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September 2011 - July 2013
August 2005 - June 2011
Publications
Publications (60)
Objective: Media portrayals of sexual violence have been associated with greater rape myth acceptance (RMA). The present study examined how social media posts rejecting or endorsing rape myths affected RMA and negative affect (NA), and moderating roles of gender and political affiliation. Method: Participants were randomized into one of three simul...
Traumatic stress reactions (TSRs) exist on a continuum that includes posttraumatic stress disorder (PTSD), highly comorbid psychopathology, and resilience, highlighting the need for comprehensive and integrative approaches capable of capturing the full spectrum of heterogeneous reactions. Here, we used a transdiagnostic and multidimensional method...
Rumination, or thinking passively and repetitively about one’s distress, and low emotional clarity, or not understanding one’s emotions, are risk factors for psychopathology. It has been suggested that people attempt to increase emotional clarity by ruminating, but whether ruminating works to help or harm emotional clarity in the moment is unknown....
Disgust is a common emotional response to trauma but is studied less frequently than fear or other negative emotions. In laboratory settings, individuals with a history of sexual assault report more disgust following exposure to trauma reminders than those exposed to other trauma types, and people with more severe posttraumatic stress disorder (PTS...
Introduction: Trauma exposure is often assessed using checklists such as the Life Events Checklist for DSM-5 (LEC-5; Weathers et al., 2013b). When participants endorse multiple events, respondents are asked to identify a single, worst event (i.e., index event). Recent work indicates that the “worst event” method leads to a concerning number of fals...
The ability to make fine-grained distinctions between discrete negative emotions—termed negative emotion differentiation (NED)—is important for emotion regulation and psychological well-being. Posttraumatic stress disorder (PTSD) is associated with elevated trauma-related negative emotions (e.g., fear, anger, guilt, shame) and self-reported difficu...
This study examined how the #MeToo movement, and backlash against it (#HimToo), influence rape myth acceptance (RMA) and negative affect among female sexual trauma survivors and controls. We randomly assigned college women (N = 389) to three social media conditions that either promoted RMA (#HimToo), challenged RMA (#MeToo), or did not address rape...
Problems with positive emotion are an important component of posttraumatic stress disorder (PTSD), with competing perspectives as to why. The global model suggests that people with PTSD experience a relatively permanent shift in their capacity for positive emotion regardless of context, whereas the context-specific model posits access to the full r...
Rumination, or thinking repetitively about one's distress, is a risk factor for posttraumatic stress disorder (PTSD). Current theories suggest that rumination contributes to PTSD symptoms directly, by increasing negative reactions to trauma cues (i.e., symptom exacerbation), or represents a form of cognitive avoidance, if verbal ruminations are les...
Objective: Posttraumatic stress disorder (PTSD) is highly comorbid with internalizing and externalizing symptoms, but few studies have examined risk factors that can account for these comorbidities. The primary aim of this study is to investigate the role of blame attribution (i.e., self-blame and other blame) and impulsivity dimensions (i.e., nega...
Prior research suggests that anhedonia symptoms related to posttraumatic stress disorder (PTSD; i.e., diminished interest, detachment from others, and difficulty experiencing positive emotions) are consistently associated with a higher degree of impairment in psychosocial functioning beyond that associated with other PTSD symptoms. Unfortunately, m...
Objective: The US military veteran population is changing rapidly, and contemporary data on the prevalence of DSM-5 posttraumatic stress disorder (PTSD) are lacking. The DSM-5 clarified PTSD Criterion A to delineate direct and indirect trauma exposures, but effects on the conditional probability of PTSD and functional impairment remain unknown. The...
Posttraumatic stress disorder (PTSD) is associated with increased health care costs; however, most studies exploring this association use PTSD diagnostic data in administrative records, which can contain inaccurate diagnostic information and be confounded by the quantity of service use. We used a diagnostic interview to determine PTSD diagnostic st...
Objective:
Emotion regulation (ER) plays a prominent role in the development and maintenance of posttraumatic stress disorder (PTSD). Although links between ER strategies and PTSD symptoms are well documented, recent advancements in ER research emphasize the need to move beyond examining ER strategies as isolated processes. Instead, there is a gro...
Respiratory sinus arrhythmia (RSA) reactivity is thought to indicate how adaptively one responds to stress. RSA reactivity has been examined across anxiety disorders and posttraumatic stress disorder (PTSD), to better understand the psychophysiological stress response of these disorders. The current state of the literature is mixed, and the associa...
Depression is a common problem with debilitating effects. Both negative interpretation biases and rumination are related to depression, but how these factors interact to produce depression is unclear. Prior cross-sectional research indicates that negative interpretation biases have an indirect effect on depression symptoms through rumination, but t...
This paper reviews and critically assesses the implications of directed forgetting (DF) research on clinical populations. We begin by reviewing the typical methods and results of the item method and list method directed forgetting procedures and provide best practice recommendations for future studies using clinical populations. Next, we note that...
The Life Events Checklist for DSM-5 (LEC-5) is a comprehensive screening instrument used to detect exposure to a range of potentially traumatic events. Despite its widespread use, research assessing the psychometric properties of scores on the LEC-5-and trauma exposure more broadly-is scarce. Using a large sample of undergraduate students (N = 1,01...
