Self-Worth as a Mediator Between Attachment and Posttraumatic Stress in Interpersonal Trauma

Lim, Ban Hong Phylice; Adams, Lauren A.; Lilly, Michelle M.

doi:10.1177/0886260511431440

Cited by 31 publications

(27 citation statements)

References 56 publications

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“…Low explicit SE may be relevant in terms of understanding the etiology of PNESs, psychological formulation, and treatment outcome: as reported in patients with PTSD, it may be that low SE contributes to the chronification of PNESs [49] and/or mediates the relationship between attachment and psychopathology [10]; however, these hypotheses have yet to be tested in this patient group.…”

Section: Discussionmentioning

confidence: 96%

“…The measure comprises 15 somatic symptoms, each scored 0 ("not bothered at all"), 1 ("bothered a little"), or 2 ("bothered a lot"). Total scores range from 0 to 30 and are classified as reflecting minimum (0-4), mild (5-9), moderate (10)(11)(12)(13)(14), or severe (15 +) somatization. The measure was not developed as a stand-alone diagnostic tool but was used to supplement other clinical information.…”

Section: Patient Health Questionnaire-15 (Phq-15)mentioning

confidence: 99%

“…Although SE has been criticized for not consistently moderating the impact of daily hassles on mood, it has been shown to significantly lessen the impact of such stressors on physical symptoms [9]. Self-esteem has also been found to mediate the relationship between insecure attachment and PTSD symptomatology in survivors of interpersonal trauma, emotional abuse, and psychopathology [10] and [11]. Despite these links and the documented association of PNESs with trauma and increased rates of insecure attachment [12], there is only limited evidence of SE levels in PNESs.…”

Section: Introductionmentioning

confidence: 99%

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Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Dimaro

Roberts

Moghaddam

et al. 2015

Epilepsy & Behavior

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Purpose: Self-esteem (SE), or one's sense of competence and worth, is reduced in many mental and physical\ud disorders. Low SE is associated with perceived stigma and disability and poor treatment outcomes. The present\ud study examined implicit and explicit SE (automatic and deliberate views about the self) in people with epilepsy\ud and people with psychogenic nonepileptic seizures (PNESs). Discrepancies between implicit SE and explicit SE\ud have been found to correlate with psychological distress in disorders often associated with PNESs but are\ud relatively unexplored in PNESs. We hypothesized that, compared with epilepsy, PNESs would be associated\ud with lower self-reported SE and greater discrepancies between implicit SE and explicit SE.\ud Methods: Thirty adults with PNESs, 25 adults with epilepsy, and 31 controls without a history of seizures were\ud asked to complete the Rosenberg Self-esteem Scale as a measure of explicit SE and an Implicit Relational\ud Assessment Procedure as a measure of implicit SE. The State–Trait Anxiety Inventory and Patient Health\ud Questionnaire—15 (a somatic symptom inventory) were also administered.\ud Results: We found significant group differences in explicit (p b 0.001) but not implicit SE. Patients with PNESs\ud reported lower SE than the other groups. No group differences were found in implicit SE. Implicit–explicit SE\ud discrepancies were larger in the group with PNESs than in the other groups (p b 0.001). Higher frequency of\ud PNESs (but not epileptic seizures) was associatedwith lower explicit SE (rs=−.83, p b 0.01) and greater SE discrepancies\ud (i.e., lower explicit relative to implicit SE; rs = .65, p b 0.01). These relationships remained significant\ud when controlling for anxiety and somatization.\ud Conclusion: Patients with PNESs had lower explicit SE than those with epilepsy or healthy controls. In keeping\ud with our expectations, there were greater discrepancies between implicit SE and explicit SE among patients\ud with PNESs than in the other groups. Our results, including the strong relationship between PNES frequency,\ud anxiety, and explicit–implicit SE discrepancies, support the interpretation that PNESs serve to reduce cognitive\ud dissonance, perhaps protecting patients' implicit SE

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Section: Discussionmentioning

confidence: 96%

Section: Patient Health Questionnaire-15 (Phq-15)mentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Dimaro

Roberts

Moghaddam

et al. 2015

Epilepsy & Behavior

View full text Add to dashboard Cite

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“…Combat was categorized as a non-interpersonal trauma, consistent with previous research that has used TLEQ categories to determine the interpersonal nature of trauma (Lilly & Valdez, 2012; Lim, Adams, & Lilly, 2012; Orcutt, Pickett, & Pope, 2005). The determination to consider combat as a non-interpersonal trauma is due to the fact that it likely represents a very different type and context of trauma compared to, for example, a sexual assault.…”

Section: Methodsmentioning

confidence: 99%

Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type.

