Article

Self Disclosing Trauma and Post Traumatic Stress Symptoms in Couples: A Longitudinal Study

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Abstract

Objective: Most research concerning the implications of self-disclosure on trauma's aftermath has focused on the salubrious effects disclosure may foster for the primary victim. However, the manner in which recipients of disclosure are symptomatically affected by it remains unexamined. Of particular interest are spouses who are often the primary support providers and are therefore susceptible to secondary traumatization Assessing posttraumatic stress symptoms (PTSS) and self-disclosure among traumatized veterans and their wives, the current longitudinal study begins to fill this gap in the literature. Method: 220 couples consisting of Israeli veterans, of whom 128 were former prisoners of war (ex-POWs) and 92 were combatants, and their wives were examined. PTSS and self-disclosure of both partners were assessed 30 and 35 years after the war using the PTSD Inventory (PTSD-I; Solomon, Benbenishty, Neria, & Abramowitz, 1993) and the self-disclosure index (SDI; Miller, Berg, & Archer, 1983) respectively. Analyses included Pearson intercorrelations analyses and four stepwise hierarchical multiple regression analyses. Results: Findings indicated that increments in veterans' disclosure are not only consistently associated with the reduction of their wives' PTSS, but may also explain and predict some of the change in the wives' PTSS over time. However, such a longitudinal effect was not evident concerning the veterans' PTSS. Conclusion: Traumatized ex-POWs' and combatants' self-disclosure within the marital relationship may contribute to the amelioration of their wives' secondary traumatization, and thus may be a goal worthwhile pursuing in therapy. However, more research is needed in order to further understand this relation.

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... PTSD symptom levels or presence of probable PTSD among supportive family members in military samples appeared to be significantly and negatively associated with partner level of education (Dekel et al., 2018;Dekel & Solomon, 2006), employment (Dekel & Solomon, 2006;Frančišković et al., 2007), couple forgiveness when fusion was high (Dekel, 2010), couple forgiveness when detachment was high (Dekel, 2010), survivor self-disclosure (Stein et al., 2017), income (Stein et al., 2017), and survivor's disclosure of trauma details . However, notably, among couples in which one spouse was a holocaust survivor and among couples in which one partner had experienced being a prisoner of war, sharing details of the traumatic event was not significantly associated with partner PTSD symptoms (Lev-Wiesel & Amir, 2001;. ...
... PTSD symptom levels or presence of probable PTSD among supportive family members in military samples appeared to be significantly and negatively associated with partner level of education (Dekel et al., 2018;Dekel & Solomon, 2006), employment (Dekel & Solomon, 2006;Frančišković et al., 2007), couple forgiveness when fusion was high (Dekel, 2010), couple forgiveness when detachment was high (Dekel, 2010), survivor self-disclosure (Stein et al., 2017), income (Stein et al., 2017), and survivor's disclosure of trauma details . However, notably, among couples in which one spouse was a holocaust survivor and among couples in which one partner had experienced being a prisoner of war, sharing details of the traumatic event was not significantly associated with partner PTSD symptoms (Lev-Wiesel & Amir, 2001;. ...
Article
The present narrative review examined quantitative and qualitative research on family members who support survivors of trauma or abuse. Studies included in the present review were found in peer-reviewed journal articles, available in English, published between 1980 and 2019, and focused specifically on the experiences of adult familial supporters of adult trauma and abuse survivors. A search of PsychInfo and Google Scholar identified 136 relevant articles, and analysis of their content generated the following categories: individual-level impacts (i.e., quality of psychological health, burden, secondary traumatic stress, quality of physical health, and positive impacts), interpersonal and environmental level impacts (i.e., quality of relationships with survivors, navigating environment, maltreatment and safety, and social impacts), and other experiences (i.e., social roles, needs, coping strategies, and sociocultural context). Findings indicate that the majority of existing studies examined the experiences of family members of adult survivors of military trauma. Results of the review suggest that family supporters of adult trauma and abuse survivors generally experience physical, emotional, cognitive, behavioral, social, safety, and relational impacts. Implications of review findings and directions for future research are discussed.
... Disclosure of emotions, especially negative emotions (e.g. fear), was associated with decreases in their own PTSD/PTSS (Stein, Lahav & Solomon, 2017). ...
