Are Individuals Always Aware of Their Trauma-Related Intrusive Thoughts? A Study of Meta-Awareness

Individuals are not always aware of their mental content. We tested whether lack of awareness occurs in those who have experienced trauma, with and without posttraumatic stress disorder (PTSD). We also examined the role of proposed cognitive mechanisms (working memory and inhibition) in explaining unnoticed intrusions. Individuals with PTSD (n = 44), and varying levels of symptoms (high posttraumatic stress [PTS]: n = 24; low PTS: n = 37) reported on intrusive thoughts throughout a reading task. Intermittently, participants responded to probes about whether their thoughts were trauma related. Participants were “caught” engaging in unreported trauma-related thoughts (unnoticed intrusions) for between 24 and 27% of the probes in the PTSD and high PTS groups, compared with 15% of occasions in the low PTS group. For trauma-related intrusions only, participants lacked meta-awareness for almost 40% of probes in the PTSD group, which was significantly less than that observed in the other groups (～60%). Contrary to predictions, working memory and response inhibition did not predict unnoticed intrusions. The results suggest that individuals who have experienced significant trauma can lack awareness about the frequency of their trauma-related thoughts. Further research is warranted to identify the mechanisms underpinning the occurrence of unnoticed intrusions.     

Interactive effects of social network centrality and social identification on stress

The present study aimed to integrate the social identity approach to health and well-being with social network analysis. Previous research on the effects of social network centrality on stress has yielded mixed results. Building on the social identity approach, we argued that these mixed results can be explained, in part, by taking into account the degree to which individuals identify with the social network. We hence hypothesized that the effects of social network centrality on stress are moderated by social identification. Using a full roster method, we assessed the social network of first-year psychology students right after the start of their study programme and three months later. The effects of network centrality (betweenness, closeness, eigenvector centrality) and social identification on stress were examined using structural equation models. As predicted, our results revealed a significant interaction between network centrality and social identification on stress: For weakly or moderately identified students, network centrality was positively related to stress. By contrast, for strongly identified students, network centrality was unrelated to stress. In conclusion, our results point to the perils of being well-connected yet not feeling like one belongs to a group.     

Trauma exposure and post-traumatic stress symptoms among Syrian refugee youth in Jordan: Social support and gender as moderators

This study assessed relations between exposure to trauma and post-traumatic stress (PTS) symptoms, and whether perceived social support from family and friends and gender moderated these associations. Syrian refugee youth (N = 418, 55.0% female) attending public schools in Jordan participated. Boys reported more age-adjusted PTS symptoms than girls. Analyses revealed that family support and gender moderated the association of trauma on PTS symptoms. For males, the benefits of family support were most evident under conditions of high traumatic stress exposure, while for females, benefits of family support were evident when no loss or injury to family members had been reported. Support from friends was not helpful for either gender. School- or family-based interventions designed to treat PTS symptoms need to consider the different needs of boys and girls, particularly within the Syrian Muslim cultural context.     

The contribution of school experience to students' resilience following a terror-related homicide

Schools have a significant effect on students' development, and serve as important social agencies for interventions for students facing disasters. However, little is known about the effect of students' school experience itself on their resilience when facing extreme negative events. The present study focused on students who were exposed to terror-related homicide with the aim of investigating the contribution of school climate resources to their resilience. Since resilience is associated not only with fewer negative outcomes, but also with positive change, the contribution of schools was studied as both inhibiting post-traumatic stress symptoms (PTS) and enhancing post-traumatic growth (PTG). A mixed-methods research design was used. The participants included 117 (52% girls) high school students (mean age = 14.54; SD = 1.49). Twenty-five of them were interviewed in addition to responding to the research questionnaires. Different aspects of the school climate were found to be associated with students' PTS and PTG, yielding two overarched factors explaining the school's role as a protective resource: sheltering and supporting. The former is associated with fewer PTS and the latter with higher PTG. The use of different resources for different forms of resilience is discussed.     

Resting autonomic activity in adults who stutter and its association with self-reports of social anxiety

PurposeThe purpose of this study was to investigate resting autonomic activity in adults who stutter (AWS) compared to adults who do not stutter (ANS) and the relationship this has on self-reports of social anxiety.MethodsThirteen AWS and 15 ANS completed the Social Interaction Anxiety Scale (SIAS; Mattick & Clark, 1998) and Brief Fear of Negative Evaluation (BFNE; Leary, 1983). Following this, measures of skin conductance levels (i.e. index of sympathetic activity) and respiratory sinus arrhythmia (i.e. index of parasympathetic activity) were taken during a 5-minute resting, baseline period. Independent sample t tests were used to assess differences between groups on self-reports of anxiety (SIAS, BFNE) and resting autonomic levels (SCL, RSA). Separate multiple regression analyses were performed in order to assess the relationship between self-reports of anxiety and autonomic measures.ResultsResults showed significantly higher mean SCL and lower mean RSA levels in the AWS compared to the ANS at resting, baseline. Regression analysis showed that self-reports from the SIAS had a significant effect on RSA levels for the AWS but not the ANS. No significant effects were found for BFNE on RSA. Nor was there a significant effect from SIAS or BFNE on SCL levels for either group.ConclusionFindings suggest that resting RSA levels may be a physiological marker for social anxiety levels in adults who stutter.     

