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Uncontrollability and Unpredictability in Post-Traumatic Stress Disorder: An Animal Model
Psychological Bulletin
Abstract
The disturbances observed in animals subjected to unpredictable and uncontrollable aversive events resemble post-traumatic stress disorder (PTSD) symptoms and thus may constitute an animal model of this disorder. It is argued that the similarity between animals' symptoms and those of trauma victims may reflect common etiological factors. Relevant experiments in which animals exhibit generalized fear and arousal, discrete fear of a conditioned stimulus (CS), analgesia, and avoidance are reviewed with the view that these manifestations may be analogous to the PTSD symptom clusters of persistent arousal, reexperiencing, numbing, and avoidance, respectively. Finally, animal paradigms are suggested to test the validity of the model and specific hypotheses are derived from the animal literature regarding trauma variables that are predictive of particular PTSD symptom clusters.
... A second theoretical perspective on PTSD is informed by animal models of neurosis (Foa, Zinbarg, & Rothbaum, 1992). Foa et al. (1989) viewed phobic avoidance as a primary symptom in PTSD and argued that PTSD is simulated in animals when avoidant responses are classically conditioned to environmental cues that had previously signaled safety. ...
... Foa et al. (1989) viewed phobic avoidance as a primary symptom in PTSD and argued that PTSD is simulated in animals when avoidant responses are classically conditioned to environmental cues that had previously signaled safety. According to their model, similar conditioning would tend to occur in humans under two conditions: (a) when a traumatic event violates strongly held knowledge (i.e., safety expectations) in a preexisting network of memories or (b) when the trauma occurs repeatedly (Foa et al., 1992). Consistent with the views of Foa and colleagues, cognitive theorists have concluded that traumatic events tend to violate previously held beliefs or expectations. ...
... Another problem for PTSD models is accounting for individual differences in responses to similar stressors. Foa et al. (1992) have noted that individual differences in information processing should render some people more vulnerable to PTSD than others. Other researchers have suggested that individual differences in cognition and coping may be important moderators of response to traumatic stress (Gibbs, 1989;Green, Wilson, & Lindy, 1985).' ...
A review of theories to predict the mental health effects of child sexual abuse suggests that existing models have not adequately defined stress and coping constructs and have not specified how those variables might interact with other environmental factors. This article outlines a transactional model that conceptualizes sexual abuse as a stressor consisting of a series of abuse events, abuse-related events, and disclosure-related events that each tend to increase risk for maladaptive outcomes. The model also proposes that cognitive appraisals and coping responses mediate the effects of these events, that developmental and environmental factors may moderate relationships between sexual abuse stressors and victim responses, and that victims' initial responses may effect subsequent levels of abuse-related stress. Empirical studies relevant to the major components of this model are reviewed, and the implications of these findings for future research are considered.
... This may reflect an underlying mechanism of a sense of safety, security and certainty as influential to refugee mental health. Conditions of safety and security in the aftermath of trauma exposure have long been recognized as being core conditions for good post-trauma recovery [163][164][165] . Fostering these conditions should represent a key priority for refugees in HICs and LMICs. ...
There are currently over 117 million forcibly displaced people worldwide, and approximately 45 million of these are refugees and asylum-seekers. Despite exposure to substantial adversity, many refugees do not develop clinically significant psychopathology. There is a need to understand factors that are associated with good mental health in refugees to inform policy-makers and practitioners working with refugees. Here we aim to synthesize research on factors that are protective (associated with lower negative mental health outcomes) or promotive (associated with higher positive mental health outcomes) among adult refugees living in high-income countries (HICs) and lower-and-middle-income countries (LMICs). We searched four databases (PubMed, Embase, ProQuest and PsycINFO) for relevant studies conducted up until December 2022. A total of 174 articles were included in this review, of which 81% were undertaken in HICs and 19% in LMICs. Key protective and promotive factors were identified across the following domains: sociodemographic characteristics (for example, male gender/sex), environmental factors (for example, financial security, permanent visa status), sociocultural factors (for example, social support, support engagement) and psychological factors (for example, self-efficacy). Based on the outcomes of this review, we provide recommendations for governments, organizations and policymakers working to support good mental health in refugees and propose a research agenda to advance knowledge in the field. Cross-domain investigation and cross-disciplinary collaboration represents a critical next step to understanding and enhancing factors that promote good mental health in refugees.
