The role of psychological defences in moderating between trauma and post‐traumatic symptoms among Palestinian men

Psychological defences are conceptualized as protective processes that help individuals to maintain their integrity in the face of threat and danger. Accordingly, their role in defending trauma victims from post‐traumatic symptoms was examined. The sample consisted of 128 Palestinian male political ex‐prisoners who had reported various degrees of torture and ill‐treatment. The first aim was to analyze the dimensionality and distribution of different defence mechanisms. The second was to examine which defences would moderate the association between the reported torture and ill‐treatment and the post‐traumatic symptoms (PTS). Third, the direct associations between reported torture and ill‐treatment and defences and between the defences and symptoms were explored. Defence mechanisms were assessed by a 40‐item version of the Defense Style Questionnaire (DSQ), and Post‐traumatic symptoms by the Harvard Trauma Questionnaire (HTQ), and experiences of torture and ill‐treatment by a scale developed for that purpose. The results show, first, that the men used predominantly mature defences such as anticipation, sublimation, suppression, and rationalization, but also relatively frequently somatization and dissociation, which are characteristic responses among trauma victims. Second, the principal component analysis revealed four defence dimensions, differentiated by the level of maturity and the approach to reality: the mature reality‐based, the consciousness‐limiting, the immature reality‐escaping, and the immature reality‐distorting defences. Third, against our hypothesis, the moderating analyses indicated that the reported torture and ill‐treatment were relatively more associated with vigilance, avoidance, and intrusion symptoms if men used consciousness‐limiting defences. Yet as expected, the mature reality‐based defences did not show a protective effect. Furthermore, a high level of reported torture and ill‐treatment was associated with a low level of the mature reality‐based defences, but not with a high level of immature defences. Last, similarly to earlier studies, the immature reality‐distorting and immature reality‐escaping defences associated directly with high, and mature reality‐based defences with low, levels of PTS‐symptoms.     

Difficult temperament predicts self‐esteem in adolescence

A six‐year longitudinal study investigated the impact of maternal hostile child‐rearing attitudes, role dissatisfaction, and maternal perceptions of adolescent temperamental difficultness on self‐esteem in late adolescence, after controlling for the initial self‐esteem measured in early adolescence. Adolescents (n = 313), derived from the Cardiovascular Risk in Young Finns study, rated their self‐esteem at the study entry at age 12, and six years later at age 18. Maternal reports of child‐rearing attitudes, of role satisfaction, and of the temperament of the adolescent were obtained at the study entry and three years later. Mother's perceptions of adolescent's temperament as difficult at ages 12 and 15 predicted adolescent's self‐reported self‐esteem in late adolescence, whereas earlier self‐esteem did not predict later perceptions of temperament or parenting. We found no evidence that maternal perceptions of parenting indirectly, or after controlling for the initial level, predicted adolescent's self‐reported self‐esteem. Copyright © 2002 John Wiley & Sons, Ltd.     

Transactional development of parent personality and child temperament

Stability and change in parental extraversion and neuroticism were studied in transaction with their views of their child's temperament from the age of six months to the age of five‐and‐a‐half years in 109 mother–father–child triads (parent–daughter: n = 61, parent–son: n = 48). While parental traits showed high stability, infants' higher positive affectivity predicted an increase in parental extraversion over 5 years, and infant's higher activity predicted a decrease in parental neuroticism. Parent‐rated temperament showed expected heterotypic continuity. Initially higher parental extraversion predicted an increase in the child's effortful control, and higher parental neuroticism predicted an increase in the child's negative affectivity. The results indicate that parental personality and child temperament develop in transaction promoting change in each other. Copyright © 2008 John Wiley & Sons, Ltd.     

Maternal perceptions and adolescent self-esteem: a six-year longitudinal study

A six-year longitudinal study investigated the development of self-esteem in relation to mother's child-rearing attitudes, role satisfaction, and perceived temperament of the child. Participants were two age cohorts of girls and boys from the Cardiovascular Risk in Young Finns study, being 6 (n = 416) and 9 years old (n = 408) at the beginning of the study (baseline). Scores regarding mother's hostile child-rearing attitudes, mother's low role satisfaction, and maternal perceptions of child's difficult temperament (high activity, negative emotionality, and low cooperativeness) were obtained at baseline and three years later. Self-esteem was measured by self-reports six years later, at the ages of 12 and 15. The results indicated considerable gender differences. Among girls nearly all childhood variables individually predicted self-esteem, whereas among boys the associations were less evident. Additionally, perceived difficult temperament at baseline predicted hostile child-rearing attitudes at first follow-up, which further predicted low self-esteem among girls only.     

Internet-provided cognitive behaviour therapy of posttraumatic stress symptoms following childbirth—a randomized controlled trial

The aim of this study was to analyse the effects of trauma-focused guided Internet-based cognitive behaviour therapy for relieving posttraumatic stress disorder (PTSD) symptoms following childbirth, a problem that about 3% women encounter postpartum. Following inclusion, 56 traumatized women were randomized to either treatment or to a waiting list control group. Primary outcome measures were the Traumatic Event Scale (TES) and Impact of Event Scale—Reversed (IES-R). Secondary measures were Beck depression inventory II, Patient Health Questionnaire (PHQ-9), Beck Anxiety Inventory, Quality Of Life Inventory and the EuroQol 5 Dimensions. The treatment was guided by a clinician and lasted eight weeks and comprised eight modules of written text. The between-group effect size (ES) was d = .82 (p < .0001) for the IES-R. The ES for the TES was small (d = .36) and not statistically significant (p = .09). A small between-group ES (d = .20; p = .02) was found for the PHQ-9. The results from pre- to post-treatment showed large within-group ESs for PTSD symptoms in the treatment group both on the TES (d = 1.42) and the IES-R (d = 1.30), but smaller ESs in the control group from inclusion to after deferred treatment (TES, d = .80; IES-R d = .45). In both groups, the treatment had positive effects on comorbid depression and anxiety, and in the treatment group also on quality of life. The results need to be verified in larger trials. Further studies are also needed to examine long-term effects.     