Thompson‐Hollands¹,

Litwack²,

Ryabchenko³

et al. 2018

Group Dynamics: Theory, Research, and Practice

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Objective Examine initial levels and pattern of change of alliance in group treatment for posttraumatic stress disorder (PTSD) for veterans. Method One hundred and seventy-eight male veterans with PTSD were recruited for this study. Participants were randomly assigned to either group cognitive behavioral therapy (GCBT) or to group present-centered therapy (GPCT). Alliance with fellow group members was assessed every other session throughout the group (total of seven assessments). Hierarchical linear modeling was used to determine whether treatment condition or index trauma type (interpersonal or non-interpersonal) impacted initial levels of alliance or change in alliance over time. Results Alliance increased significantly throughout treatment in both conditions. The presence of an interpersonal index event, compared to a non-interpersonal index event, did not significantly impact either initial levels of alliance or change in alliance over time. Participants in the GCBT condition experienced significantly greater growth in alliance over time compared to those in the GPCT condition (p > .05), but did not have significantly different initial alliance ratings. Conclusions The components and focus of the GCBT treatment may have facilitated more rapid bonding among members. Interpersonal traumatic experience did not negatively impact group alliance.

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“…This suggests that body-image may mediate the development of PTSD in individuals exposed to interpersonal traumas, but not in survivors of non-interpersonal traumas. Few studies have investigated this assumption, with inconsistent results [16].…”

Section: Mediating Effect Of Body-image Across Trauma Typesmentioning

confidence: 99%

Risk Factors for Post-traumatic Stress Disorder: The Role of Previous Traumas, Peri-traumatic Response, Social Support and Body-image

Bjerre

Dokkedahl²,

Elklit

2017

J Child Adolesc Behav

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Objective: In a non-clinical adolescent sample, the present study investigated the predictive and the mediating effects of several rudimentary risk factors for post-traumatic stress. The study had three objectives: 1) to identify predictors of posttraumatic stress, 2) to explore the mediating effect of diverse psychosocial factors on posttraumatic stress, and 3) to explore the mediating effect of body-image on posttraumatic stress across trauma types. Method:A Danish national probability sample of 1083 high school students aged 15-20 were administered a questionnaire survey that included traumatic events, psychosocial variables and the Harvard Trauma Questionnaire. The current study holds the strength of a relatively large sample size and being based on a nationally representative sample, thus preventing population biased results. Data analysis has been conducted in SPSS version 22.Results: Number of traumas, peritraumatic response, loneliness, body-image and parental support predicted 26% of the variance in post-traumatic stress disorder severity. Trauma exposure was related to posttraumatic stress via intermediate factors; the number of traumas, peritraumatic response and body-image mediated development of the disorder. Body-image acted as a mediator of post-traumatic stress only with respect to certain types of trauma, with post-traumatic stress developing via body-image in physical and non-interpersonal trauma survivors, but not in survivors of sexual traumas. Conclusion:Previous traumas, peritraumatic response and body-image were found to impact the development of posttraumatic stress. The present study additionally indicated that risk factors may influence the development of posttraumatic stress disorder in different ways, following certain types of events. This underlines the importance of considering the type of trauma in combination with other potential risk factors such as body-image. Future research is needed to further investigate factors which may mediate the development of posttraumatic stress disorder, especially about different trauma types.

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Self-Worth as a Mediator Between Attachment and Posttraumatic Stress in Interpersonal Trauma

Cited by 31 publications

References 56 publications

Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Implicit and explicit self-esteem discrepancies in people with psychogenic nonepileptic seizures

Alliance across group treatment for veterans with posttraumatic stress disorder: The role of interpersonal trauma and treatment type.

Risk Factors for Post-traumatic Stress Disorder: The Role of Previous Traumas, Peri-traumatic Response, Social Support and Body-image

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