Exploring cultural differences in the use of emotion regulation strategies in posttraumatic stress disorder

Nagulendran, Amanda; Jobson, Laura

doi:10.1080/20008198.2020.1729033

Cited by 27 publications

(23 citation statements)

References 27 publications

(36 reference statements)

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“…Another of social-emotional processes [ 29 ], which may lead to PTSD symptoms. For example, both cultural differences in relation to emotional dysregulation and associated PTSD symptoms [ 30 ], as well as in neural correlates of affective and cognitive functions that impact on the subsequent manifestation and progression of PTSD [ 31 ], have been found.…”

Section: Discussionmentioning

confidence: 99%

Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries

Stupar¹,

Stevanović²,

Vostanis

et al. 2021

Child Adolesc Psychiatry Ment Health

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Background Exposure to traumatic events in childhood is associated with the development and maintenance of various psychiatric disorders, but most frequently with posttraumatic stress disorder (PTSD). The aim of this study was to evaluate the types of traumatic events experienced and the presence and predictors of PTSD symptoms among adolescents from the general population from ten low- and middle-income countries (LMICs). Methods Data were simultaneously collected from 3370 trauma-exposed adolescents (mean age = 15.41 [SD = 1.65] years, range 12–18; 1465 (43.5%) males and 1905 (56.5%) females) in Brazil, Bulgaria, Croatia, Indonesia, Montenegro, Nigeria, the Palestinian Territories, the Philippines, Romania, and Serbia, with Portugal, a high-income country, as a reference point. The UCLA PTSD Reaction Index for the DSM-5 (PTSD-RI-5) was used for the assessment of traumatic events and PTSD symptoms. Results The most frequently reported traumatic events were death of a close person (69.7%), witnessing violence other than domestic (40.5%), being in a natural disaster (34.4%) and witnessing violent death or serious injury of a close person (33.9%). In total, 28.5% adolescents endorsed two to three DSM-5 PTSD criteria symptoms. The rates of adolescents with symptoms from all four DSM-5 criteria for PTSD were 6.2–8.1% in Indonesia, Serbia, Bulgaria, and Montenegro, and 9.2–10.5% in Philippines, Croatia and Brazil. From Portugal, 10.7% adolescents fall into this category, while 13.2% and 15.3% for the Palestinian Territories and Nigeria, respectively. A logistic regression model showed that younger age, experiencing war, being forced to have sex, and greater severity of symptoms (persistent avoidance, negative alterations in cognitions and mood, and alterations in arousal and reactivity) were significant predictors of fulfilling full PTSD criteria. Conclusions Nearly every third adolescent living in LMICs might have some PTSD symptoms after experiencing a traumatic event, while nearly one in ten might have sufficient symptoms for full DSM-5 PTSD diagnosis. The findings can inform the generation of PTSD burden estimates, allocation of health resources, and designing and implementing psychosocial interventions for PTSD in LMICs.

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Section: Discussionmentioning

confidence: 99%

Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries

Stupar¹,

Stevanović²,

Vostanis

et al. 2021

Child Adolesc Psychiatry Ment Health

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“…European Australian trauma survivors with PTSD have been found to report less use of individualistic reappraisal strategies, and greater use of suppression, worry, and emotion dysregulation than European Australian trauma survivors without PTSD. For Asian Australian trauma survivors these regulation strategies were not associated with PTSD symptoms [22]. It has recently been proposed that Asian cultures that value interdependence may find interpersonal emotion regulation strategies to be particularly effective in reducing negative affect [23].…”

Section: Introductionmentioning

confidence: 94%

“…However, these studies have all been conducted using Asian samples living in Western cultures, which raises questions about acculturation and generalizability to Asian cultures. Moreover, much of this research has demonstrated that Western-focused appraisals and emotion regulation strategies have less relevance for trauma survivors from Asian cultural backgrounds, e.g., [19][20][21][22]. Thus, important questions still remain regarding what appraisals and emotion regulation strategies are of relevance for trauma survivors with PTSD from Asian cultural backgrounds.…”

Section: Introductionmentioning

confidence: 99%

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

Jobson

Haque

Abdullah

et al. 2022

IJERPH

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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.

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“…Research has found that greater use of suppression and lower use of reappraisal is related to greater PTSS [ 12 , 21 – 23 ]. However, perceived benefits or consequences of emotion regulation strategies vary depending on context and cultural expectations [ 10 , 20 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Emotion Regulation Strategies Predict PTSS During the COVID-19 Pandemic in an American Indian Population

2021

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Background Poor emotion regulation is associated with post-traumatic stress symptoms (PTSS). However, limited prospective research prevents any directional conclusions. No known studies have assessed emotion regulation with PTSS in American Indians, a high-risk population for poor mental health outcomes. The present prospective study explored whether emotion regulation strategies (cognitive reappraisal, expressive suppression) predicted later PTSS related to the COVID-19 global pandemic in a solely American Indian sample. Methods American Indian participants (N = 210; Mean ( SD ) age = 54.85(13.08) years, 58.7% female) completed the Emotion Regulation Questionnaire (ERQ) during Phase 1 (a few weeks before pandemic declaration) and the Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic during Phase 2 (7–8 weeks after pandemic declaration). Bivariate correlations and hierarchical linear regression analyses were utilized. Results ERQ reappraisal was negatively associated with IES-R total scores, such that higher reappraisal predicted lower PTSS. In contrast, ERQ suppression was positively associated with IES-R total scores, such that higher suppression predicted higher PTSS. Conclusions Greater suppression and lower reappraisal predicts PTSS in response to the COVID-19 pandemic in an entirely American Indian sample, providing critical information for future interventions in a population at high-risk for mental health disparities.

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Exploring cultural differences in the use of emotion regulation strategies in posttraumatic stress disorder

Cited by 27 publications

References 27 publications

Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries

Posttraumatic stress disorder symptoms among trauma-exposed adolescents from low- and middle-income countries

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

Emotion Regulation Strategies Predict PTSS During the COVID-19 Pandemic in an American Indian Population

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