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

Abstract

This study investigated whether the associations between emotion regulation and cognitive appraisals and symptoms of posttraumatic stress disorder (PTSD) differ between Asian American and European American trauma survivors. Asian American (n = 103) and European American (n = 104) trauma survivors were recruited through mTurk and completed an on-line questionnaire assessing cognitive appraisals, emotion regulation and PTSD symptomatology. The European American group reported greater trauma-specific rumination, psychological inflexibility, seeking out others for comfort, and negative self-appraisals than the Asian American group. The Asian American group reported greater secondary control appraisals and cultural beliefs about adversity than the European American group. Second, cultural group moderated the associations between (a) brooding rumination, (b) fatalism, (c) self-blame, and (d) negative communal self-appraisals and PTSD symptoms. These associations were larger for the European American group than the Asian American group. Third, there was an indirect pathway from self-construal (independent and interdependent) to PTSD symptoms through certain emotion regulation approaches and cognitive appraisals. Additionally, cultural group was found to moderate several of these indirect effects. These findings highlight the importance of considering cultural background and cultural values in understanding the processes involved in PTSD. Further research in this area is needed.

Cultural differences in appraisals of control and posttraumatic stress disorder symptoms

“…Chinese Australian trauma survivors reported significantly greater endorsement of appraisals emphasizing the (a) value of adversity (Chinese cultural beliefs about adversity), (b) acceptance of adversity (fatalism), and (c) adapting oneself in response to adversity (secondary control) than the European Australian group (Hypothesis 1). This extends past research by establishing the relevance of these appraisal types for Chinese trauma survivors (Bernardi et al, 2019 ; Jobson et al, 2022b ; Shek et al, 2003 ; Xie & Wong, 2021 ). Regarding Hypotheses 2 and 3, while appraisals of fatalism and cultural beliefs emphasizing the value of adversity atemporally mediated the relationships between cultural group and PTSD symptoms, self-construal and holistic thinking moderated these pathways in specific ways.…”

“…A total of 388 survey responses were collected and subsequently assessed for quality. Responses were excluded if (a) the index trauma did not meet Criterion A (in accordance to the Life Event Checklist-5); (b) the reCAPTCHA score (generated by Qualtrics) was below 0.5, which indicates a non-human, machine-automatic response; (c) responses were recorded at latitude or longitude levels outside Australia; (d) the Conscientious Responder Scale score was ≤ 2 (Marjanovic et al, 2014 ), which indicates an unconscientious response; or (e) participants completed the survey in under 15 min (Jobson et al, 2022b ). Based on these criteria, 119 responses were excluded.…”

“…Thus, fatalistic appraisals may be less detrimental, and potentially even beneficial, on psychological outcomes for those from Asian backgrounds (Bernardi et al, 2019 ; Heiniger et al, 2015 ). Emerging research indicates that Malaysian trauma survivors reported significantly greater appraisals of fatalism than Australian trauma survivors (Jobson et al, 2022b ) and the positive association between fatalism and PTSD symptoms was significantly larger for European Americans than Asian Americans (Jobson et al, 2022a ). Thus, when integrating PTSD and cross-cultural theoretical accounts, it is posited that for Asian trauma survivors, greater endorsement of appraisals of fatalism is associated with less PTSD symptomatology, with these associations being stronger for those valuing interdependence (Bernardi et al, 2019 ; Markus & Kitayama, 2010 ) and holistic thinking (Bernardi et al, 2019 ).…”

“…Shek and colleagues ( 2003 ) developed a measure (Chinese Cultural Beliefs about Adversity Scale) that assessed these cultural beliefs about adversity. Recent studies using this measure have highlighted these cultural beliefs about adversity were more prevalent among Asian trauma survivors (Malaysian, Asian American) than Western trauma survivors (European Australian, European American) (Jobson et al, 2022a , b ). Again, when integrating PTSD and cross-cultural theoretical accounts, it is posited that for Asian trauma survivors, greater endorsement of these cultural beliefs about adversity may be associated with less PTSD symptomatology, with these associations being stronger for those valuing interdependence (Bernardi et al, 2019 ; Markus & Kitayama, 2010 ) and holistic thinking (Bernardi et al, 2019 ).…”