... Then, the results found that self-disclosure had a signi cant negative predictive effect for PTSD, which is consistent with previous studies (e.g. Schackner, Weiss, Edwards, & Sullivan, 2017;Stein, Lahav, & Solomon, 2017 ) and support the uni ed theory of repression (Erdelyi, 2006), which proposes that the repression of thoughts, feelings, and behaviors is an active process consuming physiological energy. In addition, researchers who are critical of the uni ed theory of repression argued that the most painful events are sometimes the most di cult to repress (Freyd, 2006), attempts to push unwanted thoughts out of awareness often back re, enhancing their accessibility (McNally, 2006). ...
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Background: Posttraumatic Stress Disorder (PTSD) is one of the most prevalent psychopathologies experienced by victims following natural disasters. The severity of traumatic experience may be a critical risk factor for the development of PTSD. Nevertheless, other factors may also lead to PTSD. We propose that fear and self-disclosure could be two important factors. Previous studies have examined their unique roles in PTSD, but their combined role in PTSD has been rarely assessed. To fill this gap, the aim of this study was to examine the relationship between severity of traumatic exposure, fear, self-disclosure, and PTSD among victims following flood disaster. Methods: one hundred ninety-nine participants completed self-report questionnaires. Descriptive statistics were obtained using SPSS 17.0 and Pearson correlation coefficients were calculated to obtain correlations between major variables. Results: results indicated that severity of traumatic exposure not only had a direct effect on PTSD, but also it had an indirect effect on PTSD via activating victims’ fear. Moreover, self-disclosure played a buffering role between fear and PTSD. However, the role of fear in PTSD may decrease with increases in levels of self-disclosure. Conclusions: Traumatic exposure had positive predictive effects for PTSD and fear. Self-disclosure had negative predictive effects for PTSD. Fear played a mediating role between severity of traumatic exposure and PTSD, self-disclosure played a moderating role in the relationship between fear and PTSD. Psychological interventions should focus on the regulation of fear and improvement of self-disclosure following traumatic exposure.
... Disclosure of emotions, especially negative emotions (e.g. fear), was associated with decreases in their own PTSD/PTSS (Stein, Lahav & Solomon, 2017). ...
... Then, the results found that self-disclosure had a signi cant negative predictive effect for PTSD, which is consistent with previous studies (e.g. Schackner, Weiss, Edwards, & Sullivan, 2017;Stein, Lahav, & Solomon, 2017 ) and support the uni ed theory of repression (Erdelyi, 2006), which proposes that the repression of thoughts, feelings, and behaviors is an active process consuming physiological energy. In addition, researchers who are critical of the uni ed theory of repression argued that the most painful events are sometimes the most di cult to repress (Freyd, 2006), attempts to push unwanted thoughts out of awareness often back re, enhancing their accessibility (McNally, 2006). ...
Preprint
Full-text available
Background: Posttraumatic Stress Disorder (PTSD) is one of the most prevalent psychopathologies experienced by victims following natural disasters. The severity of traumatic experience may be a critical risk factor for the development of PTSD. Nevertheless, other factors may also lead to PTSD. We propose that fear and self-disclosure could be two important factors. Previous studies have examined their unique roles in PTSD, but their combined role in PTSD has been rarely assessed. To fill this gap, the aim of this study was to examine the relationship between severity of traumatic exposure, fear, self-disclosure, and PTSD among victims following flood disaster. Methods: one hundred ninety-nine participants completed self-report questionnaires. Descriptive statistics were obtained using SPSS 17.0 and Pearson correlation coefficients were calculated to obtain correlations between major variables. Results: results indicated that severity of traumatic exposure not only had a direct effect on PTSD, but also it had an indirect effect on PTSD via activating victims’ fear. Moreover, self-disclosure played a buffering role between fear and PTSD. However, the role of fear in PTSD may decrease with increases in levels of self-disclosure. Conclusions: Traumatic exposure had positive predictive effects for PTSD and fear. Self-disclosure had negative predictive effects for PTSD. Fear played a mediating role between severity of traumatic exposure and PTSD, self-disclosure played a moderating role in the relationship between fear and PTSD. Psychological interventions should focus on the regulation of fear and improvement of self-disclosure following traumatic exposure.
