1
|
Contractor AA, Slavish DC, Wang S, Weiss NH. Posttraumatic stress symptoms and positive autobiographical memory characteristics in everyday life. J Trauma Stress 2024. [PMID: 38838082 DOI: 10.1002/jts.23064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/23/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024]
Abstract
Individuals with posttraumatic stress symptoms (PTSS) report difficulties engaging with positive autobiographical memories. Extending this line of research, we examined daily-level concurrent and lagged associations between PTSS severity and positive memory characteristics (vividness, coherence, accessibility, time perspective, sensory details, visual perspective, emotional intensity, sharing, distancing, and valence). The sample included 88 trauma survivors (Mage = 39.89 years, 59.1% female) who completed seven daily measures of PTSS and positive memory characteristics. Multilevel models examined concurrent and lagged associations between PTSS severity and positive memory characteristics. The results indicated that days with higher PTSS severity were associated with less accessibility, β = -.21, p < .001; less visual perspective, β = -0.13, p = .034; and lower positive valence of the memory, β = -.19, p = .003, as well as more emotional intensity associated with, β = .13, p = .041, and more distancing from, β = .21, p < .001, the memory. Supplemental lagged analyses indicated that higher previous-day PTSS severity was associated with more next-day distancing from, β = .15, p = .042, and sensory details of, β = .17, p = .016, the memory. Findings suggest that individuals with more severe PTSS have difficulties accessing positively valenced memories from a first-person perspective, are more distant from the recalled positive memory, and report more emotional intensity when retrieving the memory. Thus, improving access to and reducing distance from positive autobiographical memories, as well as addressing emotional intensity surrounding the retrieval of these memories, may be potential clinical targets for PTSS interventions.
Collapse
Affiliation(s)
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Siyuan Wang
- Department of Psychology, University of North Texas, Denton, Texas, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
| |
Collapse
|
2
|
Contractor AA, Messman B, Gould P, Slavish DC, Weiss NH. Impacts of repeated retrieval of positive and neutral memories on posttrauma health: An investigative pilot study. J Behav Ther Exp Psychiatry 2023; 81:101887. [PMID: 37343425 DOI: 10.1016/j.jbtep.2023.101887] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 04/23/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
BACKGROUND AND OBJECTIVES Evidence indicates that positive memory processes play a role in the etiology and maintenance of posttraumatic stress symptoms (PTSS) and related posttrauma health indicators. To extend this research, the current pilot study examined if repeated retrieval of positive vs. neutral memories was associated with (1) less PTSS and depression severity; and (2) improved affect and cognitions (fewer posttrauma cognitions, more positively-valenced affect, less negatively-valenced affect, less negative affect interference, less anhedonia, retrieval of more positive specific memories, retrieval of fewer negative specific memories). METHODS Twenty-five trauma-exposed participants were randomly assigned to a positive or neutral memory task condition. They participated in four weekly experimental sessions facilitated by an experimenter virtually; each consecutive session was separated by 6-8 days. We conducted mixed between-within subjects ANOVAs to examine study hypotheses. RESULTS No interaction effects were significant. There were significant main effects of time on PTSS and depression severity, posttrauma cognitions, positively-valenced and negatively-valenced affect, and negative affect interference. LIMITATIONS We used self-report measures, small and non-clinical sample with limited demographic diversity, and virtual format; did not record memory narratives; and did not have a trauma memory condition. CONCLUSIONS Based on pilot data, our findings suggest that individuals who retrieve positive or neutral memories repeatedly may report less PTSS and depression severity, fewer posttrauma cognitions, and improved affect. Results provide an impetus to examine impacts of and mechanisms underlying memory interventions (beyond a sole focus on negatively-valenced memories) in trauma work.
Collapse
Affiliation(s)
| | - Brett Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Preston Gould
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, RI, USA
| |
Collapse
|
3
|
Messman BA, Fentem A, Compton SE, Griffith EL, Blumenthal H, Contractor AA, Slavish DC. The role of affect in associations between sleep disturbances and posttraumatic stress disorder symptoms: A systematic review. Sleep Med 2023; 110:287-296. [PMID: 37689045 DOI: 10.1016/j.sleep.2023.08.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/14/2023] [Accepted: 08/28/2023] [Indexed: 09/11/2023]
Abstract
Strong evidence supports a bidirectional association between sleep disturbances and posttraumatic stress disorder (PTSD). Affect - temporary internal states experienced as feeling good or bad, energized or enervated - may play a central role in explaining this link. The current systematic review summarizes the literature on associations between sleep, PTSD, and affect among trauma-exposed adults. We systematically searched five electronic databases (PubMed, PsycInfo, PTSDpubs, Web of Science, CINAHL) using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Of 2656 screened articles, 6 studies met inclusion criteria. Four findings emerged: (1) greater insomnia symptom severity predicted greater PTSD symptom severity above the influence of negative affect, (2) negative affect mediated the effect of sleep quality on next-day PTSD symptom severity, (3) positive affect mediated the effect of PTSD symptom severity on insomnia symptom severity and sleep disturbances, and (4) greater negative affect (specifically, greater anger) was associated with greater severity of PTSD and sleep disturbances. Findings highlight areas for future research, such as the need to investigate more dimensions, timescales, and methods of studies simultaneously assessing affect, sleep, and PTSD, as well as the need for more longitudinal and experimental work to determine causality across these constructs.
