Catastrophizing, rumination, and reappraisal prospectively predict adolescent PTSD symptom onset following a terrorist attack

Abstract

Background Disruptions in emotion regulation are a transdiagnostic risk factor for psychopathology. However, scant research has examined whether emotion regulation strategies are related to the onset of posttraumatic stress disorder (PTSD) symptoms among youths exposed to trauma. We investigated whether pretrauma emotion regulation strategies prospectively predicted PTSD symptom onset after the 2013 Boston Marathon terrorist attack among adolescents and whether these associations were moderated by the degree of exposure to media coverage of the attack. Methods A sample of 78 Boston-area adolescents (mean age =16.72 years, 65% female) who previously participated in studies assessing emotion regulation and psychopathology were recruited following the terrorist attack. Within 4 weeks of the attack, we assessed self-reported PTSD symptoms and attack-related media exposure via an online survey. We examined the association of pretrauma emotion regulation strategies with PTSD symptom onset after adjustment for pretrauma internalizing symptoms and violence exposure. Results Greater pretrauma engagement in rumination predicted onset of PTSD symptoms following the attack. Adolescents who engaged in catastrophizing also had greater PTSD symptoms postattack, but only when exposed to high levels of media coverage of the attacks; the same pattern was observed for adolescents who engaged in low levels of cognitive reappraisal. Conclusions Engagement in specific emotion regulation strategies prior to a traumatic event predicts the onset of PTSD symptoms among youths exposed to trauma, extending transdiagnostic models of emotion regulation to encompass trauma-related psychopathology in children and adolescents.

Cognitive Emotion Regulation Strategies and Insomnia or Other Psychiatric Symptoms among Humidifier Disinfectant Victims

“…However, findings are not dif- ferent from those for depression. More maladaptive strategies such as rumination and catastrophizing are frequently reported as predictors of developing PTSD or more severe symptoms whereas more adaptive strategies are related to lower symptoms or even posttraumatic growth [7,11,26]. Our findings of significant correlations between maladaptive strategies and insomnia, depression, anxiety, and posttraumatic symptoms are consistent with findings from previous studies.…”

“…Cognitive emotion regulation strategies can be adaptive or maladaptive depending on individuals [8,9]. Maladaptive emotion regulation strategies have been associated with more distress symptoms or onset of psychopathologies such as depressive disorder and PTSD while adaptive strategies have been related to fewer symptoms and ability to overcome stressful situations [8,10,11].…”

Childhood adversities and post-traumatic stress disorder: evidence for stress sensitisation in the World Mental Health Surveys

“…Other mechanisms are also likely to play a role in the associations of these specific MFF childhood adversities with PTSD, including habitual use of maladaptive emotion regulation strategies (such as rumination) and low social support, each of which is associated with child maltreatment and parent psychopathology as well as risk for PTSD. 1,41,54-56 …”

Child trauma exposure and psychopathology: mechanisms of risk and resilience

“…Patterns of emotion regulation observed in trauma-exposed children have been associated consistently with youth internalizing and externalizing psychopathology [35,36], and, when measured prior to trauma exposure, predict the subsequent onset of PTSD symptoms following a traumatic event [37]. Longitudinal studies confirm that emotion regulation difficulties are a mechanism linking child trauma to the onset of internalizing and externalizing symptoms [18,38].…”