... In fact, Yang and Ha (2019) found that firefighters' PTG is likely to be promoted if their deliberate ruminations were enhanced after experiencing work-related traumatic events. Although, self-disclosing trauma may prevent post-traumatic stress symptoms (Stein et al., 2017), patient with PTSD can experience PTG if therapists help patients receive positive social responses from listeners and find meaning of life in the self-disclosing process. In addition, these three factors need to be considered when attempting to promote PTG even when applying other clinical methods, and not just for self-disclosure. ...
Article
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Background To explore how self-disclosure leads to post-traumatic growth (PTG) in adults who have experienced traumatic events, this study identified the relationship between self-disclosure and post-traumatic growth in Korean adults. We examined a parallel multiple mediating model for this relationship. Methods Participants were 318 Korean male and female adult participants aged 20 years or older who had experienced trauma. We measured deliberate rumination, positive social responses, and the meaning of life as mediating variables. Results The results revealed that the study variables positively correlated with PTG. Self-disclosure was positively correlated with deliberate rumination, positive social responses, and meaning of life. In the multiple mediating model, deliberate rumination, positive social responses, and meaning of life mediated the relationship between self-disclosure and PTG. Conclusion Self-disclosure, deliberate rumination, positive social responses, and meaning of life play an important role in the growth of adults who have experienced traumatic events. The findings of this study should provide valuable information for future research and for mental health professionals who want to promote the PTG of their clients.
... Unfortunately, this limits crucial insight (a) on the relationship between daily stressors and trauma-related symptoms and maladaptive relational functioning, and (b) into individual and dyadic processes that have helped couples affected by trauma successfully navigate these stressors. Much of extant research have used standardized clinical diagnostic assessments of PTSD to measure the effects of traumatic stress and exposure on couple functioning (e.g., Renshaw et al., 2014;Ruhlmann et al., 2019;Stein et al., 2017). As a result, trauma-based theoretical and clinical conceptualization and intervention stem from a diagnosis of PTSD. ...
Article
Objective: Empirical knowledge about "dual-trauma couples" (DTC), characterized by both partners with a history of trauma exposure and presentation of trauma-related symptoms, is especially deficient. We analyzed DTC partners' qualitative data culled from the Relationship Evaluation Questionnaire (Busby et al., 2001) to ascertain dyadic resiliency processes within dual-trauma couples. Method: A data-reductive thematic analysis on short-answer responses of reported relational strengths and weaknesses from female (n = 822) and male partners' (n = 831) yielded several processes that provide insight into individual perceptions, behaviors, and past experiences, and dyadic interactions that may foster or hinder effective resilience in DTC. Results: Participant responses highlighted existing dyadic strengths that fostered effective couple adaptative processes: shared beliefs and goals, mutual collaboration and psychological flexibility, and dyadic connectedness. Barriers to couple resiliency included individual perceptions, behaviors, and past experiences, and dyadic interactions that exacerbated relational instability, emotional unsafety, contentious communication, and difficulties with distress tolerance. Conclusions: Results promote a balanced conceptualization (i.e., inclusion of both adaptive and maladaptive interactions) of couples affected by trauma exposure. Implications for clinical treatment and several areas for future research are discussed.
... This is consistent with other work showing that the momentary experience of empathy for another indeed involves sharing in their distress or pain [69]. However, other work focused on marital relationships specifically found that self-disclosure is related to positive outcomes for the recipient of the disclosure [70]. There are other contextual factors that may affect how beneficial self-disclosure is for both parties that were not measured in the present study, including the valence of the patient's disclosure and their reasons for disclosing to the caregiver; it may be, for example, that patients tended to self-disclose more negative thoughts and feelings, which in turn could be stressful for caregivers to hear and respond to, thus raising their BP. ...