Collapse
Affiliation(s)
- Brett A Messman
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA.
| | - Andrea Fentem
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA
| | - Sidonia E Compton
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA
| | - Elizabeth L Griffith
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA
| | - Heidemarie Blumenthal
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA
| | - Ateka A Contractor
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA
| | - Danica C Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle, Denton, TX 76203, USA
| |
Collapse
|
4
|
Contractor AA, Messman BA, Slavish DC, Weiss NH. Do positive memory characteristics influence daily-level trajectories of posttraumatic stress disorder symptoms? an exploratory daily diary study. ANXIETY, STRESS, AND COPING 2023; 36:320-338. [PMID: 35561031 PMCID: PMC9653523 DOI: 10.1080/10615806.2022.2075856] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 04/22/2022] [Accepted: 05/05/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Evidence links posttraumatic stress disorder (PTSD) with positive memory characteristics. To extend this research, we utilized daily diary data to examine (1) concurrent/lagged associations between daily PTSD symptom severity and positive memory vividness/accessibility; and (2) associations between baseline-assessed positive memory characteristics and changes in PTSD symptom severity over time. DESIGN AND METHODS A sample of 238 trauma-exposed participants (Mage = 21.19 years; 86% women) completed baseline and 10 daily measures of PTSD symptoms and positive memory characteristics. Multilevel models covaried for gender, number of trauma types, and number of completed surveys. RESULTS Days with greater PTSD symptom severity than an individual's average associated with less vividness (b = -0.02, p < .001) and accessibility (b = -0.02, p < .001) of the positive memory on the same day. Days with greater positive memory vividness (b = -1.06, p < .001) and accessibility (b = -0.93, p < .001) than an individual's average associated with less PTSD symptom severity on the same day. There were no significant lagged associations between these constructs. There were significant interactions between baseline-assessed psychological distance and time (b = -0.04, p = .042) and between baseline-assessed visual perspective and time (b = 0.05, p = .023) on PTSD symptom severity across days. CONCLUSIONS Findings inform positive memory intervention targets for PTSD and provide impetus for longitudinal investigations on their inter-relations.
Collapse
Affiliation(s)
| | - Brett A. Messman
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Danica C. Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Nicole H. Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| |
Collapse
|
5
|
Contractor AA, Slavish DC, Thornton J, Weiss NH. Positive Affect Processes and Posttraumatic Stress Disorder Symptoms: Findings from an Open Label and Uncontrolled Pilot Study using the Positive Memory Processing Technique. JOURNAL OF PSYCHOTHERAPY INTEGRATION 2023; 33:102-122. [PMID: 37193258 PMCID: PMC10174277 DOI: 10.1037/int0000292] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Recently, a five-session Processing of Positive Memories Technique (PPMT) was proposed as a novel intervention for posttraumatic stress disorder (PTSD). One purported outcome of and mechanism underlying PPMT's effects on PTSD is improved positive affect processes. In this uncontrolled pilot study, we examined whether PPMT was associated with decreases in PTSD severity; and whether changes in positive affect levels, reactivity, and dysregulation related to changes in PTSD severity across sessions. The sample included 16 trauma-exposed participants seeking services at a University Psychology Clinic (Mage=27.44 years; 68.80% women). Multilevel linear growth models examined the main effects of each positive affect variable and their interactions with time on PTSD severity. PTSD severity decreased across PPMT treatment in each model (bs=-0.43 to -0.33; d=-0.03; ps<.001-0.008). There was a main effect of positive emotion dysregulation (b=1.16, d=0.11; p=0.009), but not of positive affect levels (p=0.821) or reactivity (p=0.356) on PTSD severity. However, positive affect processes did not modify the trajectory of PTSD severity across treatment. Regarding PTSD symptom clusters, there was an interaction between positive affect levels and time on alterations in arousal and reactivity (AAR) cluster severity (b=-0.01, p=0.036); individuals with positive affect levels 1 SD above the mean (b=-0.18, p<0.01) and at the mean (b=-0.10, p=0.01) had greater decreases in AAR cluster severity across treatment compared to individuals with positive affect levels 1 SD below the mean (b=-0.02, p=0.710). Findings suggest that PPMT may relate to improved PTSD symptoms; and that positive affect levels/dysregulation may be worthwhile targets for future investigations.
