Narratives in the Immediate Aftermath of Traumatic Injury: Markers of Ongoing Depressive and Posttraumatic Stress Disorder Symptoms

Abstract

In this study, we considered connections between the content of immediate trauma narratives and longitudinal trajectories of negative symptoms to address questions about the timing and predictive value of collected trauma narratives. Participants (N = 68) were individuals who were admitted to the emergency department of a metropolitan hospital and provided narrative recollections of the traumatic event that brought them into the hospital that day. They were then assessed at intervals over the next 12 months for depressive and posttraumatic symptom severity. Linguistic analysis identified words involving affect (positive and negative emotions), sensory input (sight, sound, taste, touch, and smell), cognitive processing (thoughts, insights, and reasons), and temporal focus (past, present, and future) within the narrative content. In participants' same-day narratives of the trauma, past-focused utterances predicted greater decreases in depressive symptom severity over the next year, d = -0.13, whereas cognitive process utterances predicted more severe posttraumatic symptom severity across time points, d = 0.32. Interaction analyses suggested that individuals who used fewer past-focused and more cognitive process utterances within their narratives tended to report more severe depressive and posttraumatic symptom severity across time, ds = 0.31 to 0.34. Overall, these findings suggest that, in addition to other demographics and baseline symptom severity, early narrative content can serve as an informative marker for longitudinal psychological symptoms, even before extensive narrative processing and phenomenological meaning-making have occurred.

Context- and Subgroup-Specific Language Changes in Individuals Who Develop PTSD After Trauma

“…In fact, the approach to access mental states by analyzing patterns of language usage is supported by a growing body of research in the fields of psychology and neuroscience . Previous studies using Linguistic Inquiry and Word Count (LIWC) have found that it is possible to characterize depression and other mental states through analyzing natural language use (Tausczik and Pennebaker, 2010;Booker et al, 2018;Kaplow et al, 2018;Tackman et al, 2018). For example, Stirman and Pennebaker showed that suicidal poets displayed a higher usage of first person pronouns in their texts and less first-plural pronouns than non-suicidal poets (Stirman and Pennebaker, 2001).…”

Implications of language use in posttraumatic nightmares on psychological symptoms.

“…The current study sought to examine clinical associations of language use in nightmare transcriptions and rescriptions to psychological functioning. This study extends the current literature about language use and posttrauma psychological functioning (e.g., Booker et al, 2018; Kleim et al, 2018) with a specific focus on the novel use of LIWC with PTNMs. The present study had several hypotheses regarding the relationship of language use to psychological symptoms by focusing specifically on words related to cognitive processing and ET, as these constructs have been previously implicated in psychological functioning.…”

“…The content of PTNMs is also associated with nightmare severity and PTSD symptom severity, such that as the content of PTNMs becomes more similar to the trauma, the more severe the nightmares and symptoms of PTSD are reported (Davis et al, 2007; Mellman et al, 1995). There is limited research on language use in PTNM narratives; however, researchers have investigated language use in idiopathic nightmares and trauma narratives (i.e., Booker et al, 2018; Bulkeley & Graves, 2018; Fireman et al, 2014; Kleim et al, 2018). As rescription involves the process of rewriting the original PTNM to include alternative responses or outcomes to the event, it will be important to study the language use in rescripted PTNMs as well, which has yet to be done.…”

Embarking on discovering the mechanisms of resilience: combining language use analysis with neuroscience.

“…It is known that a high frequency of singular and plural first pronoun usage is an indicator of depression and PTSD 25,[73][74][75][76][77][78] . We examined singular first pronoun occurrence in text data from Holocaust survivors, controls and PTSD sufferers, consisting of people who experienced trauma years ago, including childhood trauma.…”