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Relations between Emotional Expressivity Dimensions and DSM-5 Post-traumatic Stress Disorder Symptom Clusters in a Trauma-Exposed Community Sample

Published online by Cambridge University Press:  11 June 2020

Ling Jin
Affiliation:
Department of Psychology, University of North Texas, Denton, Texas, USA
Megan Dolan
Affiliation:
Department of Psychology, University of North Texas, Denton, Texas, USA
Ateka A. Contractor*
Affiliation:
Department of Psychology, University of North Texas, Denton, Texas, USA
Nicole H. Weiss
Affiliation:
Department of Psychology, University of Rhode Island, Kingston, Rhode Island, USA
Paula Dranger
Affiliation:
Counseling Services, Valparaiso University, Valparaiso, Indiana, USA Choices Counseling Services, Valparaiso, Indiana, USA
*
*Corresponding author: Ateka A. Contractor, Department of Psychology, University of North Texas, 369 Terrill Hall, Denton, TX76203, USA. Email: ateka.contractor@unt.edu
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Abstract

Background and Objective. A growing body of literature indicates a significant contribution and role of positive and negative emotions (specifically expressivity) in post-traumatic stress disorder's (PTSD) symptomatology. The current study examined the facet-level relationships between emotional expressivity and PTSD. Specifically, we investigated which emotional expressivity dimension (impulse strength, negative emotional expressivity, and positive emotional expressivity) most strongly related to DSM-5 PTSD symptom clusters severity (intrusions, avoidance, negative alterations in cognition and mood, and alterations in arousal and reactivity). Methods. The sample of 123 trauma-exposed participants seeking mental health treatment completed the PTSD Checklist for DSM-5 (PCL-5) and the Berkeley Expressivity Questionnaire (BEQ). Results. Results of multivariate multiple regression analysis indicated that only intensity of emotion and difficulty in controlling such emotions (i.e., impulse strength) was strongly related to all four PTSD symptom clusters. The valence of emotional expressivity (positive or negative) was not related to any of the PTSD symptom clusters. Conclusions. Study findings highlight the role of emotional expressivity, specifically impulse strength, in PTSD's symptomatology and may inform guidelines for emotion-focused clinical work for trauma-exposed individuals with PTSD symptoms.

Type
Standard Paper
Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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References

American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Beblo, T, Fernando, S, Klocke, S, Griepenstroh, J, Aschenbrenner, S and Driessen, M (2012). Increased suppression of negative and positive emotions in major depression. Journal of Affective Disorders, 141, 474479.CrossRefGoogle ScholarPubMed
Beblo, T, Fernando, S, Kamper, P, Griepenstroh, J, Aschenbrenner, S, Pastuszak, A, … Driessen, M (2013). Increased attempts to suppress negative and positive emotions in borderline personality disorder. Psychiatry Research, 210, 505509.CrossRefGoogle ScholarPubMed
Berenbaum, H, Raghavan, C, Le, HN, Vernon, LL and Gomez, JJ (2003). A taxonomy of emotional disturbances. Clinical Psychology: Science and Practice, 10, 206226.Google Scholar
Berg, JM, Latzman, RD, Bliwise, NG and Lilienfeld, SO (2015). Parsing the heterogeneity of impulsivity: A meta-analytic review of the behavioral implications of the UPPS for psychopathology. Psychological Assessment, 27, 11291146.CrossRefGoogle ScholarPubMed
Bovin, MJ, Marx, BP, Weathers, FW, Gallagher, MW, Rodriguez, P, Schnurr, PP and Keane, TM (2016). Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5) in veterans. Psychological Assessment, 28, 13791391.CrossRefGoogle Scholar
Briere, J, Hodges, M and Godbout, N (2010). Traumatic stress, affect dysregulation, and dysfunctional avoidance: A structural equation model. Journal of Traumatic Stress, 23, 767774.CrossRefGoogle ScholarPubMed
Chanel, G, Kronegg, J, Grandjean, D and Pun, T (2006). Emotion assessment: Arousal evaluation using EEG's and peripheral physiological signals. In International Workshop on Multimedia Content Representation, Classification and Security (pp. 530537). Berlin; Heidelberg: Springer.CrossRefGoogle Scholar