This study estimated gender differences in the posttraumatic stress disorder (PTSD) symptom network structure (i.e., the unique associations across symptoms) using network analysis in a Latin American sample. Participants were 1,104 adults, taken from epidemiological studies of mental health following natural disasters and accidents in Mexico and E...
Theory suggests that, in those with posttraumatic stress disorder (PTSD), positive emotion is likely dampened due to re-experiencing of trauma-related stimuli. Prior research has extended positive emotion experiencing to reward processing research but has not yet examined how trauma cues affect reward processing (i.e., the anticipation of and satis...
Objective:
The current study investigated whether rumination accounts for the relationship between multiple aspects of emotion regulation (ER) difficulties and posttraumatic stress disorder (PTSD) severity.
Method:
Participants were 90 community members (43% diagnosed with PTSD; Mage = 26.7, 86% female) who were interviewed using the Clinician-A...
Introduction: Emotion regulation in healthy functioning and in depression is typically examined as an intrapersonal phenomenon, but growing evidence suggests social factors affect individuals’ strategy use and effectiveness. We examined whether the role of emotion regulation in depression—concurrently and over four weeks—depends on social connected...
Objective:
Effectively responding to suicide risk among veterans involves further developing understanding of reactions to combat experiences, including life-threatening events, traumatic losses, and morally injurious experiences. An important determinant of whether stressors lead to poor mental health outcomes is the perception of meaning. The cu...
Rumination (negative thinking about the past) and worry (anxious apprehension) are two forms of repetitive thinking associated with psychopathology. Prior research indicates that rumination and worry have both distinct and overlapping features, but the extent to which there are separable groups of individuals who engage in rumination, worry, or bot...
Network theory, which conceptualizes psychiatric disorders as networks of interacting symptoms, may provide a useful framework for understanding psychopathology. However, questions have arisen regarding the stability and generalizability of network analytic methods, with some researchers arguing that symptom networks have limited replicability. The...
1 Background
Suicide rates among veterans have increased markedly since the onset of Operations Enduring Freedom (OEF) and Iraqi Freedom (OIF; LeardMann et al., 2013). Identification of factors with the greatest contribution to suicide risk among veterans is needed to inform risk assessment and to identify intervention targets.
2 Methods
This stud...
Objective:
In this study, we examined the prevalence of positive and negative perceptions of military service, associations between these perceptions and other demographic and military-related factors, and the extent to which endorsement of positive and negative perceptions of military service are associated with current mental health problems amo...
Background
The proposed ICD-11 criteria for posttraumatic stress disorder (PTSD) differ substantially from the DSM-5. ICD-11 eliminated several PTSD symptoms thought to be nonspecific, with the goal of reducing psychiatric comorbidities. However, this change also results in a narrower PTSD definition that may fail to capture individuals with clinic...
The majority of research examining affective attentional bias in posttraumatic stress disorder (PTSD) has not examined the influence of co-occurring psychiatric disorders. This study examined the individual and interactive effects of PTSD symptoms and substance use disorders (SUDs) on affective attentional processing among 323 veterans deployed to...
Background:
Combat exposure is associated with increased risk of mental disorders and suicidality. Moral injury, or persistent effects of perpetrating or witnessing acts that violate one's moral code, may contribute to mental health problems following military service. The pervasiveness of potentially morally injurious events (PMIEs) among U.S. co...
Objective:
With the publication of DSM-5, important changes were made to the diagnostic criteria for posttraumatic stress disorder (PTSD), including the addition of 3 new symptoms. Some have argued that these changes will further increase the already high rates of comorbidity between PTSD and other psychiatric disorders. This study examined the pr...
Rejection sensitivity and negative cognitive biases have been identified as important risk factors for depression. Rejection sensitivity is defined as the tendency to anxiously anticipate, easily perceive, and overreact to rejection. Although prior studies have found an association between one component of rejection sensitivity, the tendency to anx...
Although the effectiveness of exposure therapy for PTSD is recognized, treatment mechanisms are not well understood. Emotional processing theory (EPT) posits that fear reduction within and between sessions creates new learning, but evidence is limited by self-report assessments and inclusion of treatment components other than exposure. We examined...
Objective:
The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes significant changes to Criterion A for posttraumatic stress disorder (PTSD), the criterion that defines which events qualify as "traumatic." This systematic review explores the fundamental question of how to define a trauma by reviewing the d...
Traumatic brain injury (TBI) is associated with suicidal behavior among veterans, and gender differences in the strength of associations may exist. Almost all research has been limited to Veterans Health Administration (VHA) patients, and it is unclear if findings generalize to veterans who do not use VHA services. We examined gender- and VHA-user-...
Our emotional responses to stressors do not occur in a vacuum; rather, they are dependent upon the context in which they take place. In recent years, there has been a growing interest in identifying such contextual influences on emotional processes. However, two important questions have yet to be answered. First, little is known about how motivatio...
