Rumination and emotion-related biases in refreshing information.

The present research examined rumination-related biases in refreshing, a component process of memory updating that involves briefly thinking back to a just-activated thought or percept. In 2 studies, participants were presented with neutral words and with task-relevant (Study 1) and task-irrelevant (Study 2) emotional words. We predicted that brooding, a maladaptive subtype of rumination would be associated with biased refreshing. Compared with nonbrooders, brooders showed slowed refreshing (of emotional and neutral words) when relevant emotional words were presented. Moreover, whereas among nonbrooders only task-relevant emotional words impaired refreshing of neutral words, among brooders both relevant and irrelevant emotional words led to this impairment. These biases were not accounted for by depression, and they were specific to refreshing words rather than to perceptual processing of the words. These findings are discussed in relation to the magnitude and nature of emotional interference in rumination. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

An examination of the co-morbidity between chronic pain and posttraumatic stress disorder on U.S. Veterans.

The purpose of this study was to assess the comorbidity between chronic pain and posttraumatic stress disorder (PTSD) and examine the extent to which PTSD is associated with changes in the multidimensional experience of pain in a sample of Veterans with chronic pain. It was hypothesized that Veterans with comorbid chronic pain and PTSD would report significantly higher scores on measures of pain intensity, pain behaviors, pain-related disability, and affective distress than Veterans with pain alone. Data were obtained from 149 Veterans who completed self-report questionnaires as part of their participation in a Psychology Pain Management program at a northeastern Department of Veterans Affairs health care facility. Analyses indicated that 49% of the sample met criteria for PTSD. A multivariate analysis of covariance was conducted with age, sex, pain duration, and depressive symptom severity as covariates. In partial support of our hypothesis, the presence of PTSD was found to contribute significantly to measures of affective distress, even after controlling for the effects of depressive symptom severity. The implications of these data are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Processing threatening information in posttraumatic stress disorder.

The authors used a modified Stroop task to study how people with posttraumatic stress disorder (PTSD) process threatening information. Participants were motor vehicle accident (MVA) survivors with either PTSD (n?=?15), simple phobia of driving (n?=?15), or low anxiety (n?=?15). Participants named colors of 4 types of words: strong threat words (MVA related), mild threat words (MVA related), positive words, and neutral words. Participants with PTSD demonstrated greater interference on strong threat words than those with simple phobia or low anxiety. Contrary to expectation, participants with simple phobia did not display an interference effect. Findings suggest that individuals with PTSD and simple phobia may process threatening information differently. The nature of attentional bias in different anxiety conditions following trauma is discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Enhanced priming for trauma-related words predicts posttraumatic stress disorder.

There is preliminary evidence that enhanced priming for trauma-related cues plays a role in posttraumatic stress disorder (PTSD). A prospective study of 119 motor vehicle accident survivors investigated whether priming for trauma-related stimuli predicts PTSD. Participants completed a modified word-stem completion test comprising accident-related, traffic-related, general threat, and neutral words at 2 weeks post-trauma. Priming for accident-related words predicted PTSD at 6 months follow-up, even when initial symptom levels of PTSD and depression and priming for other words were controlled. The results are in line with the hypothesis that enhanced priming for traumatic material contributes to the development of chronic PTSD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Alcohol use disorder history moderates the relationship between avoidance coping and posttraumatic stress symptoms.

Avoidance coping (AVC) is common in individuals with posttraumatic stress disorder (PTSD) and in individuals with alcohol use disorder (AUD). Given that PTSD and AUD commonly co-occur, AVC may represent a risk factor for the development of comorbid posttraumatic stress and alcohol use. In this study, the relationship between AVC and PTSD symptoms (PTSS) was examined in individuals with versus without AUDs. Motor vehicle accident (MVA) victims were assessed 6 weeks postaccident for AUD history (i.e. diagnoses of current or past alcohol abuse or dependence) and AVC. PTSS were assessed 6 weeks and 6 months post-MVA. All analyses were conducted on the full sample of MVA victims as well as on the subset of participants who were legally intoxicated (blood alcohol concentration ≥ 0.08) during the accident. It was hypothesized that the relationship between AVC and PTSS would be stronger in those individuals with an AUD history and especially strong in the subset of individuals who were legally intoxicated during the MVA. Results were largely supportive of this hypothesis, even after controlling for in-hospital PTSS, gender, and current major depression. Early assessment of AUD history and avoidance coping may aid in detecting those at elevated risk for PTSD, and intervening to reduce AVC soon after trauma may help buffer the development of PTSD + AUD comorbidity. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Regional brain electrical activity in posttraumatic stress disorder after motor vehicle accident.