Article
Background Cancer impacts both patients and their family caregivers. Evidence suggests that caregiving stress, including the strain of taking on a new role, can elevate the risk of numerous health conditions, including high blood pressure (BP). However, the caregiver’s psychosocial experiences, including their interpersonal relationship with the patient, may buffer some of the negative physiological consequences of caregiving. Purpose To examine the influence of psychosocial contextual variables on caregiver ambulatory BP. Methods Participants were 81 spouse–caregivers of patients with advanced gastrointestinal or thoracic cancer. For an entire day at home with the patient, caregivers wore an ambulatory BP monitor that took readings at random intervals. Immediately after each BP reading, caregivers reported on physical circumstances (e.g., posture, activity) and psychosocial experiences since the last BP measurement, including affect, caregiver and patient disclosure, and role perceptions (i.e., feeling more like a spouse vs. caregiver). Multilevel modeling was used to examine concurrent and lagged effects of psychosocial variables on systolic and diastolic BP, controlling for momentary posture, activity, negative affect, and time. Results Feeling more like a caregiver (vs. spouse) was associated with lower systolic BP at the same time point. Patient disclosure to the caregiver since the previous BP reading was associated with higher diastolic BP. No lagged effects were statistically significant. Conclusions Caregivers’ psychosocial experiences can have immediate physiological effects. Future research should examine possible cognitive and behavioral mechanisms of these effects, as well as longer-term effects of caregiver role perceptions and patient disclosure on caregiver psychological and physical health.
... In addition, problematic communication hinders the open exchange of trauma experiences between parents and children. This may mean children make exaggerated guesses about their parents' distress (e.g., Stein et al., 2017) and have an increased probability of ruminating on trauma-related cues. In such cases, parents' marital conflicts may be associated with a lower level of self-differentiation and more psychological inflexibility and rumination among adolescents. ...
Article
Objective: Various theories have been proposed to elucidate the mechanisms underlying the effect of parental posttraumatic stress symptoms (PTSSs) on their children. However, these theories focused on unique mechanisms for some factors and overlooked the combined role of different factors. This study aimed to construct a broad theoretical framework to comprehensively understand the mechanisms underlying the effect of parents' PTSSs on adolescents. We examined the combined role of parental PTSSs and marital conflict, and adolescents' self-differentiation, psychological inflexibility, and rumination after super typhoon Lekima. Method: We used self-report questionnaires to investigate 1,218 parent-adolescent dyads in the area most affected by the disaster 3 months after the typhoon. Results: Parents' PTSSs had a direct and positive association with adolescents' PTSSs. We also observed parents' PTSSs had an indirect relationship with adolescents' PTSSs through parental marital conflict and adolescents' self-differentiation, psychological inflexibility, and rumination. Conclusions: An effect of PTSSs may be found in the dyadic interaction between parents and their children. Children's psychological and behavioral changes resulting from impaired family relationship functioning exhibited by their posttraumatic parents also play an important role in the interpersonal effect of PTSSs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Regarding the interpersonal dimension, two primary factors are important for fostering PTG among suicide-loss survivors-self-disclosure and social support. Authentic self-disclosure (to at least one significant other) is a prerequisite for a healthy adjustment (Smyth et al., 2012) and buffers against distress in various stressful situations (e.g., Gvion & Levi-Belz, 2018;Stein et al., 2017). Feigelman et al. (2018) demonstrated that high self-disclosure levels concerning a suicide event were significantly associated with diminished grief and mental health difficulties. ...
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Suicide-loss survivors often experience personal growth in the aftermath of a loss, depending on their personal and interpersonal characteristics. The current study focuses on the role of self-forgiveness (SF) as a contributing factor, both directly and indirectly, to posttraumatic growth (PTG) among suicide-loss survivors. Israeli suicide-loss survivors (N = 124) completed questionnaires measuring SF and PTG as well as adaptive coping strategies, social support, and self-disclosure. SF positively contributed to PTG, both directly and indirectly, through interpersonal and cognitive processes. These findings highlight the value of actions promoting self-forgiveness, compassion, and acceptance in psychological interventions with suicide-loss survivors.
... On a note of necessary hopefulness, it was shown that the disclosures of the traumatized ex-POWs' and combatants' within the marital relationship may have contributed to the amelioration of their wives' secondary traumatization [21]. The essential influence of the hypothalamic-pituitary-adrenal axis (HPA) in stress-related homeostasis suggests that there is a dysregulation of HPA involvement in the etiopathogenesis of PTSD. ...
