Event centrality prospectively predicts PTSD symptoms

Background: Recent evidence suggests that event centrality has a prominent association with post-traumatic stress disorder (PTSD) symptoms. However, evidence for this notion thus far has been mostly correlational. We report two studies that prospectively examined the relationship between event centrality and PTSD symptoms. Study 1 Methods: Participants (N?=?1438) reported their most stressful event (“prior event”), along with event centrality, PTSD symptoms, and neuroticism. At Time 2 participants reported their most stressful event since Time 1 (“critical event”), along with measures of event centrality and PTSD symptoms. Study 1 Results: Event centrality for the critical event predicted PTSD symptoms, after controlling for event centrality and PTSD symptoms of the prior event and neuroticism. Study 2 Methods: In the second study (N?=?161) we examined changes in event centrality and PTSD symptoms over a month. Study 2 Results: Using a cross-lagged panel design, results revealed event centrality at Time 1 significantly predicted PTSD symptoms at Time 2, but the reverse was not significant. Conclusions: In two studies, a prospective association between event centrality and PTSD symptoms, but not the reverse, emerged. This evidence implicates event centrality in the pathogenesis and/or maintenance of PTSD symptoms.     

Pretrauma Neuroticism, Negative Appraisals of Intrusions, and Severity of PTSD Symptoms

Earlier studies found that self-reported posttraumatic stress disorder (PTSD) symptoms are correlated with negative appraisals of symptoms and with neuroticism. It is unclear whether the latter two are associated. Possibly, an overarching trait such as neuroticism mediates the relationship between PTSD symptoms and negative appraisals of symptoms. Data from a previous study (see I. M. Engelhard, M. A. van den Hout, M. Kindt, A. Arntz, & E. Schouten, 2003) were used in the present effort to address these issues. Neuroticism scores were obtained from 1,372 pregnant women. One hundred and twenty-six women experienced a pregnancy loss, and 117 of them were assessed for PTSD symptoms and negative appraisals of symptoms. The 3 variables of interest were all significantly correlated. The data indicate that negative appraisals of symptoms explain and predict PTSD symptoms independently of neuroticism.     

Event centrality and posttraumatic outcomes in the context of pervasive violence: a study of teachers in El Salvador

It is well established that the importance assigned to a trauma can affect one's recovery and psychological health in numerous ways. Event centrality is an increasingly popular construct that captures the tendency among survivors to reevaluate and possibly accommodate their worldviews posttrauma. The centrality given to trauma appears to serve as a “double-edged sword” in that this construct might factor prominently in both posttraumatic stress disorder (PTSD) and posttraumatic growth (PTG). Focusing on 257 violence-exposed teachers from educational departments throughout El Salvador, we examined whether the centrality assigned by the teachers to stressful life events uniquely predicted both PTSD symptomatology and PTG. Results revealed that event centrality was positively related to both PTSD and PTG, even when controlling for demographic factors, violence exposure, and depression. In addition, PTSD symptomatology and PTG were not associated with one another in this sample. In summary, these findings support the role of event centrality as a contributing factor for PTSD and PTG among persons exposed to pervasive trauma.     

Individuals high in neuroticism are not more reactive to adverse events

Numerous studies have related neuroticism to negative emotional outcomes of adverse life events, including post-traumatic stress disorder (PTSD) symptoms. However, the nature of the relationship between neuroticism and post-trauma symptoms is unclear. The purpose of this study was to prospectively examine whether individuals high in neuroticism, relative to low neuroticism individuals, show a larger increase in symptoms after an adverse event. A sample of infantry troops completed questionnaires before deployment to Iraq (n = 214) and about five months (n = 170; 76%) thereafter. The findings showed that, after controlling for an indicator of trauma severity, (a) higher neuroticism individuals reported more PTSD symptoms, depression symptoms, and somatic problems after negative events, and (b) these relationships disappeared after controlling for pre-trauma symptoms. There were no significant differences between individuals high and low in neuroticism in the increase in symptoms from pre to post-trauma. This suggests that individuals high in neuroticism are not more reactive to adverse events.     

I Am > Trauma: Experimentally Reducing Event Centrality and PTSD Symptoms in a Clinical Trial

Event centrality has been one of the strongest predictors of PTSD symptoms. We attempted to experimentally reduce event centrality using a modified version of Acceptance and Commitment Therapy (ACT) in a sample of traumatized participants from a community outreach center. Relative to a control group, participants who received ACT evidenced significant decreases in PTSD symptoms, depression, and event centrality. A mediation analysis revealed that the effect of condition on PTSD symptoms was mediated by decreases in event centrality. Only the effect of condition on depression was still significant at six weeks posttreatment. This study is the first to manipulate event centrality and suggests that components of ACT may be effective at reducing event centrality.     

