Cultural differences in autobiographical memory of trauma

Grieving Parents' Meaning-Making Narration in Relation to Value Orientations: A Cross-Cultural Study

This study investigated the association between prolonged grief (PG) severity and meaning-making narration in a cross-cultural context, and specifically aimed to illustrate the role of value orientation in shaping the grieving process. 30 Chinese and 22 Swiss parents who lost their child were asked to narrate and appraise specific memories to reflect their self-evaluation of traditional and modern values. The self-reported Prolonged Grief Disorder Scale (ref ICD-11) assessed PG severity. Compared with the Swiss sample, the Chinese sample provided more elaborated memories, which was not associated with symptom severity. Both Chinese and Swiss bereaved parents with more severe PG provided more narratives of loss-related memories, particularly in response to modern values. They also provided more appraisals of negative meanings for self-defining memories, particularly in relation to their traditional values. These findings indicate that, despite cultural differences in narration tendency, PG severity in bereaved parents was associated with the maladaptive integration of autobiographical memories across different cultures, in relation to value orientations. A clinical implication is the potential value of facilitating narrations of grieving clients that center on value orientations to mitigate the hardship of the personal loss.

The Relationship Between Dissociation and Complex Post-Traumatic Stress Disorder: A Scoping Review

Complex post-traumatic stress disorder (CPTSD) has recently been recognized as an official psychiatric diagnosis in ICD-11, after years of research and advocacy in the field. It has been suggested that dissociative symptoms are a major feature of CPTSD. This scoping review aimed to summarize the existing knowledge base on the relationship between dissociation and CPTSD, and to identify relevant research gaps. We searched the two largest and most widely used academic databases (i.e., the Web of Science and Scopus databases) and the ProQuest database and identified original studies published in English relevant to our research questions, namely: (1) Would CPTSD be associated with dissociative symptoms? 2) How common are dissociative symptoms among people with CPTSD? (3) What are the correlates of dissociative symptoms among people with CPTSD? In all, 26 studies were included. We found 10 studies which reported that people with CPTSD scored significantly higher on a dissociation measure than those without CPTSD, and 11 studies reported a positive correlation between CPTSD symptoms and psychoform/somatoform dissociation scores. While very few studies reported the prevalence and correlates of dissociative symptoms among people with CPTSD, there may be a considerable subgroup of people with CPTSD who have clinically significant levels of dissociative symptoms (e.g., 28.6-76.9%). Dissociation may also be associated with other comorbidities (e.g., DSM-IV Axis II features, shame, somatic symptoms) in people with CPTSD. We recommend that more studies are needed to investigate the prevalence of dissociative symptoms among people with CPTSD and examine how these symptoms are associated with other comorbid conditions and clinical needs in this vulnerable group.

Psychometric properties of the Chinese version of the Centrality of Event Scale across multiple trauma-exposed Taiwanese samples

The widely used Centrality of Event Scale (CES) measures the extent that a traumatic event serves as a central component of self-identity, a reference point, and a turning point in an individual's life story. The present study aimed to develop a Chinese version of the CES and assess its reliability, criterion validity, and factor structure. Data were collected from three samples of trauma-exposed Taiwanese individuals (N = 939), including 420 earthquake survivors, 300 trauma-exposed community adults, and 219 trauma-exposed undergraduate students. We conducted an exploratory factor analysis and confirmatory factor analysis and compared the resulting models with a one-factor model and the originally proposed model. The results indicated that a new three-factor model, S-Bχ² (167, N = 519) = 687.01, p < .001, CFI = .95, IFI = .95, NNFI = .94, RMSEA = .078, SRMR = .047, might better represent the construct compared to the one-factor or originally proposed model. Furthermore, the Chinese CES demonstrated excellent internal consistency, Cronbach's αs = .89-.94; adequate 1-month reliability, rs = .54-.64, and 6-month temporal stability, rs = .52-.67; and good concurrent and predictive validity. The findings indicate that the Chinese version of the CES demonstrates good psychometric properties with a three-factor structure, and it could be used to assess event centrality among nonclinical trauma-exposed Taiwanese adults.

