < .001), the extraversion, conscientiousness and neuroticism dimensions of which are found consistently to predict impulse buying.