A double‐edged sword: Event centrality,PTSD and posttraumatic growth

Previous research has demonstrated negative mental health consequences (including PTSD symptoms) of construing a potentially traumatic event as central to one's identity. In the current paper, we replicated an association between event centrality and PTSD symptoms. We also found event centrality similarly predicts posttraumatic growth (PTG) even after controlling for PTSD symptoms, depression, DSM‐IV A1 and A2 status of the event, coping styles and cognitive processing of the event. Because predictive relationships between event centrality and PTSD symptoms, as well as event centrality and PTG were positive, construing an event as central to one's identity can indeed become a double‐edged sword, allowing for both debilitation and growth. Copyright © 2010 John Wiley & Sons, Ltd.     

Neuroticism and self-criticism associated with posttraumatic stress disorder in a nationally representative sample

Broad and specific psychological traits may uniquely differentiate trauma victims with PTSD from trauma victims without PTSD, but there is a need for representative, population-based research. We investigated elevated neuroticism and self-criticism in association with the presence versus absence of PTSD in a nationally representative sample of adults who experienced a traumatic stressor. Respondents were from the National Comorbidity Survey Part II (N=5877) (). Individuals who experienced one or more traumatic events were selected (N=3238). In separate regression analyses, elevated levels of neuroticism and self-criticism were each significantly associated with PTSD among men and women who had experienced one or more traumatic events. After controlling for types of traumas experienced and other previously identified factors (Bromet, Sonnega, & Kessler, 1998. American Journal of Epidemiology, 147, 353-361), neuroticism remained significantly associated with PTSD in women and both neuroticism and self-criticism remained significant in men. Evidence from this nationally representative sample of adults who experienced traumatic events suggests that self-criticism and especially the broad personality domain of neuroticism may represent robust psychological dimensions associated with the presence of PTSD.     

Memory in posttraumatic stress disorder: properties of voluntary and involuntary, traumatic and nontraumatic autobiographical memories in people with and without posttraumatic stress disorder symptoms

One hundred fifteen undergraduates rated 15 word-cued memories and their 3 most negatively stressful, 3 most positive, and 7 most important events and completed tests of personality and depression. Eighty-nine also recorded involuntary memories online for 1 week. In the first 3-way comparisons needed to test existing theories, comparisons were made of memories of stressful events versus control events and involuntary versus voluntary memories in people high versus low in posttraumatic stress disorder (PTSD) symptom severity. For all participants, stressful memories had more emotional intensity, more frequent voluntary and involuntary retrieval, but not more fragmentation. For all memories, participants with greater PTSD symptom severity showed the same differences. Involuntary memories had more emotional intensity and less centrality to the life story than voluntary memories. Meeting the diagnostic criteria for traumatic events had no effect, but the emotional responses to events did. In 533 undergraduates, correlations among measures were replicated and the Negative Intensity factor of the Affect Intensity Measure correlated with PTSD symptom severity. No special trauma mechanisms were needed to account for the results, which are summarized by the autobiographical memory theory of PTSD.     

震后儿童创伤后应激障碍的症状网络演化

本研究借助网络分析方法,探讨儿童创伤后应激障碍(PTSD)症状的演化规律。以经历汶川地震的197名儿童为研究对象,在灾后4、29、40和52个月对其PTSD症状进行了历时4年的追踪测量。网络分析结果显示,闪回的中心性一直较高,而其他高中心性的症状随时间的推移发生了变化：侵入性想法和创伤线索引发生理性反应的中心性随时间推移呈上升趋势,线索引发情感反应和未来无望的中心性随时间推移呈下降趋势。本研究拓宽了学界对儿童PTSD症状学的认识, 并为建立灾后阶段性干预模式提供启示。     

What role does neuroticism play in the association between negative job characteristics and anxiety and depression?

Many studies have established an association between job characteristics and anxiety and depression and noted that personality characteristics such as neuroticism likely play a role in creating or modifying these associations. Few studies, however, have explicitly tested or compared these possible alternative roles. In this study, we tested several specific hypotheses about neuroticism and its effects on job characteristics, anxiety and depression and their association in a series of structural equation models. Participants (N = 372) completed the Big Five Inventory, Job Contents Questionnaire and General Health Questionnaire. We tested (a) whether neuroticism is likely to be an important confounder of the association between job characteristics and anxiety and depression and (b) whether neuroticism moderates the association between job characteristics and anxiety and depression. Results indicated large attenuations by neuroticism of the association between job characteristics and anxiety and depression but there remained significant effects of psychological demands on anxiety, and social support on depression independent of neuroticism. Evidence was also found for interaction effects between neuroticism and decision latitude, with those lower in neuroticism being at higher risk for depression under conditions of low control.     

