Trauma-Related Negative Cognitions Mediate the Relationship Between Avoidant Personality Beliefs and Impeded Response to Psychotherapy for PTSD

There is strong research evidence for the association of personality pathology and posttraumatic stress disorder (PTSD), as well as trauma-related negative cognitions (TRNC) and PTSD symptoms. However, the relationship between personality pathology and TRNC in the context of PTSD is mostly unknown. In the present study, we aimed to examine whether avoidant and borderline personality beliefs (PB, indicator of personality pathology) could predict therapy outcome in PTSD, and whether the relationship between PB and therapy outcome could be mediated by TRNC. Sixty patients with PTSD were assessed for PB, TRNC and PTSD symptoms at baseline, and for PTSD symptoms at the termination of Prolonged Exposure Therapy. Baseline avoidant PB predicted significant variance in PTSD symptoms at termination over and above baseline PTSD symptoms (16% reduction in treatment effect per SD on avoidant PB). Moreover, TRNC at baseline fully mediated the relationships between baseline avoidant PB and PTSD symptoms at termination. This is the first study to show that avoidant PB predicts treatment response in PTSD, and that patients with avoidant beliefs are more vulnerable to have TRNC, which are associated with impeded therapy response. Our results highlight the importance of targeting both dysfunctional PB and TRNC in PTSD interventions.     

A Single-Arm Meta-Analysis of Cognitive Processing Therapy in Addressing Trauma-Related Negative Cognitions

Cognitive Processing Therapy (CPT) is a first-line treatment for posttraumatic stress disorder designed to address cognitive “stuck points” connected to a patient’s trauma-related negative cognitions (NCs). Although CPT has well-established efficacy, the ability of CPT to address NCs remains understudied. The purpose of this study was to conduct a single-arm meta-analysis to determine the overall effect of CPT in attenuating NCs pre- to posttreatment across multiple clinical trials. A review of the existing literature was performed with only peer-reviewed clinical trials included in the meta-analysis. Nine studies with data from 583 participants were entered into the meta-analysis. CPT was found to have a large effect size in reducing NCs from pre- to posttreatment. Findings are limited by the single-arm nature of analyses and heterogeneity in included trial methodology (e.g., gender, trauma type, civilian versus veteran).     

Childhood Sexual Abuse and Intimate Partner Violence in a Clinical Sample of Men: The Mediating Roles of Adult Attachment and Anger Management

This study examined the association between men’s experience of childhood sexual abuse and later perpetration of intimate partner violence, considering the roles of attachment insecurity and poor anger regulation. The sample was 302 Canadian men undergoing counseling for relationship difficulties or aggression. They completed questionnaires assessing childhood sexual abuse, the two dimensions of attachment insecurity (anxiety and avoidance), anger regulation processes, physical and psychological aggression, and social desirability bias. Path analyses showed that men who experienced childhood sexual abuse scored higher on attachment anxiety, which in turn was associated with aggressive behaviors directly and through four anger-related variables (trait anger, anger-in, anger-out, and low anger control). Attachment-related avoidance predicted psychological aggression, but not physical aggression, through men’s trait anger and anger-in.     

Attachment Anxiety,Depressive Symptoms,and Adolescent Dating Violence Perpetration: A Longitudinal Mediation Analysis

Adolescent dating violence (ADV) is a prevalent public health issue that has been linked to many negative effects, including attachment anxiety and depressive symptoms. Previous literature suggests that the negative mental states characteristic of attachment anxiety could be associated with dating violence perpetration. Similarly, the negative mental states characteristic of depression have also been linked to perpetration, and might potentially increase an anxiously attached individual’s likelihood of engaging in dating violence perpetration. This study used a 10-month longitudinal design with a sample of 140 middle school and high school students from Southern California. Participants ranged in age from 13 to 18 years and were ethnically diverse. The study aimed at exploring depressive symptoms as a potential mediator for the relationship between attachment anxiety and ADV perpetration. Positive associations were found between attachment anxiety and perpetration (10 months after), attachment anxiety and depressive symptoms (10 months after), and between depressive symptoms and perpetration (both 10 months after). Furthermore, depressive symptoms partially mediated the relationship between attachment anxiety and ADV perpetration (10 months after). These findings have implications for the development of empirically driven school-based prevention and intervention programs.     