Self-distancing, or viewing oneself from a third-person perspective, reduces reactivity when analyzing one’s feelings. Self-distancing may have important effects among individuals with posttraumatic stress disorder (PTSD), who have heightened emotional and physiological reactivity to trauma memories, but the effects of self-distancing in this group...
To describe the prevalence of posttraumatic stress disorder (PTSD) and comorbid psychiatric disorders and identify correlates of PTSD in a contemporary, nationally representative sample of US veterans.
Data were analyzed from Wave 1 of the National Health and Resilience in Veterans Study, a cross-sectional, retrospective, web-based survey of a popu...
Cognitive theories propose that negatively biased thinking is an important factor in the development and maintenance of depression. The mechanisms by which cognitive biases lead to depression, however, have not been thoroughly researched. One potential mechanism is that negatively biased thoughts trigger rumination, or the process of focusing passi...
Postdoctoral training is increasingly common in the field of psychology. Although many individuals pursue postdoctoral training in psychology, guidelines for research training programs at this level do not exist. The rapid advances in the field, particularly with respect to genetics, neuroimaging, and data analytic approaches, require clinical scie...
Suicide is a prevalent problem among veterans deployed to Iraq and Afghanistan. Traumatic brain injury (TBI) and psychiatric conditions, such as posttraumatic stress disorder (PTSD), are potentially important risk factors for suicide in this population, but the literature is limited by a dearth of research on female veterans and imprecise assessmen...
The high degree of comorbidity among mental disorders has generated interest in identifying transdiagnostic processes associated with multiple types of psychopathology. Susan Nolen-Hoeksema conceptualized rumination as one such transdiagnostic process associated with depression, anxiety, substance abuse, binge eating, and self-injurious behavior. T...
We examined the extent to which cognitive emotion-regulation (ER) strategies moderated posttraumatic stress disorder (PTSD) treatment outcome among 40 motor vehicle accident survivors. Participants were randomly assigned to either a brief written exposure therapy (WET) condition or a waitlist condition and were assessed pre- and posttreatment and a...
Intense subjective distress and physiologic reactivity upon exposure to reminders of the traumatic event are each diagnostic features of posttraumatic stress disorder (PTSD). However, subjective reports and psychophysiological data often suggest different conclusions. For the present study, we combined data from five previous studies to assess the...
Presents an obituary for Susan Nolen-Hoeksema. Susan received her bachelor's degree from Yale University and her doctorate in clinical psychology from the University of Pennsylvania. Her undergraduate and graduate school mentors were Irving Janis, Robert Sternberg, and Martin Seligman. Susan began her career at Stanford University, where she became...
Background:
Suicide is a significant public health problem. Although various studies have found evidence of posttraumatic stress disorder (PTSD) as a risk factor for suicidal behaviors, no study has examined whether or not PTSD treatment decreases suicidal thoughts. This study aims to fill this gap in the literature by examining changes in suicida...
Attentional interference by threat is associated with PTSD, but the mechanisms of this relationship remain unclear. Attentional interference might be related to increased use of maladaptive thought control strategies, such as suppressing unwanted thoughts (thought suppression) or replacing threatening thoughts with everyday concerns (worry), which...
Post-traumatic stress disorder (PTSD) is a prevalent problem among military personnel and veterans. Identification of effective screening tools, diagnostic technologies, and treatments for PTSD is essential to ensure that all individuals in need of treatment are offered interventions with proven efficacy. Well-validated methods for screening and di...
Attentional biases for sadness are integral to cognitive theories of depression, but do not emerge under all conditions. Some researchers have argued that depression is associated with delayed withdrawal from, but not facilitated initial allocation of attention toward, sadness. We compared two types of withdrawal processes in clinically depressed a...
Cognitive theories of depression emphasize negatively biased interpretations as an important target of therapy. Much of the research on interpretation bias in depression has focused on selection, or deciding which of several interpretations is likely. However, depressive biases may also exist in the generation of possible interpretations, or the ab...
The selective recall of positive memories is thought to be an effective mood repair technique, but little research has examined individual differences in the motivation or ability to implement this strategy. This study examined factors considered likely to impact valenced memory recall: dysphoria and emotion regulation strategies (i.e., cognitive r...
Rumination is a response to distress in which individuals focus repetitively on their feelings and the causes and consequences
of those feelings. When induced to ruminate, dysphorics exhibit more negative mood and recall more negative memories, but
these effects are not seen in nondysphorics. This pattern of results could be due to trait-like diffe...
Cognitive models of depression, which propose that depression is associated with negatively biased thinking, have typically focused on either the content or the processes of depressive cognition. Content-based models suggest that depressive thought is more negative for self-relevant than for externally-focused content. Process-based models propose...
This chapter reviews the evidence that a ruminative response style increases risk for depression, describes the proposed mechanisms by which rumination increases this risk, and discusses possible treatment implications. Increased risk is not specific to depression but generalizes to other forms of psychopathology. Rumination is a mode of responding...
The response styles theory (Nolen-Hoeksema, 1991) was proposed to explain the insidious relationship between rumination and depression. We review the aspects of the response styles theory that have been well-supported, including evidence that rumination exacerbates depression, enhances negative thinking, impairs problem solving, interferes with ins...