Cross-cultural exploration of the characteristics, content and themes of intrusive autobiographical memories recalled during depression

The recall of intrusive memories is highly prevalent during depression. While past research has examined memory themes and characteristics (e.g., frequency), possible cultural differences in these variables have not been investigated. Furthermore, cross-cultural research has documented content differences in voluntary autobiographical remembering, but such content analyses have not been conducted in regard to intrusive memories. This study, therefore, investigated the characteristics, content and themes of intrusive memories using a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design. European Australian (n = 46) and East Asian (n = 45) participants living in Australia reported two memories in real-time using an online memory diary and rated the characteristics of their memories. East Asian participants reported more frequent and distressing memories, compared to European Australians, while the European Australian group reported more specific memories than the East Asian group. Most of the characteristics, themes and content variables, however, did not differ between cultural groups. Additionally, depressed participants, regardless of cultural group, reported more frequent, distressing and numbing memories, compared to healthy controls. These findings suggest that while depressive symptomatology impacts the experience of intrusive memories, memory content and characteristics are largely similar across the two cultural groups.

Self-concept, post-traumatic self-appraisals and post-traumatic psychological adjustment: what are the relationships?

BACKGROUND

Cognitive models of post-traumatic psychological adjustment have implicated both self-concept and self-appraisals in post-traumatic stress disorder (PTSD). Two studies investigated the relationship between self-concept and trauma-related self-appraisals, and whether culture influenced this relationship.

METHOD

In Study 1, a student sample (Asian n = 41, British n = 34) who self-identified as having been through a trauma or extremely stressful event completed measures of self-concept, trauma-related self-appraisals and trauma-related distress. Study 2 extended this by asking Asian (n = 47) and British (n = 48) trauma survivors with and without PTSD to complete the same self measures as those administered in Study 1.

RESULTS

Study 1 found that overall for the British group, disruptions in self-concept (i.e. self-discrepancies and trauma-themed self-concept) correlated significantly with negative self, world and self-blame appraisals and depression. However, the same was not found in the Asian group. Study 2 found that pan-culturally those with PTSD had greater self-discrepancies and trauma-defined self-concept than those without PTSD. Additionally, pan-culturally, trauma-defined self-concept correlated significantly with negative self appraisals and depression; ideal self-discrepancies correlated significantly with negative self-appraisals across cultures and depression for the British group; while ought self-discrepancies correlated significantly with negative world appraisals for the Asian group and negative self and self-blame appraisals for the British. Lastly, negative self, world and self-blame appraisals correlated with symptoms of depression.

CONCLUSIONS

Taken together, the findings relay the important associations between appraisals, self-concept and post-traumatic psychological adjustment.

The impact of depression and culture on responses to intrusive autobiographical memories: Cognitive appraisals, cognitive avoidance, and brooding rumination

OBJECTIVES

Those with depression ascribe more negative appraisals to intrusive autobiographical memories and use maladaptive strategies to regulate intrusive memory distress. However, it is unknown whether these patterns extend to East Asian samples. This study investigated the influence of culture and depression on intrusive remembering.

DESIGN

The study used a 2 (group: European Australian, East Asian) × 2 (depression: depressed, control) cross-sectional design, with an online intrusive memory diary.

METHODS

European Australian (n = 46) and East Asian (n = 45) participants living in Australia, with and without depression, reported two intrusive memories in real-time and completed self-report measures indexing their appraisals of the memories, and their use of cognitive avoidance and brooding rumination in response to the memories.

RESULTS

East Asian participants reported significantly greater negative, control, and responsibility appraisals than European Australian participants. Regardless of cultural group, depressed participants endorsed greater maladaptive memory appraisals and brooding compared to controls. Additionally, among East Asian participants, those with depression cognitively avoided memories significantly more than controls. When comparing the two depressed groups, East Asians reported significantly greater brooding and avoidance in response to intrusive memories than Australians.

CONCLUSIONS

The findings suggest that depression may be associated with some similar maladaptive responses to intrusive autobiographical memories across cultural groups. Clinical interventions targeting unhelpful responses may, therefore, be beneficial for those with depression, regardless of cultural background.