... Perceived control is frequently discussed in conjunction with stressful life events, in which events perceived as uncontrollable are more distressing than those perceived as controllable (Foa et al., 1992). According to Skinner (1995), experiencing control is an innate and universal need for individuals to facilitate interactions with their environment. ...
During the COVID-19 pandemic, many regions and countries implemented lockdowns and isolation to curb the virus’s spread, which might increase loneliness and lead to a series of psychological distress. This study aims to investigate the association between loneliness and depression during the COVID-19 pandemic and examine whether perceived social support and perceived internal control mediate the loneliness-depression relationship in China. Self-report questionnaires were distributed online in two waves during the pandemic in 2020. At Wave 1, demographics and loneliness were reported when the lockdown was initially implemented in China, and at Wave 2, as the pandemic came under control and the epicenter lifted its lockdown. Depression, perceived social support, and perceived internal control were measured at both two waves. Higher levels of loneliness at Wave 1 were associated with more depression at Wave 2 after controlling for baseline depression and demographic variables. Simple mediation models showed that both perceived social support and internal control at two waves independently mediated the relationship between Wave 1 loneliness and Wave 2 depression. Additionally, the serial multiple mediation model indicated that perceived social support and perceived internal control sequentially mediated the path from loneliness to subsequent depression. A higher level of loneliness during the initial lockdown was linked with more severe depression with the development of the COVID-19 pandemic. Both perceived social support and perceived internal control acted as essential protective factors against depression from loneliness. Meanwhile, social support might protect mental health by enhancing the sense of self-control when facing loneliness.
... There is emerging interest in the predictability of childhood stressors themselves. An abundance of human and non-human animal studies demonstrate that exposure to unpredictable stress is associated with poorer outcomes than predictable stress (Foa et al., 1992;Miller, 1981;Seligman et al., 1971;Weiss, 1970). However, there is a smaller body of research that focuses on how predictable stress may contribute to resilience. ...
Greater unpredictability in childhood from the level of the caregiver-child dyad to broader family, home, or environmental instability is consistently associated with disruptions in cognitive, socioemotional, behavioral, and biological development in humans. These findings are bolstered by experimental research in non-human animal models suggesting that early life unpredictability is an important environmental signal to the developing organism that shapes neurodevelopment and behavior. Research on childhood unpredictability has surged in the past several years, guided in part by theoretical grounding from the developmental psychopathology framework (shaped largely by Dr. Dante Cicchetti’s innovative work). The current review focuses on future directions for unpredictability research, including probing intergenerational effects, the role of predictability in resilience, cultural and contextual considerations, and novel developmental outcomes that should be tested in relation to childhood unpredictability. We urge the integration of multidisciplinary perspectives and collaborations into future research on unpredictability. We also provide ideas for translating this research to real-world practice and policy and encourage high-quality research testing whether incorporating predictability into interventions and policy improves developmental outcomes, which would support further dissemination of these findings.
... Mental defeat is related to, but not identical with, the concept of perceived uncontrollability, which is thought to be of crucial importance in the etiology of PTSD (Basoglu & Mineka, 1992;Foa, Zinbarg, & Rothbaum, 1992). Tortured people may feel completely out of control and hopeless (e.g., "There is nothing I can do; he is going to kill me") but may still retain the sense that they have a will of their own and that their value system is unaffected by the perpetrator; they may even get some satisfaction from facing death with an unbroken spirit (i.e., uncontrollability, but no mental defeat). ...
An interview study of 81 former political prisoners investigated whether posttraumatic stress disorder (PTSD) is related to the way individuals process the prison experience. In contrast to participants without PTSD, those with chronic or remitted PTSD were more likely to perceive mental defeat and an overall feeling of alienation from other people. Chronic PTSD was also related to perceived negative and permanent change in their personalities or life aspirations. The groups did not differ in their attempts to gain control during imprisonment. Evidence for a relationship between political commitment and PTSD was mixed. The results suggest that mental defeat, alienation, and permanent change are related to PTSD after interpersonal trauma and may need to be addressed in treatment.