Chemtob, CM, Novaco, RW, Hamada, RS and Gross, DM (1997). Cognitive-behavioral treatment for severe anger in posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 65, 184189.CrossRefGoogle ScholarPubMed
Claycomb, M, Roley, ME, Contractor, AA, Armour, C, Dranger, P, Wang, L and Elhai, JD (2016). The relationship between negative expressivity, anger, and PTSD symptom clusters. Psychiatry Research, 243, 14.CrossRefGoogle ScholarPubMed
Cloitre, M, Jackson, C and Schmidt, JA (2016). STAIR for strengthening social support and relationships among veterans with military sexual trauma and PTSD. Military Medicine, 181, e183e187.CrossRefGoogle ScholarPubMed
Contractor, AA, Elhai, JD, Ractliffe, KC and Forbes, D (2013). PTSD's underlying symptom dimensions and relations with behavioral inhibition and activation. Journal of Anxiety Disorders, 27, 645651.CrossRefGoogle ScholarPubMed
Contractor, AA, Mehta, P, Tiamiyu, MF, Hovey, JD, Geers, AL, Charak, R, … Elhai, JD (2014). Relations between PTSD and distress dimensions in an Indian child/adolescent sample following the 2008 Mumbai terrorist attacks. Journal of Abnormal Child Psychology, 42, 925935.CrossRefGoogle Scholar
Contractor, AA, Armour, C, Forbes, D and Elhai, JD (2016). Posttraumatic stress disorder's underlying dimensions and their relation with impulsivity facets. The Journal of Nervous and Mental Disease, 204, 2025.CrossRefGoogle ScholarPubMed
Contractor, AA, Weiss, NH, Dranger, P, Ruggero, C and Armour, C (2017). PTSD's risky behavior criterion: Relation with DSM-5 PTSD symptom clusters and psychopathology. Psychiatry Research, 252, 215222.CrossRefGoogle ScholarPubMed
Contractor, AA, Greene, T, Dolan, M and Elhai, JD (2018). Relations between PTSD and depression symptom clusters in samples differentiated by PTSD diagnostic status. Journal of Anxiety Disorders, 59, 1726.CrossRefGoogle ScholarPubMed
Cramer, EM and Nicewander, WA (1979). Some symmetric, invariant measures of multivariate association. Psychometrika, 44, 4354.CrossRefGoogle Scholar
Csikszentmihalyi, M and Larson, R (1987). Validity and reliability of the experience-sampling method. The Journal of Nervous and Mental Disease, 175, 526536.CrossRefGoogle ScholarPubMed
Cyders, MA, Smith, GT, Spillane, NS, Fischer, S, Annus, AM and Peterson, C (2007). Integration of impulsivity and positive mood to predict risky behavior: Development and validation of a measure of positive urgency. Psychological Assessment, 19, 107118.CrossRefGoogle ScholarPubMed
Dattalo, P (2013). Analysis of multiple dependent variables. New York, NY: Oxford Scholar.CrossRefGoogle Scholar
Elhai, JD, Miller, ME, Ford, JD, Biehn, TL, Palmieri, PA and Frueh, BC (2012). Posttraumatic stress disorder in DSM-5: Estimates of prevalence and symptom structure in a nonclinical sample of college students. Journal of Anxiety Disorders, 26, 5864.CrossRefGoogle Scholar
Foa, EB and Riggs, DS (1993). Post-traumatic stress disorder in rape victims. In Oldham, J, Riba, MB and Tasman, A (Eds.), American psychiatric press review of psychiatry, (vol. 12, pp. 273303). Washington, DC: American Psychiatric Press.Google Scholar
Foa, EB and Rothbaum, BO (1998). Treating the trauma of rape: Cognitive-behavioral therapy for PTSD. New York: Guilford Press.Google Scholar
Foa, EB, Riggs, DS, Massie, ED and Yarczower, M (1995). The impact of fear activation and anger on the efficacy of exposure treatment for posttraumatic stress disorder. Behavioral Therapy, 26, 487499.CrossRefGoogle Scholar
Galatzer-Levy, IR and Bryant, RA (2013). 636,120 ways to have posttraumatic stress disorder. Perspectives on Psychological Science, 8, 651662.CrossRefGoogle ScholarPubMed
Goodman, LA, Corcoran, C, Turner, K, Yuan, N and Green, BL (1998). Assessing traumatic event exposure: General issues and preliminary findings for the Stressful Life Events Screening Questionnaire. Journal of Traumatic Stress, 11, 521542.CrossRefGoogle ScholarPubMed
Gratz, KL and Roemer, L (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26, 4154.CrossRefGoogle Scholar