A Comparison of Multidimensional Health Profiles across Three Trauma-Exposed Diagnostic Groups

Posttraumatic stress disorder has been associated with adverse health outcomes. The extent to which the health effects of PTSD differ from other diagnoses has not been explored empirically. The current study investigated the Multidimensional Health Profile (including both Psychosocial and Health factors), across three diagnostic groups and one group of well-adjusted participants (N = 92) in a contrasted-groups design. Participants were all trauma-exposed and were assessed using structured clinical interviews. The PTSD and depression groups tended to differ from the social phobia and well-adjusted groups. Both the PTSD and depression groups demonstrated elevated profiles on variables assessing psychological distress, negative social exchange, and hypochondriasis. Results are consistent with prior research suggesting PTSD is associated with worse psychological and health functioning relative to trauma-exposed individuals without PTSD, although these health outcomes seem to differ little between those with PTSD and those with depression.     

Younger adults report more distress and less well-being: A cross-cultural study of event centrality,depression, post-traumatic stress disorder and life satisfaction

The extent to which highly emotional autobiographical memories become central to one's identity and life story influences mental health. Young adults report higher distress and lower well-being, compared with middle-aged and/or older adults; whether this replicates across cultures is still unclear. First, we provide a review of the literature that examines age-differences in depression, post-traumatic stress disorder (PTSD), and life satisfaction in adulthood across cultures. Second, we report findings from a cross-cultural study that examined event centrality of highly positive and negative autobiographical memories along with symptoms of depression and PTSD, and levels of life satisfaction in approximately 1000 young and middle-aged adults from Mexico, Greenland, China and Denmark. Both age groups provided higher centrality ratings to the positive life event; however, the relative difference between the ratings for the positive and negative event was smaller in the young adults. Young adults reported significantly more distress and less well-being across cultures.     

Links between neuroticism,emotional distress,and disengaging attention: Evidence from a single-target RSVP task

Anxiety and depression are often associated with attention control deficits, but few studies have explored whether neuroticism can account for these links. In the present study, undergraduate students (n=146) completed self-report measures of neuroticism, worry, anxious arousal, and anhedonic depression and also completed a visual attention task in which they were asked to identify a red target letter embedded within a rapid sequence of items. Neuroticism was associated with detection of the target when it was preceded by a distracter with which it shared a feature in common (a green letter). Specifically, these distracters produced longer attentional blinks in individuals with elevated levels of neuroticism. In contrast, target detection was not significantly associated with worry, anxious arousal, or anhedonic depression. We discuss the implications of this link between neuroticism and attention for cognitive models of emotional distress and disorders.     

Autobiographical memory for shame or guilt provoking events: Association with psychological symptoms

The diagnostic criteria for posttraumatic stress disorder (PTSD) specify that a qualifying traumatic stressor must incite extreme peritraumatic fear, horror, or helplessness. However, research suggests that events inciting guilt or shame may be associated with PTSD. We devised a web-based survey in which non-clinical participants identified an event associated with shame or guilt and completed questionnaire measures of shame, guilt, PTSD, and depression. In addition, we assessed characteristics of memory for the event, including visual perspective and the centrality of the memory to the participant’s autobiographical narrative (CES). Shame predicted depression and PTSD symptoms. There was no association between guilt and psychological symptoms after controlling statistically for the effects of shame. CES predicted the severity of depression and PTSD symptoms. In addition, CES mediated the moderating effect of visual perspective on the relationship between emotional intensity and PTSD symptoms. Our results suggest shame is capable of eliciting the intrusive and distressing memories characteristic of PTSD. Furthermore, our results suggest aversive emotional events are associated with psychological distress when memory for those events becomes central to one’s identity and autobiographical narrative.     

Predictors of suicidal thoughts: Mood instability versus neuroticism

The personality trait neuroticism predicts depression and suicidal thoughts. Neuroticism is also linked to mood instability (MI)¹ that is common in patients with depression. This study investigated (a) whether MI predicts suicidal thoughts in depressed patients and (b) the relationship of MI to neuroticism. All 129 patients with Major Depression (MINI interview) were assessed on MI (Affective Lability Scale), neuroticism (Short Eysenck Neuroticism Scale), depression (Beck Depression Inventory), and suicidal thoughts (Beck Scale for Suicidal Ideation). Participants also completed the Perceived Stress Scale, Mood Disorder Questionnaire and five clinical questions on MI. Factor analysis of the Eysenck Neuroticism Scale revealed unstable moods as one of three main factors. Only depression severity and MI predicted suicidal thoughts once other variables including neuroticism were controlled. Mediation analyses showed that MI mediated the relationship between neuroticism and suicidal thoughts. These results suggest that MI as measured by the Affective Lability Scale typifies the type of depression that predicts suicidal thoughts and that MI may be more directly associated with suicidal thoughts than neuroticism. This demonstrates the clinical value of assessing MI rather than neuroticism in the treatment of patients with depression with suicidal thoughts.     