La psychothérapie assistée par la MDMA dans la prise en charge du syndrome de stress post-traumatique

Posttraumatic stress disorder (PTSD) is estimated to remain chronic and severe for 25–50% of patients despite psychotherapeutic treatment. Part of the reasons is that patients with PTSD can have difficulties in establishing a good therapeutical alliance with the therapist. Moreover, they often fail to re-think the content of the trauma without being overwhelmed by negative emotions and tend to rely on avoidance strategies and/or to abandon the therapy. MDMA (“ecstasy”) is a drug classified as an entactogen (en “within”, tactus “touch”, and gen “produce”), an amphetamine with psychedelic properties that possesses psychopharmacological properties to overcome these issues. Indeed, MDMA triggers the release of oxytocin, which favors the establishment of interpersonal relationship based on kindness and trust. Moreover, MDMA diminishes the activity of the amygdale, allowing patients to work on challenging memories with less fear and anxiety. Finally, MDMA may also provide access to meaningful spiritual experiences, release of tensions and a sense of healing on a non-verbal level that are not completely understood. But are viewed as important by patients. Today, there is no evidence that the use of MDMA in a clinical setting has bad neurologic, psychological or cognitive consequences. Results of phase II trials in the United States and Europe confirm that MDMA favors psychotherapy's outcome without severe adverse effects. Phase III trials are underway. The Multidisciplinary Association for Psychedelic Studies (MAPS) has published online a method proposal and trains therapists in MDMA-assisted psychotherapy.ConclusionFood and Drug Administration (FDA) and European Medicines Agency (EMA) could approve this therapeutic tool in the coming years.     

Conducting Prolonged Exposure for PTSD During the COVID-19 Pandemic: Considerations for Treatment

The unprecedented effects and duration of the COVID-19 crisis are likely to elevate the population’s level of anxiety due to psychological stress, economic hardship, and social isolation. This effect may be especially potent for individuals with preexisting mental health conditions, such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) therapy is a highly effective treatment for PTSD across trauma-exposed populations, and has been implemented effectively via telehealth. Nevertheless, PE implementation via telehealth may require specific adaptations during the COVID-19 crisis due to public health mandates calling for sheltering in place and physical distancing. This paper discusses strategies for implementing PE for PTSD during the COVID-19 pandemic, which may also be applied to other situations in which physical distancing must be considered.     

即刻消退缺损的原因分析及其神经生物学机制

即刻消退缺损(immediate extinction deficit, IED)是指在条件性恐惧习得后, 立即进行的消退训练不能长期抑制恐惧记忆的现象。IED可能与消退起始时的应激水平和事件分割等因素有关。在高应激水平下, 消退记忆的巩固受损导致IED; 而在中等或较低的应激水平条件下, 即刻消退有效但效果可能容易受事件分割的影响。IED的神经生物学机制涉及应激激活蓝斑去甲肾上腺素能系统, 去甲肾上腺素引起杏仁核基底外侧核(basolateral amygdala, BLA)过度兴奋, 然后BLA通过投射突触抑制在恐惧消退中起核心作用的内侧前额叶神经元的活动。未来研究应注意即刻消退缺损引起的长期后果, 并深入探讨如何优化即刻消退在临床上的应用。     

青少年创伤后应激障碍症状与网络成瘾症状的关系：惩罚敏感性和孤独感的中介及性别的调节

汶川地震9.5年后,对汶川县和都江堰市767名中学生进行调查,考察惩罚敏感性和孤独感在创伤后应激障碍症状和网络成瘾症状之间的多重中介作用及性别差异。结果发现：（1）PTSD症状正向预测网络成瘾症状,并分别通过惩罚敏感性、孤独感的单独中介作用及两者的链式中介作用显著预测网络成瘾症状;（2）女性的PTSD症状显著正向预测网络成瘾症状,并分别通过惩罚敏感性和孤独感间接影响网络成瘾症状;男性的网络成瘾症状仅被PTSD症状正向预测。     

四周简易正念减压训练对初中生焦虑的影响

选取68名初一学生并以班级为单位分为四周正念减压(mindfulness-based stress reduction,MBSR)训练组和对照组,探讨四周MBSR对初中生焦虑和正念水平的影响,以及训练效果是否存在基线效应与性别差异。结果发现:(1)四周MBSR可以提高初中生的正念水平,缓解其焦虑情况;(2)“不判断”和“特质焦虑”基线水平影响正念训练的效果;(3)四周MBSR对初中生的训练效果不存在性别差异。