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Based on attachment theory and a social-cognitive model of posttraumatic stress disorder (PTSD), this study examined the roles of parent–child communication, perceived parental depression, and intrusive rumination in the association between insecure attachment to parents and PTSD among adolescents following the Jiuzhaigou earthquake. In this study, 620 adolescents were recruited to complete self-report questionnaires. The results showed that the direct association between anxious attachment and PTSD was significant, but that between avoidant attachment and PTSD was non-significant. In addition, both anxious and avoidant attachment had indirect associations with PTSD via the mediating effects of parent–child communication openness and problems, perceived parental depression, and intrusive rumination. However, the specific paths between anxious and avoidant attachment and PTSD were different. The findings indicated that insecure attachment among adolescents following the earthquake was predictive for their PTSD, and the mechanisms underlying the association between anxious attachment and PTSD and the association between avoidant attachment and PTSD were distinct. To alleviate PTSD, more attention should be paid to improving the quality of parent–child communication for adolescents with avoidant attachment to parents, and to reducing negative cognition in adolescents with anxious attachment.
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Secondary traumatization describes the phenomenon whereby those in proximity to trauma survivors develop psychological symptoms similar to those experienced by the direct survivor. The current study examined secondary trauma (ST) and generalized distress symptoms (general psychiatric symptomatology, functional disability, and self-rated health) in wives of former prisoners of war (ex-POWs). The study compared wives of Israeli ex-POWs from the 1973 Yom Kippur War with wives of a matched control group of non-POW Yom Kippur War combat veterans (CVs). The wives also were divided into groups based on their husbands' current posttraumatic stress disorder (PTSD) status and PTSD trajectory (i.e., chronic, delayed), and their outcomes were compared with resilient CVs. We found that wives of ex-POWs with PTSD reported higher ST and generalized distress than wives of ex-POWs and non-POW CVs without PTSD. Wives of ex-POWs with chronic PTSD reported the highest levels of functional disability. We also found that the relationships between husbands' prior captivity, and wives' ST and general psychiatric symptomatology were fully mediated by the husbands' PTSD symptoms. These findings indicate that it is exposure to a partner with PTSD that leads to overall ST and other distress symptoms, and not simply to a trauma survivor. Furthermore, the more severe their husbands' PTSD, the more wives are at risk for ST and general psychiatric symptomatology. Wives of partners with PTSD should therefore be considered high-risk groups for ST and distress that may require targeted interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
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Although secondary traumatization has been extensively studied, gender difference in susceptibility has received limited attention. This study addressed the issue by a meta-analysis of published findings on male and female persons in close, extended relationships with trauma victims, namely, their spouses, parents, children, and therapists. The analysis included peer-reviewed studies, written in English and published between 1990 and January 2012. Twelve studies reporting 17 findings on 1,623 subjects were identified. All the studies showed females' higher susceptibility to secondary traumatization, with a mean effect size of 0.48 (95% CI [0.35, 0.60]). Moderator analysis revealed that studies conducted in the United States reported lower gender discrepancies than studies conducted elsewhere. The consistent finding that females are considerably more susceptible to secondary traumatization than males means that professionals must be made aware of the special vulnerability of girls and women and help them adopt ways of caring for the traumatized family member or clients while maintaining their own psychological boundaries. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Article
Virtually all discussions and applications of statistical mediation analysis have been based on the condition that the independent variable is dichotomous or continuous, even though investigators frequently are interested in testing mediation hypotheses involving a multicategorical independent variable (such as two or more experimental conditions relative to a control group). We provide a tutorial illustrating an approach to estimation of and inference about direct, indirect, and total effects in statistical mediation analysis with a multicategorical independent variable. The approach is mathematically equivalent to analysis of (co)variance and reproduces the observed and adjusted group means while also generating effects having simple interpretations. Supplementary material available online includes extensions to this approach and Mplus, SPSS, and SAS code that implements it.
Article
Building on knowledge from research focusing on "vicarious traumatization" or "compassion fatigue" on therapists and others who work with victims of trauma, this study focused on researchers. The article reports the results of an exploratory, qualitative study of eighteen interviewers of Holocaust survivors from four different Holocaust research projects using a survey instrument and several open-ended questions. The results indicate that there were more positive than negative impacts on the researchers. Positive impacts include: increased appreciation for the resilience and strength of survivors; a greater appreciation for one's life; a stronger Jewish identity; and a greater sense of justice. Negative impacts include only one case of what could be viewed as vicarious traumatization or compassion fatigue. Other negative impacts on the interviewers were: difficulty in listening to the traumatic narratives, increased fear and vulnerability as a Jew, and a general sadness about the dark side of humanity. However, in all cases these negative impacts were mitigated by the positive benefits the interviewer respondents felt they gained from doing this work. The latter part of the paper discusses how interviewers coped with the traumatic material and the implications for future research.