Gross, JJ and John, OP (1995). Facets of emotional expressivity: Three self-report factors and their correlates. Personality and Individual Differences, 19, 555568.CrossRefGoogle Scholar
Gross, JJ and John, OP (1997). Revealing feelings: Facets of emotional expressivity in self-reports, peer ratings, and behavior. Journal of Personality and Social Psychology, 72, 435448.CrossRefGoogle ScholarPubMed
Gross, JJ and John, OP (1998). Mapping the domain of expressivity: Multimethod evidence for a hierarchical model. Journal of Personality and Social Psychology, 74, 170191.CrossRefGoogle ScholarPubMed
Gross, JJ, John, OP and Richards, JM (2000). The dissociation of emotion expression from emotion experience: A personality perspective. Personality and Social Psychology Bulletin, 26, 712726.CrossRefGoogle Scholar
Hair, JF, Black, WC, Babin, BJ and Anderson, RE (2009). Multivariate data analysis (7th ed.). New York, NY: Pearson.Google Scholar
Harned, MS and Linehan, MM (2008). Integrating dialectical behavior therapy and prolonged exposure to treat co-occurring borderline personality disorder and PTSD: Two case studies. Cognitive and Behavioral Practice, 15, 263276.CrossRefGoogle Scholar
Kilpatrick, DG, Resnick, HS, Milanak, ME, Miller, MW, Keyes, KM and Friedman, MJ (2013). National estimates of exposure to traumatic events and PTSD prevalence using DSM-IV and DSM-5 criteria. Journal of Traumatic Stress, 26, 537547.CrossRefGoogle ScholarPubMed
Kline, RB (2005). Principles and practice of structural equation modeling. New York, NY, USA: Guilford Press.Google Scholar
Lawrence, VA and Lee, D (2014). An exploration of people's experiences of compassion-focused therapy for trauma, using interpretative phenomenological analysis. Clinical Psychology & Psychotherapy, 21, 495507.Google ScholarPubMed
Levanthal, H (1984). A perceptual-motor theory of emotion. In Scherer, KR and Ekman, P (Eds.), Approaches to emotion (pp. 271291). New York: Academic Press.Google Scholar
Litz, BT (1992). Emotional numbing in combat-related post-traumatic stress disorder: A critical review and reformulation. Clinical Psychology Review, 12, 417432.CrossRefGoogle Scholar
Litz, BT, Orsillo, SM, Kaloupek, D and Weathers, F (2000). Emotional processing in posttraumatic stress disorder. Journal of Abnormal Psychology, 109, 2639.CrossRefGoogle ScholarPubMed
Litz, BT, Gray, MJ, Bryant, RA and Adler, AB (2002). Early intervention for trauma: Current status and future directions. Clinical Psychology: Science and Practice, 9, 112134.Google Scholar
Marshall-Berenz, EC, Vujanovic, AA and MacPherson, L (2011). Impulsivity and alcohol use coping motives in a trauma-exposed sample: The mediating role of distress tolerance. Personality and Individual Differences, 50, 588592.CrossRefGoogle Scholar
Michael, T, Halligan, SL, Clark, DM and Ehlers, A (2007). Rumination in posttraumatic stress disorder. Depression and Anxiety, 24, 307317.CrossRefGoogle ScholarPubMed
Naifeh, JA, Tull, MT and Gratz, KL (2012). Anxiety sensitivity, emotional avoidance, and PTSD symptom severity among crack/cocaine dependent patients in residential treatment. Cognitive Therapy and Research, 36, 247257.CrossRefGoogle ScholarPubMed
O'brien, RM (2007). A caution regarding rules of thumb for variance inflation factors. Quality & Quantity, 41, 673690.CrossRefGoogle Scholar
Pickett, SM, Barbaro, N and Mello, D (2016). The relationship between subjective sleep disturbance, sleep quality, and emotion regulation difficulties in a sample of college students reporting trauma exposure. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 2533.CrossRefGoogle Scholar
Pietrzak, RH, Johnson, DC, Goldstein, MB, Malley, JC, Rivers, AJ, Morgan, CA and Southwick, SM (2010). Psychosocial buffers of traumatic stress, depressive symptoms, and psychosocial difficulties in veterans of Operations Enduring Freedom and Iraqi Freedom: The role of resilience, unit support, and postdeployment social support. Journal of Affective Disorders, 120, 188192.CrossRefGoogle ScholarPubMed
Rauch, M, Sheila, A, Eftekhari, A and Ruzek, JI (2012). Review of exposure therapy: A gold standard for PTSD treatment. Journal of Rehabilitation Research & Development, 49, 679687.CrossRefGoogle ScholarPubMed
