Examining Cultural Differences in the Associations between Appraisals and Emotion Regulation and PostTraumatic Stress Disorder in Malaysian and Australian Trauma Survivors

Abstract

Appraisals and emotional regulation play a central role in posttraumatic stress disorder (PTSD). Despite research demonstrating cultural differences in everyday appraisals and emotion regulation, little research has investigated the influence of culture on these processes in PTSD. This study examined cultural differences in the associations between appraisals, emotion regulation and PTSD symptoms using trauma survivors from an individualistic Western culture (Australia) and a collectivistic Asian culture (Malaysia). Trauma survivors (N = 228; 107 Australian with European cultural heritage, 121 Malaysian with Malay, Indian or Chinese cultural heritage) completed an on-line survey assessing PTSD (PTSD Checklist for the DSM-5 with Life Events Checklist), appraisals (trauma-related, fatalism, cultural beliefs about adversity) and emotion regulation (suppression, reappraisal, interpersonal). The Malaysian group reported significantly greater fatalism, cultural beliefs about adversity, suppression and interpersonal emotion regulation than the Australian group. Greater trauma-specific appraisals, greater suppression, fewer cultural beliefs about adversity, and less use of social skills to enhance positivity were generally associated with greater PTSD symptom severity, with little evidence of cultural group moderating these associations. Interdependent self-construal mediated the relationships between cultural adversity beliefs, enhanced positivity, reappraisal, perspective taking and PTSD symptoms. Independent self-construal mediated the relationships between fatalism and perspective taking and PTSD symptoms. Cultural group did not moderate these indirect effects. Interdependent self-construal mediated the associations between interpersonal regulation strategies of soothing and social modelling with PTSD symptoms for the Malaysian but not the Australian group. These findings demonstrate the importance of considering self-construal and culture in understanding factors associated with PTSD.

Investigating the associations between cognitive appraisals, emotion regulation and symptoms of posttraumatic stress disorder among Asian American and European American trauma survivors

“…Our cultural group difference findings support notions that those from Asian cultural backgrounds place greater value on cognitive appraisals of secondary control, fatalism, and specific cultural beliefs about adversity 7 , 32 , 33 , 38 and those from European cultures emphasize their self-aspects 29 , 42 . As the foundations of psychological flexibility are associated with Eastern ideologies 23 , it is not surprising that the European American group reported less psychological flexibility.…”

“…Despite these findings, important questions remain regarding what emotion regulation and cognitive appraisals are of importance for trauma survivors with PTSD symptoms from Asian cultural backgrounds. While an initial study supported the notion that fatalism, cultural beliefs about adversity, and interpersonal emotion regulation may be valued in trauma survivors from Malaysia, and associated with PTSD symptom severity 38 , greater research is still needed to understand the relevance of these associations for Asian American groups.…”

Appraisal styles for adverse life events: An examination of the Adversity Appraisal Questionnaire.

“…As such, future research should continue to examine the reliability, validity, and factor structure found in the present study, with different samples. In particular, future research should examine the factor structure and potential differences based on culture, as prior research has found cultural differences in trauma appraisals such as fatalism/control/agency and beliefs about adversity (Jobson et al, 2022).…”

Posttraumatic Stress Disorder in Refugees

“…Moreover, collectivism appears to mediate the relationship between the roles of specific cognitive appraisals and emotion regulation strategies in PTSD symptom severity, irrespective of cultural group. One study found the association that whereas collectivist self-construal mediated the relationship between interpersonal regulation strategies (such as soothing and social modeling) with PTSD in a Malaysian sample, this was not evident in a Western sample ( Jobson et al 2022).…”