Psychometric properties of the screen for child anxiety related emotional disorders (SCARED) among elementary school children in Finland

Anxiety disorders are the most common mental disorders in children and youth. Effective screening methods are needed to identify children in need of treatment. The Screen for Child Anxiety Related Emotional Disorders (SCARED) questionnaire is a widely used tool to assess childhood anxiety. We aim toevaluate the psychometric properties of the SCARED questionnaire, test the SCARED factor structure, and evaluate the prevalence of anxiety symptoms in a community sample of Finnish elementary school children, based on both a child and parent report. The sample included all pupils (n = 1,165) in grades 2 through 6 (ages 8–13) in four elementary schools in the city of Turku, Finland. Children completed a Finnish translation of the SCARED questionnaire at school, with one parent report questionnaire per child completed at home. In total, 663 child‐parent dyads (56.9%) completed the questionnaire. Internal consistency was high for both child and parent reports on all subscales (0.71–0.92), except for school avoidance (0.57 child, 0.63 parent report). Inter‐rater reliability ranged from poor to fair across subscales (intraclass correlation 0.27–0.47). Self‐reported anxiety scores were higher than the parent reported scores. Females had significantly higher total scores than males based on the child reports (p = 0.003), but not the parent reports. In the confirmatory factor analysis, hypothesized models did not have a good fit with the data, and modification was needed. The Finnish SCARED questionnaire has good internal consistency. Low child‐parent agreement calls for the importance of including both child and parental reports in the assessment of anxiety symptoms.     

Do Dispositional Pessimism and Optimism Predict Ambulatory Blood Pressure During Schooldays and Nights in Adolescents?

We tested the hypotheses that (1) high pessimism and low optimism (LOT-R overall and subscale scores) would predict high ambulatory blood pressure (ABP) level and 24-hour load (percentage of ABP values exceeding the pediatric 95th percentile) among healthy Black and White adolescents (n=201; 14-16 yrs) across 2 consecutive school days and (2) that the relationships for the pessimism and optimism subscales would show nonlinear effects. The hypotheses were confirmed for pessimism but not for optimism. The results suggest that high pessimism may have different effects than low optimism on ABP and that even moderate levels of pessimism may effect blood pressure regulation. These results suggest that optimism and pessimism are not the opposite poles on a single continuum but ought to be treated as separate constructs.     

Association between socioeconomic status and metabolic syndrome in women: testing the reserve capacity model

OBJECTIVE: Low socioeconomic status (SES) environments may impede the development of a bank of resources, labeled reserve capacity, and may also be stressful, thereby depleting available reserves. In consequence, lower SES persons may experience more negative emotions, leading to adverse health consequences. The authors tested the reserve capacity model in relation to the metabolic syndrome. DESIGN: There were 401 initially healthy women who followed longitudinally for 12 years. Self-reported characteristics, stressors, and cardiovascular risk factors were measured repeatedly. Structural equation modeling was used to evaluate hypothesized relationships. MAIN OUTCOME MEASURE: Metabolic syndrome factor. RESULTS: Confirmatory factor analysis verified reserve capacity as the aggregate of optimism, self-esteem, and social support, and negative emotion as the aggregate of depressive symptoms, anger, and tension. Structural equation modeling showed two pathways to the metabolic syndrome factor, (chi2(59) = 111.729, p < .0001 chi2/df = 1.894; CFI = .956; RMSEA = .047): direct from low SES to the metabolic syndrome factor (B = -0.19, t = -3.24, p = .001); and indirect, from low SES to low reserve capacity to high negative emotions to the metabolic syndrome factor (B = -0.024, t = -2.05, p = .04). CONCLUSION: Low SES may increase risk for metabolic syndrome, in part, through reserve capacity and negative emotions.     

Adolescent temperament,perceived social support,and depressive tendencies as predictors of depressive tendencies in young adulthood

A 5 year longitudinal study investigated the interrelations of temperament dimensions (negative emotionality, activity, and sociability), perceived social support (friend, significant other, and family support), and depressive tendencies. Temperament (EASTS; Buss, 1991), perceived social support (PSS‐R; Blumenthal, Burg, Barefoot, Williams, Haney and Zimet, 1987) and depressive tendencies (a modified version of the BDI) were measured by self‐reports in a randomly selected, community‐based sample of 302 adolescents at age 15, and depressive tendencies were measured again five years later at age 20. The authors hypothesized a model comprising direct as well as mediated effects between the adolescent predictor variables and depressive tendencies in young adulthood. The structural modelling analyses supported these hypotheses in part, and also indicated some qualitative sex differences. For both girls and boys, a significant direct as well as mediating role was indicated for the current level of depressive tendencies: depressive tendencies at age 15 predicted depressive tendencies at age 20, also mediating the effects of negative emotionality at age 15, and additionally mediating the effects of a low level of activity in girls and a low level of family support in boys. Furthermore, even when the prior level of depressive tendencies was controlled, direct effects were indicated in boys for a low level of sociability, and in girls for significant other support, which also mediated the effects of a low level of sociability. These results highlight the importance of the sex‐differentiated interplay of both intrapersonal and psychosocial factors in relation to depressive tendencies both during adolescence and from adolescence to young adulthood. Copyright © 1999 John Wiley & Sons, Ltd.