Trauma as an objective or subjective experience: The association between types of traumatic events,personality traits,subjective experience of the event,and posttraumatic symptoms

The study aimed to examine the discrete effect of objective (type of trauma and demographic characteristics) and subjective (proximity to the trauma, subjective experience of the trauma as a threat, the Big Five personality traits, and dissociative symptoms) factors on the risk for PTSD among 1,210 undergraduate students. The findings indicate that survivors of physical/sexual assault scored the highest on proximity to the trauma, subjective experience of the trauma as a threat, neuroticism, dissociation, and PTSD symptoms. In addition, subjective experience of the trauma, proximity to it, type of trauma, dissociation, and neuroticism were associated with the risk for PTSD symptoms. The findings point to the significance of both subjective and objective variables in the risk for PTSD symptoms.     

Symptoms of Post-Traumatic Stress Disorder in Bereaved Children and Adolescents: Factor Structure and Correlates

This study investigated the factor structure and correlates of posttraumatic stress-disorder (PTSD) symptoms among children and adolescents confronted with the death of a loved one. Three hundred thirty-two bereaved children and adolescents (aged 8–18; 56.9 % girls) who all received some form of psychosocial support after their loss, completed self-report measures of PTSD, together with measures tapping demographic and loss-related variables, depression, prolonged grief, and functional impairment. Parent-rated indices of impairment were also collected. We first evaluated the fit of six alternative models of the factor structure of PTSD symptoms, using confirmatory factor analyses. Outcomes showed that the 4-factor numbing model from King et al. (Psychological Assessment 10, 90–96, 1998), with distinct factors of reexperiencing, avoidance, emotional numbing, and hyperarousal fit the data best. Of all participants, 51.5 % met DSM-IV criteria for PTSD. PTSD-status and scores on the PTSD factors varied as a function of age and gender, but were unrelated to other demographic and loss-related variables. PTSD-status and scores on the PTSD factors were significantly associated symptom-levels of depression, prolonged grief, and functional impairment. Findings complement prior evidence that the DSM-IV model of the factor structure of PTSD symptoms may not represent the best conceptualization of these symptoms and highlight the importance of addressing PTSD symptoms in children and adolescents seeking help after bereavement.     

Role of event centrality and emotion regulation in posttraumatic stress disorder symptoms among internally displaced persons

Background: Event centrality and emotion regulation in relation to posttraumatic stress disorder (PTSD) have been documented in various global samples especially in Western cultures; but internally displaced persons (IDPs) still constitute an underrepresented population in psychotraumatology literature. This study tested the roles of event centrality and emotion regulation strategies (cognitive reappraisal and expressive suppression) in PTSD symptoms among IDPs in Nigeria.

Design: The multi-group cross-sectional design was adopted.

Methods: Tiv language versions of the Centrality of Events Scale, Emotion Regulation Questionnaire, and Harvard Trauma Questionnaire were completed by 859 IDPs in two camps located in Benue State, North-central region of Nigeria.

Results: Hierarchical multiple linear regression results indicated that event centrality positively predicted PTSD symptoms. Cognitive reappraisal was a negative predictor of PTSD symptoms while expressive suppression was a positive predictor of PTSD symptoms. Bonferroni corrections indicated that expressive suppression was the strongest predictor of total PTSD symptoms, avoidance/numbing symptoms, and hyper-arousal symptoms; but event centrality was the most robust predictor of PTSD intrusion/re-experiencing symptoms.

Conclusion: The findings underscore recent developments in psychotraumatology indicating that the extent to which individual differences impact the development of PTSD is essential in clinical psychology research and practice.     

Links between neuroticism, emotional distress, and disengaging attention: evidence from a single-target RSVP task

Anxiety and depression are often associated with attention control deficits, but few studies have explored whether neuroticism can account for these links. In the present study, undergraduate students (n=146) completed self-report measures of neuroticism, worry, anxious arousal, and anhedonic depression and also completed a visual attention task in which they were asked to identify a red target letter embedded within a rapid sequence of items. Neuroticism was associated with detection of the target when it was preceded by a distracter with which it shared a feature in common (a green letter). Specifically, these distracters produced longer attentional blinks in individuals with elevated levels of neuroticism. In contrast, target detection was not significantly associated with worry, anxious arousal, or anhedonic depression. We discuss the implications of this link between neuroticism and attention for cognitive models of emotional distress and disorders.