Autobiographical Memory Disturbances in Childhood Abuse Survivors

Summary

Clinicians have noted that childhood abuse survivors frequently report that they have forgotten large parts of their childhood. While memory for abusive experiences has attracted a great deal of attention from researchers, other types of memory disturbances may also accompany a history of childhood trauma. Many clinicians report that certain types of sexual abuse, and abuse at certain developmental stages, is more likely to result in reports of gaps in memory for the abuse. However, because information has been mainly collected in clinical populations, the possibility of confounding between abusive experiences and psychological disturbances cannot be ruled out. This article reports on data gathered from a large, epidemiologic study conducted within a health maintenance organization. A history of childhood physical or sexual abuse doubled the prevalence of general autobiographical memory loss for women, while for men, the rate increased 1.5 times over those with no abuse history. Higher rates of autobiographical memory loss were noted where both types of abuse were reported. Further, multiple incidents of sexual abuse, sexual abuse by a relative, and more severe sexual abuse increased reports of autobiographical memory loss. Theoretical perspectives on changes in the memory system that may affect trauma survivors are discussed.     

The Mediating Role of Peritraumatic Dissociation and Thought Control Strategies on Posttraumatic Stress in Women Survivors of Child Sexual and Physical Abuse

This study examined the link between cognitive coping strategies, type of abuse, and posttraumatic stress symptomatology. In a sample of 294 undergraduate women, several key findings emerged: (a) reported use of cognitive coping strategies significantly differed based on the type of abuse; (b) some differences in posttraumatic stress symptomatology emerged based on the type of abuse; (c) once the cognitive coping strategies were accounted for, the type of abuse was no longer associated with posttraumatic stress symptomatology. These findings suggest that peritraumatic dissociation, punishment, and social control significantly mediated the relationship between the type of abuse and posttraumatic stress symptomatology. This is important information for interventionists striving to help their clients maximize already-occurring adaptive strategies (e.g., social control).     

Preface

Abstract

Child victimization is a serious and on-going problem in the United States and throughout the world. In 2000, an estimated 900,000 children were victims of abuse and neglect in the United States. New and different responses to child maltreatment will have to be developed and implemented in response to the increasingly diverse contexts and situations within which maltreatment occurs. Emerging trends in adult-child boundary violations are explored within this volume from a cross-section of disciplines, including law, sociology, criminal justice, psychology, and health services. The selections analyze issues critical to child maltreatment and offer intriguingly different perspectives of present and future issues related to child abuse.     

Experimental and Self-Reported Indices of Childhood Abuse Using the Binghamton Childhood Abuse Screen

This study describes the validation of the Binghamton Childhood Abuse Screen (BCAS) using response latencies on an emotional Stroop task as a criterion measure. Sixty-four male undergraduate participants were selected based on their responses to the BCAS and a brief screen of their abuse history. Participants completed an emotional Stroop task in which they named the colors of neutral, positive, and abuse words. Participants scoring high on the BCAS exhibited greater response latencies to abuse words than participants scoring low on the BCAS. No group differences were found for positive words. The results provide support for the validity of the BCAS.     

Linking Childhood Maltreatment to Substance Use in College Students: The Mediating Role of Self-Worth Contingencies

This study investigated the link between childhood maltreatment and substance use, focusing on examining contingencies of self-worth (CSWs) as mediators among college students (N?=?513). Structural equation modeling indicated that childhood sexual abuse among females was related to lower God's love CSW, which in turn was related to higher levels of cigarette, marijuana, and other illicit drug use, supporting the mediational role of God's love CSW. Correlational analyses demonstrated that, for both male and female students, external contingency of appearance was related to higher substance use, whereas internal contingencies of God's love and virtue were related to lower substance use. The findings highlight the protective role of internal CSWs in substance use among females with childhood sexual abuse.     

Sticks,Stones, or Words? Counting the Prevalence of Different Types of Intimate Partner Violence Reported by New Zealand Women

This study documents the lifetime and 12-month prevalence and overlap of psychological/emotional, physical, and sexual intimate partner violence (IPV) reported by a representative sample of New Zealand women. Use of controlling behaviors by women's current or most recent intimate partner was also explored. The results indicated that 55% of ever-partnered women had experienced any IPV in their lifetime: 33% had experienced more than one type of IPV (usually psychological/emotional violence and physical and/or sexual violence), and 22% had experienced one type of IPV. Use of controlling behaviors by the woman's current or most recent partner was associated with partner's use of physical or sexual violence. Implications are discussed at the population level, for service providers, and for future studies.