Earthquakes are natural disasters that cause loss of life, property, and can lead to mental health issues such as PTSD. The Kahramanmaraş Earthquakes, which caused widespread destruction across Turkey on February 6, 2023, significantly impacted the psychosocial well-being of university students. The aim of this study was to investigate the relationship between the symptoms of post-traumatic stress disorder, coping strategies with earthquake stress, and striving for goals and the factors affecting them in university students after the 6 February earthquakes in Turkey. The mean scale scores of the participants were ESCS (46.0±8.7) high, SGS (40.8±6.1) moderate, and PSS-SR (32.9±12.0) moderate. According to the sociodemographic characteristics of the participants and their experiences in the earthquake, the mean scores of ESCS and PSS-SR and the median score value of SGS showed a significant difference (p
Emerging evidence suggests that the enhanced activity of lateral habenula (LHb) is involved in depressive disorders. This abnormal potentiation of LHb neurons was shown to originate from presynaptic alterations; however, the mechanisms underlying this presynaptic enhancement and physiological consequences are yet to be elucidated. Previously, we reported that presynaptic transmission in the LHb is temporally rhythmic, showing greater activity in the afternoon than in the morning. Here, we used a learned helpless rodent model of depression to show that exposure to a stressor or incubation with the stress hormone, corticosterone, abolished the presynaptic temporal variation in the LHb. In addition, selective inhibition of mitogen-activated protein kinase (MAPK) kinase (MAPKK, MEK) activity in the LHb restored the presynaptic alteration even after stress exposure. Moreover, we observed a slight increase in phosphorylated synapsin I after stress exposure. Finally, we found that a blockade of MAPK signaling before stress exposure successfully prevented the depression-like behaviors, including behavioral despair and helplessness, in an acute learned helpless animal model of depression. Our study delineates the cellular and molecular mechanisms responsible for the abnormal presynaptic enhancement of the LHb in depression, which may mediate depressive behaviors.
Uncertainty about potential future threats and the associated anxious anticipation represents a key feature of anxiety. However, the neural systems that underlie the subjective experience of threat anticipation under uncertainty remain unclear. Combining an uncertainty-variation threat anticipation paradigm that allows precise modulation of the level of momentary anxious arousal during functional magnetic resonance imaging (fMRI) with multivariate predictive modeling, we train a brain model that accurately predicts subjective anxious arousal intensity during anticipation and test it across 9 samples (total n = 572, both gender). Using publicly available datasets, we demonstrate that the whole-brain signature specifically predicts anxious anticipation and is not sensitive in predicting pain, general anticipation or unspecific emotional and autonomic arousal. The signature is also functionally and spatially distinguishable from representations of subjective fear or negative affect. We develop a sensitive, generalizable, and specific neuroimaging marker for the subjective experience of uncertain threat anticipation that can facilitate model development.
The Veterans Health Administration’s Whole Health system of care focuses on offering veterans holistic health approaches and tailoring health care to individual’s goals and preferences. The present study assessed factors associated with Whole Health use and its potential benefits among veterans with posttraumatic stress disorder (PTSD) receiving Veterans Health Administration care. This cohort study used retrospective electronic health records combined with survey data (baseline, 6 months) from 18 Veterans Affairs Whole Health pilot implementation sites and compared patient-reported outcomes between veterans who used Whole Health services versus those who did not, among veterans with (n = 1,326) and without (n = 3,243) PTSD. Patient-reported outcomes assessed were pain (PEG), patient-reported outcomes measurement information system physical and mental health functioning, and a one-item global meaning and purpose assessment. Veterans with PTSD were more likely to have used Whole Health (38% vs. 21%) than those without PTSD. Veterans with PTSD who used Whole Health services experienced small improvements over 6 months in physical (Cohen’s d = .12) and mental (Cohen’s d = .15) health functioning. Veterans without PTSD who used Whole Health services experienced small improvements in physical health (Cohen’s d = .09) but not mental health (Cohen’s d = .04). Veterans with PTSD were frequently connected with Whole Health services even though implementation efforts were not explicitly focused on reaching this population. Results suggest Whole Health may play an important role in how veterans with PTSD engage with health care.
This article applies recent developments in cognitive–social theory to health-protective behavior, articulating a Cognitive-Social Health Information Processing (C-SHIP) model. This model of the genesis and maintenance of health-protective behavior focuses on the individual's encodings and construals, expectancies, affects, goals and values, self-regulatory competencies, and their interactions with each other and the health-relevant information in the course of cognitive–affective processing. In processing health information, individuals are assumed to differ in both the accessibility of these mental representations and the organization of relationships among them. In this article, the model is applied to analyze and integrate the often-confusing findings on breast self-examination in cancer screening. Implications are considered for assessments and interventions to enhance adherence to complex, long-term, health-protective regimens, tailored to the needs and characteristics of the individual.
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