Collapse
Affiliation(s)
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, U.S
| | | | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, U.S
| |
Collapse
|
6
|
Messman BA, Jin L, Slavish DC, Alghraibeh AM, Aljomaa SS, Contractor AA. The role of positive affect processes in the association between posttraumatic stress disorder symptoms and sleep: A multi-study design. J Affect Disord 2023; 324:511-520. [PMID: 36603602 DOI: 10.1016/j.jad.2022.12.125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/04/2022] [Accepted: 12/23/2022] [Indexed: 01/04/2023]
Abstract
OBJECTIVES Posttraumatic stress disorder (PTSD) symptoms have been linked to sleep disturbances. Limited work has explored how positive affect processes may account for this relationship. Advancing research in this area, we utilized a multi-study design to investigate the role of positive affect processes (levels of positive affect, positive emotionality, hedonic deficits, negative affect interference) in the PTSD-sleep association. METHODS Data from 149 trauma-exposed firefighters (Mage = 38.93 ± 9.65, 5.40 % women) were collected between September 2021 and November 2021, and data from 119 trauma-exposed community members (Mage = 29.60 ± 8.67, 68.10 % women) were collected between February 2021 and December 2021. Participants completed an online survey on PTSD symptoms, sleep disturbances, and positive affect processes. RESULTS Positive affect levels (b = 0.03, 95 % confidence interval [CI] [0.01, 0.06]; firefighter sample), positive emotionality (b = 0.07, CI [0.03, 0.13]; community sample), and negative affect interference (b = 0.06, CI [0.01, 0.14]; community sample) significantly accounted for the associations between PTSD symptom severity and sleep disturbances controlling for the effects of gender and age. CONCLUSION Findings highlight the role of positive affect processes in the link between PTSD and sleep, and support addressing positive affect processes as potential targets in clinical interventions for co-occurring PTSD-sleep problems.
Collapse
Affiliation(s)
- Brett A Messman
- Department of Psychology, University of North Texas, Denton, TX, USA.
| | - Ling Jin
- Werklund School of Education, University of Calgary, Calgary, AB, Canada
| | - Danica C Slavish
- Department of Psychology, University of North Texas, Denton, TX, USA
| | - Ahmad M Alghraibeh
- Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia
| | - Suliman S Aljomaa
- Department of Psychology, College of Education, King Saud University, Riyadh, Saudi Arabia
| | | |
Collapse
|
7
|
Wang X, Tu Q, Huang D, Jin P, Cai X, Zhao H, Lu Z, Dong C. A latent profile analysis of emotional expression among patients with unintentional injuries. BMC Psychiatry 2022; 22:729. [PMID: 36424565 PMCID: PMC9694566 DOI: 10.1186/s12888-022-04390-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2022] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Emotional expression has been suggested to affect the well-being of individuals with unintentional injuries. However, few studies have investigated it as a heterogeneous phenomenon. The purpose of this study was to characterize the patterns of emotional expression among patients with unintentional injuries using latent profile analysis, and to examine the relationship among these latent profiles and cognitive processing, posttraumatic growth, and posttraumatic stress disorder. METHODS A cross-sectional study was carried out at two general hospitals in Wenzhou, China. In total, 352 patients with unintentional injuries completed the socio-demographic questionnaire, Berkeley Expressivity Questionnaire, Ambivalence Over Emotional Expression Questionnaire, Event-Related Rumination Inventory, the Posttraumatic Growth Inventory, and PTSD Checklist-Civilian Version. RESULTS: Three unique profiles were identified: high emotional expressivity (n = 238, 67.6%), moderate emotional expressivity (n = 45, 12.8%), and low emotional expressivity (n = 69, 19.6%). The ANOVA and chi-square tests demonstrated significant differences among the three groups concerning deliberate rumination and posttraumatic growth. Multinomial logistic regression analysis indicated that monthly income and time since injury significantly predicted profile membership. CONCLUSIONS Most patients showed high emotional expressivity after an unintentional injury. Emotional expression profiles were associated with deliberate rumination and posttraumatic growth. Emotional expression interventions tailored for different profiles are warranted after an unintentional injury.
