Fractured Pasts: The Structure of the Life Story in Sexual-Trauma Survivors With Posttraumatic Stress Disorder.

We examined the organization of past and future affective autobiographical knowledge in sexual-trauma survivors compared with control participants. Participants (N = 113) divided their past (and future) life into chapters (e.g., "college," "marriage"), then characterized each chapter using positive or negative attributes. Sexual-trauma survivors (n = 27) endorsed a greater proportion of negative attributes, demonstrated greater affective compartmentalization (separation of positive and negative attributes into different chapters), and showed reduced redundancy (consistent endorsement across chapters) of positive attributes relative to control participants (n = 23). Groups did not differ on negative redundancy for past life structure or any metrics for future life structure. In a secondary analysis, we compared life structures for the sexual-trauma group and for individuals with chronic depression but no sexual-trauma history (n = 30) and matched control participants (n = 56), which revealed significantly greater negative redundancy in the depressed group. The distinct life structure presented by sexual-trauma survivors may reflect efforts to constrain the impact of trauma on an individual's self-identity.

Negative and positive emotional complexity in the autobiographical representations of sexual trauma survivors.

This study examined the diversity of experienced positive and negative emotions - emodiversity - within two existing datasets involving female survivors of sexual abuse and assault, who all met criteria for chronic Posttraumatic Stress Disorder (PTSD) as well as a diversity of comorbid diagnoses. Study 1 investigated the structure of the self-concept and Study 2 explored the organization of past autobiographical knowledge. In each study, we measured emodiversity for positive and negative emotion constructs in the trauma sample, relative to healthy control participants with no history of sexual trauma or PTSD. Results confirmed our hypotheses that individuals with a severe sexual trauma history and resultant PTSD would show elevated negative emodiversity and reduced positive diversity across both the structure of the self-concept and the structure of the life narrative, relative to control participants. The current results differ from community studies where greater negative emodiversity is associated with better mental health but mirror those from a prior study with individuals with Major Depressive Disorder. This suggests that valence-based differences in emodiversity may result from chronic emotional disturbance.

Compartmentalization of self-representations in female survivors of sexual abuse and assault, with posttraumatic stress disorder (PTSD).

BACKGROUND: This study examined the structure of the self-concept in a sample of sexual trauma survivors with posttraumatic stress disorder (PTSD) compared to healthy controls using a self-descriptive card-sorting task. We explored whether individuals with PTSD possess a highly affectively-compartmentalized self-structure, whereby positive and negative self-attributes are sectioned off into separate components of self-concept (e.g. self as an employee, lover, mother). We also examined redundancy (i.e. overlap) of positive and negative self-attributes across the different components of self-concept. METHOD: Participants generated a set of self-aspects that reflected their own life (e.g. 'self at work'). They were then asked to describe their self-aspects using list of positive or negative attributes. RESULTS: Results revealed that, relative to the control group, the PTSD group used a greater proportion of negative attributes and had a more compartmentalized self-structure. However, there were no significant differences between the PTSD and control groups in positive or negative redundancy. Sensitivity analyses demonstrated that the key findings were not accounted for by comorbid diagnosis of depression. CONCLUSION: Findings indicated that the self-structure is organized differently in those with PTSD, relative to those with depression or good mental health.

Prevalence of auditory pseudohallucinations in adult survivors of physical and sexual trauma with chronic post-traumatic stress disorder (PTSD).

Auditory Verbal Hallucinations (AVHs) are commonly associated with psychosis but are also reported in post-traumatic stress disorder (PTSD). Hearing voices after the experience of stress has been conceptualised as a dissociative experience. Brewin and Patel's (2010) seminal study reported that hearing voices is relatively common in PTSD, as hearing voices was associated with PTSD in half and two thirds of military veterans and survivors of civilian trauma, respectively. The authors conceptualised these voices as "auditory pseudohallucinations." To build upon this work, we administered Brewin and Patel's' interview to adult survivors (n = 40) of physical and sexual trauma with chronic PTSD, and healthy controls (n = 39). In contrast to previous findings, only 5% (n = 2) of our PTSD sample reported recently hearing a voice that was consistent with an auditory pseudohallucination, with no reports in our control group. Thus, no support was provided for auditory pseudohallucinations as a significant symptom in this population.

Developing an Emotion- and Memory-Processing Group Intervention for PTSD with complex features: a group case series with survivors of repeated interpersonal trauma.

Individuals who experience repeated interpersonal trauma exposure often present with posttraumatic stress disorder (PTSD) with more complex features. There is currently no consensus regarding whether current evidence-based interventions for PTSD need to be tailored to better account for these complex features. However, one recommended adaptation is to adopt a phase-based or sequenced approach involving three phases, each with a distinct function. This paper describes the development of a 12-session Emotion- and Memory-Processing Group Programme, adapted from Cloitre's Skills Training in Affective and Interpersonal Regulation (STAIR) phase-based treatment protocol. A single case series provided a preliminary examination of the group-based intervention's efficacy for three groups of women with a history of repeated interpersonal trauma and PTSD with complex features (N = 15; age 19-46 years) at The Haven Sexual Assault Referral Centre in London. Results revealed significant reductions in: PTSD, complex features of PTSD, and depression, along with improvements in process measures of maladaptive cognitions and emotion processing. Results from this case series demonstrate that an Emotion- and Memory-Processing Group Programme holds promise for treating individuals with a history of interpersonal trauma in outpatient settings, and provides evidence to warrant the completion of a feasibility trial.

Las personas que experimentan una exposición al trauma interpersonal de manera repetida a menudo presentan un Trastorno de Estrés Postraumático (TEPT) con características más complejas. Actualmente, no hay consenso respecto a la necesidad de adaptar las intervenciones para el TEPT basadas en la evidencia disponible, con el fin de considerar mejor estas características complejas. Sin embargo, una adaptación recomendada es adoptar un abordaje basado en fases, o secuenciado, que involucra tres fases, cada una con una función distinta. Este artículo describe el desarrollo de un Programa Grupal de Procesamiento de Emociones y Memoria de 12 sesiones, adaptado del protocolo de tratamiento basado en fases del Entrenamiento de Habilidades en Regulación Afectiva e Interpersonal (STAIR) de Cloitre. Una serie de casos únicos proporcionó un examen preliminar de la eficacia de la intervención basada en grupos para tres grupos de mujeres con una historia de trauma interpersonal repetido y TEPT con características complejas (N = 15, edades 19 años-46 años) en el Centro de Derivación de Agresión Sexual de Haven en Londres. Los resultados revelaron reducciones significativas en: TEPT, características complejas del TEPT, y depresión, junto con mejoras en medidas de procesos de cogniciones desadaptativas y procesamiento de emociones. Los resultados de esta serie de casos demuestran que el Programa de Grupo de Procesamiento en Emoción y Memoria es prometedor para tratar individuos con una historia de trauma interpersonal en contextos ambulatorios, y proporciona evidencia para garantizar la realización de un ensayo de viabilidad.