PRACTITIONER POINTS

Across both European Australian and East Asian cultures, depressed participants endorsed higher maladaptive intrusive memory appraisals and brooded more in response to memories. Clinical interventions targeting appraisals and emotion regulation in response to intrusive memories may be beneficial for those with depression across both cultural groups. Language and acculturation may have impacted findings, as measures were administered in English and in Australia. Replication using a cross-country design and larger sample would be beneficial to confirm findings.

Investigating the mediating role of self-construal on the relationship between cultural group (Malay and Australian) and the characteristics and functional use of autobiographical memory

Cultural differences in autobiographical memory characteristics and function have often been presumed to be associated with different cultural beliefs related to the self. The current research aimed to investigate whether self-construal mediated the relationship between cultural group and the characteristics and functional use of autobiographical memory. Caucasian Australians (n = 71) and Malay Malaysians (n = 50) completed an online questionnaire that included the Self-Defining Memory task, the Thinking About Life Experiences Revised Questionnaire and the Self Construal Scale. As expected, the Australian group provided longer, more autonomously oriented, specific memories than the Malay group. However, contrary to our predictions, self-construal did not mediate the relationships between cultural group and memory characteristics. The Malay group reported more frequently using autobiographical memories for self-continuity than the Australian group. Finally, there was support for an indirect pathway between cultural group and use of autobiographical memories for self-continuity and social-bonding through self-construal (i.e. independent self relative to interdependent self). The findings highlight the importance of explicitly examining values assumed to be associated with autobiographical remembering, and relating these values to memory characteristics and function.

Psychometric properties of the Posttraumatic Growth Inventory in a sample of Brazilian university students

OBJECTIVE

To examine psychometric properties of the Brazilian version of the Posttraumatic Growth Inventory (PTGI).

METHOD

A total of 300 university students were evaluated though instruments that investigated trauma history, depression and posttraumatic symptoms, and personality traits through the Big Five model. Pearson's correlation was used to assess internal consistency, inter-item reliability and construct validity. Principal component analysis and confirmatory factor analysis were performed to investigate the factor structure of the PTGI.

RESULTS

Results confirmed the original five-factor structure. The results showed good internal consistency for the total scale (α = 0.91) and its subscales, ranging from α = 0.85 to α = 0.70. Also, evidence of construct and convergent validity was observed through correlations with posttraumatic and depression symptoms and personality measures.

CONCLUSIONS

These preliminary results suggest that the Brazilian PTGI is reliable and showed adequate evidence of validity.

Presentation of the Coding and Assessment System for Narratives of Trauma (CASNOT): Application in Spanish Battered Women and Preliminary Analyses

This study introduces a new coding system, the Coding and Assessment System for Narratives of Trauma (CASNOT), to analyse several language domains in narratives of autobiographical memories, especially in trauma narratives. The development of the coding system is described. It was applied to assess positive and traumatic/negative narratives in 50 battered women (trauma-exposed group) and 50 nontrauma-exposed women (control group). Three blind raters coded each narrative. Inter-rater reliability analyses were conducted for the CASNOT language categories (multirater Kfree coefficients) and dimensions (intraclass correlation coefficients). High levels of inter-rater agreement were found for most of the language domains. Categories that did not reach the expected reliability were mainly those related to cognitive processes, which reflects difficulties in operationalizing constructs such as lack of control or helplessness, control or planning, and rationalization or memory elaboration. Applications and limitations of the CASNOT are discussed to enhance narrative measures for autobiographical memories.

Exploring trauma associated appraisals in trauma survivors from collectivistic cultures

Appraisals are a key feature in understanding an individual’s experience; this is especially important when the experience is a traumatic one. However, research is diminutive when looking at the interaction between trauma appraisals and culture in relation to posttraumatic stress disorder using qualitative methodologies. This study explored cultural differences in perceptions and appraisals of trauma using three qualitative focus groups with community members (n = 11) from collectivistic cultures who had experienced a traumatic event and three qualitative individual key informant interviews with mental health practitioners (n = 3) routinely working with trauma survivors. Using template analysis, eight emergent themes were highlighted from the data sets [(1) trauma and adjustment; (2) cultural and social roles; (3) traumatised self; (4) relationships; (5) external attribution; (6) future; (7) education; (8) language] that potentially have significant consequences for posttrauma psychological adjustment and recovery. Cumulatively, while a number of themes are similar to that which is emphasised in current literature (e.g. damaged self, negative appraisals of the world, others, future) a number of themes were also resonant and warrant further scrutiny. For instance, the importance and interconnectedness of the group to the individual and the impact trauma has on this; the importance of social roles, cultural appropriateness and violations of cultural values and norms; findings and implications are discussed.