Rodin, R, Bonanno, GA, Rahman, N, Kouri, NA, Bryant, RA, Marmar, CR and Brown, AD (2017). Expressive flexibility in combat veterans with posttraumatic stress disorder and depression. Journal of Affective Disorders, 207, 236241.CrossRefGoogle ScholarPubMed
Roemer, L, Litz, BT, Orsillo, SM and Wagner, AW (2001). A preliminary investigation of the role of strategic withholding of emotions in PTSD. Journal of Traumatic Stress, 14, 149156.CrossRefGoogle Scholar
Roley, ME, Contractor, AA, Weiss, NH, Armour, C and Elhai, JD (2017). Impulsivity facets’ predictive relations with DSM–5 PTSD symptom clusters. Psychological Trauma: Theory, Research, Practice, and Policy, 9, 7679.CrossRefGoogle ScholarPubMed
Schafer, JL and Graham, JW (2002). Missing data: Our view of the state of the art. Psychological Methods, 7, 147177.CrossRefGoogle ScholarPubMed
Schlomer, GL, Bauman, S and Card, NA (2010). Best practices for missing data management in counseling psychology. Journal of Counseling Psychology, 57, 110.CrossRefGoogle ScholarPubMed
Sijbrandij, M, Engelhard, IM, Lommen, MJ, Leer, A and Baas, JM (2013). Impaired fear inhibition learning predicts the persistence of symptoms of posttraumatic stress disorder (PTSD). Journal of Psychiatric Research, 47, 19911997.CrossRefGoogle Scholar
Stevens, J (1996). Applied multivariate statistics for the social sciences (3rd ed.). Mahwah, NJ: Lawrence Erlbaum.Google Scholar
Swick, D, Honzel, N, Larsen, J, Ashley, V and Justus, T (2012). Impaired response inhibition in veterans with post-traumatic stress disorder and mild traumatic brain injury. Journal of the International Neuropsychological Society, 18, 917926.CrossRefGoogle ScholarPubMed
Tolin, DF and Foa, EB (2006). Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research. Psychological Bulletin, 132, 959992.CrossRefGoogle ScholarPubMed
Tull, MT, Barrett, HM, McMillan, ES and Roemer, L (2007). A preliminary investigation of the relationship between emotion regulation difficulties and posttraumatic stress symptoms. Behavior Therapy, 38, 303313.CrossRefGoogle ScholarPubMed
Tull, MT, Jakupcak, M, Paulson, A and Gratz, KL (2007). The role of emotional inexpressivity and experiential avoidance in the relationship between posttraumatic stress disorder symptom severity and aggressive behavior among men exposed to interpersonal violence. Anxiety, Stress, and Coping, 20, 337351.CrossRefGoogle ScholarPubMed
Weathers, FW, Litz, BT, Keane, TM, Palmieri, PA, Marx, BP and Schnurr, PP (2013). The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD. Scale available from the National Center for PTSD at www.ptsd.va.gov.Google Scholar
Weathers, FW, Marx, BP, Friedman, MJ and Schnurr, PP (2014). Posttraumatic stress disorder in DSM-5: New criteria, new measures, and implications for assessment. Psychological Injury and Law, 7, 93107.CrossRefGoogle Scholar
Weiss, NH, Tull, MT, Anestis, MD and Gratz, KL (2013). The relative and unique contributions of emotion dysregulation and impulsivity to posttraumatic stress disorder among substance dependent inpatients. Drug and Alcohol Dependence, 128, 4551.CrossRefGoogle ScholarPubMed
Weiss, NH, Gratz, KL and Lavender, JM (2015). Factor structure and initial validation of a multidimensional measure of difficulties in the regulation of positive emotions: The DERS-positive. Behavior Modification, 39, 431453.CrossRefGoogle ScholarPubMed
Weiss, NH, Tull, MT and Sullivan, TP (2015). Emotion dysregulation and risky, self-destructive, and health compromising behaviors: A review of the literature. In Bryant, ML (Ed.), Handbook on emotion regulation: Processes, cognitive effects and social consequences (pp. 3756). Hauppauge, NY: Nova Science Publishers.Google Scholar
Weiss, NH, Tull, MT, Sullivan, TP, Dixon-Gordon, KL and Gratz, KL (2015). Posttraumatic stress disorder symptoms and risky behaviors among trauma-exposed inpatients with substance dependence: The influence of negative and positive urgency. Drug and Alcohol Dependence, 155, 147153.CrossRefGoogle ScholarPubMed
Weiss, NH, Forkus, SR, Contractor, AA and Schick, MR (2018). Difficulties regulating positive emotions and alcohol and drug misuse: A path analysis. Addictive Behaviors, 84, 4552.CrossRefGoogle ScholarPubMed