This study examined whether patients with posttraumatic stress disorder (PTSD) related to motor vehicle accidents (MVAs) would show an abnormal pattern of electroencephalographic (EEG) alpha asymmetries, which has been proposed for particular types of anxiety. Patients with PTSD (n = 22) or subsyndromal PTSD (n = 21), traumatized controls without PTSD (non-PTSD with MVA; n = 21), and healthy controls without MVA (n = 23) underwent measurement of EEG activity during baseline and exposure to a neutral, a positive, a negative, and an accident-related picture. Differences in brain asymmetry between groups were observed only during exposure to trauma-related material. PTSD and subsyndromal PTSD patients showed a pattern of enhanced right anterior and posterior activation, whereas non-PTSD with MVA participants showed the opposite pattern. Furthermore, posterior asymmetry in nontraumatized healthy controls varied with gender, with female participants showing a pattern of higher right posterior activation. The results support the hypothesis that symptomatic MVA survivors are characterized by a pattern of right hemisphere activation that is associated with anxious arousal and symptoms of PTSD during processing of trauma-specific information. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual and perceptual priming and dissociation in chronic posttraumatic stress disorder.

Cognitive models of posttraumatic stress disorder (PTSD) assert that memory processes play a significant role in PTSD (see e.g., Ehlers & Clark, 2000). Intrusive reexperiencing in PTSD has been linked to perceptual processing of trauma-related material with a corresponding hypothesized lack of conceptual processing. In an experimental study that included clinical participants with and without PTSD (N = 50), perceptual priming and conceptual priming for trauma-related, general threat, and neutral words were investigated in a population with chronic trauma-induced complaints as a result of the Troubles in Northern Ireland. The study used a new version of the word-stem completion task (Michael, Ehlers, & Halligan, 2005) and a word-cue association task. It also assessed the role of dissociation in threat processing. Further evidence of enhanced perceptual priming in PTSD for trauma stimuli was found, along with evidence of lack of conceptual priming for such stimuli. Furthermore, this pattern of priming for trauma-related words was associated with PTSD severity, and state dissociation and PTSD group made significant contributions to predicting perceptual priming for trauma words. The findings shed light on the importance of state dissociation in trauma-related information processing and posttraumatic symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive Processing of Emotional Information in Depression, Panic, and Somatoform Disorder.

Emotional Stroop tasks (subliminal/supraliminal exposures), implicit memory tasks (tachistoscopic word identification), and explicit memory tasks (free recall after incidental learning) with 4 word types (physical threat, positive, negative, and neutral words) were administered to patients with major depressive disorder (n = 30), panic disorder (n = 33), somatoform disorder (n = 25), and healthy control participants (n = 33). On the Stroop task, panic patients showed subliminal interferences for physical threat and negative words, depressive patients showed supraliminal interferences for negative words, and somatoform patients showed supraliminal interferences for physical threat words. No patient groups demonstrated implicit memory biases. On the explicit memory task, depressive and panic patients showed memory biases for negative words; somatoform patients showed biases for physical threat words. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Responding to threat: Hemispheric asymmetries and interhemispheric division of input.

This investigation examined how hemispheric asymmetry and interhemispheric processing contribute to attentional biases toward emotional information. Participants (n?=?88) named the color of lateralized squares presented concurrently with neutral, positive, or threatening words. A left-hemisphere advantage in color naming was reduced when distractors were emotional, suggesting right-hemisphere priming by emotional stimuli. Furthermore, the advantage of dividing the word and color across visual fields was increased for emotion words when they were frequently presented, indicating a strategic use of interhemispheric division of labor to reduce the distracting effect of emotional words. Finally, participants with high levels of anxious apprehension were most likely to make use of this interhemispheric processing strategy, supporting a processing efficiency theory of cognitive function in anxiety. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Imaginal exposure alone and imaginal exposure with cognitive restructuring in treatment of posttraumatic stress disorder.