Collapse
Affiliation(s)
- Xinlu Wang
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Qiongyao Tu
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Dongdong Huang
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Pinpin Jin
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Xue Cai
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China
| | - Haifeng Zhao
- grid.268099.c0000 0001 0348 3990School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang China ,grid.416271.70000 0004 0639 0580Ningbo City First Hospital, Ningbo, China
| | - Zhongqiu Lu
- Emergency Intensive Care Unit, Emergency Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
| | - Chaoqun Dong
- School of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang, China.
| |
Collapse
|
8
|
Griffith EL, Jin L, Contractor AA, Slavish DC, Vujanovic AA. Heterogeneity in patterns of posttraumatic stress disorder symptoms and sleep disturbances among firefighters: Latent profile analyses. J Psychiatr Res 2022; 153:64-72. [PMID: 35802952 DOI: 10.1016/j.jpsychires.2022.06.052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/12/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
Abstract
Firefighters are at increased risk for posttraumatic stress disorder (PTSD) symptoms and sleep disturbances due to occupational trauma exposure as well as the nature of their job (e.g., shift work, workplace stress). PTSD symptoms co-occur with sleep disturbances, including poor sleep quality, short sleep duration, and low sleep efficiency. No published studies have examined subgroups of firefighters based on PTSD symptoms and sleep disturbances. Thus, we used latent profile analysis to identify the best-fitting class solution to categorize firefighters based on endorsed PTSD symptoms and sleep disturbances and examined relations between the optimal class solution and health covariates (i.e., anger reactions, depression symptoms, emotion regulation difficulties, number of traumatic event types). The sample included 815 trauma-exposed firefighters (Mage = 38.63; 93.20% male). Results indicated three latent subgroups: High PTSD-Sleep Disturbances, Moderate PTSD-Sleep Disturbances, and Low PTSD-Sleep Disturbances. Multinomial logistic regression indicated that endorsing greater anger reactions, depression symptoms, and emotion regulation difficulties increased the chances of being in the more severe classes. Endorsing greater number of traumatic event types increased the chances of being in the Moderate vs. Low PTSD-Sleep Disturbances Classes. Findings improve our understanding of subgroups of firefighters based on PTSD and sleep disturbances and underscore the importance of addressing depression symptoms, anger management, and emotion regulation skills for firefighters reporting more severe PTSD symptoms and sleep disturbances.
Collapse
Affiliation(s)
- Elizabeth L Griffith
- Department of Psychology, University of North Texas, 1155 Union Circle, #311280, Denton, TX, 73203, USA.
| | - Ling Jin
- Werklund School of Education, The University of Calgary, 2750, University Way NW, Calgary AB, T2N, Canada.
| | - Ateka A Contractor
- Department of Psychology, University of North Texas, 1155 Union Circle, #311280, Denton, TX, 73203, USA.
| | - Danica C Slavish
- Department of Psychology, University of North Texas, 1155 Union Circle, #311280, Denton, TX, 73203, USA.
| | - Anka A Vujanovic
- Department of Psychology, University of Houston, 3695 Cullen Boulevard, 126 Heyne Building, Houston, TX, 77204, USA.
| |
Collapse
|
9
|
Contractor AA, Banducci AN, Weiss NH. Critical considerations for the positive memory-posttraumatic stress disorder model. Clin Psychol Psychother 2021; 29:81-91. [PMID: 33870586 DOI: 10.1002/cpp.2599] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 04/12/2021] [Accepted: 04/12/2021] [Indexed: 11/05/2022]
Abstract
Posttraumatic stress disorder (PTSD) includes changes in processes such as encoding and retrieval for both traumatic and positive memories. However, most work has predominantly focused on traumatic memories. Thus, Contractor and colleagues proposed a Positive Memory-PTSD model, which highlighted potential benefits associated with and mechanisms underlying positive memory retrieval/processing among individuals reporting PTSD symptoms. To enhance research on and clinical impacts of this model, the current review provides critical considerations for the Positive Memory-PTSD model. Drawing from emerging research and clinical observations, we (i) clarify that the model addresses specific versus overgeneral positive memories; (ii) underscore the importance of considering the heterogeneity in, and transitionary nature of, affect processes following positive memory retrieval; and (iii) highlight the rationale for considering trauma type/count and co-occurring conditions, as potential moderators of relations between positive memory processing and PTSD. Hereby, we provide an updated Positive Memory-PTSD model and implications for positive memory interventions drawing from this model.
Collapse
Affiliation(s)
| | - Anne N Banducci
- The National Center for PTSD, VA Boston Healthcare System, Boston, MA, USA.,Department of Psychiatry, Boston University School of Medicine, Boston, MA, USA
| | - Nicole H Weiss
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| |
Collapse
|