A network analysis of anger, shame, proposed ICD-11 post-traumatic stress disorder, and different types of childhood trauma in foster care settings in a sample of adult survivors

Abstract

Background: Anger and shame are aspects that are specifically associated with psychopathology and maladaptation after childhood abuse and neglect. They are known to influence symptom maintenance and exacerbation; however, their interaction is not fully understood. Objective: To explore with network analysis the association and interaction of prolonged, complex interpersonal childhood abuse and neglect in institutional foster care settings [institutional abuse (IA)] with anger, shame, and the proposed 11th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-11) post-traumatic stress disorder (PTSD) symptoms in adult survivors. Method: Adult survivors of IA (N = 220, mean age = 57.95 years) participated in the study and were interviewed using the Childhood Trauma Questionnaire, the International Trauma Questionnaire, the State–Trait Anger Expression Inventory, the Displaced Aggression Questionnaire, and shame-related items. To identify the most central aspects, we used a staged network analysis and centrality analysis approach: (1) on the scale level; (2) on the item/symptom level; and (3) with modularity analysis to find communities within the item-level network. Results: Trait anger, anger rumination, emotional abuse, and PTSD re-experiencing symptoms played the most important roles on a scale level and were then further analyzed on the item/symptom level. The most central symptom on the item level was anger rumination related to meaningful past events. The modularity analysis supported discriminant validity of the included scales. Conclusions: Anger is an important factor in the psychopathological processes following childhood abuse. Anger rumination is closely related to PTSD symptoms; however, anger is not a part of the proposed ICD-11 PTSD in the present study.

The Study of Psychopathology from the Network Analysis Perspective: A Systematic Review

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A decennial review of psychotraumatology: what did we learn and where are we going?

“…In 2017, EJPT led the way by being the first journal to publish a special issue on network analysis in psychotraumatology (Armour, Fried, & Olff, 2017). This special issue contained network analyses of PTSD in refugees (Spiller et al, 2017), sexual abuse survivors (McNally, Heeren, & Robinaugh, 2017), and terror attack survivors , as well as a study exploring comorbidity of ICD-11 PTSD symptoms with anger and shame (Glück, Knefel, & Lueger-Schuster, 2017).…”

Associations Between Child Maltreatment, Autonomic Regulation, and Adverse Cardiovascular Outcome in an Urban Population: The HELIUS Study

“…Moreover, missing data in the child maltreatment questionnaire were significantly more frequent in every ethnicity compared to the Dutch ethnicity, which may be related to two factors. First, there could be a larger component of shame and taboo within some ethnicities to report these adverse experiences (65). Second, the ethnic differences may have resulted from the formulation of our items on child maltreatment: it is possible that some participants would have endorsed the objective explanation (e.g.…”