This study investigated the extent to which providing cognitive restructuring (CR) with prolonged imaginal exposure (IE) would lead to greater symptom reduction than providing IE alone for participants with posttraumatic stress disorder (PTSD). Fifty-eight civilian survivors of trauma with PTSD were randomly allocated to IE/CR, IE, or supportive counseling (SC). Treatment involved 8 individual weekly sessions with considerable homework. Independent assessments were conducted pretreatment, posttreatment, and at 6-month follow-up. IE/CR and IE resulted in reduced PTSD and depression compared with SC at posttreatment and follow-up. Further, IE/CR participants had greater reductions in PTSD and maladaptive cognitive styles than IE participants at follow-up. These findings suggest that providing CR in combination with IE may enhance treatment gains. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Are gender differences in post-traumatic stress disorder rates attenuated in substance use disorder patients?

We review 15 studies that examined rates of post-traumatic stress disorder (PTSD) in substance use disorder (SUD) patients to determine whether the typical female-greater-than- male gender difference in PTSD rates is attenuated in SUD samples. Since the majority of studies reviewed did not find a gender difference in PTSD rates, we critically examined methodological factors that might account for this attenuation, but none appeared to completely account for the variability in detection of gender differences across studies. Several factors may contribute to making rates of PTSD among SUD males equivalent to the high rates observed in SUD females: 1) the risky lifestyle associated with men's substance abuse may increase their exposure to traumatic events, 2) a history of more severe trauma characteristics may be apparent among men with SUDs, or 3) attenuated gender differences in rates of other comorbidities that increase PTSD risk (e.g., depression) may exist. Clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Assessing posttraumatic disorder with the MMPI–2 in a sample of workplace accident victims.

In this study, the predictive capacity of the Minnesota Multiphasic Personality Inventory–2 Posttraumatic Stress Disorder–Keane (MMPI–2 PK) scale was examined in a sample of trauma victims who experienced a serious workplace-related accident and subsequent injury. In keeping with a number of previous investigations, the PK scale was largely ineffective in identifying posttraumatic stress disorder (PTSD) beyond overall symptom and functional severity. In contrast, sets of clinical and content scales proved to be significant predictors of PTSD. These findings suggest that the PK scale is not particularly useful in detecting PTSD in civilian trauma samples. Clinicians might be best advised to use the MMPI–2 clinical and content scales in their assessment of PTSD in civilian patients presenting with a history of trauma. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Revisiting bias effects in word-initial phonological priming.

The phonological priming paradigm, in which participants respond to the second of 2 consecutively presented spoken words, has the potential to be a useful tool with which to study lexical processing. Concerns about response biases distorting the results have persisted since its introduction. This study explored the manifestation of biases by modifying the standard priming experiment such that the magnitude of priming effects using the same items could be compared at different points during the testing session. Four experiments investigated whether a recent dissociation of response biases and priming effects is evidence of lexical inhibition when the prime and target overlap by the first 3 word-initial phonemes (M. Hamburger & L. A Slowiaczek, 1996). Biases were found in conditions previously thought to prevent their influence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treatment of posttraumatic stress disorder with comorbid panic attacks: Combining cognitive processing therapy with panic control treatment techniques.

A large proportion of patients who present for treatment of posttraumatic stress disorder (PTSD) experience comorbid panic attacks, yet currently available PTSD treatment programs do not address this problem. This report provides an initial evaluation of a newly developed treatment, multiple channel exposure therapy (M-CET), for comorbid PTSD and panic attacks. The treatment uses elements of cognitive processing therapy treatment for PTSD and elements of panic control treatment to target physiological, cognitive, and behavioral symptoms. Results suggest that M-CET may be a promising treatment program for a subset of PTSD patients who experience panic attacks. Preliminary guidelines for conducting M-CET in a group format with participants exposed to diverse traumatic events are provided. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Brain potentials elicited by garden-path sentences: Evidence of the application of verb information during parsing.

Event-related potentials were recorded from 13 scalp locations while participants read sentences containing a syntactic ambiguity. In Exp 1, syntactically disambiguating words that were inconsistent with the "favored" syntactic analysis elicited a positive-going brain potential (P600). Exp 2 examined whether syntactic ambiguities are resolved by application of a phrase-structure-based minimal attachment principle or by word-specific subcategorization information. P600 amplitude was a function of subcategorization biases rather than syntactic complexity. These findings indicate that such biases exist and can influence the parser under certain conditions and that P600 amplitude is a function of the perceived syntactic well-formedness of the sentence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Remembering the Good, Forgetting the Bad: Intentional Forgetting of Emotional Material in Depression.