Article
Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Article
This study combines the fever model with communication privacy management to examine the conditions under which military wives are likely to disclose their family stressors or engage in protective buffering with their deployed husbands. Military wives (N =105) whose husbands were deployed and who had at least one child completed a web-based survey about the communication of family stressors during deployment. Protective buffering was associated with negative health symptoms, and disclosure was related to marital satisfaction. Wives' perceptions that their husbands were in dangerous situations as well as their perceptions that husbands were supportive of their disclosures were both related to protective buffering and disclosure.
Article
Previous research has shown that receiving social support in the face of negative events (i.e., enacted support) is sometimes correlated with positive outcomes, sometimes unrelated to outcomes, and sometimes associated with negative outcomes. However, people's perception that they have high-quality support available to them when they have a stressor (i.e., perceived support) is consistently and strongly associated with better health, well-being, and relationship functioning. However, both enacted and perceived support available in response to positive event disclosures are consistently associated with positive outcomes. In 2 studies, we examined why enacted support for negative events has such a spotty record and compared it with enacted support for positive events; a third study examined how support for positive events may be a major contributor to perceived availability of effective support for negative events. The results showed that providing responsive support to negative events is particularly difficult; received support for negative events disclosures (but not positive event disclosures) involves substantial drawbacks and risks, especially when that support is not responsive to the recipient's needs; and that enacted support for positive events was a better predictor of later perceptions of the quality of available support for stressors than enacted support for negative events. Findings are discussed in terms of implications for the social support literature and how positive relationship processes influence health and well-being, not only directly but also indirectly by providing critical information regarding the availability of others if a problem occurs. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Article
This review of the literature reveals that veterans' posttraumatic stress disorder (PTSD) following exposure to combat violence affects veterans' familial relationships and the psychological adjustment of family members. Previous study within other trauma populations has conceptualized the negative impact of an individual's traumatic stress on his/her family members as “secondary traumatization.” This review examines the processes by which secondary traumatization occurs within combat veterans' families. Research has identified PTSD as mediating the effect of veterans' combat experience on the family. Veterans' numbing/arousal symptoms are especially predictive of family distress; while, to a lesser extent, veterans' anger is also associated with troubled family relationships and secondary traumatization among family members. Empirical modeling of additional factors involved in secondary traumatization is needed. Marital/family interventions have largely focused on improving relationships and reducing veterans' symptoms, rather than targeting improvements in the psychological well-being of the spouse and children. Interventions directly addressing the needs of significant others, especially spouses, are advocated. The potential for increased effectiveness of PTSD interventions and possible cost-savings attained by improving relationships and reducing caregiver burden are also discussed.
Article
: Individuals who have experienced traumatic events often share their experiences in story form. This sharing has consequences for both storytellers and listeners. Understanding the experience of both members of the listener-storyteller dyad is of value to nurses who are often the listener within the nurse-patient dyad. : The aim of this study was to illuminate the experiences of the listener and the storyteller when a traumatic event is shared within the dyad. : The phenomenon was explored using an interpretive phenomenological approach. Participants consisted of 12 dyads, each with a storyteller and a listener. The storytellers were individuals who had been involved in U.S. Airways Flight 1549 when it crash-landed in the Hudson River in January 2009. Each storyteller identified a listener who had listened to them share their story of this event, dubbed The Miracle on the Hudson. In-depth interviews were conducted with each storyteller and each listener. : Five essential themes emerged from the data: Theme 1, The Story Has a Purpose; Theme 2, The Story as a Whole May Continue to Change as Different Parts Are Revealed; Theme 3, The Story Is Experienced Physically, Mentally,Emotionally, and Spiritually; Theme 4, Imagining the "What" as well as the "What If"; and Theme 5, The Nature of the Relationship Colors the Experience of the Listener and the Storyteller. Roy's Adaptation Model of Nursing was found to be applicable to the findings of this study. : For the participants in this study, the experience of sharing a traumatic event involved facts, feelings, and images. The story evolved as it was remembered, told, and listened to in a nonlinear, multifaceted way. The listener and the storyteller collaborated, adapted, and responded physically, mentally, emotionally, and spiritually.