Incident-level analysis of 703 retrospective self-reports of ordinary violence recalled by 334 Swedes aged 6 to 45 years

There is wide variation in how exposure to violence is conceptualized. Perceptions of ordinary violence are linked to people's actual experiences, which may be direct, indirect, observed, or vicarious, and all through filters of gender, class, community, and culture. Event-recall interviews were conducted among a convenience sample of Swedish males (n = 132) and females (n = 202) aged 6 to 45 years. Respondents spontaneously recalled 703 events (averaging 2.3 events for males, 2.1 for females). For men, 93% of events were male(s)-on-male(s), 2% female-on-female, and 2% male(s)-on-female(s). For women, 42% of events were male(s)-on-male(s), 19% female(s)-on-female(s), 24% male(s)-on-females, and 10% female(s)-on-male(s). Interviewee's roles differed. Of males, 17% were aggressors, 40% victims, and 43% observers. Of females, 12% were aggressors, 30% victims, and 58% observers. For males, there was a significant increase in degree of seriousness of events from junior-, to high school, to college. For females, events became more serious as interviewees progressed from aggressor to victim to observer. For males, violent events between strangers were significantly more serious than all other combinations of acquaintanceship. Most recently recalled events were the most serious for males (no effect for females). Participation in sports was linked to seriousness of events recalled by females, events being described as more serious by females who participated in sports, this effect being stronger for those females who participated in contact/collision and self-defense sports. The significant correlation between trauma and seriousness is nearly twice as strong for females which might be taken as an indication of stronger moral pathos.

An investigation of trauma-associated appraisals and posttraumatic stress disorder in British and Asian trauma survivors: the development of the Public and Communal Self Appraisals Measure (PCSAM)

Two studies examined the role of culture on cognitive appraisals of trauma and associated implications for posttraumatic psychological adjustment. Study 2 also investigated the reliability and validity of a new measure assessing public and communal aspects of trauma-associated appraisals (Public and Communal Self Appraisals Measure; PCSAM). Study 1′s non-clinical sample (N = 75) and Study 2′s sample of British and Asian trauma survivors with and without PTSD (N = 95) provided an everyday and trauma memory, completed an Appraisal Inventory, the Posttraumatic Cognitions Inventory and measures of PTSD. Study 2 participants also completed the PCSAM. Conjoined, there were cultural differences in appraisals of everyday and trauma experiences. Nonetheless, there appeared to be cultural similarities in the dysfunctional appraisals of those with PTSD. The PSCAM had good internal consistency, test-retest reliability, convergent validity, and discriminative validity. Findings are discussed in terms of combining cultural models of self with current PTSD models.

Cultural differences in personal identity in post-traumatic stress disorder

OBJECTIVES

This study investigated cultural differences in goals, self-defining memories, and self-cognitions in those with and without post-traumatic stress disorder (PTSD).

METHOD

Trauma survivors with and without PTSD, from independent and interdependent cultures (N=106) provided major personal goals, self-defining memories, and self-cognitions.

RESULTS

Trauma survivors with PTSD from independent cultures reported more goals, self-defining memories, and self-cognitions that were trauma-related than non-PTSD trauma survivors from independent cultures. In contrast, for those from interdependent cultures, there was no difference between trauma survivors with and without PTSD in terms of trauma-centred goals, self-defining memories, and self-cognitions.

CONCLUSIONS

The results suggest cultural variability in the impact of trauma on memory and identity, and highlight the need for contemporary models of PTSD to more explicitly consider culture in their accounts of PTSD. Clinical implications of these findings, such as cultural considerations in assessment and treating trauma relevant self-schema in cognitive therapy for PTSD, are discussed.