The authors examined intentional forgetting of negative material in depression. Participants were instructed to not think about emotional nouns that they had learned to associate with a neutral cue word. The authors provided participants with multiple occasions to suppress the unwanted words. Overall, depressed participants successfully forgot negative words. Moreover, the authors obtained a clear practice effect. However, forgetting came at a cost: Compared with the nondepressed participants and with the depressed participants who were instructed to forget positive words, depressed participants who were instructed to forget negative words showed significantly worse recall of the baseline words. These results indicate that training depressed individuals in intentional forgetting could prove to be an effective strategy to counteract automatic ruminative tendencies and mood-congruent biases. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Classification of chronic pain patients with the Brief Symptom Inventory: Patient characteristics of cluster profiles.

In this study, the psychological symptom patterns of individuals with chronic pain on the Brief Symptom Inventory (BSI) were cluster analyzed. Cluster analysis was initially performed on a sample of 1,489 people with chronic pain and then cross-validated on a smaller sample of 244 people. A 2-cluster solution was deemed most appropriate. The clusters reflected low- and high-profile elevations on all BSI subscales. As part of their clinical evaluation, participants also completed the Pain Disability Index, the adjective list from the McGill Pain Questionnaire, and a modified version of the Posttraumatic Chronic Pain Test. Among persons in the smaller sample, high-profile participants were more likely to be involved in litigation, report a higher frequency of posttraumatic stress symptoms, and display poorer psychosocial functioning. The results suggest that the BSI subgroups are associated with psychosocial characteristics that may be important in terms of treatment planning and outcome. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Processing of threat-related information in rape victims.

We investigated selective processing of threat information in persons with posttraumatic stress disorder (PTSD) by using a modified Stroop Color and Word Test. Ss were 15 rape victims with PTSD, 13 rape victims without the disorder, and 16 nontraumatized control Ss. They were asked to name the color of 4 types of words: specific threat (rape-related) words, general threat (related to physical harm and death) words, neutral words, and nonwords. Rape victims with PTSD evidenced a longer response latency for color naming of rape-related words than for other target-word types. Response latencies of non-PTSD victims and nonvictim control Ss did not differ across word types. Possible mechanisms underlying the selective processing of threat material are considered, and clinical implications are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Shifts in attention biases in response to acute pain induction: Examination of a model of "conversion" among repressors.

Unlike most people, those who are characterized by a repressive coping style report high levels of physical (sensory) pain but low levels of emotional distress (affective pain), which is a discrepancy that may suggest a “conversion” process. In two studies, we tested an attention allocation model, proposing that repressors direct attention away from threatening negative affective information and toward nonthreatening physical pain information during emotionally arousing (painful) situations. In Study 1, 84 participants underwent a cold pressor and then recovered. Repressors reported greater pain during recovery than low- and high-anxious participants, but they reported lower distress than high-anxious participants. Repressors reported significant and large discrepancies between high pain and low distress, whereas these differences were less pronounced for other groups. In Study 2, 77 participants underwent an ischemic pain task while performing a modified dot-probe task with sensory and negative affective pain words as stimuli. Repressors showed increasing biases away from affective pain words and toward sensory pain words as the pain task continued, whereas low- and high-anxious participants did not show these shifts in attention. The results support the notion that conversion among repressors may involve a process by which attention is directed away from emotional distress during noxious stimulation and is focused instead on sensory information from pain. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Pain, depression, and physical functioning following burn injury.

Objective: Little is known about how pain and depression after burn injury may influence long-term outcomes such as physical functioning. This prospective study examined associations between pain, depression, and physical functioning in a sample of burn injury survivors. Design and Participants: Questionnaires assessing pain, depression, and physical functioning were completed by 64 (52% of original sample) adult burn survivors shortly after discharge from burn care and at 1- and 2-year follow-ups. Results: Pain and physical functioning improved over the 2 years of the study, whereas depression levels were stable. Pain and depression were associated with poorer physical functioning over time, but associations varied according to the time span under consideration. Also, the association between pain and physical functioning was strongest among persons with higher depression scores. Conclusions: Pain and depression may contribute independently to compromises in physical functioning. The co-occurrence of pain and depression represents even greater risk for reduced physical functioning over time among burn survivors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)