Mental Defeat and Cumulative Trauma Experiences Predict Trauma-Related Psychopathology: Evidence From a Postconflict Population in Northern Uganda

Wilker, Sarah; Kleim, Birgit; Geiling, Angelika; Pfeiffer, Anett; Elbert, Thomas; Kolassa, Iris‐Tatjana

doi:10.1177/2167702617719946

Cited by 16 publications

(15 citation statements)

References 40 publications

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“…Indeed, research has consistently suggested that the likelihood of suffering from posttraumatic stress increases when an individual is exposed to more of these stressors (Johnson & Thompson, 2008). For example, a robust dose–effect relationship has been found in multiple refugee and conflict‐affected populations, wherein cumulative exposure to more trauma has been shown to be associated with higher levels of posttraumatic stress (Mollica et al., 1998; Neuner et al., 2004; Wilker et al., 2017). Furthermore, certain experiences seem to confer an additional risk for poor mental health outcomes, particularly traumatic events that are interpersonal in nature, such as torture or sexual violence (Steel et al., 2009).…”

Section: External Factors Impacting Refugee Mental Healthmentioning

confidence: 99%

An Interaction Model of Environmental and Psychological Factors Influencing Refugee Mental Health

Kashyap

Keegan²,

Liddell

et al. 2020

Journal of Traumatic Stress

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In this paper, we draw on empirical research and theoretical models of refugee and posttrauma mental health to propose the “Psychological Interaction with Environment (PIE) Matrix Model” of refugee mental health. This model focuses on the mental health of adult refugees and proposes that psychological factors and the external environment interact to influence mental health outcomes and functioning for individuals with refugee backgrounds. Environmental factors include adversity faced before, during, and after the migration journey, including adversity faced in a resettlement or postdisplacement environment. Psychological factors refer to psychological (i.e., cognitive and emotional) mechanisms that individuals may use to cope with adversity. We posit that individuals from refugee backgrounds are likely to show individual differences in psychological processes that may protect against or underpin the development and maintenance of psychopathology following exposure to trauma and displacement. The PIE Matrix Model proposes a framework to guide intervention by identifying key pathways by which psychological and environmental factors impact one another. We suggest that psychological interventions can be targeted according to the kind and level of support different individuals may require, based on individualized and context‐driven assessments of the interaction between environmental and psychological factors at any given point in time. This model draws on existing models of refugee adaptation and highlights the need for longitudinal and experimental research to explain the interaction between these factors and their causal impact on refugee mental health.

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Section: External Factors Impacting Refugee Mental Healthmentioning

confidence: 99%

An Interaction Model of Environmental and Psychological Factors Influencing Refugee Mental Health

Kashyap

Keegan²,

Liddell

et al. 2020

Journal of Traumatic Stress

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“…Use of cognitive words in trauma narratives might reflect this elaboration process (15, 16). Peritraumatic mental defeat, a peritraumatic process, consisting of complete loss of inner resistance has also been implicated in the development in PTSD (14, 17, 18) as well as perceived threat to life (19). Earlier studies have indexed the use of death-related words in trauma narratives as linguistic indicator and proxy of these processes, which was related to PTSD as expected (20, 21).…”

Section: Early Linguistic Markers Of Trauma-specific Processing Predimentioning

confidence: 99%

Early Linguistic Markers of Trauma-Specific Processing Predict Post-trauma Adjustment

et al. 2018

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Identifying early predictors for psychiatric disorders, such as post-traumatic stress disorder (PTSD), is crucial for effective treatment and prevention efforts. Obtaining such predictors is challenging and methodologically limited, for example by individuals' distress, arousal, and reduced introspective ability. We investigated the predictive power of language-based, implicit markers of psychological processes (N = 163) derived from computerized text-analysis of trauma and control narratives provided within 18 days post-trauma. Trauma narratives with fewer cognitive processing words (indicating less cognitive elaboration), more death-related words (indicating perceived threat to life), and more first-person singular pronouns (indicating self-immersed processing) predicted greater PTSD symptoms at 6 months. These effects were specific to trauma narratives and held after controlling for early PTSD symptom severity and verbal intelligence. When self-report questionnaires of related processes were considered together with the trauma narrative linguistic predictors, use of more first-person singular pronouns remained a significant predictor alongside self-reported mental defeat. Language-based processing markers may complement questionnaire measures in early forecasting of post-trauma adjustment.

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“…Mental defeat has been found to predict PTSD symptom trajectories in prospective studies up to 6 to 9 months following trauma (Dunmore et al, 2001;Freeman et al, 2013;Kleim, Ehlers, & Glucksman, 2012). Studies to date have mostly focused on assault survivors (Dunmore et al, 1999(Dunmore et al, , 2001), survivors of political imprisonment (Ehlers, Maercker, & Boos, 2000), and on post-conflict contexts (Wilker et al, 2017).…”

mentioning

confidence: 99%

The structure of peritraumatic reactions and their relationship with PTSD among disaster survivors.

Massazza¹,

Joffe²,

Brewin³

2021

Journal of Abnormal Psychology

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Peritraumatic reactions such as fear, psychic and somatoform dissociation, tonic immobility, data-driven processing, and mental defeat are important in the etiology of posttraumatic stress disorder (PTSD). However current measures of such reactions overlap conceptually and do not clearly identify distinct peritraumatic processes. It is not known which processes are uniquely associated with PTSD. We investigated the factor structure of six standard peritraumatic measures and their relationship with the four DSM-5 PTSD symptom clusters. Measures were administered to 308 earthquake survivors with high levels of exposure to traumatic events. Items comprising the six measures were investigated using exploratory structural equation modeling, which identified five peritraumatic response factors. Items from most measures loaded on multiple factors. The factors labeled Mental Defeat and Somatoform Dissociation significantly predicted all PTSD symptom clusters. The factor labeled Cognitive Overload significantly predicted Intrusions, Avoidance, and Alterations in Arousal and Reactivity. The factor labeled Immobility significantly predicted Intrusions and Avoidance while Distress significantly predicted Negative Alterations in Cognition and Mood and Alterations in Arousal and Reactivity. Due to the key role such reactions play in the development of PTSD, the findings are likely to benefit the study of etiological mechanisms, the prediction of those at greatest risk, and the design of preventative interventions.

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Mental Defeat and Cumulative Trauma Experiences Predict Trauma-Related Psychopathology: Evidence From a Postconflict Population in Northern Uganda

Cited by 16 publications

References 40 publications

An Interaction Model of Environmental and Psychological Factors Influencing Refugee Mental Health

An Interaction Model of Environmental and Psychological Factors Influencing Refugee Mental Health

Early Linguistic Markers of Trauma-Specific Processing Predict Post-trauma Adjustment

The structure of peritraumatic reactions and their relationship with PTSD among disaster survivors.

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