Article
Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.
Article
Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.
Article
The challenges of peacekeeping place individuals at risk for the development of significant psychological distress (e.g., B. T. Litz, S. Orsillo, M. Freidman, P. Ehlich, & A. Batres, 1997). Self-disclosure has been shown to ameliorate psychological distress following exposure to potentially traumatic events (J. W. Pennebaker & K. D. Harber, 1993). Sharing, or self-disclosure of deployment-related experiences, was the focus of this study and was hypothesized to be associated with adaptation. As part of a larger investigation, 426 U.S. military personnel who served as peacekeepers in Somalia were administered a comprehensive psychosocial questionnaire that included measures of exposure to negative and potentially traumatic experiences, reception at homecoming, self-disclosure, and PTSD symptom severity. The results indicate that adjustment to peacekeeping is significantly related to self-disclosure, especially to supportive significant others.
Article
Post-traumatic stress (PTS) is a significant clinical problem in the general population. However, only a portion of those exposed to trauma develop PTS. Patterns of emotional self-disclosure have the potential to explain some of the individual differences in the development and continuation of symptoms. In this study, the authors investigated the links between emotional self-disclosure, as measured by the Emotional Self-Disclosure Scale (ESDS; W. E. Snell, R. S. Miller, & S. S. Belk, 1988). and a post-trauma psychological state, as measured by the Trauma Symptom Inventory (TSI; J. Briere, 1995). Their results showed that, in general, men engaged in less emotional self-disclosure than did women, and as TSI scores increased, the men were significantly less willing to disclose emotions of happiness. For women, as TSI scores increased they were significantly more willing to engage in talk about emotions related to anxiety but less willing to talk about emotions related to fear. The authors considered these data within current understandings of the role of emotional self-disclosure in the processing of traumatic experiences.
Article
Marriage is a ubiquitous social status that consistently is linked to health. Despite this, there has been very little theory development or related research on the extent to which couple members are jointly motivated to and actively engage in health-enhancing behaviors. In this paper we propose an integrative model, based on interdependence theory and communal coping perspectives, that explicitly considers dyadic processes as determinants of couple behavior. Our integrated model applies these constructs to consider how couple dynamics might influence adoption of risk-reducing health habits. Accordingly, we suggest that the couple's interdependence can transform motivation from doing what is in the best interest of the self (person-centered), to doing even selfless actions that are best for the continuation of the relationship (relationship-centered). In turn, this transformation can lead to enhanced motivation for the couple to cope communally or act cooperatively in adopting health-enhancing behavior change. Implications for research related to couples and health behavior change are also highlighted.
Article
The aim of the study is to examine secondary traumatization of wives of former prisoners of war (POWs) as manifested in posttraumatic stress disorder (PTSD) symptoms, additional psychiatric symptoms, and marital adjustment. In addition, it assessed the role of several contributors to the wives' secondary traumatization: the husband's PTSD, the level of his verbal and physical aggression, and the wife's level of self-disclosure. The study compared three groups of Israeli wives: wives of POWs with PTSD (N=18), wives of POWs without PTSD, (N=64), and a control group of wives of veterans without PTSD (N=72). The highest level of distress in all measures was endorsed by the wives of POWs with PTSD. Moreover, in addition to husband's PTSD and captivity, both the man's aggression and the wife's self-disclosure played a role in the wife's level of distress. The findings show that the husbands' PTSD was more strongly associated with the wives' secondary traumatization than their captivity.
Article
Disclosing information, thoughts, and feelings about personal and meaningful topics (experimental disclosure) is purported to have various health and psychological consequences (e.g., J. W. Pennebaker, 1993). Although the results of 2 small meta-analyses (P. G. Frisina, J. C. Borod, & S. J. Lepore, 2004; J. M. Smyth, 1998) suggest that experimental disclosure has a positive and significant effect, both used a fixed effects approach, limiting generalizability. Also, a plethora of studies on experimental disclosure have been completed that were not included in the previous analyses. One hundred forty-six randomized studies of experimental disclosure were collected and included in the present meta-analysis. Results of random effects analyses indicate that experimental disclosure is effective, with a positive and significant average r-effect size of .075. In addition, a number of moderators were identified.
Diagnostic and statistical manual of mental disorders
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Publishing.